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"content": "\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" target=\"_blank\" rel=\"noopener noreferrer\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>Climate change means it’s getting hotter everywhere in California, making it feel like summer for more of the year.\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/09/Covering-Climate-Now-Logo.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-1947420\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/09/Covering-Climate-Now-Logo-1020x1019.png\" alt=\"\" width=\"219\" height=\"219\">\u003c/a>\u003c/p>\n\u003cp>But heat can be a sneaky threat to our health and safety. You might think of it as a party crasher. But heat isn’t leaving. In fact, it’s getting more dangerous and deadly — even in parts of California you wouldn’t expect, like the coast.\u003c/p>\n\u003cp>From Inland Empire distribution warehouses to genteel homes in San Francisco’s nook-and-cranny neighborhoods, heat creeps in and harms anyone in the way.\u003c/p>\n\u003cp>For the last three years, KQED Science reporter \u003ca href=\"https://www.kqed.org/author/mpeterson\" target=\"_blank\" rel=\"noopener noreferrer\">Molly Peterson\u003c/a> has been chasing heat here in California.\u003c/p>\n\u003cp>[aside postID=science_1934110,science_1932692,science_1932903,science_1933237,science_1933708 label='Read The Full Heat Series' \u003ci>\u003cspan style=\"font-weight: 400\">heroURL=\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">'https://www.kqed.org/heat'\u003c/span>]\u003c/p>\n\u003cp>She’s found it in homes, schools and workplaces. She’s talked to more than 100 Californians living and working where it gets too hot, to chart some of the ways this unwanted visitor affects the most vulnerable people — laborers, elders and those with high blood pressure and respiratory ailments.\u003c/p>\n\u003cp>To illuminate how high temperatures affect indoor workers’ ability to function, think and stay healthy, Peterson sent small heat index sensors into places a journalist couldn’t go.\u003c/p>\n\u003cp>People who clean office buildings after the air conditioning shuts off, or attach security tags on fast-fashion apparel draped in plastic hanger bags carried those sensors to their workplaces, where they routinely recorded indoor temperatures in the 90s, even at night.\u003c/p>\n\u003cp>They also described how hard it is to cool down, take breaks or get other relief on the job.\u003c/p>\n\u003cp>No federal or state laws regulate heat exposure for people who work indoors.\u003c/p>\n\u003cp>Heat also lurks where people least expect it, defying the old adage that the coldest winter can be a summer in San Francisco. During Labor Day weekend in 2017, a heat wave killed more than a dozen people in three Bay Area counties.\u003c/p>\n\u003cfigure id=\"attachment_11776830\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-11776830\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-800x1067.jpg\" alt=\"\" width=\"272\" height=\"363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-840x1120.jpg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-687x916.jpg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-414x552.jpg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-354x472.jpg 354w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut.jpg 864w\" sizes=\"(max-width: 272px) 100vw, 272px\">\u003cfigcaption class=\"wp-caption-text\">Colleen Loughman lived alone much of her life, in temperate San Francisco. Then a heat wave brought 100-degree temperatures to the city for two straight days in 2017. Loughman was an enthusiastic godmother to Claudia Hernandez and Hernandez’s children. \u003ccite>(Molly Peterson/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The average age of the victims was 78, and some succumbed in homes without air conditioning. One woman died inside the place she’d called home all her life, flanked by neighbors she no longer knew.\u003c/p>\n\u003cp>Like the United Kingdom, where the government includes a cabinet-level Minister for Loneliness, the city of San Francisco recognizes that social isolation can jeopardize health.\u003c/p>\n\u003cp>That’s why organizers promote block parties and other activities that encourage neighbors to meet one another and band together during emergencies including power outages, earthquakes and extreme heat episodes.\u003c/p>\n\u003cp>The California Report Magazine devotes its whole show this week to stories about heat, and about ways we can protect ourselves from it.\u003c/p>\n\u003cp>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci>This documentary was reported and written by Molly Peterson, with grant support \u003c/i>\u003c/span>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci>from the USC Annenberg Center for Health Journalism Impact Fund.\u003c/i>\u003c/span>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci> It’s part of KQED Science’s partnership with Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003ca href=\"http://itunes.apple.com/us/podcast/the-california-report-magazine/id1314750545?mt=2\" target=\"_blank\" rel=\"noopener noreferrer\">Listen to this and more in-depth storytelling by subscribing to The California Report Magazine podcast.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>Climate change means it’s getting hotter everywhere in California, making it feel like summer for more of the year.\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/09/Covering-Climate-Now-Logo.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-1947420\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/09/Covering-Climate-Now-Logo-1020x1019.png\" alt=\"\" width=\"219\" height=\"219\">\u003c/a>\u003c/p>\n\u003cp>But heat can be a sneaky threat to our health and safety. You might think of it as a party crasher. But heat isn’t leaving. In fact, it’s getting more dangerous and deadly — even in parts of California you wouldn’t expect, like the coast.\u003c/p>\n\u003cp>From Inland Empire distribution warehouses to genteel homes in San Francisco’s nook-and-cranny neighborhoods, heat creeps in and harms anyone in the way.\u003c/p>\n\u003cp>For the last three years, KQED Science reporter \u003ca href=\"https://www.kqed.org/author/mpeterson\" target=\"_blank\" rel=\"noopener noreferrer\">Molly Peterson\u003c/a> has been chasing heat here in California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She’s found it in homes, schools and workplaces. She’s talked to more than 100 Californians living and working where it gets too hot, to chart some of the ways this unwanted visitor affects the most vulnerable people — laborers, elders and those with high blood pressure and respiratory ailments.\u003c/p>\n\u003cp>To illuminate how high temperatures affect indoor workers’ ability to function, think and stay healthy, Peterson sent small heat index sensors into places a journalist couldn’t go.\u003c/p>\n\u003cp>People who clean office buildings after the air conditioning shuts off, or attach security tags on fast-fashion apparel draped in plastic hanger bags carried those sensors to their workplaces, where they routinely recorded indoor temperatures in the 90s, even at night.\u003c/p>\n\u003cp>They also described how hard it is to cool down, take breaks or get other relief on the job.\u003c/p>\n\u003cp>No federal or state laws regulate heat exposure for people who work indoors.\u003c/p>\n\u003cp>Heat also lurks where people least expect it, defying the old adage that the coldest winter can be a summer in San Francisco. During Labor Day weekend in 2017, a heat wave killed more than a dozen people in three Bay Area counties.\u003c/p>\n\u003cfigure id=\"attachment_11776830\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-11776830\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-800x1067.jpg\" alt=\"\" width=\"272\" height=\"363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-800x1067.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-160x213.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-840x1120.jpg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-687x916.jpg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-414x552.jpg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut-354x472.jpg 354w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/RS33116_IMG_6270-qut.jpg 864w\" sizes=\"(max-width: 272px) 100vw, 272px\">\u003cfigcaption class=\"wp-caption-text\">Colleen Loughman lived alone much of her life, in temperate San Francisco. Then a heat wave brought 100-degree temperatures to the city for two straight days in 2017. Loughman was an enthusiastic godmother to Claudia Hernandez and Hernandez’s children. \u003ccite>(Molly Peterson/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The average age of the victims was 78, and some succumbed in homes without air conditioning. One woman died inside the place she’d called home all her life, flanked by neighbors she no longer knew.\u003c/p>\n\u003cp>Like the United Kingdom, where the government includes a cabinet-level Minister for Loneliness, the city of San Francisco recognizes that social isolation can jeopardize health.\u003c/p>\n\u003cp>That’s why organizers promote block parties and other activities that encourage neighbors to meet one another and band together during emergencies including power outages, earthquakes and extreme heat episodes.\u003c/p>\n\u003cp>The California Report Magazine devotes its whole show this week to stories about heat, and about ways we can protect ourselves from it.\u003c/p>\n\u003cp>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci>This documentary was reported and written by Molly Peterson, with grant support \u003c/i>\u003c/span>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci>from the USC Annenberg Center for Health Journalism Impact Fund.\u003c/i>\u003c/span>\u003cspan style=\"color: black;font-family: -webkit-standard,serif\">\u003ci> It’s part of KQED Science’s partnership with Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Kaiser Permanente and a coalition of 11 unions that represent the health care provider’s employees in several states, including California, reached a tentative contract deal on Wednesday. The four-year agreement includes wage increases, a workforce development program and stronger restrictions on outsourcing.\u003c/p>\n\u003cp>“This agreement will allow us to rebuild the worker-management partnership that has been so important to all of us in making Kaiser successful over the last 20 years,” said Georgette Bradford, an ultrasound technologist at Kaiser in Sacramento, in a union press release. “Reaching an agreement was not easy, it had lots of twists and turns, but in the end we accomplished what we set out to do — reach an agreement that is good for patients, workers and our communities.”\u003c/p>\n\u003cp>The deal comes after months of bargaining and several demonstrations by members of the Coalition of Kaiser Permanente Unions. Workers were threatening a nationwide strike in mid-October that would have involved more than 80,000 employees. The threat of this strike has now been withdrawn, according to Kaiser Permanente.\u003c/p>\n\u003cp>“We greatly respect and value our employees who deliver on our mission every day,” said Arlene Peasnall, interim chief human resources officer of Kaiser Permanente Health Plan and Hospitals, in a statement. “This agreement is a testament to the dedication, compassion, and skill those employees bring to work every day and demonstrates that Kaiser Permanente and the Coalition have a shared commitment to affordability for our members.”\u003c/p>\n\u003cp>“Kaiser Permanente has an unparalleled track record of working constructively with labor to solve problems together to improve the care and service offered to our members and patients,” Peasnall added. “We may disagree at times, but we have always been able to work through our challenges to align on common goals.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"kaiser-permanente\"]\u003c/p>\n\u003cp>All employees covered by the contract, which spans seven states and Washington, D.C., will receive wage increases. The contract covers only Kaiser Permanente employees whose unions are part of the coalition, the bulk of whom are based in California.\u003c/p>\n\u003cp>The roughly 67,000 California-based employees included in the agreement will receive annual raises of 3% through 2023. The deal also outlines full protection of retirement benefits and a ban on subcontracting.\u003c/p>\n\u003cp>Notably, the agreement will create a $130 million program to reduce the shortage of health care workers in California.\u003c/p>\n\u003cp>“We’re not aware of a similar arrangement in a similar industry, and certainly not at this scale,” said Sean Wherley of SEIU-United Healthcare Workers West, one of the unions in the coalition. “This is something the workers have been pushing for in bargaining.”\u003c/p>\n\u003cp>The tentative agreement now goes to members of the coalition for ratification. Voting is expected to be completed by the end of October.\u003c/p>\n\u003cp>If ratified, the contract will go into effect on Oct. 1, 2019, and will cover many of Kaiser Permanente’s workers in California, Oregon, Washington, Colorado, Maryland, Virginia, Hawaii and Washington, D.C.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Alice Woelfle contributed to this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kaiser Permanente and a coalition of 11 unions that represent the health care provider’s employees in several states, including California, reached a tentative contract deal on Wednesday. The four-year agreement includes wage increases, a workforce development program and stronger restrictions on outsourcing.\u003c/p>\n\u003cp>“This agreement will allow us to rebuild the worker-management partnership that has been so important to all of us in making Kaiser successful over the last 20 years,” said Georgette Bradford, an ultrasound technologist at Kaiser in Sacramento, in a union press release. “Reaching an agreement was not easy, it had lots of twists and turns, but in the end we accomplished what we set out to do — reach an agreement that is good for patients, workers and our communities.”\u003c/p>\n\u003cp>The deal comes after months of bargaining and several demonstrations by members of the Coalition of Kaiser Permanente Unions. Workers were threatening a nationwide strike in mid-October that would have involved more than 80,000 employees. The threat of this strike has now been withdrawn, according to Kaiser Permanente.\u003c/p>\n\u003cp>“We greatly respect and value our employees who deliver on our mission every day,” said Arlene Peasnall, interim chief human resources officer of Kaiser Permanente Health Plan and Hospitals, in a statement. “This agreement is a testament to the dedication, compassion, and skill those employees bring to work every day and demonstrates that Kaiser Permanente and the Coalition have a shared commitment to affordability for our members.”\u003c/p>\n\u003cp>“Kaiser Permanente has an unparalleled track record of working constructively with labor to solve problems together to improve the care and service offered to our members and patients,” Peasnall added. “We may disagree at times, but we have always been able to work through our challenges to align on common goals.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>All employees covered by the contract, which spans seven states and Washington, D.C., will receive wage increases. The contract covers only Kaiser Permanente employees whose unions are part of the coalition, the bulk of whom are based in California.\u003c/p>\n\u003cp>The roughly 67,000 California-based employees included in the agreement will receive annual raises of 3% through 2023. The deal also outlines full protection of retirement benefits and a ban on subcontracting.\u003c/p>\n\u003cp>Notably, the agreement will create a $130 million program to reduce the shortage of health care workers in California.\u003c/p>\n\u003cp>“We’re not aware of a similar arrangement in a similar industry, and certainly not at this scale,” said Sean Wherley of SEIU-United Healthcare Workers West, one of the unions in the coalition. “This is something the workers have been pushing for in bargaining.”\u003c/p>\n\u003cp>The tentative agreement now goes to members of the coalition for ratification. Voting is expected to be completed by the end of October.\u003c/p>\n\u003cp>If ratified, the contract will go into effect on Oct. 1, 2019, and will cover many of Kaiser Permanente’s workers in California, Oregon, Washington, Colorado, Maryland, Virginia, Hawaii and Washington, D.C.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED’s Alice Woelfle contributed to this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Juul Accepts Proposed Ban On Flavored Vaping Products As CEO Steps Down",
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"content": "\u003cp>\u003cstrong>Updated at 1:01 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Juul Labs has agreed to stop advertising its popular e-cigarettes in the United States and announced that its chief executive officer is stepping down as state and federal regulators examine hundreds of cases of people who are sick from what appears to be a vaping-related lung disease.\u003c/p>\n\u003cp>The company also said in a \u003ca href=\"https://newsroom.juul.com/2019/09/25/juul-labs-names-new-leadership-outlines-changes-to-policy-and-marketing-efforts/\">Wednesday statement\u003c/a> that it will not push back on a Trump administration plan to pull flavored e-cigarettes from the market until the controversial products are approved by federal regulators.\u003c/p>\n\u003cp>In the statement, Juul officials said the company will be “refraining from lobbying the administration on its draft guidance” \u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/11/759851853/fda-to-banish-flavored-e-cigarettes-to-combat-youth-vaping\">that proposes\u003c/a> banning fruit-flavored vaping products, unless approved by the Food and Drug Administration, in an attempt to make the e-cigarettes less available to young consumers.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"juul\"]News of the departure of Juul’s CEO, Kevin Burns, was accompanied by \u003ca href=\"http://investor.altria.com/file/Index?KeyFile=399843894\">an announcement\u003c/a> that merger discussions have been called off between Philip Morris, the maker of Marlboro cigarettes, and Altria, the tobacco giant that owns \u003ca href=\"http://investor.altria.com/file/Index?KeyFile=396169695\">a 35% stake in Juul\u003c/a>.\u003c/p>\n\u003cp>Burns will be succeeded by K.C. Crosthwaite, the chief growth officer at Altria.\u003c/p>\n\u003cp>In a statement, Crosthwaite said vaping products originally were introduced to move adult smokers to a safer alternative. But hundreds of cases around the country of mostly young users experiencing a mysterious breathing ailment thought to be tied to vaping is raising new alarms.\u003c/p>\n\u003cp>He said the company’s original mission is at risk “due to unacceptable levels of youth usage and eroding public confidence in our industry. Against that backdrop, we must strive to work with regulators, policymakers and other stakeholders, and earn the trust of the societies in which we operate,” Crosthwaite said.\u003c/p>\n\u003cp>Flavored e-cigarettes represent the majority of Juul’s sales, but analysts have said the company’s decision to stop fighting the Trump administration’s regulations might fend off an even bigger blow to the company: the federal government banning Juul from selling any of its products.\u003c/p>\n\u003cp>At least 530 people in 38 states \u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/24/763968586/if-e-cigs-were-romaine-lettuce-theyd-be-off-the-shelf-vapers-mom-tells-congress\">have been sickened\u003c/a> with a vaping-related lung disease, and nine people have died. Health experts are also concerned about long-term pulmonary issues from vaping.\u003c/p>\n\u003cp>Yet health experts have not tied the outbreak to any specific product or type of e-cigarette. Many cases of the mysterious respiratory illness are connected to people who have used e-cigarette products to vape marijuana bought on the black market.\u003c/p>\n\u003cp>States including \u003ca href=\"https://www.wgbh.org/news/local-news/2019/09/24/baker-plans-4-month-ban-on-vaping-products-in-massachusetts\">Massachusetts,\u003c/a> \u003ca href=\"https://www.wnyc.org/story/new-york-moves-enact-statewide-flavored-e-cig-ban/\">New York\u003c/a> and \u003ca href=\"https://www.michiganradio.org/post/gov-whitmer-orders-ban-flavored-e-cigarettes\">Michigan\u003c/a> have passed bans on the sale of vaping products and attorneys general in a number of states, including \u003ca href=\"http://illinoisattorneygeneral.gov/pressroom/2019_09/20190923.html\">Illinois\u003c/a>, are investigating whether Juul violated consumer protection laws by marketing its products to underage teenagers.\u003c/p>\n\u003cp>Ned Sharpless, the acting FDA commissioner, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/remarks-prepared-testimony-us-house-energy-and-commerce-subcommittee-fda-regulation-electronic\">told\u003c/a> a subcommittee of the House Energy and Commerce Committee on Wednesday that the Trump administration’s soon-to-be finalized policy of banning flavored vaping products could change if e-cigarette companies can win federal approval.\u003c/p>\n\u003cp>“This policy would not mean that flavored e-cigarettes could never be marketed,” Sharpless said. “If a company can show through an application to FDA that a specific product meets the standard set forth by Congress, then the FDA would authorize” the sale of the products, he said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation=\"K.C. Crosthwaite, Juul's newly appointed CEO\"]‘We must strive to work with regulators, policymakers and other stakeholders, and earn the trust of the societies in which we operate.’[/pullquote]\u003c/p>\n\u003cp>During the hearing, Democratic Rep. Joe Kennedy of Massachusetts asked if the surge in vaping-related illnesses represents “a massive regulatory failure.” Sharpless conceded that the federal government missed some important warning signs.\u003c/p>\n\u003cp>“In retrospect, the FDA should have acted sooner,” Sharpless said. “We should have acted to regulate these devices sooner.”\u003c/p>\n\u003cp>Data from the National Institute on Drug Abuse \u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2019/09/teen-e-cigarette-use-doubles-2017\">found that\u003c/a> the percentage of teenagers who are vaping doubled in the past two years, with about 1 in 4 high school students using e-cigarettes in the past month. That has led the institute’s director, Nora Volkow, to declare vaping “a public health crisis.”\u003c/p>\n\u003cp>“These products introduce the highly addictive chemical nicotine to these young people and their developing brains, and I fear we are only beginning to learn the possible health risks and outcomes for youth,” Volkow said.\u003c/p>\n\u003cp>The FDA is set to release its policy restricting the sale of flavored vaping products in the coming weeks.\u003c/p>\n\u003cp>For its part, Juul has taken steps to combat the selling of its products to minors, including requiring some retail stores to electronically verify government-issued ID before allowing someone to buy its products.\u003c/p>\n\u003cp>[ad fullwidth] \u003c/p>\n\u003cp>But critics of Juul have accused the company of deliberately targeting young people by marketing flavors including mango, cucumber and mint.\u003c/p>\n\u003cp>The FDA’s office of criminal investigations is currently probing products that are reportedly making people ill.\u003c/p>\n\u003cp>“FDA is not pursuing any actions associated with personal use of any vaping products, our interest is in the suppliers,” Sharpless told Congress on Wednesday. “But to be clear, if we determine that someone is manufacturing or distributing illicit, adulterated vaping products that caused illness and death for personal profit, we would consider that to be a criminal act.”\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Juul+Accepts+Proposed+Ban+On+Flavored+Vaping+Products+As+CEO+Steps+Down&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\n",
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"excerpt": "Flavored e-cigarettes are the majority of Juul's sales, but agreeing to stop fighting the Trump administration's regulations may fend off a move to pull Juul products from the market altogether.",
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"title": "Juul Accepts Proposed Ban On Flavored Vaping Products As CEO Steps Down | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated at 1:01 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>Juul Labs has agreed to stop advertising its popular e-cigarettes in the United States and announced that its chief executive officer is stepping down as state and federal regulators examine hundreds of cases of people who are sick from what appears to be a vaping-related lung disease.\u003c/p>\n\u003cp>The company also said in a \u003ca href=\"https://newsroom.juul.com/2019/09/25/juul-labs-names-new-leadership-outlines-changes-to-policy-and-marketing-efforts/\">Wednesday statement\u003c/a> that it will not push back on a Trump administration plan to pull flavored e-cigarettes from the market until the controversial products are approved by federal regulators.\u003c/p>\n\u003cp>In the statement, Juul officials said the company will be “refraining from lobbying the administration on its draft guidance” \u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/11/759851853/fda-to-banish-flavored-e-cigarettes-to-combat-youth-vaping\">that proposes\u003c/a> banning fruit-flavored vaping products, unless approved by the Food and Drug Administration, in an attempt to make the e-cigarettes less available to young consumers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>News of the departure of Juul’s CEO, Kevin Burns, was accompanied by \u003ca href=\"http://investor.altria.com/file/Index?KeyFile=399843894\">an announcement\u003c/a> that merger discussions have been called off between Philip Morris, the maker of Marlboro cigarettes, and Altria, the tobacco giant that owns \u003ca href=\"http://investor.altria.com/file/Index?KeyFile=396169695\">a 35% stake in Juul\u003c/a>.\u003c/p>\n\u003cp>Burns will be succeeded by K.C. Crosthwaite, the chief growth officer at Altria.\u003c/p>\n\u003cp>In a statement, Crosthwaite said vaping products originally were introduced to move adult smokers to a safer alternative. But hundreds of cases around the country of mostly young users experiencing a mysterious breathing ailment thought to be tied to vaping is raising new alarms.\u003c/p>\n\u003cp>He said the company’s original mission is at risk “due to unacceptable levels of youth usage and eroding public confidence in our industry. Against that backdrop, we must strive to work with regulators, policymakers and other stakeholders, and earn the trust of the societies in which we operate,” Crosthwaite said.\u003c/p>\n\u003cp>Flavored e-cigarettes represent the majority of Juul’s sales, but analysts have said the company’s decision to stop fighting the Trump administration’s regulations might fend off an even bigger blow to the company: the federal government banning Juul from selling any of its products.\u003c/p>\n\u003cp>At least 530 people in 38 states \u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/24/763968586/if-e-cigs-were-romaine-lettuce-theyd-be-off-the-shelf-vapers-mom-tells-congress\">have been sickened\u003c/a> with a vaping-related lung disease, and nine people have died. Health experts are also concerned about long-term pulmonary issues from vaping.\u003c/p>\n\u003cp>Yet health experts have not tied the outbreak to any specific product or type of e-cigarette. Many cases of the mysterious respiratory illness are connected to people who have used e-cigarette products to vape marijuana bought on the black market.\u003c/p>\n\u003cp>States including \u003ca href=\"https://www.wgbh.org/news/local-news/2019/09/24/baker-plans-4-month-ban-on-vaping-products-in-massachusetts\">Massachusetts,\u003c/a> \u003ca href=\"https://www.wnyc.org/story/new-york-moves-enact-statewide-flavored-e-cig-ban/\">New York\u003c/a> and \u003ca href=\"https://www.michiganradio.org/post/gov-whitmer-orders-ban-flavored-e-cigarettes\">Michigan\u003c/a> have passed bans on the sale of vaping products and attorneys general in a number of states, including \u003ca href=\"http://illinoisattorneygeneral.gov/pressroom/2019_09/20190923.html\">Illinois\u003c/a>, are investigating whether Juul violated consumer protection laws by marketing its products to underage teenagers.\u003c/p>\n\u003cp>Ned Sharpless, the acting FDA commissioner, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/remarks-prepared-testimony-us-house-energy-and-commerce-subcommittee-fda-regulation-electronic\">told\u003c/a> a subcommittee of the House Energy and Commerce Committee on Wednesday that the Trump administration’s soon-to-be finalized policy of banning flavored vaping products could change if e-cigarette companies can win federal approval.\u003c/p>\n\u003cp>“This policy would not mean that flavored e-cigarettes could never be marketed,” Sharpless said. “If a company can show through an application to FDA that a specific product meets the standard set forth by Congress, then the FDA would authorize” the sale of the products, he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>During the hearing, Democratic Rep. Joe Kennedy of Massachusetts asked if the surge in vaping-related illnesses represents “a massive regulatory failure.” Sharpless conceded that the federal government missed some important warning signs.\u003c/p>\n\u003cp>“In retrospect, the FDA should have acted sooner,” Sharpless said. “We should have acted to regulate these devices sooner.”\u003c/p>\n\u003cp>Data from the National Institute on Drug Abuse \u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2019/09/teen-e-cigarette-use-doubles-2017\">found that\u003c/a> the percentage of teenagers who are vaping doubled in the past two years, with about 1 in 4 high school students using e-cigarettes in the past month. That has led the institute’s director, Nora Volkow, to declare vaping “a public health crisis.”\u003c/p>\n\u003cp>“These products introduce the highly addictive chemical nicotine to these young people and their developing brains, and I fear we are only beginning to learn the possible health risks and outcomes for youth,” Volkow said.\u003c/p>\n\u003cp>The FDA is set to release its policy restricting the sale of flavored vaping products in the coming weeks.\u003c/p>\n\u003cp>For its part, Juul has taken steps to combat the selling of its products to minors, including requiring some retail stores to electronically verify government-issued ID before allowing someone to buy its products.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> \u003c/p>\n\u003cp>But critics of Juul have accused the company of deliberately targeting young people by marketing flavors including mango, cucumber and mint.\u003c/p>\n\u003cp>The FDA’s office of criminal investigations is currently probing products that are reportedly making people ill.\u003c/p>\n\u003cp>“FDA is not pursuing any actions associated with personal use of any vaping products, our interest is in the suppliers,” Sharpless told Congress on Wednesday. “But to be clear, if we determine that someone is manufacturing or distributing illicit, adulterated vaping products that caused illness and death for personal profit, we would consider that to be a criminal act.”\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Juul+Accepts+Proposed+Ban+On+Flavored+Vaping+Products+As+CEO+Steps+Down&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "a-daily-baby-aspirin-could-help-many-pregnancies-and-save-lives",
"title": "A Daily Baby Aspirin Could Help Many Pregnancies And Save Lives",
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"content": "\u003cp>Bridget Desmukes was surprised when \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/6263239/rita-driggers\" target=\"_blank\" rel=\"noopener\">Dr. Rita Driggers\u003c/a>, Desmukes’ OB-GYN in Washington, D.C., recommended low-dose aspirin at her first prenatal appointment this past spring. She knew about daily low-dose aspirin being prescribed to people recovering from a heart attack or stroke. But for pregnant women?\u003c/p>\n\u003cp>In a past pregnancy, Desmukes, who is now 42, had developed preeclampsia, a potentially serious complication that involves high blood pressure. A small amount of daily aspirin, it turns out, can significantly cut the risk of developing preeclampsia in pregnancy. It’s currently recommended for many pregnant women by two influential groups — the \u003ca href=\"https://acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Low-Dose-Aspirin-Use-During-Pregnancy?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">American College of Obstetricians and Gynecologists\u003c/a> and the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>, an independent panel of experts commissioned by the federal government.\u003c/p>\n\u003cp>The challenge, some OB-GYNs believe, is getting the word out to women who are at risk that the low-dose aspirin regimen is something that could benefit them. In that way, Desmukes and her husband, Jeffrey, were lucky to hear about it early in her pregnancy.\u003c/p>\n\u003cp>She says her doctor, an associate professor at Johns Hopkins School of Medicine, “explained to us that because of my age and the fact that I had a history of preeclampsia, aspirin would be recommended for me to take. Just precautionarily — to keep the flow of nutrients and oxygen and everything to the baby and help it continue to thrive and grow.”\u003c/p>\n\u003cfigure id=\"attachment_11775892\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11775892\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85-800x387.jpg\" alt=\"A photo of Bridget Desmukes, next to a photo of her hand, holding a baby aspirin. \" width=\"800\" height=\"387\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85-160x77.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">As an older mom with a history of preeclampsia, Desmukes is considered at high risk for developing the condition again. She’s a nurse by training and knows the risks, so she agreed with her OB-GYN that taking a single baby aspirin daily is a good idea. “Just precautionarily,” she says, “to keep the flow of nutrients and oxygen … to the baby.” \u003ccite>(Ryan Kellman/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Desmukes says at first she was hesitant. A nurse by training, she knows any medicine can have side effects and says she prefers a “holistic” approach to her own health. But she also knows the risks of preeclampsia, and how it can be fatal — it’s a leading cause of the \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\">high maternal mortality rate in the U.S\u003c/a>. And as a black woman, Desmukes’ risk of dying in childbirth is elevated; maternal mortality rates among black women in the U.S. are about three times those of white women.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She did some research, thought about it, and decided to take the aspirin. She is due in November, and so far everything’s going well — no signs of hypertension.\u003c/p>\n\u003cp>\u003cstrong>How it works\u003c/strong>\u003c/p>\n\u003cp>The cause of preeclampsia in a pregnant woman \u003ca href=\"https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/causes\" target=\"_blank\" rel=\"noopener\">is still unknown\u003c/a>, but the mechanism of danger is clear: Her blood vessels constrict, which means, among other things, blood can’t flow easily to her kidneys or brain or uterus. \u003ca href=\"https://www.preeclampsia.org/health-information/sign-symptoms\" target=\"_blank\" rel=\"noopener\">Telltale signs\u003c/a> include a terrible headache and swollen hands and feet.\u003c/p>\n\u003cp>“What aspirin does is relax blood vessels, [which] lowers the blood pressure, but also improves blood flow to the baby, to the kidneys, and to the brain, lowering the chance that the woman would have any complications to her pregnancy that would affect either her or her baby,” says \u003ca href=\"https://www.bmc.org/about-us/directory/doctor/jodi-f-abbott-md-msc-mhcm\" target=\"_blank\" rel=\"noopener\">Dr. Jodi Abbott\u003c/a>, an OB-GYN who specializes in treating high-risk pregnancies at Boston Medical Center and is also an associate professor at Boston University School of Medicine.\u003c/p>\n\u003cp>Prenatal aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/final-evidence-summary51/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication#results\" target=\"_blank\" rel=\"noopener\">cut the risk\u003c/a> of preeclampsia by 24%, according to a \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">comprehensive review\u003c/a> of the scientific evidence by the USPSTF in 2014. That guidance described the harms of taking low-dose aspirin in pregnancy as “no greater than small.”\u003c/p>\n\u003cp>“It’s been shown to be very safe,” says \u003ca href=\"https://www.bmc.org/about-us/directory/doctor/nyia-l-noel-md-mph\" target=\"_blank\" rel=\"noopener\">Dr. Nyia Noel\u003c/a>, who is Abbott’s co-director of the \u003ca href=\"https://www.prenatalaspirin.com/\" target=\"_blank\" rel=\"noopener\">Prenatal Aspirin Project\u003c/a>, an initiative at BMC created to increase implementation of the task force’s recommendations. “Things that people worry about — such as bleeding in pregnancy or something called placental abruption, which is early separation of the placenta — have not shown to be increased in women on low-dose aspirin.”\u003c/p>\n\u003cp>Now, this is not like taking aspirin for pain relief — that’s a much higher dose, usually 325 mg per pill, and one or two pills every four to six hours. In contrast, low-dose aspirin tablets are about 81 mg. They’re usually cheap and can be prescribed — they’re often covered by insurance — or bought over the counter.\u003c/p>\n\u003cp>Noel says for her, telling women about the benefits of prenatal aspirin is personal. African American women are \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/preeclampsia-screening1#clinical-considerations\" target=\"_blank\" rel=\"noopener\">more likely than white women\u003c/a> to develop preeclampsia, and they’re more likely to die from it.\u003c/p>\n\u003cp>“This topic is very important to me — as a black woman — but also as a black obstetrician-gynecologist in the service of women of color every day,” she says. “I’ve experienced what feels like one degree of separation between myself and women just like me that have died or almost died from preeclampsia,” Noel says. “So I really feel aspirin is not the only thing, but it is a step, and women should really feel empowered to speak with their providers about this.”\u003c/p>\n\u003cp>\u003cstrong>Aspirin coming to a prenatal vitamin near you?\u003c/strong>\u003c/p>\n\u003cp>Any woman pregnant with twins or triplets, or who has diabetes or hypertension, or who has had preeclampsia before, is considered at \u003ca href=\"https://acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Low-Dose-Aspirin-Use-During-Pregnancy?IsMobileSet=false\">high risk\u003c/a> of the condition and should talk to her doctor about taking low-dose aspirin, Abbott says.\u003c/p>\n\u003cp>Beyond that group of “high risk” characteristics, there are the moderate risk factors — like being pregnant with a first baby, or being obese, or over 35, or African American. Having two or more of those characteristics means low-dose aspirin should be considered for you, too, the guidelines suggest.\u003c/p>\n\u003cp>Abbott says when you add up the women in all those categories, it equals a whole lot of people.\u003c/p>\n\u003cp>“Eighty-six percent of our patients [at Boston Medical Center] would be eligible for aspirin based on those criteria,” Abbott says. “When you look at a number like 86% you can understand why I would be in favor — as a public health initiative — of all pregnant women getting it.”\u003c/p>\n\u003cp>As Abbott sees it, screening for all those risk factors means someone who could benefit will inevitably get missed. And since she doesn’t see significant downsides to low-dose aspirin, she thinks it should just go to everybody who’s pregnant.\u003c/p>\n\u003cp>“My suspicion — if I had to guess ahead 10 years — is that you’ll be able to buy, included in your prenatal vitamin, low-dose aspirin,” she says.\u003c/p>\n\u003cp>\u003cstrong>The need for research on the universal question\u003c/strong>\u003c/p>\n\u003cp>But not everyone is convinced — at least at this point — that every pregnant woman should take aspirin. Count \u003ca href=\"https://feinstein.northwell.edu/institutes-researchers/our-researchers/karina-davidson-phd\" target=\"_blank\" rel=\"noopener\">Karina Davidson\u003c/a> among them. She’s the senior vice president for research at Northwell Health and a member of the U.S. Preventive Services Task Force panel that reviewed the evidence on this issue in 2014.\u003c/p>\n\u003cp>“We know that aspirin prevents the devastating consequences of preeclampsia and of many of the hypertensive disorders of pregnancy for those who are at risk,” she says. “For those who are at risk, we absolutely want both clinicians and patients to know they should be discussing whether aspirin is right for them to help them minimize their exposure — and their infants’ exposure — to those devastating consequences.”\u003c/p>\n\u003cp>Still, that group’s current \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/final-evidence-summary51/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> stop short of advising prenatal aspirin for all.\u003c/p>\n\u003cp>“We have a very specific mandate, which is that we make recommendations based on evidence,” Davidson says. “When we looked in 2014 we found little evidence that existed that in average-risk populations there was benefit.” In other words, there needs to be a benefit to taking aspirin for women currently considered at low risk of developing preeclampsia — not just the absence of significant harm.\u003c/p>\n\u003cp>In June, the task force began looking to see whether new research has been done since 2014 that would make the group want to change its prenatal aspirin guidance, but \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/draft-research-plan/aspirin-use-to-prevent-preeclampsia-and-related-morbidity-and-mortality-preventive-medication1\" target=\"_blank\" rel=\"noopener\">that review\u003c/a> won’t be finished for several years.\u003c/p>\n\u003cp>\u003cstrong>Dr. Google, and other barriers\u003c/strong>\u003c/p>\n\u003cp>Boston Medical Center’s Prenatal Aspirin Project began in 2017 with the goal of getting the word out about the benefits of low-dose aspirin in pregnancy for eligible women and researching the barriers to implementing the task force’s recommendations.\u003c/p>\n\u003cp>Through focus groups, leaders of the project found most of their patients had never heard of preeclampsia. “We also found that they had been told it’s not safe to take medications in pregnancy or that aspirin can be dangerous and you shouldn’t take it,” Abbott says. “[Or they would] go to the pharmacy and the pharmacist would tell them that aspirin was unsafe in pregnancy.”\u003c/p>\n\u003cp>Abbott believes pharmacists may have not been aware of the prenatal aspirin recommendations from the past few years or may have been thinking of the guidance that \u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/headaches-during-pregnancy/faq-20058265\" target=\"_blank\" rel=\"noopener\">pregnant women take Tylenol\u003c/a> (rather than aspirin) for headaches.\u003c/p>\n\u003cp>The team at the Prenatal Aspirin Project ended up reaching out to big commercial pharmacies — CVS, Walgreens and Walmart — and got them to remove warnings on prenatal aspirin prescriptions. After having some patients tell them “I got a prescription, but I’m going to Google it before I take it,” members of the project team also worked to bump up their Google rankings so the project’s advice would appear above information that might be outdated.\u003c/p>\n\u003cp>Eliminating these barriers is important, Abbott says. “Everybody deserves a healthy baby and a healthy mother, and we’re failing at that right now,” she says. “This is really an opportunity for all women — but especially for women of color — to be able to claim back some power over their ability to have healthy pregnancies and healthy children.”\u003c/p>\n\u003cp>Of course, low-dose aspirin isn’t the only answer to the country’s high rate of maternal mortality. “There are certainly other things to be addressed — structural barriers, structural racism involved in the disparities that exist,” says Noel.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This tiny pill isn’t going to fix all of that. However, Noel says, it has great potential to reduce the number of cases of preeclampsia, a condition that is killing a lot of women.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Daily+Baby+Aspirin+Could+Help+Many+Pregnancies+And+Save+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bridget Desmukes was surprised when \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/6263239/rita-driggers\" target=\"_blank\" rel=\"noopener\">Dr. Rita Driggers\u003c/a>, Desmukes’ OB-GYN in Washington, D.C., recommended low-dose aspirin at her first prenatal appointment this past spring. She knew about daily low-dose aspirin being prescribed to people recovering from a heart attack or stroke. But for pregnant women?\u003c/p>\n\u003cp>In a past pregnancy, Desmukes, who is now 42, had developed preeclampsia, a potentially serious complication that involves high blood pressure. A small amount of daily aspirin, it turns out, can significantly cut the risk of developing preeclampsia in pregnancy. It’s currently recommended for many pregnant women by two influential groups — the \u003ca href=\"https://acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Low-Dose-Aspirin-Use-During-Pregnancy?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">American College of Obstetricians and Gynecologists\u003c/a> and the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>, an independent panel of experts commissioned by the federal government.\u003c/p>\n\u003cp>The challenge, some OB-GYNs believe, is getting the word out to women who are at risk that the low-dose aspirin regimen is something that could benefit them. In that way, Desmukes and her husband, Jeffrey, were lucky to hear about it early in her pregnancy.\u003c/p>\n\u003cp>She says her doctor, an associate professor at Johns Hopkins School of Medicine, “explained to us that because of my age and the fact that I had a history of preeclampsia, aspirin would be recommended for me to take. Just precautionarily — to keep the flow of nutrients and oxygen and everything to the baby and help it continue to thrive and grow.”\u003c/p>\n\u003cfigure id=\"attachment_11775892\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11775892\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85-800x387.jpg\" alt=\"A photo of Bridget Desmukes, next to a photo of her hand, holding a baby aspirin. \" width=\"800\" height=\"387\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/aprin_2_custom-d7da3fdb07319c6661a38386c1662a4d8c2a26bd-s800-c85-160x77.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">As an older mom with a history of preeclampsia, Desmukes is considered at high risk for developing the condition again. She’s a nurse by training and knows the risks, so she agreed with her OB-GYN that taking a single baby aspirin daily is a good idea. “Just precautionarily,” she says, “to keep the flow of nutrients and oxygen … to the baby.” \u003ccite>(Ryan Kellman/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Desmukes says at first she was hesitant. A nurse by training, she knows any medicine can have side effects and says she prefers a “holistic” approach to her own health. But she also knows the risks of preeclampsia, and how it can be fatal — it’s a leading cause of the \u003ca href=\"https://www.npr.org/series/543928389/lost-mothers\">high maternal mortality rate in the U.S\u003c/a>. And as a black woman, Desmukes’ risk of dying in childbirth is elevated; maternal mortality rates among black women in the U.S. are about three times those of white women.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She did some research, thought about it, and decided to take the aspirin. She is due in November, and so far everything’s going well — no signs of hypertension.\u003c/p>\n\u003cp>\u003cstrong>How it works\u003c/strong>\u003c/p>\n\u003cp>The cause of preeclampsia in a pregnant woman \u003ca href=\"https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/causes\" target=\"_blank\" rel=\"noopener\">is still unknown\u003c/a>, but the mechanism of danger is clear: Her blood vessels constrict, which means, among other things, blood can’t flow easily to her kidneys or brain or uterus. \u003ca href=\"https://www.preeclampsia.org/health-information/sign-symptoms\" target=\"_blank\" rel=\"noopener\">Telltale signs\u003c/a> include a terrible headache and swollen hands and feet.\u003c/p>\n\u003cp>“What aspirin does is relax blood vessels, [which] lowers the blood pressure, but also improves blood flow to the baby, to the kidneys, and to the brain, lowering the chance that the woman would have any complications to her pregnancy that would affect either her or her baby,” says \u003ca href=\"https://www.bmc.org/about-us/directory/doctor/jodi-f-abbott-md-msc-mhcm\" target=\"_blank\" rel=\"noopener\">Dr. Jodi Abbott\u003c/a>, an OB-GYN who specializes in treating high-risk pregnancies at Boston Medical Center and is also an associate professor at Boston University School of Medicine.\u003c/p>\n\u003cp>Prenatal aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/final-evidence-summary51/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication#results\" target=\"_blank\" rel=\"noopener\">cut the risk\u003c/a> of preeclampsia by 24%, according to a \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">comprehensive review\u003c/a> of the scientific evidence by the USPSTF in 2014. That guidance described the harms of taking low-dose aspirin in pregnancy as “no greater than small.”\u003c/p>\n\u003cp>“It’s been shown to be very safe,” says \u003ca href=\"https://www.bmc.org/about-us/directory/doctor/nyia-l-noel-md-mph\" target=\"_blank\" rel=\"noopener\">Dr. Nyia Noel\u003c/a>, who is Abbott’s co-director of the \u003ca href=\"https://www.prenatalaspirin.com/\" target=\"_blank\" rel=\"noopener\">Prenatal Aspirin Project\u003c/a>, an initiative at BMC created to increase implementation of the task force’s recommendations. “Things that people worry about — such as bleeding in pregnancy or something called placental abruption, which is early separation of the placenta — have not shown to be increased in women on low-dose aspirin.”\u003c/p>\n\u003cp>Now, this is not like taking aspirin for pain relief — that’s a much higher dose, usually 325 mg per pill, and one or two pills every four to six hours. In contrast, low-dose aspirin tablets are about 81 mg. They’re usually cheap and can be prescribed — they’re often covered by insurance — or bought over the counter.\u003c/p>\n\u003cp>Noel says for her, telling women about the benefits of prenatal aspirin is personal. African American women are \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/preeclampsia-screening1#clinical-considerations\" target=\"_blank\" rel=\"noopener\">more likely than white women\u003c/a> to develop preeclampsia, and they’re more likely to die from it.\u003c/p>\n\u003cp>“This topic is very important to me — as a black woman — but also as a black obstetrician-gynecologist in the service of women of color every day,” she says. “I’ve experienced what feels like one degree of separation between myself and women just like me that have died or almost died from preeclampsia,” Noel says. “So I really feel aspirin is not the only thing, but it is a step, and women should really feel empowered to speak with their providers about this.”\u003c/p>\n\u003cp>\u003cstrong>Aspirin coming to a prenatal vitamin near you?\u003c/strong>\u003c/p>\n\u003cp>Any woman pregnant with twins or triplets, or who has diabetes or hypertension, or who has had preeclampsia before, is considered at \u003ca href=\"https://acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Low-Dose-Aspirin-Use-During-Pregnancy?IsMobileSet=false\">high risk\u003c/a> of the condition and should talk to her doctor about taking low-dose aspirin, Abbott says.\u003c/p>\n\u003cp>Beyond that group of “high risk” characteristics, there are the moderate risk factors — like being pregnant with a first baby, or being obese, or over 35, or African American. Having two or more of those characteristics means low-dose aspirin should be considered for you, too, the guidelines suggest.\u003c/p>\n\u003cp>Abbott says when you add up the women in all those categories, it equals a whole lot of people.\u003c/p>\n\u003cp>“Eighty-six percent of our patients [at Boston Medical Center] would be eligible for aspirin based on those criteria,” Abbott says. “When you look at a number like 86% you can understand why I would be in favor — as a public health initiative — of all pregnant women getting it.”\u003c/p>\n\u003cp>As Abbott sees it, screening for all those risk factors means someone who could benefit will inevitably get missed. And since she doesn’t see significant downsides to low-dose aspirin, she thinks it should just go to everybody who’s pregnant.\u003c/p>\n\u003cp>“My suspicion — if I had to guess ahead 10 years — is that you’ll be able to buy, included in your prenatal vitamin, low-dose aspirin,” she says.\u003c/p>\n\u003cp>\u003cstrong>The need for research on the universal question\u003c/strong>\u003c/p>\n\u003cp>But not everyone is convinced — at least at this point — that every pregnant woman should take aspirin. Count \u003ca href=\"https://feinstein.northwell.edu/institutes-researchers/our-researchers/karina-davidson-phd\" target=\"_blank\" rel=\"noopener\">Karina Davidson\u003c/a> among them. She’s the senior vice president for research at Northwell Health and a member of the U.S. Preventive Services Task Force panel that reviewed the evidence on this issue in 2014.\u003c/p>\n\u003cp>“We know that aspirin prevents the devastating consequences of preeclampsia and of many of the hypertensive disorders of pregnancy for those who are at risk,” she says. “For those who are at risk, we absolutely want both clinicians and patients to know they should be discussing whether aspirin is right for them to help them minimize their exposure — and their infants’ exposure — to those devastating consequences.”\u003c/p>\n\u003cp>Still, that group’s current \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/final-evidence-summary51/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> stop short of advising prenatal aspirin for all.\u003c/p>\n\u003cp>“We have a very specific mandate, which is that we make recommendations based on evidence,” Davidson says. “When we looked in 2014 we found little evidence that existed that in average-risk populations there was benefit.” In other words, there needs to be a benefit to taking aspirin for women currently considered at low risk of developing preeclampsia — not just the absence of significant harm.\u003c/p>\n\u003cp>In June, the task force began looking to see whether new research has been done since 2014 that would make the group want to change its prenatal aspirin guidance, but \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/draft-research-plan/aspirin-use-to-prevent-preeclampsia-and-related-morbidity-and-mortality-preventive-medication1\" target=\"_blank\" rel=\"noopener\">that review\u003c/a> won’t be finished for several years.\u003c/p>\n\u003cp>\u003cstrong>Dr. Google, and other barriers\u003c/strong>\u003c/p>\n\u003cp>Boston Medical Center’s Prenatal Aspirin Project began in 2017 with the goal of getting the word out about the benefits of low-dose aspirin in pregnancy for eligible women and researching the barriers to implementing the task force’s recommendations.\u003c/p>\n\u003cp>Through focus groups, leaders of the project found most of their patients had never heard of preeclampsia. “We also found that they had been told it’s not safe to take medications in pregnancy or that aspirin can be dangerous and you shouldn’t take it,” Abbott says. “[Or they would] go to the pharmacy and the pharmacist would tell them that aspirin was unsafe in pregnancy.”\u003c/p>\n\u003cp>Abbott believes pharmacists may have not been aware of the prenatal aspirin recommendations from the past few years or may have been thinking of the guidance that \u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/headaches-during-pregnancy/faq-20058265\" target=\"_blank\" rel=\"noopener\">pregnant women take Tylenol\u003c/a> (rather than aspirin) for headaches.\u003c/p>\n\u003cp>The team at the Prenatal Aspirin Project ended up reaching out to big commercial pharmacies — CVS, Walgreens and Walmart — and got them to remove warnings on prenatal aspirin prescriptions. After having some patients tell them “I got a prescription, but I’m going to Google it before I take it,” members of the project team also worked to bump up their Google rankings so the project’s advice would appear above information that might be outdated.\u003c/p>\n\u003cp>Eliminating these barriers is important, Abbott says. “Everybody deserves a healthy baby and a healthy mother, and we’re failing at that right now,” she says. “This is really an opportunity for all women — but especially for women of color — to be able to claim back some power over their ability to have healthy pregnancies and healthy children.”\u003c/p>\n\u003cp>Of course, low-dose aspirin isn’t the only answer to the country’s high rate of maternal mortality. “There are certainly other things to be addressed — structural barriers, structural racism involved in the disparities that exist,” says Noel.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This tiny pill isn’t going to fix all of that. However, Noel says, it has great potential to reduce the number of cases of preeclampsia, a condition that is killing a lot of women.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Daily+Baby+Aspirin+Could+Help+Many+Pregnancies+And+Save+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Mentioning \u003ca href=\"http://bit.ly/fioretrumpneedles\" target=\"_blank\" rel=\"noopener\">needles going into the ocean\u003c/a> and threatening EPA action, President Trump said San Francisco is in “total violation” due to pollution from homeless people.\u003c/p>\n\u003cp>I’m all for \u003ca href=\"https://www.kqed.org/news/11678299/cartooning-the-needle-sweepers\" target=\"_blank\" rel=\"noopener\">keeping waste and needles out of the ocean\u003c/a> but it is jaw-dropping that Trump would criticize San Francisco over an environmental issue. (And, yes, I know jaw-dropping is what the president always intends.)\u003c/p>\n\u003cp>While some filth in our ocean and getting stuck with a needle at the beach would be awful, remember that the current administration recently killed the Clean Power Act, as well as scores of other \u003ca href=\"https://www.nytimes.com/interactive/2019/climate/trump-environment-rollbacks.html\" target=\"_blank\" rel=\"noopener\">rules and regulations\u003c/a>.\u003c/p>\n\u003cp>Trump’s own EPA \u003ca href=\"https://www.washingtonpost.com/news/energy-environment/wp/2017/11/01/trumps-epa-says-obamas-climate-rule-could-prevent-up-to-4500-deaths-annually-moves-to-scrap-it/\" target=\"_blank\" rel=\"noopener\">analyzed the Obama-era Clean Power Plan \u003c/a>and determined it would prevent 4,500 premature deaths every year by 2030.\u003c/p>\n\u003cp>The EPA recently replaced the previous climate plan with the new “Affordable Clean Energy” rule, that would\u003cem> cause\u003c/em> *only* \u003ca href=\"https://www.rollcall.com/news/epa-finalizes-clean-power-plan-replacement\" target=\"_blank\" rel=\"noopener\">1,400 premature deaths every year\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mentioning \u003ca href=\"http://bit.ly/fioretrumpneedles\" target=\"_blank\" rel=\"noopener\">needles going into the ocean\u003c/a> and threatening EPA action, President Trump said San Francisco is in “total violation” due to pollution from homeless people.\u003c/p>\n\u003cp>I’m all for \u003ca href=\"https://www.kqed.org/news/11678299/cartooning-the-needle-sweepers\" target=\"_blank\" rel=\"noopener\">keeping waste and needles out of the ocean\u003c/a> but it is jaw-dropping that Trump would criticize San Francisco over an environmental issue. (And, yes, I know jaw-dropping is what the president always intends.)\u003c/p>\n\u003cp>While some filth in our ocean and getting stuck with a needle at the beach would be awful, remember that the current administration recently killed the Clean Power Act, as well as scores of other \u003ca href=\"https://www.nytimes.com/interactive/2019/climate/trump-environment-rollbacks.html\" target=\"_blank\" rel=\"noopener\">rules and regulations\u003c/a>.\u003c/p>\n\u003cp>Trump’s own EPA \u003ca href=\"https://www.washingtonpost.com/news/energy-environment/wp/2017/11/01/trumps-epa-says-obamas-climate-rule-could-prevent-up-to-4500-deaths-annually-moves-to-scrap-it/\" target=\"_blank\" rel=\"noopener\">analyzed the Obama-era Clean Power Plan \u003c/a>and determined it would prevent 4,500 premature deaths every year by 2030.\u003c/p>\n\u003cp>The EPA recently replaced the previous climate plan with the new “Affordable Clean Energy” rule, that would\u003cem> cause\u003c/em> *only* \u003ca href=\"https://www.rollcall.com/news/epa-finalizes-clean-power-plan-replacement\" target=\"_blank\" rel=\"noopener\">1,400 premature deaths every year\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cstrong>Updated at 11:20 a.m. ET\u003c/strong>\u003c/p>\n\u003cp>House Speaker Nancy Pelosi unveiled her long-anticipated plan to lower the cost of prescription drugs on Thursday. It is a priority shared by President Trump, fueling a glimmer of hope a deal to be had on the issue ahead of the 2020 elections.\u003c/p>\n\u003cp>“It is transformative,” Pelosi said of her plan.”We do hope to have White House buy-in.”\u003c/p>\n\u003cp>The speaker’s proposal calls for the federal government, through the health and human services secretary, to annually negotiate prices for the top 250 most expensive drugs on the market that don’t have at least two competitors. The price determined by the negotiations would be available to all purchasers, not just Medicare beneficiaries.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='President Donald Trump']‘Why should other nations pay much less than us? They’ve taken advantage of the system for a long time, pharma.’[/pullquote]The amounts would be pegged to the costs of the same drugs in other countries, which are generally much cheaper, under an “international price index.” It would also levy steep fines — starting at 65% of the gross sales of the drug — on drug companies that refuse to engage in negotiations and limit how much drug costs can go up.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This steep, escalating penalty creates a powerful financial incentive for drug manufacturers to negotiate and abide by the final price,” the proposal states. The plan calls for reinvesting the taxpayer money saved in negotiations back into drug research at the National Institutes of Health.\u003c/p>\n\u003cp>The proposal also includes a $2,000 out-of-pocket cap on prescription drugs for Medicare beneficiaries and the disabled.\u003c/p>\n\u003cp>Pelosi told reporters the proposal was not the last word.\u003c/p>\n\u003cp>“This is an introduction. So much more will be added in the committee process and the public review of it. But we’re very excited about it and happy that we can give some hope to people that help is on the way,” she said.\u003c/p>\n\u003cp>However, Pelosi said empowering the HHS secretary to negotiate drug prices must be included in any final bill.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Jim Greenwood, president of the Biotechnology Innovation Organization']‘This proposal crushes the desperate hopes of patients and their families that life science innovators will be the answer to their prayers.’[/pullquote]It is rare for the speaker to take an early and formative role in crafting a bill — policy work generally left to committees — so Pelosi’s engagement on the issue sends a clear message that it is a top priority for the party. Her office has been quietly negotiating the details of the proposal for months, which Pelosi has run by moderate and progressive factions within the Democratic Caucus ahead of Thursday’s official release.\u003c/p>\n\u003cp>The speaker met Tuesday evening with the Blue Dog Coalition, a faction of moderates who often represent many of the party’s swing seats.\u003c/p>\n\u003cp>“We appreciate that Speaker Pelosi took the time to meet with the Blue Dogs to discuss a path forward to lower the cost of prescription drugs,” Rep. Stephanie Murphy, D-Fla., a co-chair of the coalition, said in a statement. “Our constituents want to see solutions implemented today, and we hope House Republicans will join in coming forward with bold solutions to bring down drug costs and increase transparency surrounding drug pricing.”\u003c/p>\n\u003cp>A source at the Blue Dog meeting said lawmakers were particularly eager to change the conversation in the House.\u003c/p>\n\u003cp>“Members would like to be talking less about impeachment and more about an issue that their constituents are bringing up at every town hall back home,” the source said. “We’re eager to see the legislation itself.”\u003c/p>\n\u003cp>[aside tag='prescription-drugs' label='More Coverage']Committees are expected to take up the legislation as soon as next week, with the goal of passing it out of the House by the end of the year. There are only 34 legislative days left in 2019. The non-partisan Congressional Budget Office has not yet released an evaluation on the proposal’s costs and savings.\u003c/p>\n\u003cp>Pelosi’s proposal is the most sweeping plan on the table, and while traditional Republicans are sure to object, it includes ideas that President Trump has indicated in the past he could support to help drive down drug prices for Americans.\u003c/p>\n\u003cp>If Pelosi and Trump could come to an agreement, Democrats believe he could bring enough Republicans on board to get it through Congress and signed into law.\u003c/p>\n\u003cp>The president supports a drug price index, and the administration is reviewing a possible executive order to that end.\u003c/p>\n\u003cp>“Why should other nations pay much less than us? They’ve taken advantage of the system for a long time, pharma,” Trump told reporters in July.\u003c/p>\n\u003cp>He also used his State of the Union address earlier this year to call for action to lower drug costs.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Proposal by House Speaker Nancy Pelosi']‘This steep, escalating penalty creates a powerful financial incentive for drug manufacturers to negotiate and abide by the final price.’[/pullquote]“It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, this is unfair, and together we will stop it. We will stop it fast,” he said in February.\u003c/p>\n\u003cp>The pharmaceutical lobby, with backing from GOP allies, opposes any effort to regulate the drug market.\u003c/p>\n\u003cp>“This proposal crushes the desperate hopes of patients and their families that life science innovators will be the answer to their prayers,” Jim Greenwood, president of the Biotechnology Innovation Organization, which represents biotechnology companies, said in a statement.\u003c/p>\n\u003cp>“It abandons any pretense of allowing a free and fair market system to determine the value of prescription medicines, including for the most innovative medical breakthroughs,” he added.\u003c/p>\n\u003cp>At least one powerful Senate Republican, Finance Committee Chairman Chuck Grassley, R-Iowa, \u003ca href=\"https://www.npr.org/2019/08/09/749669233/top-senate-republican-pushes-forward-with-drug-bill-that-divides-gop\">is willing to buck party orthodoxy\u003c/a> to get a bill to lower drug prices.\u003c/p>\n\u003cp>Grassley and Sen. Ron Wyden, D-Ore., cut a deal in July on legislation that limits out-of-pocket costs for seniors in Medicare’s Part D prescription drug program to $3,100 per year starting in 2022.\u003c/p>\n\u003cp>Grassley moved a draft version of that proposal out of committee over the objection of most Republicans on the Senate Finance panel, who oppose it on free-market principles. His proposal is more modest — the House plan would regulate drug prices more aggressively and outside the scope of Medicare as well — but Grassley is hoping Pelosi’s broader bill will help Republicans rally around his.\u003c/p>\n\u003cp>Grassley has been pitching his proposal to Senate Republicans as the more moderate plan on an issue generally popular with voters everywhere. He is also warning Republicans that if they do not coalesce around an alternative to offer to the president for his support, Trump could join forces with Pelosi instead.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A spokesman for Grassley said a formal text of his legislation will be introduced soon.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This steep, escalating penalty creates a powerful financial incentive for drug manufacturers to negotiate and abide by the final price,” the proposal states. The plan calls for reinvesting the taxpayer money saved in negotiations back into drug research at the National Institutes of Health.\u003c/p>\n\u003cp>The proposal also includes a $2,000 out-of-pocket cap on prescription drugs for Medicare beneficiaries and the disabled.\u003c/p>\n\u003cp>Pelosi told reporters the proposal was not the last word.\u003c/p>\n\u003cp>“This is an introduction. So much more will be added in the committee process and the public review of it. But we’re very excited about it and happy that we can give some hope to people that help is on the way,” she said.\u003c/p>\n\u003cp>However, Pelosi said empowering the HHS secretary to negotiate drug prices must be included in any final bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, this is unfair, and together we will stop it. We will stop it fast,” he said in February.\u003c/p>\n\u003cp>The pharmaceutical lobby, with backing from GOP allies, opposes any effort to regulate the drug market.\u003c/p>\n\u003cp>“This proposal crushes the desperate hopes of patients and their families that life science innovators will be the answer to their prayers,” Jim Greenwood, president of the Biotechnology Innovation Organization, which represents biotechnology companies, said in a statement.\u003c/p>\n\u003cp>“It abandons any pretense of allowing a free and fair market system to determine the value of prescription medicines, including for the most innovative medical breakthroughs,” he added.\u003c/p>\n\u003cp>At least one powerful Senate Republican, Finance Committee Chairman Chuck Grassley, R-Iowa, \u003ca href=\"https://www.npr.org/2019/08/09/749669233/top-senate-republican-pushes-forward-with-drug-bill-that-divides-gop\">is willing to buck party orthodoxy\u003c/a> to get a bill to lower drug prices.\u003c/p>\n\u003cp>Grassley and Sen. Ron Wyden, D-Ore., cut a deal in July on legislation that limits out-of-pocket costs for seniors in Medicare’s Part D prescription drug program to $3,100 per year starting in 2022.\u003c/p>\n\u003cp>Grassley moved a draft version of that proposal out of committee over the objection of most Republicans on the Senate Finance panel, who oppose it on free-market principles. His proposal is more modest — the House plan would regulate drug prices more aggressively and outside the scope of Medicare as well — but Grassley is hoping Pelosi’s broader bill will help Republicans rally around his.\u003c/p>\n\u003cp>Grassley has been pitching his proposal to Senate Republicans as the more moderate plan on an issue generally popular with voters everywhere. He is also warning Republicans that if they do not coalesce around an alternative to offer to the president for his support, Trump could join forces with Pelosi instead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A spokesman for Grassley said a formal text of his legislation will be introduced soon.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400;\">Gov. Gavin Newsom on Monday defended his request for\u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\"> last-minute changes to SB 276\u003c/a>, a bill that gives the state more oversight of vaccine medical exemptions for schoolkids. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">After initially asking for and receiving earlier amendments, Newsom said he would sign the measure. But in the final weeks of the legislative session, he said he wanted more changes to the bill. \u003c/span>\u003c/p>\n\u003cp>“I worked with the administration to figure out the details of the implementation and felt that we need to clarify some additional points to help with the implementation,” Newsom said.\u003c/p>\n\u003cp>In response, lawmakers passed a companion measure to SB 276 making the changes Newsom called for. \u003ca href=\"https://www.kqed.org/news/11773308/anti-vaccine-protesters-swarm-capitol-as-lawmakers-pass-bill-limiting-medical-exemptions\">He then signed both bills\u003c/a>.\u003c/p>\n\u003cp>But critics said Newsom bungled his handling of the situation and emboldened anti-vaccine protesters.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’ve never seen a governor give his word and change his mind twice,” said Republican consultant Mike Madrid, referring to Newsom twice asking for amendments to the bill. “No question it created confusion for the advocates, emboldened the protesters and left legislators scratching their heads. This was an unforced error. The real damage was done because this was a vaccine bill. A no-brainer.”\u003c/p>\n\u003cp>[aside tag='childhood-vaccinations' label='More Coverage']In the final week of the Legislature, protesters shut down Senate and Assembly sessions with their shouting. During the last session of the year, a woman \u003ca href=\"https://www.kqed.org/news/11774151/what-passed-or-is-in-limbo-catch-up-with-the-california-legislature-as-session-ends\">threw a menstrual cup filled with what appeared to be blood\u003c/a> onto the floor of the Senate during a vote.\u003c/p>\n\u003cp>Newsom bristled at the suggestion that his request for late changes to the bill or the fact that his office took meetings with vaccine opponents contributed to the protests. He noted he took meetings with people on all sides of the issue.\u003c/p>\n\u003cp>“I think that’s appropriate,” he said.\u003c/p>\n\u003cp>The governor wouldn’t comment on whether his wife, Jennifer Siebel Newsom, was involved in the request for changes to SB 276. Protesters had seen her as a potential ally, tagging her in messages on social media.\u003c/p>\n\u003cp>https://twitter.com/Stacytitoni/status/1131007413170069504\u003c/p>\n\u003cp>“Everyone has opinions. I’ll leave it at that,” Newsom said. “I did what I needed to do to make (SB 276) more successful and to make sure we implement it in an effective way. And I’m proud that I signed the bill. I support vaccines.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Newsom said he wasn’t aware of anyone in his leadership team being opposed to vaccines, and said no one in his family has requested a medical exemption.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400;\">Gov. Gavin Newsom on Monday defended his request for\u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\"> last-minute changes to SB 276\u003c/a>, a bill that gives the state more oversight of vaccine medical exemptions for schoolkids. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">After initially asking for and receiving earlier amendments, Newsom said he would sign the measure. But in the final weeks of the legislative session, he said he wanted more changes to the bill. \u003c/span>\u003c/p>\n\u003cp>“I worked with the administration to figure out the details of the implementation and felt that we need to clarify some additional points to help with the implementation,” Newsom said.\u003c/p>\n\u003cp>In response, lawmakers passed a companion measure to SB 276 making the changes Newsom called for. \u003ca href=\"https://www.kqed.org/news/11773308/anti-vaccine-protesters-swarm-capitol-as-lawmakers-pass-bill-limiting-medical-exemptions\">He then signed both bills\u003c/a>.\u003c/p>\n\u003cp>But critics said Newsom bungled his handling of the situation and emboldened anti-vaccine protesters.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I’ve never seen a governor give his word and change his mind twice,” said Republican consultant Mike Madrid, referring to Newsom twice asking for amendments to the bill. “No question it created confusion for the advocates, emboldened the protesters and left legislators scratching their heads. This was an unforced error. The real damage was done because this was a vaccine bill. A no-brainer.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In the final week of the Legislature, protesters shut down Senate and Assembly sessions with their shouting. During the last session of the year, a woman \u003ca href=\"https://www.kqed.org/news/11774151/what-passed-or-is-in-limbo-catch-up-with-the-california-legislature-as-session-ends\">threw a menstrual cup filled with what appeared to be blood\u003c/a> onto the floor of the Senate during a vote.\u003c/p>\n\u003cp>Newsom bristled at the suggestion that his request for late changes to the bill or the fact that his office took meetings with vaccine opponents contributed to the protests. He noted he took meetings with people on all sides of the issue.\u003c/p>\n\u003cp>“I think that’s appropriate,” he said.\u003c/p>\n\u003cp>The governor wouldn’t comment on whether his wife, Jennifer Siebel Newsom, was involved in the request for changes to SB 276. Protesters had seen her as a potential ally, tagging her in messages on social media.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>“Everyone has opinions. I’ll leave it at that,” Newsom said. “I did what I needed to do to make (SB 276) more successful and to make sure we implement it in an effective way. And I’m proud that I signed the bill. I support vaccines.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Newsom said he wasn’t aware of anyone in his leadership team being opposed to vaccines, and said no one in his family has requested a medical exemption.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In case you missed it … California has a new vaccination law on the books.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, which Gov. Gavin Newsom signed into law last week, cracks down on doctors who inappropriately issue medical exemptions that allow kids to skip some or all vaccines that most schools require. It gives power over the exemption process to public health officials and will create a vaccination database of all children with medical exemptions.\u003c/p>\n\u003cp>Supporters of the law are pleased that doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. The more children who get vaccines, the safer schools will be for all kids, proponents of the legislation say.\u003c/p>\n\u003cp>Critics fear the law will effectively shut down access to waivers for kids who could be harmed by vaccines, which carry some risk, or who need them for other medical reasons. Doctors may fear the investigative provisions of the law, opponents say, and thousands of children could even be tossed out of school if they are not fully up-to-date on vaccines.\u003c/p>\n\u003cp>Here are five things to know about the law, which goes into effect Jan. 1.\u003c/p>\n\u003cp>[aside label=\"related stories\" tag=\"vaccines\"]\u003c/p>\n\u003ch3>\u003cstrong>1. What does the new law do?\u003c/strong>\u003c/h3>\n\u003cp>In California, children are required to be vaccinated, or have a medical exemption, to attend school. The new \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201920200SB276\">law\u003c/a> creates a review process that gives public health officials the final say on those waivers, with the authority to reject them. Reasons for medical exemptions must still follow strict guidelines, and doctors will now be barred from charging any fees for exams or forms related to them.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, the law’s author, said he was concerned when the number of medical waivers rose across the state after a previous law that he wrote eliminated personal-belief exemptions in 2016 but kept medical exemptions intact. Pan said his goal this year was to keep physicians from issuing waivers for payment or for reasons that are not allowed.\u003c/p>\n\u003cp>The law, signed by the governor last week, \u003ca href=\"https://www.chhs.ca.gov/blog/2019/09/09/senate-bill-276-and-senate-bill-714-vaccinations-and-medical-exemptions-questions-and-answers/\">requires\u003c/a> doctors to examine patients and submit their recommendations to the state Department of Public Health. State officials will then cross-check recommendations against guidelines from the Centers for Disease Control’s Advisory Committee on Immunization \u003ca href=\"https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html\">Practices\u003c/a> or the American Academy of Pediatrics.\u003c/p>\n\u003cp>Currently, the state is not involved in how students are granted medical exemptions. Parents get them from doctors and submit them to schools, and schools with kindergartens are required to submit aggregate data to the state each autumn. The state does not receive exemption forms or information about doctors writing exemptions, according to the Department of Public Health.\u003c/p>\n\u003cp>Starting next year, parents will continue to get waiver letters from doctors, as they do now, and submit them to schools. In 2021, the state is set to have a standardized form and a new submission process: Doctors will send exemptions\u003cstrong> \u003c/strong>directly to the state for review and dissemination to schools.\u003c/p>\n\u003cp>Once the law takes effect in January, state health officials will begin reviewing all medical exemptions at schools in which fewer than 95% of students are vaccinated. They will also review doctors who submit five or more exemptions in one year as well as schools that have not shared vaccination rates with the state.\u003c/p>\n\u003cp>If the state determines a physician is “contributing to a public health risk,” it will report the physician to California’s medical board. The state will cancel waivers written by doctors who are under investigation by the medical board.\u003c/p>\n\u003cp>“It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable” by local doctors selling inappropriate exemptions, Pan said in a written statement.\u003c/p>\n\u003cp>Kids with medical exemptions issued before next Jan. 1 may keep their exemptions until they move into the next grade span. The spans are defined as birth to preschool, kindergarten to sixth grade and seventh to 12th grades. After July 1, 2021, students with temporary exemptions will need to receive a new one each year, and no exemptions will carry over when a child enters a new grade span.\u003c/p>\n\u003ch3>\u003cstrong>2. How did we get here?\u003c/strong>\u003c/h3>\n\u003cp>Vaccinations have been a hot issue in California for several years, even though nearly 95% of kindergartners were fully vaccinated in the last school year. At the same time, the portion of kindergartners with medical exemptions \u003ca href=\"https://calmatters.org/health/2019/02/california-made-it-hard-to-avoid-vaccinating-kids-medical-waivers-have-tripled-now-what/\">has been rising\u003c/a> since personal-belief exemptions were eliminated. Last year, nearly 1% of kindergartners — 4,812 of them — had exemptions. In some places rates are higher: The legislation notes that 16 counties had kindergarten vaccination rates lower than 90% in the last school year.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/a5d34577-fae8-4b96-9afe-c8f002f888c1?src=embed\" title=\"Vaccination Rates in California\" width=\"550\" height=\"700\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pan’s latest proposal drew opposition groups to the capital for weeks of protest, at times all but shutting down meetings and regularly scheduled operations in the Capitol building. Advocates for Physicians’ Rights, Physicians for Informed Consent and parents from across the state testified against the bill in committee hearings, saying their children had been injured by vaccines and that they didn’t want to be required to obtain more immunizations. Some also said their children had autoimmune disorders or similar conditions and many feared the bill would dissuade doctors from providing new exemptions.\u003c/p>\n\u003cp>Anti-vaccination activists reacted similarly in 2015, when Pan first proposed elimination of personal-belief exemptions. At that time, he \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">agreed\u003c/a> that a medical exemption is absolutely up to a physician and \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">argued\u003c/a> that parents would be able to find a practitioner to sign a form.\u003c/p>\n\u003cp>And, to the surprise some of the bill’s supporters, Gov. Gavin Newsom also had reservations.\u003c/p>\n\u003cp>Initially, he expressed \u003ca href=\"https://www.sfchronicle.com/politics/article/Gavin-Newsom-signals-opposition-to-tightening-13916178.php\">concern\u003c/a> about state involvement in the doctor-patient relationship. But after negotiations with the author and some amendments, Newsom said he would support the proposal. But\u003cstrong> \u003c/strong>as the bill advanced through the Legislature, Newsom \u003ca href=\"https://twitter.com/CAgovernor/status/1169027421930184705\">signaled\u003c/a> he wanted more changes. Pan agreed again and put them in a companion \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB714\">bill\u003c/a>. Newsom signed both bills into law.\u003c/p>\n\u003cp>The changes Newsom asked for allow kids who have medical exemptions before the law goes into effect on Jan. 1 to keep them until they enter a new grade span. Doctors also gained some breathing room in the amended version: Initially, Pan’s proposal said they would sign exemptions under penalty of perjury, but that clause was removed.\u003c/p>\n\u003ch3>3. The vast majority of kids are vaccinated, so what’s the big deal?\u003c/h3>\n\u003cp>A state Department of Public Health’s \u003ca href=\"http://eziz.org/assets/docs/shotsforschool/2018-19CAKindergartenSummaryReport.pdf\">review\u003c/a> shows that California’s vaccination rates are high: 94.8% of kindergartners in the last school year were vaccinated, a slight decrease from the year before. Meanwhile, the slight increase in medical exemptions represents families who had previously sought personal-belief exemptions and switched to medical waivers, say parents who oppose the new law.\u003c/p>\n\u003cp>Supporters of the new law, including the California Medical Association and the American Academy of Pediatrics in California, say it will strengthen community immunity and that vaccines are safe and effective for keeping communities healthy. They also content that it will crack down on physicians “practicing outside the accepted standard of care,” said David Aizuss, president of the medical association, in a written statement.\u003c/p>\n\u003cp>Doctors who oppose the law say they are concerned about losing their right to say what’s best for their patients, and about the lack of liability for those injured by vaccines, explained Debra Schaefer, spokeswoman \u003ca href=\"https://www.physiciansrights.org/mission/\">for\u003c/a> Advocates for Physicians’ Rights, in an email.\u003c/p>\n\u003cp>“The CDC itself warns that there are risks involved with vaccinations, and where there is risk, there should at least be a discussion between a doctor and a patient, like with any other pharmaceutical,” she said. “This bill is nothing more than government overreach. … Doctors were scared to write (medical exemptions) before this bill; this is just creating an additional killing effect.”\u003c/p>\n\u003cp>Other opponents say the law tries to solve a problem that doesn’t exist. Instead, it may force thousands of children to leave school or quickly get caught up on vaccines even if they have legitimate medical exemptions, said Toby Rogers, an independent researcher and prominent critic of the law.\u003c/p>\n\u003cp>“If you are missing a single shot in this bloated schedule, you are considered noncompliant and kicked out of school,” said Rogers, referring to the \u003ca href=\"https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html\">CDC schedule\u003c/a> of vaccinations for children. In California, kids are required to receive 15-16 vaccine \u003ca href=\"https://www.shotsforschool.org/k-12/\">shots \u003c/a>to enter kindergarten. Some of the shots carry combined doses.\u003c/p>\n\u003cp>Rogers suggested the state focus instead on the larger percentage of children affected by such diseases and conditions as diabetes, asthma, autoimmune disorders and autism.\u003c/p>\n\u003ch3>4. Are vaccines dangerous, as some critics say?\u003c/h3>\n\u003cp>Critics of the new law argue that it does not properly acknowledge the risk that vaccines pose. The law states that “for all but a small number of individuals, immunizations are safe and effective,” but does not elaborate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Other opponents say the new requirements ignore the real needs of children who have been injured by vaccines and could be further harmed if forced into more. For example, they could have allergic reactions to vaccine components or have other underlying health conditions.\u003c/p>\n\u003cp>Vaccinations also can have \u003ca href=\"https://www.cdc.gov/vaccines/vac-gen/side-effects.htm\">side effects\u003c/a>, ranging from fevers and seizures to very rare cases of death, according to the literature included with the medications and the Centers for Disease Control and Prevention. In 1986, the federal government \u003ca href=\"https://pediatrics.aappublications.org/content/98/6/1179\">created \u003c/a>the National Childhood Vaccine Injury \u003ca href=\"https://www.congress.gov/bill/99th-congress/house-bill/5546\">Act\u003c/a>. that freed pharmaceutical companies from liability in cases of such injury. Under that law, billions of government dollars have been paid to families with children harmed by vaccines.\u003c/p>\n\u003cp>The group Physicians for Informed Consent, which opposes California’s new law, \u003ca href=\"https://physiciansforinformedconsent.org/wp-content/uploads/2019/07/PIC-MBC-SB276-7-9-19.pdf\">says \u003c/a>it is partly based on misinformation. The organization argues that some of the vaccines required for school are for illnesses that are not contagious and therefore do not affect herd immunity or other children. Those include immunizations against tetanus and Hepatitis B, which is first administered to newborns for an illness \u003ca href=\"https://www.cdc.gov/hepatitis/hbv/bfaq.htm\">transmitted\u003c/a> through sex and intravenous drug use.\u003c/p>\n\u003cp>Opponents also point to the Vaccine Adverse Effects \u003ca href=\"https://vaers.hhs.gov/\">Registry\u003c/a> and the National Vaccine Injury Compensation \u003ca href=\"https://www.hrsa.gov/vaccine-compensation/index.html\">Program\u003c/a> as evidence that vaccination decisions should be left to physicians.\u003c/p>\n\u003ch3>\u003cstrong>5. So is this fight over now?\u003c/strong>\u003c/h3>\n\u003cp>Robert F. Kennedy Jr., a vocal opponent of the California law, said at a rally last week that his \u003ca href=\"https://childrenshealthdefense.org/news/americans-can-handle-an-open-discussion-on-vaccines-rfk-jr-responds-to-criticism-from-his-family/\">organization\u003c/a>, Children’s Health Defense, intends to sue the state to block the law. And a group of opponents this week began the process of trying to overturn the new law through a ballot measure that would go to voters next November.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. Opponents say physicians may now be afraid to provide waivers, even for kids who need them.\r\n",
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"title": "Five Things to Know About California’s New Vaccine Law | KQED",
"description": "Doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. Opponents say physicians may now be afraid to provide waivers, even for kids who need them.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In case you missed it … California has a new vaccination law on the books.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, which Gov. Gavin Newsom signed into law last week, cracks down on doctors who inappropriately issue medical exemptions that allow kids to skip some or all vaccines that most schools require. It gives power over the exemption process to public health officials and will create a vaccination database of all children with medical exemptions.\u003c/p>\n\u003cp>Supporters of the law are pleased that doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. The more children who get vaccines, the safer schools will be for all kids, proponents of the legislation say.\u003c/p>\n\u003cp>Critics fear the law will effectively shut down access to waivers for kids who could be harmed by vaccines, which carry some risk, or who need them for other medical reasons. Doctors may fear the investigative provisions of the law, opponents say, and thousands of children could even be tossed out of school if they are not fully up-to-date on vaccines.\u003c/p>\n\u003cp>Here are five things to know about the law, which goes into effect Jan. 1.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>1. What does the new law do?\u003c/strong>\u003c/h3>\n\u003cp>In California, children are required to be vaccinated, or have a medical exemption, to attend school. The new \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201920200SB276\">law\u003c/a> creates a review process that gives public health officials the final say on those waivers, with the authority to reject them. Reasons for medical exemptions must still follow strict guidelines, and doctors will now be barred from charging any fees for exams or forms related to them.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, the law’s author, said he was concerned when the number of medical waivers rose across the state after a previous law that he wrote eliminated personal-belief exemptions in 2016 but kept medical exemptions intact. Pan said his goal this year was to keep physicians from issuing waivers for payment or for reasons that are not allowed.\u003c/p>\n\u003cp>The law, signed by the governor last week, \u003ca href=\"https://www.chhs.ca.gov/blog/2019/09/09/senate-bill-276-and-senate-bill-714-vaccinations-and-medical-exemptions-questions-and-answers/\">requires\u003c/a> doctors to examine patients and submit their recommendations to the state Department of Public Health. State officials will then cross-check recommendations against guidelines from the Centers for Disease Control’s Advisory Committee on Immunization \u003ca href=\"https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html\">Practices\u003c/a> or the American Academy of Pediatrics.\u003c/p>\n\u003cp>Currently, the state is not involved in how students are granted medical exemptions. Parents get them from doctors and submit them to schools, and schools with kindergartens are required to submit aggregate data to the state each autumn. The state does not receive exemption forms or information about doctors writing exemptions, according to the Department of Public Health.\u003c/p>\n\u003cp>Starting next year, parents will continue to get waiver letters from doctors, as they do now, and submit them to schools. In 2021, the state is set to have a standardized form and a new submission process: Doctors will send exemptions\u003cstrong> \u003c/strong>directly to the state for review and dissemination to schools.\u003c/p>\n\u003cp>Once the law takes effect in January, state health officials will begin reviewing all medical exemptions at schools in which fewer than 95% of students are vaccinated. They will also review doctors who submit five or more exemptions in one year as well as schools that have not shared vaccination rates with the state.\u003c/p>\n\u003cp>If the state determines a physician is “contributing to a public health risk,” it will report the physician to California’s medical board. The state will cancel waivers written by doctors who are under investigation by the medical board.\u003c/p>\n\u003cp>“It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable” by local doctors selling inappropriate exemptions, Pan said in a written statement.\u003c/p>\n\u003cp>Kids with medical exemptions issued before next Jan. 1 may keep their exemptions until they move into the next grade span. The spans are defined as birth to preschool, kindergarten to sixth grade and seventh to 12th grades. After July 1, 2021, students with temporary exemptions will need to receive a new one each year, and no exemptions will carry over when a child enters a new grade span.\u003c/p>\n\u003ch3>\u003cstrong>2. How did we get here?\u003c/strong>\u003c/h3>\n\u003cp>Vaccinations have been a hot issue in California for several years, even though nearly 95% of kindergartners were fully vaccinated in the last school year. At the same time, the portion of kindergartners with medical exemptions \u003ca href=\"https://calmatters.org/health/2019/02/california-made-it-hard-to-avoid-vaccinating-kids-medical-waivers-have-tripled-now-what/\">has been rising\u003c/a> since personal-belief exemptions were eliminated. Last year, nearly 1% of kindergartners — 4,812 of them — had exemptions. In some places rates are higher: The legislation notes that 16 counties had kindergarten vaccination rates lower than 90% in the last school year.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/a5d34577-fae8-4b96-9afe-c8f002f888c1?src=embed\" title=\"Vaccination Rates in California\" width=\"550\" height=\"700\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pan’s latest proposal drew opposition groups to the capital for weeks of protest, at times all but shutting down meetings and regularly scheduled operations in the Capitol building. Advocates for Physicians’ Rights, Physicians for Informed Consent and parents from across the state testified against the bill in committee hearings, saying their children had been injured by vaccines and that they didn’t want to be required to obtain more immunizations. Some also said their children had autoimmune disorders or similar conditions and many feared the bill would dissuade doctors from providing new exemptions.\u003c/p>\n\u003cp>Anti-vaccination activists reacted similarly in 2015, when Pan first proposed elimination of personal-belief exemptions. At that time, he \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">agreed\u003c/a> that a medical exemption is absolutely up to a physician and \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">argued\u003c/a> that parents would be able to find a practitioner to sign a form.\u003c/p>\n\u003cp>And, to the surprise some of the bill’s supporters, Gov. Gavin Newsom also had reservations.\u003c/p>\n\u003cp>Initially, he expressed \u003ca href=\"https://www.sfchronicle.com/politics/article/Gavin-Newsom-signals-opposition-to-tightening-13916178.php\">concern\u003c/a> about state involvement in the doctor-patient relationship. But after negotiations with the author and some amendments, Newsom said he would support the proposal. But\u003cstrong> \u003c/strong>as the bill advanced through the Legislature, Newsom \u003ca href=\"https://twitter.com/CAgovernor/status/1169027421930184705\">signaled\u003c/a> he wanted more changes. Pan agreed again and put them in a companion \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB714\">bill\u003c/a>. Newsom signed both bills into law.\u003c/p>\n\u003cp>The changes Newsom asked for allow kids who have medical exemptions before the law goes into effect on Jan. 1 to keep them until they enter a new grade span. Doctors also gained some breathing room in the amended version: Initially, Pan’s proposal said they would sign exemptions under penalty of perjury, but that clause was removed.\u003c/p>\n\u003ch3>3. The vast majority of kids are vaccinated, so what’s the big deal?\u003c/h3>\n\u003cp>A state Department of Public Health’s \u003ca href=\"http://eziz.org/assets/docs/shotsforschool/2018-19CAKindergartenSummaryReport.pdf\">review\u003c/a> shows that California’s vaccination rates are high: 94.8% of kindergartners in the last school year were vaccinated, a slight decrease from the year before. Meanwhile, the slight increase in medical exemptions represents families who had previously sought personal-belief exemptions and switched to medical waivers, say parents who oppose the new law.\u003c/p>\n\u003cp>Supporters of the new law, including the California Medical Association and the American Academy of Pediatrics in California, say it will strengthen community immunity and that vaccines are safe and effective for keeping communities healthy. They also content that it will crack down on physicians “practicing outside the accepted standard of care,” said David Aizuss, president of the medical association, in a written statement.\u003c/p>\n\u003cp>Doctors who oppose the law say they are concerned about losing their right to say what’s best for their patients, and about the lack of liability for those injured by vaccines, explained Debra Schaefer, spokeswoman \u003ca href=\"https://www.physiciansrights.org/mission/\">for\u003c/a> Advocates for Physicians’ Rights, in an email.\u003c/p>\n\u003cp>“The CDC itself warns that there are risks involved with vaccinations, and where there is risk, there should at least be a discussion between a doctor and a patient, like with any other pharmaceutical,” she said. “This bill is nothing more than government overreach. … Doctors were scared to write (medical exemptions) before this bill; this is just creating an additional killing effect.”\u003c/p>\n\u003cp>Other opponents say the law tries to solve a problem that doesn’t exist. Instead, it may force thousands of children to leave school or quickly get caught up on vaccines even if they have legitimate medical exemptions, said Toby Rogers, an independent researcher and prominent critic of the law.\u003c/p>\n\u003cp>“If you are missing a single shot in this bloated schedule, you are considered noncompliant and kicked out of school,” said Rogers, referring to the \u003ca href=\"https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html\">CDC schedule\u003c/a> of vaccinations for children. In California, kids are required to receive 15-16 vaccine \u003ca href=\"https://www.shotsforschool.org/k-12/\">shots \u003c/a>to enter kindergarten. Some of the shots carry combined doses.\u003c/p>\n\u003cp>Rogers suggested the state focus instead on the larger percentage of children affected by such diseases and conditions as diabetes, asthma, autoimmune disorders and autism.\u003c/p>\n\u003ch3>4. Are vaccines dangerous, as some critics say?\u003c/h3>\n\u003cp>Critics of the new law argue that it does not properly acknowledge the risk that vaccines pose. The law states that “for all but a small number of individuals, immunizations are safe and effective,” but does not elaborate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Other opponents say the new requirements ignore the real needs of children who have been injured by vaccines and could be further harmed if forced into more. For example, they could have allergic reactions to vaccine components or have other underlying health conditions.\u003c/p>\n\u003cp>Vaccinations also can have \u003ca href=\"https://www.cdc.gov/vaccines/vac-gen/side-effects.htm\">side effects\u003c/a>, ranging from fevers and seizures to very rare cases of death, according to the literature included with the medications and the Centers for Disease Control and Prevention. In 1986, the federal government \u003ca href=\"https://pediatrics.aappublications.org/content/98/6/1179\">created \u003c/a>the National Childhood Vaccine Injury \u003ca href=\"https://www.congress.gov/bill/99th-congress/house-bill/5546\">Act\u003c/a>. that freed pharmaceutical companies from liability in cases of such injury. Under that law, billions of government dollars have been paid to families with children harmed by vaccines.\u003c/p>\n\u003cp>The group Physicians for Informed Consent, which opposes California’s new law, \u003ca href=\"https://physiciansforinformedconsent.org/wp-content/uploads/2019/07/PIC-MBC-SB276-7-9-19.pdf\">says \u003c/a>it is partly based on misinformation. The organization argues that some of the vaccines required for school are for illnesses that are not contagious and therefore do not affect herd immunity or other children. Those include immunizations against tetanus and Hepatitis B, which is first administered to newborns for an illness \u003ca href=\"https://www.cdc.gov/hepatitis/hbv/bfaq.htm\">transmitted\u003c/a> through sex and intravenous drug use.\u003c/p>\n\u003cp>Opponents also point to the Vaccine Adverse Effects \u003ca href=\"https://vaers.hhs.gov/\">Registry\u003c/a> and the National Vaccine Injury Compensation \u003ca href=\"https://www.hrsa.gov/vaccine-compensation/index.html\">Program\u003c/a> as evidence that vaccination decisions should be left to physicians.\u003c/p>\n\u003ch3>\u003cstrong>5. So is this fight over now?\u003c/strong>\u003c/h3>\n\u003cp>Robert F. Kennedy Jr., a vocal opponent of the California law, said at a rally last week that his \u003ca href=\"https://childrenshealthdefense.org/news/americans-can-handle-an-open-discussion-on-vaccines-rfk-jr-responds-to-criticism-from-his-family/\">organization\u003c/a>, Children’s Health Defense, intends to sue the state to block the law. And a group of opponents this week began the process of trying to overturn the new law through a ballot measure that would go to voters next November.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "can-a-catholic-hospital-deny-a-hysterectomy-to-a-transgender-man-california-court-to-decide",
"title": "Can a Catholic Hospital Deny a Hysterectomy to a Transgender Man? California Court to Decide",
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"headTitle": "Can a Catholic Hospital Deny a Hysterectomy to a Transgender Man? California Court to Decide | KQED",
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"content": "\u003cp>It was two days before Evan Minton was scheduled to have a hysterectomy. The nurse from Mercy San Juan Medical Center near Sacramento called to go over the pre-op instructions. Minton told the nurse he’s transgender.\u003c/p>\n\u003cp>“I just let them know, ‘Hey, I go by he, him and his pronouns. Just wanted to give you a heads-up,’ ” Minton recalled explaining.\u003c/p>\n\u003cp>The next day, the hospital canceled the surgery.\u003c/p>\n\u003cp>“I was devastated,” said Minton. “Because it was based on who I am — and I had struggled for years and years and years to come to terms with who I am. It hit me to my core.”\u003c/p>\n\u003cp>Minton sued the hospital for discrimination.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Barry Landsberg, an attorney representing Dignity Health']‘This is not gender discrimination. This is religious observance.’[/pullquote]Dignity Health, the hospital chain that runs Mercy and 30 other hospitals in California, said in legal documents that performing the surgery conflicts with its Catholic directives, which prohibit elective sterilizations or the removal of a “healthy uterus.”\u003c/p>\n\u003cp>“A Catholic hospital cannot be Catholic if it violates its ethical and religious directives,” said Barry Landsberg, an attorney with Manatt, Phelps & Phillips representing Dignity Health, during a hearing before the state Court of Appeal in San Francisco on Tuesday.\u003c/p>\n\u003cp>In the end, there was no harm done, the hospital’s attorneys argued, because Minton got his 2016 surgery three days after his scheduled appointment at one of Dignity’s non-Catholic hospitals.\u003c/p>\n\u003cp>The lower court agreed, \u003ca href=\"https://www.aclunc.org/docs/2017.11.17_Order_Sustain_Demurrer_to_1st_Am_Complaint.pdf\" target=\"_blank\" rel=\"noopener\">ruling in favor\u003c/a> of the hospital.\u003c/p>\n\u003cp>But attorneys from the ACLU representing Minton say that decision was a mistake and appealed. They argued to the appellate justices that this case was different from a Catholic hospital’s religious objections to providing abortion, for example, because the hospital routinely performs hysterectomies on women.\u003c/p>\n\u003cp>Sending a trans man to a different hospital for the same care is just as illegal as requiring black people to sit in a different part of a theater or to drink from a separate water fountain, they argued.\u003c/p>\n\u003cp>“That kind of treatment, of ‘Well, we cannot treat you here, but we’ll treat you somewhere else,’ really undermines the purpose of full and equal access,” said Elizabeth Gill, senior staff attorney with the ACLU of Northern California, which is also representing \u003ca href=\"https://www.aclunc.org/news/aclu-sues-st-joseph-health-discrimination-against-transgender-patient\" target=\"_blank\" rel=\"noopener\">another trans man\u003c/a> who was denied a hysterectomy at St. Joseph’s Catholic hospital in Eureka.\u003c/p>\n\u003cp>In many rural parts of California, Gill said, the Catholic hospital is the only game in town — leaving trans people no alternatives for care.\u003c/p>\n\u003cp>“Although Dignity Health happens to have a non-Catholic hospital in Sacramento, it doesn’t in most parts of the state,” Gill said. “And certainly as entities like Dignity Health eat up a significantly greater share of our health care market, that’s going to be increasingly true.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Elizabeth Gill, ACLU of Northern California']‘That kind of treatment of, ‘Well, we cannot treat you here, but we’ll treat you somewhere else,’ really undermines the purpose of full and equal access.’[/pullquote]Dignity Health operates in 21 states and runs 31 hospitals in California. Earlier this year, the chain\u003ca href=\"https://www.modernhealthcare.com/article/20190201/NEWS/190209994/catholic-health-initiatives-dignity-health-combine-to-form-commonspirit-health\" target=\"_blank\" rel=\"noopener\"> joined forces\u003c/a> with Catholic Health Initiatives, making it the fifth-largest health system in the country, according to \u003ca href=\"https://www.dignityhealth.org/about-us\" target=\"_blank\" rel=\"noopener\">Dignity’s website\u003c/a>. It is one of a series of mergers and acquisitions among the state’s faith-based hospital chains in recent years.\u003c/p>\n\u003cp>This is why Minton’s attorneys argued over and over during the appeal hearing that the discrimination against him occurred the moment the hospital denied his surgery.\u003c/p>\n\u003cp>“Regardless of what happened after, that’s the problem,” Gill said.\u003c/p>\n\u003cp>Dignity Health’s lawyers used different terms for what happened.\u003c/p>\n\u003cp>“This is not gender discrimination. This is religious observance,” Landsberg told the justices. “This is about tolerance and respect for religion.”\u003c/p>\n\u003cp>The hospital is bound by Catholic directives on care, which obliges all Catholic hospitals “to preserve the functional integrity of the human body,” according to \u003ca href=\"https://www.aclunc.org/docs/2019.02.14_Respondent's_Brief.pdf\" target=\"_blank\" rel=\"noopener\">legal documents\u003c/a>.\u003c/p>\n\u003cp>Interpreting California’s civil rights law to require Mercy hospital “to perform medical procedures prohibited by Catholic doctrine would severely burden Catholic health care’s ability to express its message about human dignity,” Landsberg wrote in \u003ca href=\"https://www.aclunc.org/docs/2019.02.14_Respondent's_Brief.pdf\" target=\"_blank\" rel=\"noopener\">his brief\u003c/a> to the appellate court, and which he reiterated during oral argument.\u003c/p>\n\u003cp>[aside tag='transgender' label='More Coverage']The case was heard by a panel of three appeals court justices: Justice Tracie Brown, Justice Alison Tucher and Presiding Justice Stuart Pollak, all of whom repeatedly challenged Landsberg’s reasoning during the hearing. They sometimes borrowed the ACLU’s arguments to frame their questions.\u003c/p>\n\u003cp>They pointed out that Mercy routinely performed hysterectomies on women for chronic pelvic pain or uterine fibroids, and that Minton’s doctors ordered his hysterectomy as treatment for his gender dysphoria, which his attorneys described as a serious medical condition “inextricably intertwined with Minton’s gender identity.”\u003c/p>\n\u003cp>Three times, Justice Pollak asked Landsberg to confirm he was arguing that the hospital’s actions did not violate the state’s civil rights law. The third time Landsberg answered no, there was no violation, Pollak dropped his chin in his hand, furrowed his brow and rubbed his jawline.\u003c/p>\n\u003cp>“Your honor, I can see you’re rolling your eyes at me,” Landsberg said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Evan Minton, who says he was denied a hysterectomy because he is transgender']‘It’s so wrong for a hospital system to pick and choose who they provide care to, particularly for such a vulnerable and sensitive population.’[/pullquote]Attorneys for Minton say it’s impossible to predict anything about what the justices will decide, based on their questioning. The appeals court has 90 days to issue its ruling, either upholding the opinion in favor of the hospital or sending the case back to the trial court for further fact-finding.\u003c/p>\n\u003cp>But Minton, who lives in Sacramento, left the hearing hopeful and optimistic.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“It made me feel great, because from my lay person’s perspective, the judges could see that [Dignity] denies care to transgender people,” Minton said. “I think it’s so wrong for a hospital system to pick and choose who they provide care to, particularly for such a vulnerable and sensitive population.”\u003c/p>\n\n",
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"title": "Can a Catholic Hospital Deny a Hysterectomy to a Transgender Man? California Court to Decide | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was two days before Evan Minton was scheduled to have a hysterectomy. The nurse from Mercy San Juan Medical Center near Sacramento called to go over the pre-op instructions. Minton told the nurse he’s transgender.\u003c/p>\n\u003cp>“I just let them know, ‘Hey, I go by he, him and his pronouns. Just wanted to give you a heads-up,’ ” Minton recalled explaining.\u003c/p>\n\u003cp>The next day, the hospital canceled the surgery.\u003c/p>\n\u003cp>“I was devastated,” said Minton. “Because it was based on who I am — and I had struggled for years and years and years to come to terms with who I am. It hit me to my core.”\u003c/p>\n\u003cp>Minton sued the hospital for discrimination.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Dignity Health, the hospital chain that runs Mercy and 30 other hospitals in California, said in legal documents that performing the surgery conflicts with its Catholic directives, which prohibit elective sterilizations or the removal of a “healthy uterus.”\u003c/p>\n\u003cp>“A Catholic hospital cannot be Catholic if it violates its ethical and religious directives,” said Barry Landsberg, an attorney with Manatt, Phelps & Phillips representing Dignity Health, during a hearing before the state Court of Appeal in San Francisco on Tuesday.\u003c/p>\n\u003cp>In the end, there was no harm done, the hospital’s attorneys argued, because Minton got his 2016 surgery three days after his scheduled appointment at one of Dignity’s non-Catholic hospitals.\u003c/p>\n\u003cp>The lower court agreed, \u003ca href=\"https://www.aclunc.org/docs/2017.11.17_Order_Sustain_Demurrer_to_1st_Am_Complaint.pdf\" target=\"_blank\" rel=\"noopener\">ruling in favor\u003c/a> of the hospital.\u003c/p>\n\u003cp>But attorneys from the ACLU representing Minton say that decision was a mistake and appealed. They argued to the appellate justices that this case was different from a Catholic hospital’s religious objections to providing abortion, for example, because the hospital routinely performs hysterectomies on women.\u003c/p>\n\u003cp>Sending a trans man to a different hospital for the same care is just as illegal as requiring black people to sit in a different part of a theater or to drink from a separate water fountain, they argued.\u003c/p>\n\u003cp>“That kind of treatment, of ‘Well, we cannot treat you here, but we’ll treat you somewhere else,’ really undermines the purpose of full and equal access,” said Elizabeth Gill, senior staff attorney with the ACLU of Northern California, which is also representing \u003ca href=\"https://www.aclunc.org/news/aclu-sues-st-joseph-health-discrimination-against-transgender-patient\" target=\"_blank\" rel=\"noopener\">another trans man\u003c/a> who was denied a hysterectomy at St. Joseph’s Catholic hospital in Eureka.\u003c/p>\n\u003cp>In many rural parts of California, Gill said, the Catholic hospital is the only game in town — leaving trans people no alternatives for care.\u003c/p>\n\u003cp>“Although Dignity Health happens to have a non-Catholic hospital in Sacramento, it doesn’t in most parts of the state,” Gill said. “And certainly as entities like Dignity Health eat up a significantly greater share of our health care market, that’s going to be increasingly true.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Dignity Health operates in 21 states and runs 31 hospitals in California. Earlier this year, the chain\u003ca href=\"https://www.modernhealthcare.com/article/20190201/NEWS/190209994/catholic-health-initiatives-dignity-health-combine-to-form-commonspirit-health\" target=\"_blank\" rel=\"noopener\"> joined forces\u003c/a> with Catholic Health Initiatives, making it the fifth-largest health system in the country, according to \u003ca href=\"https://www.dignityhealth.org/about-us\" target=\"_blank\" rel=\"noopener\">Dignity’s website\u003c/a>. It is one of a series of mergers and acquisitions among the state’s faith-based hospital chains in recent years.\u003c/p>\n\u003cp>This is why Minton’s attorneys argued over and over during the appeal hearing that the discrimination against him occurred the moment the hospital denied his surgery.\u003c/p>\n\u003cp>“Regardless of what happened after, that’s the problem,” Gill said.\u003c/p>\n\u003cp>Dignity Health’s lawyers used different terms for what happened.\u003c/p>\n\u003cp>“This is not gender discrimination. This is religious observance,” Landsberg told the justices. “This is about tolerance and respect for religion.”\u003c/p>\n\u003cp>The hospital is bound by Catholic directives on care, which obliges all Catholic hospitals “to preserve the functional integrity of the human body,” according to \u003ca href=\"https://www.aclunc.org/docs/2019.02.14_Respondent's_Brief.pdf\" target=\"_blank\" rel=\"noopener\">legal documents\u003c/a>.\u003c/p>\n\u003cp>Interpreting California’s civil rights law to require Mercy hospital “to perform medical procedures prohibited by Catholic doctrine would severely burden Catholic health care’s ability to express its message about human dignity,” Landsberg wrote in \u003ca href=\"https://www.aclunc.org/docs/2019.02.14_Respondent's_Brief.pdf\" target=\"_blank\" rel=\"noopener\">his brief\u003c/a> to the appellate court, and which he reiterated during oral argument.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The case was heard by a panel of three appeals court justices: Justice Tracie Brown, Justice Alison Tucher and Presiding Justice Stuart Pollak, all of whom repeatedly challenged Landsberg’s reasoning during the hearing. They sometimes borrowed the ACLU’s arguments to frame their questions.\u003c/p>\n\u003cp>They pointed out that Mercy routinely performed hysterectomies on women for chronic pelvic pain or uterine fibroids, and that Minton’s doctors ordered his hysterectomy as treatment for his gender dysphoria, which his attorneys described as a serious medical condition “inextricably intertwined with Minton’s gender identity.”\u003c/p>\n\u003cp>Three times, Justice Pollak asked Landsberg to confirm he was arguing that the hospital’s actions did not violate the state’s civil rights law. The third time Landsberg answered no, there was no violation, Pollak dropped his chin in his hand, furrowed his brow and rubbed his jawline.\u003c/p>\n\u003cp>“Your honor, I can see you’re rolling your eyes at me,” Landsberg said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Attorneys for Minton say it’s impossible to predict anything about what the justices will decide, based on their questioning. The appeals court has 90 days to issue its ruling, either upholding the opinion in favor of the hospital or sending the case back to the trial court for further fact-finding.\u003c/p>\n\u003cp>But Minton, who lives in Sacramento, left the hearing hopeful and optimistic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cstrong>Updated on Friday at 8:15 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention said Friday that the number of possible cases of severe respiratory illnesses among people who vaped nicotine or cannabis-related products has more than doubled, to 450 in 33 states.\u003c/p>\n\u003cp>“Although more investigation is needed to determine the vaping agent or agents responsible, there is clearly an epidemic that begs for an urgent response,” David Christiani of the Harvard T.H. Chan School of Public Health writes in an \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMe1912032\" target=\"_blank\" rel=\"noopener\">editorial \u003c/a>published Friday in \u003cem>The New England Journal of Medicine\u003c/em>.\u003c/p>\n\u003cp>In a media briefing Friday, the CDC suggested people should avoid using e-cigarettes.\u003c/p>\n\u003cp>“While this investigation is ongoing, people should consider not using e-cigarette products,” says Dr. Dana Meaney-Delman, incident manager of the CDC’s response to the vaping-related lung injuries.\u003c/p>\n\u003cp>“People who do use e-cigarette products should monitor themselves for symptoms, for example, cough, shortness of breath, chest pain, nausea and vomiting — and promptly seek medical attention for any health concerns.”\u003c/p>\n\u003cp>Late last month, the CDC said the number of reported vaping-related cases stood at 215. Five people have died — in Illinois, Oregon, Indiana, Minnesota and California.\u003c/p>\n\u003cp>[aside tag='vaping' label='More Coverage.']\u003c/p>\n\u003cp>Many, though not all, of the patients who have fallen ill had used cannabis-derived vaping products, and some also used nicotine-containing products. A smaller group reported using nicotine only.\u003c/p>\n\u003cp>No infectious causes have been identified, and the CDC told reporters that the “lung illnesses are likely associated with a chemical exposure.” But it is too early to pinpoint a single product or substance that is common to all cases, the CDC said, based on \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1911614?query=recirc_curatedRelated_article\" target=\"_blank\" rel=\"noopener\">preliminary research\u003c/a> also published Friday.\u003c/p>\n\u003cp>In those studies, officials in Illinois and Wisconsin detailed 53 cases they’ve investigated, 28 in Wisconsin and 25 in Illinois. They described the vaping history of 41 patients where complete information was available.\u003c/p>\n\u003cp>About 80% of those patients had used products containing THC, the active ingredient in marijuana, and 61% used nicotine products. Some 7% used cannabidiol, or CBD, products.\u003c/p>\n\u003cp>Most of the patients were male, with an average age of 19, and all were previously healthy. They were sick for several days prior to being hospitalized, with respiratory symptoms being most common, followed by fever, fatigue, weight loss and gastrointestinal symptoms.\u003c/p>\n\u003cp>In some of these cases, officials said, patients either used only THC products or only nicotine. Patients reported using 14 different brands of THC products and 13 brands of nicotine products in a wide range of flavors. It’s possible patients did not accurately report which kinds of products they had vaped.\u003c/p>\n\u003cp>It is because no single product or substance has been definitively tied to the respiratory illnesses, the CDC said, that people should consider not using e-cigarettes, particularly those purchased from sources other than authorized retailers, such as dispensaries in states where the drug is legal.\u003c/p>\n\u003cp>Adult smokers who vape nicotine in order to quit smoking should consult with their health care provider and use proven treatments, the CDC says, not e-cigarettes.\u003c/p>\n\u003cp>On Thursday, New York state health officials said lab tests found vitamin E acetate in a number of cannabis-containing vaping cartridges submitted by people who fell ill and that it is now a “key focus” of their investigation.\u003c/p>\n\u003cp>Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in Friday’s briefing that the agency now had 120 samples of e-cigarettes available for testing and that “no one substance or compound, including vitamin E acetate, has been identified in all the samples tested.”\u003c/p>\n\u003cp>Zeller said the FDA is \u003ca href=\"https://www.prnewswire.com/news-releases/vaping-illnesses-consumers-can-help-protect-themselves-by-avoiding-tetrahydrocannabinol-thc-containing-vaping-products-300913542.html\" target=\"_blank\" rel=\"noopener\">analyzing samples\u003c/a> for a broad range of substances, including nicotine, THC and other cannabinoids, along with cutting agents, diluents, additives, pesticides, opioids, poisons and toxins.\u003c/p>\n\u003cp>“With these increasing reports,” Zeller said, “if you’re thinking of purchasing one of these products off the street, out of the back of a car, out of a trunk, in an alley — or if you are then going to go home and make modifications to the product yourself using something that you purchased from some third party or got from a friend — think twice.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit\u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\"> www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CDC+Says+Number+Of+Possible+Cases+Of+Vaping-Related+Lung+Illness+Has+Doubled&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>[ad fullwidth]\u003c/div>\n\u003cp>\u003c/p>\n",
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"excerpt": "The CDC says it's probing 450 reported cases of illness in people who vaped nicotine or cannabis products. Health officials say it's too soon to pinpoint a single product or substance as the cause.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated on Friday at 8:15 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention said Friday that the number of possible cases of severe respiratory illnesses among people who vaped nicotine or cannabis-related products has more than doubled, to 450 in 33 states.\u003c/p>\n\u003cp>“Although more investigation is needed to determine the vaping agent or agents responsible, there is clearly an epidemic that begs for an urgent response,” David Christiani of the Harvard T.H. Chan School of Public Health writes in an \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMe1912032\" target=\"_blank\" rel=\"noopener\">editorial \u003c/a>published Friday in \u003cem>The New England Journal of Medicine\u003c/em>.\u003c/p>\n\u003cp>In a media briefing Friday, the CDC suggested people should avoid using e-cigarettes.\u003c/p>\n\u003cp>“While this investigation is ongoing, people should consider not using e-cigarette products,” says Dr. Dana Meaney-Delman, incident manager of the CDC’s response to the vaping-related lung injuries.\u003c/p>\n\u003cp>“People who do use e-cigarette products should monitor themselves for symptoms, for example, cough, shortness of breath, chest pain, nausea and vomiting — and promptly seek medical attention for any health concerns.”\u003c/p>\n\u003cp>Late last month, the CDC said the number of reported vaping-related cases stood at 215. Five people have died — in Illinois, Oregon, Indiana, Minnesota and California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many, though not all, of the patients who have fallen ill had used cannabis-derived vaping products, and some also used nicotine-containing products. A smaller group reported using nicotine only.\u003c/p>\n\u003cp>No infectious causes have been identified, and the CDC told reporters that the “lung illnesses are likely associated with a chemical exposure.” But it is too early to pinpoint a single product or substance that is common to all cases, the CDC said, based on \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1911614?query=recirc_curatedRelated_article\" target=\"_blank\" rel=\"noopener\">preliminary research\u003c/a> also published Friday.\u003c/p>\n\u003cp>In those studies, officials in Illinois and Wisconsin detailed 53 cases they’ve investigated, 28 in Wisconsin and 25 in Illinois. They described the vaping history of 41 patients where complete information was available.\u003c/p>\n\u003cp>About 80% of those patients had used products containing THC, the active ingredient in marijuana, and 61% used nicotine products. Some 7% used cannabidiol, or CBD, products.\u003c/p>\n\u003cp>Most of the patients were male, with an average age of 19, and all were previously healthy. They were sick for several days prior to being hospitalized, with respiratory symptoms being most common, followed by fever, fatigue, weight loss and gastrointestinal symptoms.\u003c/p>\n\u003cp>In some of these cases, officials said, patients either used only THC products or only nicotine. Patients reported using 14 different brands of THC products and 13 brands of nicotine products in a wide range of flavors. It’s possible patients did not accurately report which kinds of products they had vaped.\u003c/p>\n\u003cp>It is because no single product or substance has been definitively tied to the respiratory illnesses, the CDC said, that people should consider not using e-cigarettes, particularly those purchased from sources other than authorized retailers, such as dispensaries in states where the drug is legal.\u003c/p>\n\u003cp>Adult smokers who vape nicotine in order to quit smoking should consult with their health care provider and use proven treatments, the CDC says, not e-cigarettes.\u003c/p>\n\u003cp>On Thursday, New York state health officials said lab tests found vitamin E acetate in a number of cannabis-containing vaping cartridges submitted by people who fell ill and that it is now a “key focus” of their investigation.\u003c/p>\n\u003cp>Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in Friday’s briefing that the agency now had 120 samples of e-cigarettes available for testing and that “no one substance or compound, including vitamin E acetate, has been identified in all the samples tested.”\u003c/p>\n\u003cp>Zeller said the FDA is \u003ca href=\"https://www.prnewswire.com/news-releases/vaping-illnesses-consumers-can-help-protect-themselves-by-avoiding-tetrahydrocannabinol-thc-containing-vaping-products-300913542.html\" target=\"_blank\" rel=\"noopener\">analyzing samples\u003c/a> for a broad range of substances, including nicotine, THC and other cannabinoids, along with cutting agents, diluents, additives, pesticides, opioids, poisons and toxins.\u003c/p>\n\u003cp>“With these increasing reports,” Zeller said, “if you’re thinking of purchasing one of these products off the street, out of the back of a car, out of a trunk, in an alley — or if you are then going to go home and make modifications to the product yourself using something that you purchased from some third party or got from a friend — think twice.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit\u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\"> www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CDC+Says+Number+Of+Possible+Cases+Of+Vaping-Related+Lung+Illness+Has+Doubled&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>\u003c/p>\u003c/div>",
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"content": "\u003cp>The author of a \u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\" target=\"_blank\" rel=\"noopener\">hot-button state bill\u003c/a> limiting medical exemptions for vaccinations on Friday accepted Gov. Gavin Newsom’s last-minute demand for additional changes, setting up a final series of votes before lawmakers adjourn for the year next week.\u003c/p>\n\u003cp>Democratic state Sen. Richard Pan of Sacramento amended a companion bill to reflect the governor’s wishes, days after lawmakers sent Newsom a bill cracking down on doctors who sell fraudulent medical exemptions.\u003c/p>\n\u003cp>Pan said in a statement he appreciates Newsom’s commitment to sign the bill and the amendments, which he says will “ensure we maintain the community immunity needed to protect our kids.”\u003c/p>\n\u003cp>The amendments would give school children grace periods that could last several years on existing medical exemptions. For instance, a kindergartener with an exemption could retain it through 6th grade, while a 7th grader could be exempted through high school.\u003c/p>\n\u003cp>[aside postID=\"news_11743713\" label=\"History of Anti-Vax\"]\u003c/p>\n\u003cp>That is similar to the phase-out period allowed when California eliminated personal belief vaccine exemptions in 2015, officials said.\u003c/p>\n\u003cp>Another new provision could revoke any medical exemptions written by Robert Sears, a Southern California doctor who has been disciplined by the Medical Board of California for writing an improper vaccine exemption.\u003c/p>\n\u003cp>The provision would apply to exemptions written by any doctor who has faced disciplinary action, but at this time Sears is the only California doctor to be disciplined regarding vaccine exemptions, said Carlos Villatoro, a medical board spokesman.\u003c/p>\n\u003cp>Sears told The Los Angeles Times it would result in hundreds of his patients losing their exemptions.\u003c/p>\n\u003cp>“This seems like a broad overreach from a government that is supposed to protect its medically fragile children,” he said.\u003c/p>\n\u003cp>Other changes would make it clear that enforcement will start next year, meaning doctors who previously granted a high number of medical exemptions won’t face scrutiny.\u003c/p>\n\u003cp>They also would remove a requirement that doctors swear under penalty of perjury that they are not charging fees to fill out medical exemption forms. And one change would ensure that an expert panel reviewing appeals of exemption denials could consider additional information from the doctor beyond the exemption form.\u003c/p>\n\u003cp>Newsom spokesman Nathan Click said the governor would sign the bill once the new amendments have also won legislative approval.\u003c/p>\n\u003cp>“These amendments clarify legal and administrative processes in SB276 in order to ensure medical providers, parents, school administrators and public health officials know the rules of the road once it takes effect,” Click said in a statement, referencing the bill number.\u003c/p>\n\u003cp>Newsom’s 11th-hour demands had roiled the Legislature and frustrated the bill’s supporters, all of whom were caught by surprise when he announced them in a tweet this week.\u003c/p>\n\u003cp>https://twitter.com/CAgovernor/status/1169027421930184705\u003c/p>\n\u003cp>It prompted several newspapers across California to editorially question the freshman governor’s commitment to limiting vaccine exemptions during a year of record measles outbreaks.\u003c/p>\n\u003cp>Senate President Pro Tem Toni Atkins, a fellow Democrat from San Diego, said both chambers plan to vote on the companion bill on Monday, with the understanding that Newsom would then sign the original measure.\u003c/p>\n\u003cp>[aside tag=\"childhood-vaccinations\" label=\"Related Stories\"]\u003c/p>\n\u003cp>Signing the bill would also counter opponents who have threatened and harassed Pan and other lawmakers over the pending legislation, she said: “It is important that we send the message that loud and violent will not drown out reason and science in how we govern California.”\u003c/p>\n\u003cp>The last-minute amendments are unlikely to mollify opponents who have swarmed the Capitol and had hoped Newsom might veto the bill, given his insistence on significant changes in June and again this week.\u003c/p>\n\u003cp>But the compromise pleased the bill’s supporters.\u003c/p>\n\u003cp>American Academy of Pediatrics, California, chief executive Kris Calvin and Vaccinate California executive director Leah Russin both praised Newsom and Pan for working out their differences.\u003c/p>\n\u003cp>Russin called the agreement “a victory for science over fear and for sound public health policy over conspiracy and misinformation,” while also urging Newsom to immediately sign the bill already on his desk.\u003c/p>\n\u003cp>Calvin said her group supports the amendments if it means both bills become law.\u003c/p>\n\u003cp>“We are perfectly satisfied that this bill will satisfy its objective of making sure that bogus medical exemptions are uncovered … while protecting valid medical exemptions,” Calvin said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The author of a \u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\" target=\"_blank\" rel=\"noopener\">hot-button state bill\u003c/a> limiting medical exemptions for vaccinations on Friday accepted Gov. Gavin Newsom’s last-minute demand for additional changes, setting up a final series of votes before lawmakers adjourn for the year next week.\u003c/p>\n\u003cp>Democratic state Sen. Richard Pan of Sacramento amended a companion bill to reflect the governor’s wishes, days after lawmakers sent Newsom a bill cracking down on doctors who sell fraudulent medical exemptions.\u003c/p>\n\u003cp>Pan said in a statement he appreciates Newsom’s commitment to sign the bill and the amendments, which he says will “ensure we maintain the community immunity needed to protect our kids.”\u003c/p>\n\u003cp>The amendments would give school children grace periods that could last several years on existing medical exemptions. For instance, a kindergartener with an exemption could retain it through 6th grade, while a 7th grader could be exempted through high school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That is similar to the phase-out period allowed when California eliminated personal belief vaccine exemptions in 2015, officials said.\u003c/p>\n\u003cp>Another new provision could revoke any medical exemptions written by Robert Sears, a Southern California doctor who has been disciplined by the Medical Board of California for writing an improper vaccine exemption.\u003c/p>\n\u003cp>The provision would apply to exemptions written by any doctor who has faced disciplinary action, but at this time Sears is the only California doctor to be disciplined regarding vaccine exemptions, said Carlos Villatoro, a medical board spokesman.\u003c/p>\n\u003cp>Sears told The Los Angeles Times it would result in hundreds of his patients losing their exemptions.\u003c/p>\n\u003cp>“This seems like a broad overreach from a government that is supposed to protect its medically fragile children,” he said.\u003c/p>\n\u003cp>Other changes would make it clear that enforcement will start next year, meaning doctors who previously granted a high number of medical exemptions won’t face scrutiny.\u003c/p>\n\u003cp>They also would remove a requirement that doctors swear under penalty of perjury that they are not charging fees to fill out medical exemption forms. And one change would ensure that an expert panel reviewing appeals of exemption denials could consider additional information from the doctor beyond the exemption form.\u003c/p>\n\u003cp>Newsom spokesman Nathan Click said the governor would sign the bill once the new amendments have also won legislative approval.\u003c/p>\n\u003cp>“These amendments clarify legal and administrative processes in SB276 in order to ensure medical providers, parents, school administrators and public health officials know the rules of the road once it takes effect,” Click said in a statement, referencing the bill number.\u003c/p>\n\u003cp>Newsom’s 11th-hour demands had roiled the Legislature and frustrated the bill’s supporters, all of whom were caught by surprise when he announced them in a tweet this week.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>It prompted several newspapers across California to editorially question the freshman governor’s commitment to limiting vaccine exemptions during a year of record measles outbreaks.\u003c/p>\n\u003cp>Senate President Pro Tem Toni Atkins, a fellow Democrat from San Diego, said both chambers plan to vote on the companion bill on Monday, with the understanding that Newsom would then sign the original measure.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Signing the bill would also counter opponents who have threatened and harassed Pan and other lawmakers over the pending legislation, she said: “It is important that we send the message that loud and violent will not drown out reason and science in how we govern California.”\u003c/p>\n\u003cp>The last-minute amendments are unlikely to mollify opponents who have swarmed the Capitol and had hoped Newsom might veto the bill, given his insistence on significant changes in June and again this week.\u003c/p>\n\u003cp>But the compromise pleased the bill’s supporters.\u003c/p>\n\u003cp>American Academy of Pediatrics, California, chief executive Kris Calvin and Vaccinate California executive director Leah Russin both praised Newsom and Pan for working out their differences.\u003c/p>\n\u003cp>Russin called the agreement “a victory for science over fear and for sound public health policy over conspiracy and misinformation,” while also urging Newsom to immediately sign the bill already on his desk.\u003c/p>\n\u003cp>Calvin said her group supports the amendments if it means both bills become law.\u003c/p>\n\u003cp>“We are perfectly satisfied that this bill will satisfy its objective of making sure that bogus medical exemptions are uncovered … while protecting valid medical exemptions,” Calvin said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>San Francisco Mayor London Breed on Wednesday announced a new long-term plan to help get more homeless people suffering from mental illness and substance abuse off the streets and into treatment programs.\u003c/p>\n\u003cp>The initiative aims to provide lasting care for the nearly 4,000 people on the streets that public health officials have identified as having the highest level of service needs, Breed said, calling it a necessary alternative to simply cycling that population in and out of city jails and emergency rooms.\u003c/p>\n\u003cp>The care would come through a multi-agency pilot program that would streamline housing and health care and increase access to behavioral health services by expanding hours at the city’s Behavioral Health Access Center.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation=\"S.F. Mayor London Breed\"]‘What I see is something I’ve never seen in my lifetime of growing up in the city, and that is people who are in serious, serious crisis.’[/pullquote]\u003c/p>\n\u003cp>Breed, a lifelong San Franciscan, said she was acutely aware of the harrowing scenes on the city’s streets.\u003c/p>\n\u003cp>“We know that there’s a mental health crisis here in San Francisco,” Breed said during Wednesday’s news conference at South of Market Mental Health Services on Harrison Street. “What I see is something I’ve never seen in my lifetime of growing up in the city, and that is people who are in serious, serious crisis. And the fact is, that in San Francisco, the frustration is that we have a lot of resources, we have a lot of dedicated revenues to help support people, but we have discovered that the coordination has to be better, it has to be more efficient.”\u003c/p>\n\u003cp>The first stage of the pilot will target a select group of 230 — out of 4,000 — of the most vulnerable homeless individuals, who will receive immediate care and be placed in permanent supportive housing, Breed said.\u003c/p>\n\u003cp>The initiative is largely centered on data gathered by the city’s Department of Public Health, according to Dr. Anton Nigusse Bland, San Francisco’s newly hired Director of Mental Health Reform.\u003c/p>\n\u003cp>“We looked very closely at who used San Francisco’s social and health care services in the most recent fiscal year,” he said. “Out of nearly 18,000 people experiencing homeless, we found that close to 4,000 of them also have both a history of serious mental illness and of substance abuse disorder.”\u003c/p>\n\u003cp>Bland acknowledged the challenge of getting many of those most in need of treatment to participate voluntarily, but said the new program would be “relentless” in pursuing them and offering help. On average, it takes about four months of contact before individuals in this high-need population accept help, he noted.\u003c/p>\n\u003cp>[aside label=\"Related stories\" tag=\"homelessness\"]\u003c/p>\n\u003cp>“We’re going to do whatever it takes to reach these people, to engage them into services and to make sure they can achieve stability and wellness,” he said.\u003c/p>\n\u003cp>Some city leaders, however, say the plan falls far short of fulfilling the massive need on the street.\u003c/p>\n\u003cp>“I unfortunately wish the Department of Public Health would begin to react to the scale of the problem instead of nibbling around the edges,” said Supervisor Hillary Ronen, who has advocated for extending these services to everyone who needs them.\u003c/p>\n\u003cp>Ronen is pushing for an overhaul of the city’s mental health system with a measure slated for the March 2020 ballot. Dubbed “Mental Health SF,” the program, if approved by voters, would provide free and immediate access to mental health care to San Francisco residents, regardless of insurance. It would also require the creation of a new round-the-clock drop-in center for people seeking help with mental health or substance abuse issues.\u003c/p>\n\u003cp>Yolanda Morrissette, a recovering drug addict who was able to overcome her struggles thanks to city services and programs, said that she hopes to serve as an example of someone who can turn her life around despite suffering from mental health and addiction issues.\u003c/p>\n\u003cp>“They were able to help me get on medication. They were able to get me therapy to get to the root of the problem,” she said. “I had a lot of anger issues, depression, suicidal thoughts.”\u003c/p>\n\u003cp>Morrissette said she now lives in a one-bedroom apartment and works full-time as a mental health advocate.\u003c/p>\n\u003cp>“I just slowly said I was going to build myself up,” she said.\u003c/p>\n\u003cp>\u003cem>Additional reporting was provided by Bay City News.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco Mayor London Breed on Wednesday announced a new long-term plan to help get more homeless people suffering from mental illness and substance abuse off the streets and into treatment programs.\u003c/p>\n\u003cp>The initiative aims to provide lasting care for the nearly 4,000 people on the streets that public health officials have identified as having the highest level of service needs, Breed said, calling it a necessary alternative to simply cycling that population in and out of city jails and emergency rooms.\u003c/p>\n\u003cp>The care would come through a multi-agency pilot program that would streamline housing and health care and increase access to behavioral health services by expanding hours at the city’s Behavioral Health Access Center.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re going to do whatever it takes to reach these people, to engage them into services and to make sure they can achieve stability and wellness,” he said.\u003c/p>\n\u003cp>Some city leaders, however, say the plan falls far short of fulfilling the massive need on the street.\u003c/p>\n\u003cp>“I unfortunately wish the Department of Public Health would begin to react to the scale of the problem instead of nibbling around the edges,” said Supervisor Hillary Ronen, who has advocated for extending these services to everyone who needs them.\u003c/p>\n\u003cp>Ronen is pushing for an overhaul of the city’s mental health system with a measure slated for the March 2020 ballot. Dubbed “Mental Health SF,” the program, if approved by voters, would provide free and immediate access to mental health care to San Francisco residents, regardless of insurance. It would also require the creation of a new round-the-clock drop-in center for people seeking help with mental health or substance abuse issues.\u003c/p>\n\u003cp>Yolanda Morrissette, a recovering drug addict who was able to overcome her struggles thanks to city services and programs, said that she hopes to serve as an example of someone who can turn her life around despite suffering from mental health and addiction issues.\u003c/p>\n\u003cp>“They were able to help me get on medication. They were able to get me therapy to get to the root of the problem,” she said. “I had a lot of anger issues, depression, suicidal thoughts.”\u003c/p>\n\u003cp>Morrissette said she now lives in a one-bedroom apartment and works full-time as a mental health advocate.\u003c/p>\n\u003cp>“I just slowly said I was going to build myself up,” she said.\u003c/p>\n\u003cp>\u003cem>Additional reporting was provided by Bay City News.\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": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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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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"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": {
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"reveal": {
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},
"rightnowish": {
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"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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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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