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"content": "\u003cp>About 1,000 health care workers protested in Oakland Monday to show Kaiser Permanente they’re serious about a potential strike in October, after negotiations for a new contract stalled.\u003c/p>\n\u003cp>Kaiser Permanente employees and their families rallied at Mosswood Park in Oakland and then marched to Kaiser’s Oakland Medical Center. The streets surrounding the hospital, at West MacArthur Boulevard and Broadway, shut down as protesters peacefully blocked traffic.\u003c/p>\n\u003cp>Employees represented by the Coalition of Kaiser Permanente Unions have been without a contract since September of last year. They said Kaiser is not bargaining fairly with them and is outsourcing jobs that would otherwise go to union members.\u003c/p>\n\u003cp>This impacts patient care, union members said. Sonya Allen-Smith is a radiology technician at the hospital. She has worked for Kaiser for 10 years and says things have changed recently.\u003c/p>\n\u003cp>“We see the change in higher patient wait times in the hospital, less time that we can give to patients at times,” she said.\u003c/p>\n\u003cp>https://twitter.com/lauraklivans/status/1168575047180541957\u003c/p>\n\u003cp>Wearing a SEIU-United Healthcare Workers West T-shirt, Union President Dave Regan told the crowd during the rally that the workers’ fight is simple.\u003c/p>\n\u003cp>“Are you with the workers? Are you with the people? Are you with the community? Are you with the caregivers? Or are you with the millionaires?” Regan said.\u003c/p>\n\u003cp>https://twitter.com/lauraklivans/status/1168574674369859585\u003c/p>\n\u003cp>Edmund Chan, Kaiser Permanente’s senior vice president, said the health care organization is also committed to patient care and working with unions.\u003c/p>\n\u003cp>“Our latest proposal is creating competitive wages and we are maintaining strong benefits for our employees,” said Chan. “We’ve put across-the-table guaranteed wage increases over the life of the next contract through 2022.”\u003c/p>\n\u003cp>https://twitter.com/lauraklivans/status/1168585228983492609\u003c/p>\n\u003cp>The unions and representatives from Kaiser Permanente will sit down again to bargain on Sept. 16. If no agreement is reached, the Coalition of Kaiser Permanente Unions said they will strike at the start of October.\u003c/p>\n\u003cp>Employees say Kaiser has been increasing its use of outsourcing. Allen-Smith, the radiology technician, said that impacts local communities.\u003c/p>\n\u003cp>“Right now people can’t even afford to live in the Bay Area,” said Allen-Smith. “So now we talking outsourcing jobs — where are these people gonna come from? Are they gonna work two or three jobs? Are they commuting from a larger distance to take care of our members? It’s not right.”\u003c/p>\n\u003cp>The unions said Kaiser made more than $5 billion in profits in the last two quarters. Among the workers, there’s a feeling that Kaiser Permanente, which is a nonprofit, has gone astray and is too focused on profit.\u003c/p>\n\u003cp>Chan called Monday’s protest a “publicity stunt.”\u003c/p>\n\u003cp>“It’s unfortunate that today’s being used by some of our unions to stage a planned civil disobedience, and quite frankly a publicity stunt, that’s taking away city and police resources,” he said. “We remain committed to meeting and being at the bargaining table to create a contract for our employees that makes sense for all parties.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Supreme Court Justice Sonia Sotomayor was diagnosed with Type 1 diabetes early in life, and ever since has given herself insulin shots before she eats, to help manage her blood sugar levels. No big deal. But some years ago, she had an upsetting experience at a restaurant.\u003c/p>\n\u003cp>She was in the restaurant bathroom, just finishing up her injection when another woman walked in. They both returned to their dinners, but as Sotomayor left the restaurant, she heard the woman from the restroom say: “She’s a drug addict.”\u003c/p>\n\u003cp>Sotomayor stopped, turned around, and said: “Madam, I am not a drug addict. I am diabetic, and that injection you saw me give to myself is insulin. It’s the medicine that keeps me alive. If you don’t know why someone’s doing something, just ask them. Don’t assume the worst in people.”\u003c/p>\n\u003cp>And walked away.\u003c/p>\n\u003cp>The justice has replayed that scene in her mind many times over the years, and it ultimately led her to write the children’s book \u003ca href=\"https://www.npr.org/books/titles/755853270/just-ask-be-different-be-brave-be-you\" target=\"_blank\" rel=\"noopener\">Just Ask! Be Different, Be Brave, Be You.\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I wanted to talk about children like me,” Sotomayor says.\u003c/p>\n\u003cp>\u003cem>Just Ask! \u003c/em>is about 12 young people working together to plant a garden. “Each of us is doing what we do best …” Sotomayor explains. “Each child is doing something to contribute to the garden, despite how they’re differently able.”\u003c/p>\n\u003cp>The book is illustrated by Rafael López. Sotomayor says she was drawn to his work because of his use of bold, vivid colors. “Coming from Mexico, I grew up surrounded by color,” López says. “Whether you’re in the market, or you were in the fields, or you were just walking around … You can see the buildings of Mexico that are painted so brightly.”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-11771703\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/soto-800x488.jpg\" alt=\"\" width=\"800\" height=\"488\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/soto.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/soto-160x98.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>To him, bright colors represent emotion and diversity. “The whole idea is that you’re bringing this explosion of color … this explosion of diversity that we ideally would like to have in a community,” López explains.\u003c/p>\n\u003cp>Sotomayor says that the concept of the garden was important to her as she wrote the book. “Just the way gardens have different plants, and different trees, and different kinds of flowers, and different birds and animals that populate the garden, we in our society have different kinds of people, too, doing different kinds of things,” she says.\u003c/p>\n\u003cp>One of Sotomayor’s favorite scenes in the book shows a young girl named Julia winking at an owl. Julia has Tourette syndrome. “Sometimes I wiggle or make sounds that I can’t control,” Julia says in the book. López says this illustration was one of the most challenging for him to draw, but “there was this sweetness about this animal, this owl, connecting emotionally to Julia.”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-11771704\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85-800x488.jpg\" alt=\"\" width=\"800\" height=\"488\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85-160x98.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>López says one of the reasons that he connected to Sotomayor’s children’s story is because his son, Santiago, has autism. “He has taught me so much,” López says. “He’s made me a more patient person … he has made me a better listener, a more understanding person.”\u003c/p>\n\u003cp>There are two children with autism in the book — and Sotomayor says it’s important that they are depicted in very different ways: Jordon loves to talk about dinosaurs. But Tiana prefers not to talk. “Conditions vary,” Sotomayor says. “Their presentations are never identical.”\u003c/p>\n\u003cp>López says he hopes his son Santiago and other children will recognize themselves in these characters. Though they’ll all come away with different lessons, if these young readers feel empowered, “I think we did our job,” López says.\u003c/p>\n\u003cp>Sotomayor says the takeaway of the book is that differences are not bad. “I want every child to understand that whatever condition they bear in life, they are special in a good way,” she says.\u003c/p>\n\u003cp>“You can learn so much by getting to know someone that perhaps does things a little bit different than you,” López adds. “Be patient and be curious … and don’t be afraid to ask.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Samantha Balaban and Evie Stone produced and edited this interview for broadcast. Beth Novey adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">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=%27Just+Ask%21%27+Says+Sonia+Sotomayor.+She+Knows+What+It%27s+Like+To+Feel+Different&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I wanted to talk about children like me,” Sotomayor says.\u003c/p>\n\u003cp>\u003cem>Just Ask! \u003c/em>is about 12 young people working together to plant a garden. “Each of us is doing what we do best …” Sotomayor explains. “Each child is doing something to contribute to the garden, despite how they’re differently able.”\u003c/p>\n\u003cp>The book is illustrated by Rafael López. Sotomayor says she was drawn to his work because of his use of bold, vivid colors. “Coming from Mexico, I grew up surrounded by color,” López says. “Whether you’re in the market, or you were in the fields, or you were just walking around … You can see the buildings of Mexico that are painted so brightly.”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-11771703\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/soto-800x488.jpg\" alt=\"\" width=\"800\" height=\"488\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/soto.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/soto-160x98.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>To him, bright colors represent emotion and diversity. “The whole idea is that you’re bringing this explosion of color … this explosion of diversity that we ideally would like to have in a community,” López explains.\u003c/p>\n\u003cp>Sotomayor says that the concept of the garden was important to her as she wrote the book. “Just the way gardens have different plants, and different trees, and different kinds of flowers, and different birds and animals that populate the garden, we in our society have different kinds of people, too, doing different kinds of things,” she says.\u003c/p>\n\u003cp>One of Sotomayor’s favorite scenes in the book shows a young girl named Julia winking at an owl. Julia has Tourette syndrome. “Sometimes I wiggle or make sounds that I can’t control,” Julia says in the book. López says this illustration was one of the most challenging for him to draw, but “there was this sweetness about this animal, this owl, connecting emotionally to Julia.”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-11771704\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85-800x488.jpg\" alt=\"\" width=\"800\" height=\"488\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/09/just-ask_int-4p5_custom-5b309a3cfe57f6f5248d687ed8ecbe455d5e5331-s800-c85-160x98.jpg 160w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>López says one of the reasons that he connected to Sotomayor’s children’s story is because his son, Santiago, has autism. “He has taught me so much,” López says. “He’s made me a more patient person … he has made me a better listener, a more understanding person.”\u003c/p>\n\u003cp>There are two children with autism in the book — and Sotomayor says it’s important that they are depicted in very different ways: Jordon loves to talk about dinosaurs. But Tiana prefers not to talk. “Conditions vary,” Sotomayor says. “Their presentations are never identical.”\u003c/p>\n\u003cp>López says he hopes his son Santiago and other children will recognize themselves in these characters. Though they’ll all come away with different lessons, if these young readers feel empowered, “I think we did our job,” López says.\u003c/p>\n\u003cp>Sotomayor says the takeaway of the book is that differences are not bad. “I want every child to understand that whatever condition they bear in life, they are special in a good way,” she says.\u003c/p>\n\u003cp>“You can learn so much by getting to know someone that perhaps does things a little bit different than you,” López adds. “Be patient and be curious … and don’t be afraid to ask.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Samantha Balaban and Evie Stone produced and edited this interview for broadcast. Beth Novey adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">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=%27Just+Ask%21%27+Says+Sonia+Sotomayor.+She+Knows+What+It%27s+Like+To+Feel+Different&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Updated Tuesday at 10:35 a.m.\u003c/em>\u003c/p>\n\u003cp>Maria Isabel Bueso has overcome many challenges as a result of the debilitating genetic disease she was born with that eventually left her confined to a wheelchair, breathing through a device and reliant upon weekly treatments to survive.\u003c/p>\n\u003cp>She trained to become a dance teacher and now is an instructor, and she graduated summa cum laude from California State University, East Bay — where she set up a scholarship fund for students with disabilities. She also advocates for people with her disease and other rare illnesses, traveling to Washington, D.C., to lobby for medical research.\u003c/p>\n\u003cp>Now, Bueso is fighting for her life once more.\u003c/p>\n\u003cp>Immigration authorities previously told her and her family to leave the U.S. by mid-September — or face deportation to her home country of Guatemala.\u003c/p>\n\u003cp>On Monday, USCIS \u003ca href=\"https://www.uscis.gov/news/alerts/uscis-re-opens-previously-pending-deferral-requests\" target=\"_blank\" rel=\"noopener\">announced\u003c/a> the agency will reopen the pending cases of immigrants, often with severe medical conditions who were denied humanitarian relief to stay in the country.\u003c/p>\n\u003cp>In a statement, the Bueso family called the news of USCIS reconsidering cases, “encouraging.”\u003c/p>\n\u003cp>“We see this as a first step in revisiting our status as U.S. residents and will be working with out local representatives to find a more permanent solution that guarantees Isabel’s life is never put at risk again,” according to the statement.\u003c/p>\n\u003cp>USCIS’ announcement comes as KQED and other media outlets reported her case. Members of Congress from the Bay Area also joined roughly 100 colleagues demanding answers about the agency’s decision.\u003c/p>\n\u003cp>But it is still unclear what will happen to the future of the medical deferred action program, which allowed Bueso and her family to stay in the U.S.\u003c/p>\n\u003cp>“I feel like I’m advocating for my own life,” Bueso, 24, of Concord, said last week.\u003c/p>\n\u003cp>\u003cstrong>‘Pulling the Plug on a Respirator’\u003c/strong>\u003c/p>\n\u003cp>Bueso and her family have lived in the U.S. under “deferred action,” a form of temporary humanitarian relief that they renewed every few years.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Maria Isabel Bueso, 24, of Concord']‘My mom and I, we started crying together. I started shaking. … It was just a shock for me because I depend on that treatment.’[/pullquote]When she was 7, doctors in the Bay Area invited Bueso to participate in a clinical trial for a new drug to treat her condition — mucopolysaccharidosis type VI. In 2003, her family moved to California from Guatemala. The clinical trial eventually led to federal approval for the treatment.\u003c/p>\n\u003cp>People with Bueso’s disease lack an enzyme that allows the body to break down certain sugars. The genetic mutation leads to very short stature, because the skeletal system cannot develop normally, as well as pulmonary, heart and other problems.\u003c/p>\n\u003cp>Every week, Bueso receives an intravenous infusion of medicine at a hospital in Oakland. Her doctor said the treatments have extended her life many years beyond what Guatemalan physicians had predicted when Bueso was a child.\u003c/p>\n\u003cp>Without the weekly treatment replenishing the missing enzyme, Bueso would die in six to 12 months, said Dr. Paul Harmatz, a pediatrician at UCSF Benioff Children’s Hospital and Bueso’s physician.\u003c/p>\n\u003cp>It seemed Bueso had finally reached a sense of stability until mid-August, when she got a letter from U.S. Citizenship and Immigration Services (USCIS) informing her she was no longer authorized to stay in the country and had 33 days to leave or face deportation. The medicine she needs to survive is not available in Guatemala.\u003c/p>\n\u003cp>“It’s devastating,” said Harmatz, who led the clinical trial Bueso entered 16 years ago. “I would never even contemplate stopping enzyme therapy on a patient with this type of disease. It would be literally pulling the plug on a respirator.”\u003c/p>\n\u003cp>Bueso was getting her weekly IV infusion at UCSF when she learned of the initial news.\u003c/p>\n\u003cp>“My mom and I, we started crying together. I started shaking. I was pale,” said Bueso. “It was just a shock for me because I depend on that treatment.”\u003c/p>\n\u003cp>\u003cstrong>‘A Hunt to Restrict Immigration’\u003c/strong>\u003c/p>\n\u003cp>In early August, USCIS stopped considering requests for medical deferred action. The only exceptions will be for military families, said an agency spokeswoman who declined to be identified.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Dr. Paul Harmatz, a UCSF pediatrician who led the trial in which Maria Isabel Bueso participated']‘I would never even contemplate stopping enzyme therapy on a patient with this type of disease. It would be literally pulling the plug on a respirator.’[/pullquote]\u003c/p>\n\u003cp>The spokeswoman previously disputed that the program was ending altogether, saying that U.S. Immigration and Customs Enforcement (ICE) — the agency in charge of deportations — would now be handling medical deferred action requests instead.\u003c/p>\n\u003cp>Bueso’s attorney, Martin Lawler, said ICE had not yet provided a way to apply for protection from deportation, and USCIS had not provided the family any more information as of last week.\u003c/p>\n\u003cp>“There’s no reason not to extend the status of people who are here who will basically die without the medicines that we provide them,” Lawler said about the initial notice Bueso and her family received from immigration. “They have private medical insurance, they are no burden to the taxpayer. Isabel’s father works and supports the family.”\u003c/p>\n\u003cp>The policy changes come as part of a series of new rules and interpretations of regulations by the Trump administration that are aimed at restricting new immigration and denying protections to immigrants already in the country, advocates say.\u003c/p>\n\u003cp>Such recent policies include penalizing green card applicants who use certain public benefits, and making it much harder for thousands of migrants at the U.S.-Mexico border to gain asylum protections. Many of these executive actions are being challenged in the courts.\u003c/p>\n\u003cp>[aside tag='migrants' label='Related Coverage']“This latest decision is yet another indication that the Trump administration is seeking to close off all avenues of relief for people here in the United States,” said Aaron Reichlin-Melnick, a policy analyst with the American Immigration Council. “There seems to be no guiding principle behind all of this except for a hunt to restrict immigration in as many ways as possible.”\u003c/p>\n\u003cp>Rep. Judy Chu (D-Monterey Park) denounced the Trump administration’s policy change.\u003c/p>\n\u003cp>“It’s clear that this administration will not stop looking for any opportunity to wage war on immigrants,” said Chu. “These families deserve the certainty of knowing that they can stay together and in one place while seeking treatment for diseases like cancer, HIV and cerebral palsy.”\u003c/p>\n\u003cp>ICE did not return requests for comment on how people can apply for medical deferred action, or why Bueso’s denial letter failed to mention she could seek a review of her case with the agency.\u003c/p>\n\u003cp>“ICE reviews each case on its own merits and exercises appropriate discretion after reviewing all the facts involved,” said Paul Prince, an agency spokesman.\u003c/p>\n\u003cp>Officials with USCIS say they receive about 1,000 non-military requests a year for deferred action on humanitarian grounds. Many are related to family support or medical issues, and most are denied, according to USCIS.\u003c/p>\n\u003cp>It is unclear how many immigrants have received denial notices like Bueso’s. But attorneys in multiple states reported getting similar rejection letters from USCIS for pending applications, some of which were submitted months before the initial policy change, according to the American Immigration Lawyers Association.\u003c/p>\n\u003cp>Sen. Kamala Harris and Rep. Mark DeSaulnier, whose district includes Concord, where the Bueso family has lived for six years, urged the Department of Homeland Security to grant an extension of the medical deferred action protections (Homeland Security is the parent agency that includes USCIS and ICE).\u003c/p>\n\u003cfigure id=\"attachment_11771439\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11771439\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/08/RS38885_IMG_1325-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Karla Barrera and her daughter, Maria Isabel Bueso, at their attorney’s offices in San Francisco on Aug. 29, 2019. “I haven’t slept for days,” said Barrera, 50, who fears her daughter could lose vital medical treatment in the U.S.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘We Made a Life Here’\u003c/strong>\u003c/p>\n\u003cp>[aside tag='immigration' label='More Coverage']USCIS also told Bueso’s mother, father and older sister to leave the U.S. Bueso’s father, Alberto, works in sales at an import-export company, while her sister, Ana Lucia, is a preschool teacher.\u003c/p>\n\u003cp>“We made a life here. We left family, careers, friends behind in Guatemala for Maria Isabel,” said Bueso’s mother Karla Barrera, 50. “Getting a letter telling us that we have to leave the country in 33 days from the date of the letter is shocking. I’m still processing it.”\u003c/p>\n\u003cp>Bueso’s participation in the years-long clinical trial was important in getting the drug, called Naglazyme, approved by the U.S. Food and Drug Administration, said Harmatz, who led the trial.\u003c/p>\n\u003cp>“There will be a devastating loss to our community,” said Harmatz. “It will be a tragic outcome for Isabel, after all she’s gone through, taking care of her disease.”\u003c/p>\n\u003cp>Bueso remembers watching as babies with her condition, also known as MPS VI, were given Naglazyme to help stop the disease’s progression early on and avoid some of the health issues she struggles with daily.\u003c/p>\n\u003cp>“I felt really proud that I could help other people,” said Bueso.\u003c/p>\n\u003cp>Bueso and her family say if they are placed in deportation proceedings, they will fight their case as best they can. But they have not given up hope that the government will reconsider.\u003c/p>\n\u003cp>“I have just been praying a lot and telling people to pray for me,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“This latest decision is yet another indication that the Trump administration is seeking to close off all avenues of relief for people here in the United States,” said Aaron Reichlin-Melnick, a policy analyst with the American Immigration Council. “There seems to be no guiding principle behind all of this except for a hunt to restrict immigration in as many ways as possible.”\u003c/p>\n\u003cp>Rep. Judy Chu (D-Monterey Park) denounced the Trump administration’s policy change.\u003c/p>\n\u003cp>“It’s clear that this administration will not stop looking for any opportunity to wage war on immigrants,” said Chu. “These families deserve the certainty of knowing that they can stay together and in one place while seeking treatment for diseases like cancer, HIV and cerebral palsy.”\u003c/p>\n\u003cp>ICE did not return requests for comment on how people can apply for medical deferred action, or why Bueso’s denial letter failed to mention she could seek a review of her case with the agency.\u003c/p>\n\u003cp>“ICE reviews each case on its own merits and exercises appropriate discretion after reviewing all the facts involved,” said Paul Prince, an agency spokesman.\u003c/p>\n\u003cp>Officials with USCIS say they receive about 1,000 non-military requests a year for deferred action on humanitarian grounds. Many are related to family support or medical issues, and most are denied, according to USCIS.\u003c/p>\n\u003cp>It is unclear how many immigrants have received denial notices like Bueso’s. But attorneys in multiple states reported getting similar rejection letters from USCIS for pending applications, some of which were submitted months before the initial policy change, according to the American Immigration Lawyers Association.\u003c/p>\n\u003cp>Sen. Kamala Harris and Rep. Mark DeSaulnier, whose district includes Concord, where the Bueso family has lived for six years, urged the Department of Homeland Security to grant an extension of the medical deferred action protections (Homeland Security is the parent agency that includes USCIS and ICE).\u003c/p>\n\u003cfigure id=\"attachment_11771439\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11771439\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/08/RS38885_IMG_1325-qut.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Karla Barrera and her daughter, Maria Isabel Bueso, at their attorney’s offices in San Francisco on Aug. 29, 2019. “I haven’t slept for days,” said Barrera, 50, who fears her daughter could lose vital medical treatment in the U.S.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘We Made a Life Here’\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>USCIS also told Bueso’s mother, father and older sister to leave the U.S. Bueso’s father, Alberto, works in sales at an import-export company, while her sister, Ana Lucia, is a preschool teacher.\u003c/p>\n\u003cp>“We made a life here. We left family, careers, friends behind in Guatemala for Maria Isabel,” said Bueso’s mother Karla Barrera, 50. “Getting a letter telling us that we have to leave the country in 33 days from the date of the letter is shocking. I’m still processing it.”\u003c/p>\n\u003cp>Bueso’s participation in the years-long clinical trial was important in getting the drug, called Naglazyme, approved by the U.S. Food and Drug Administration, said Harmatz, who led the trial.\u003c/p>\n\u003cp>“There will be a devastating loss to our community,” said Harmatz. “It will be a tragic outcome for Isabel, after all she’s gone through, taking care of her disease.”\u003c/p>\n\u003cp>Bueso remembers watching as babies with her condition, also known as MPS VI, were given Naglazyme to help stop the disease’s progression early on and avoid some of the health issues she struggles with daily.\u003c/p>\n\u003cp>“I felt really proud that I could help other people,” said Bueso.\u003c/p>\n\u003cp>Bueso and her family say if they are placed in deportation proceedings, they will fight their case as best they can. But they have not given up hope that the government will reconsider.\u003c/p>\n\u003cp>“I have just been praying a lot and telling people to pray for me,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>How much marijuana is really in that pot brownie? Chocolate can throw off potency tests so labels aren’t always accurate, and now scientists are trying to figure out why.\u003c/p>\n\u003cp>In states where marijuana is legal, pot comes in cookies, mints, gummies, protein bars — even pretzels. These commercial products are labeled with the amount of high-inducing THC. That helps medical marijuana patients get the desired dose and other consumers attune their buzz.\u003c/p>\n\u003cp>But something about chocolate, chemists say, seems to interfere with potency testing. A chocolate labeled as 10 milligrams of THC could have far more and send someone to the emergency room with hallucinations.\u003c/p>\n\u003cp>The latest research on chocolate, to be presented at a San Diego meeting this week, is one example of chemistry’s growing role in the marijuana industry. Besides chocolate’s quirks, chemists are working on extending shelf life, mimicking marijuana’s earthy aroma and making products safer.\u003c/p>\n\u003cp>The marijuana business is at a crossroads in its push for legitimacy. The federal government still considers marijuana illegal, yet more than 30 U.S. states allow it for at least medical use. Even in those states, there are no recognized standard methods for testing products for safety and quality.\u003c/p>\n\u003cp>Chemists working for marijuana companies and testing labs are developing those standards and some are legally protecting their ideas.\u003c/p>\n\u003cp>Scores of cannabis-related inventions have received U.S. patents, said Boston attorney Vincent Capuano, who holds a doctorate in organic chemistry. Inventors have patented ways of putting cannabis into milk, coffee pods, ice pops and chewing gum.\u003c/p>\n\u003cfigure id=\"attachment_11770220\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11770220\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-800x483.jpg\" alt=\"\" width=\"800\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-800x483.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-160x97.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-1020x615.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-1200x724.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\" />\u003cfigcaption class=\"wp-caption-text\">Edibles \u003ccite>( Ethan Miller / Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s a lot of flash and hipness, snake oil and marketing. But there’s still a lot of real chemical advance happening,” Capuano said of the industry. “It’s right in center field for chemists.”\u003c/p>\n\u003cp>Marijuana contains hundreds of chemicals, including cannabinoids such as THC and CBD, a trendy ingredient with unproven health claims. Some pose challenges when they’re processed. Chocolate is a good example.\u003c/p>\n\u003cp>“The chocolate itself is affecting our ability to measure the cannabinoids within it,” said David Dawson, chemist and lead researcher at CW Analytical Laboratories in Oakland, which tests marijuana.\u003c/p>\n\u003cp>The more chocolate in the vial, the less accurate the test results, he found. He thinks some of the THC is clinging to the fat in chocolate, effectively hiding from the test.\u003c/p>\n\u003cp>Dawson’s research is on the agenda at the American Chemical Society meeting in San Diego. The conference includes 20 presentations about marijuana’s technical challenges, said Markus Roggen, a Vancouver, British Columbia-based chemist organizing the program. That’s a big change from a few years ago when presenters didn’t get much beyond the basics such as: “This is THC. This is CBD.”\u003c/p>\n\u003cp>Some in the marijuana industry hold “a mythical belief in the goddess of cannabis,” Roggen said, but chemists view marijuana more objectively. For its part, the industry is learning to accept the “new guard of scientists with a different approach to the plant,” he said.\u003c/p>\n\u003cp>Another focus of research is a group of chemicals called terpenes that give the marijuana plant its pungent aroma. Many terpenes get lost or changed in the process of making a THC or CBD extract. But users want a certain smell and taste, said chemist Jeffrey Raber.\u003c/p>\n\u003cp>Raber heads the Werc Shop, a Los Angeles company that mixes terpenes from lavender, oranges, black pepper and other plants to mimic the flavor and scent of cannabis varieties. The mashups are sold to companies who add them to oils, tinctures and foods.\u003c/p>\n\u003cp>Monica Vialpando, a San Francisco chemist, is working to prevent drinks with CBD and THC oils from separating into unappealing layers while sitting on the shelf. The oils don’t dissolve in water, a problem for companies trying to create new drinks.\u003c/p>\n\u003cp>“We’re fighting against the true nature of the THC,” said Vialpando, who came to cannabis from the pharmaceutical industry.\u003c/p>\n\u003cp>[aside tag=\"weed, cannabis, pot\" label=\"More Cannabis Stories.\"]\u003c/p>\n\u003cp>Chemists solve the problem by increasing the surface area of the oil particles and adding ingredients, called surfactants and emulsifiers, to prevent separation.\u003c/p>\n\u003cp>She said consumers should be skeptical of outrageous claims for edibles and beverages, including that all the THC or CBD in a product will be absorbed. Some potency will always be lost in the digestive system before it hits the bloodstream, she said.\u003c/p>\n\u003cp>But for now, exactly what happens in the human body with most of these products is unclear, Vialpando said, because there’s been very little safety testing of cannabis emulsions in animals, much less in humans.\u003c/p>\n\u003cp>In Ottawa, Ontario, a Canadian government lab is working on a sensor to help police identify stoned drivers. The goal is to detect cannabinoid molecules in saliva or breath droplets, using light and nanoparticles. Still years away from roadside use, the technology might someday also be used by marijuana growers to determine the peak time to harvest, said chemist Li-Lin Tay, who leads the work for National Research Council of Canada.\u003c/p>\n\u003cp>To do his work with chocolate, Dawson grinds a THC-infused chocolate bar in a commercial food processor, weighs samples, adds solvent to the material (“It starts looking like chocolate milk,” he says), before measuring the THC potency. He’s tested cocoa powder, baking chocolate and white chocolate to try to determine what ingredients are hiding the THC during testing.\u003c/p>\n\u003cp>This will lead to better testing standards and safer products, he said.\u003c/p>\n\u003cp>“We need good ‘capital S’ science,” he said.\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>How much marijuana is really in that pot brownie? Chocolate can throw off potency tests so labels aren’t always accurate, and now scientists are trying to figure out why.\u003c/p>\n\u003cp>In states where marijuana is legal, pot comes in cookies, mints, gummies, protein bars — even pretzels. These commercial products are labeled with the amount of high-inducing THC. That helps medical marijuana patients get the desired dose and other consumers attune their buzz.\u003c/p>\n\u003cp>But something about chocolate, chemists say, seems to interfere with potency testing. A chocolate labeled as 10 milligrams of THC could have far more and send someone to the emergency room with hallucinations.\u003c/p>\n\u003cp>The latest research on chocolate, to be presented at a San Diego meeting this week, is one example of chemistry’s growing role in the marijuana industry. Besides chocolate’s quirks, chemists are working on extending shelf life, mimicking marijuana’s earthy aroma and making products safer.\u003c/p>\n\u003cp>The marijuana business is at a crossroads in its push for legitimacy. The federal government still considers marijuana illegal, yet more than 30 U.S. states allow it for at least medical use. Even in those states, there are no recognized standard methods for testing products for safety and quality.\u003c/p>\n\u003cp>Chemists working for marijuana companies and testing labs are developing those standards and some are legally protecting their ideas.\u003c/p>\n\u003cp>Scores of cannabis-related inventions have received U.S. patents, said Boston attorney Vincent Capuano, who holds a doctorate in organic chemistry. Inventors have patented ways of putting cannabis into milk, coffee pods, ice pops and chewing gum.\u003c/p>\n\u003cfigure id=\"attachment_11770220\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11770220\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-800x483.jpg\" alt=\"\" width=\"800\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-800x483.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-160x97.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-1020x615.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut-1200x724.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/08/RS38748_GettyImages-805234916-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\" />\u003cfigcaption class=\"wp-caption-text\">Edibles \u003ccite>( Ethan Miller / Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There’s a lot of flash and hipness, snake oil and marketing. But there’s still a lot of real chemical advance happening,” Capuano said of the industry. “It’s right in center field for chemists.”\u003c/p>\n\u003cp>Marijuana contains hundreds of chemicals, including cannabinoids such as THC and CBD, a trendy ingredient with unproven health claims. Some pose challenges when they’re processed. Chocolate is a good example.\u003c/p>\n\u003cp>“The chocolate itself is affecting our ability to measure the cannabinoids within it,” said David Dawson, chemist and lead researcher at CW Analytical Laboratories in Oakland, which tests marijuana.\u003c/p>\n\u003cp>The more chocolate in the vial, the less accurate the test results, he found. He thinks some of the THC is clinging to the fat in chocolate, effectively hiding from the test.\u003c/p>\n\u003cp>Dawson’s research is on the agenda at the American Chemical Society meeting in San Diego. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Chemists solve the problem by increasing the surface area of the oil particles and adding ingredients, called surfactants and emulsifiers, to prevent separation.\u003c/p>\n\u003cp>She said consumers should be skeptical of outrageous claims for edibles and beverages, including that all the THC or CBD in a product will be absorbed. Some potency will always be lost in the digestive system before it hits the bloodstream, she said.\u003c/p>\n\u003cp>But for now, exactly what happens in the human body with most of these products is unclear, Vialpando said, because there’s been very little safety testing of cannabis emulsions in animals, much less in humans.\u003c/p>\n\u003cp>In Ottawa, Ontario, a Canadian government lab is working on a sensor to help police identify stoned drivers. The goal is to detect cannabinoid molecules in saliva or breath droplets, using light and nanoparticles. Still years away from roadside use, the technology might someday also be used by marijuana growers to determine the peak time to harvest, said chemist Li-Lin Tay, who leads the work for National Research Council of Canada.\u003c/p>\n\u003cp>To do his work with chocolate, Dawson grinds a THC-infused chocolate bar in a commercial food processor, weighs samples, adds solvent to the material (“It starts looking like chocolate milk,” he says), before measuring the THC potency. He’s tested cocoa powder, baking chocolate and white chocolate to try to determine what ingredients are hiding the THC during testing.\u003c/p>\n\u003cp>This will lead to better testing standards and safer products, he said.\u003c/p>\n\u003cp>“We need good ‘capital S’ science,” he said.\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Updated 3:40 p.m. Wednesday \u003c/em>\u003c/p>\n\u003cp>Police arrested an anti-vaccine campaigner for allegedly assaulting state Sen. Richard Pan in Sacramento on Wednesday. \u003c/p>\n\u003cp>Pan, a Democrat whose district covers most of central and suburban Sacramento, is the Legislature’s leading advocate for vaccines. \u003c/p>\n\u003cp>Pan is also a pediatrician and the author of \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB276\" rel=\"noopener\" target=\"_blank\">SB 276\u003c/a>, which would require the state Department of Public Health to approve and track all physician-authorized vaccine exemptions.\u003c/p>\n\u003cp>[aside postID=\"news_11746429,news_11742525\" label=\"Related Coverage\"]\u003c/p>\n\u003cp>Pan was walking with Sen. Ash Kalra, D-San Jose, on his way to a noon event when the suspect, identified as Austin Bennett, shoved the legislator from behind. \u003c/p>\n\u003cp>“He struck me pretty hard but I didn’t fall,” Pan said in an interview Wednesday afternoon. “He kept shouting.”\u003c/p>\n\u003cp>Sacramento police said the 54-year-old Bennett was charged with misdemeanor assault and released. The incident took place on on L Street near Eighth Street.\u003c/p>\n\u003cp>Bennett, who challenged Pan in last year’s primary and is working to recall the senator, was shooting a Facebook Live video as he followed down the street — and filmed the moment he pushed Pan in the back. \u003c/p>\n\u003cp>“Yes, I pushed Richard Pan for lying, laughing at us and for treason,” Bennett admitted on Facebook.\u003c/p>\n\u003cp>Before the encounter with Pan, the video depicts Bennett strolling in downtown Sacramento, discoursing on a series of topics he says he’s concerned about: CIA “crimes,” including what he called mind control efforts; angel statues on the Capitol Mall he described as preparing the way for the arrival of Lucifer and rule by the Antichrist; how President Trump has committed blasphemy “against the blood of Jesus Christ”; and the use of chemtrails for “mass spraying … to stop the solar radiation” he describes as necessary to human health.\u003c/p>\n\u003cp>At that point, Bennett sees Pan approaching and exclaims, “What are the chances?” The video shows Bennett badgering Pan with a series of questions. After following the senator for about a minute, Bennett gives him a hard shove from behind.\u003c/p>\n\u003cp>The push happens about 10 minutes into the video. \u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://www.facebook.com/plugins/video.php?href=https%3A%2F%2Fwww.facebook.com%2Fkennethaustin.bennett%2Fvideos%2F2469900373067300%2F&show_text=0&width=560\" width=\"800\" height=\"450\" style=\"border:none;overflow:hidden\" scrolling=\"no\" frameborder=\"0\" allowtransparency=\"true\" allowfullscreen=\"true\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“I probably shouldn’t have done that,” Bennett says in the video a few moments after pushing Pan. \u003c/p>\n\u003cp>The suspect’s Twitter page says he is “fighting against mandatory vaccines, child act care laws” and is “for people’s rights and freedoms.”\u003c/p>\n\u003cp>Pan says Bennett has verbally harassed him in the past.\u003c/p>\n\u003cp>“He’s approached me here in the Capitol and in the district as well,” Pan said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Pan’s pro-vaccine leadership in the Legislature has led to other severe reactions.\u003c/p>\n\u003cp>“I get harassed on social media, practically daily,” Pan said. “We’ve got to tone down the rhetoric. Assaulting a public official is the next logical outcome of violence-inciting language.”\u003c/p>\n\u003cp>State Senate President pro Tempore Toni Atkins issued a statement following the assault. \u003c/p>\n\u003cp>“There is absolutely no reason for resorting to violence,” Atkins said. \u003c/p>\n\u003cp>“We may not all agree on every piece of legislation, but that is no reason to resort to aggressive and harmful behavior. There is ample room to discuss differences of opinion within the Legislative process, which is transparent and open to the public, and it is shameful that someone would betray the trust we have placed in that process and physically attack Dr. Pan.”\u003c/p>\n\u003cp>\u003cem>KQED’s Tara Siler contributed reporting to this story. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Police have arrested Austin Bennett for allegedly assaulting Sen. Richard Pan, a medical doctor and the Legislature's leading advocate for vaccines, in Sacramento on Wednesday.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 3:40 p.m. Wednesday \u003c/em>\u003c/p>\n\u003cp>Police arrested an anti-vaccine campaigner for allegedly assaulting state Sen. Richard Pan in Sacramento on Wednesday. \u003c/p>\n\u003cp>Pan, a Democrat whose district covers most of central and suburban Sacramento, is the Legislature’s leading advocate for vaccines. \u003c/p>\n\u003cp>Pan is also a pediatrician and the author of \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB276\" rel=\"noopener\" target=\"_blank\">SB 276\u003c/a>, which would require the state Department of Public Health to approve and track all physician-authorized vaccine exemptions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pan was walking with Sen. Ash Kalra, D-San Jose, on his way to a noon event when the suspect, identified as Austin Bennett, shoved the legislator from behind. \u003c/p>\n\u003cp>“He struck me pretty hard but I didn’t fall,” Pan said in an interview Wednesday afternoon. “He kept shouting.”\u003c/p>\n\u003cp>Sacramento police said the 54-year-old Bennett was charged with misdemeanor assault and released. The incident took place on on L Street near Eighth Street.\u003c/p>\n\u003cp>Bennett, who challenged Pan in last year’s primary and is working to recall the senator, was shooting a Facebook Live video as he followed down the street — and filmed the moment he pushed Pan in the back. \u003c/p>\n\u003cp>“Yes, I pushed Richard Pan for lying, laughing at us and for treason,” Bennett admitted on Facebook.\u003c/p>\n\u003cp>Before the encounter with Pan, the video depicts Bennett strolling in downtown Sacramento, discoursing on a series of topics he says he’s concerned about: CIA “crimes,” including what he called mind control efforts; angel statues on the Capitol Mall he described as preparing the way for the arrival of Lucifer and rule by the Antichrist; how President Trump has committed blasphemy “against the blood of Jesus Christ”; and the use of chemtrails for “mass spraying … to stop the solar radiation” he describes as necessary to human health.\u003c/p>\n\u003cp>At that point, Bennett sees Pan approaching and exclaims, “What are the chances?” The video shows Bennett badgering Pan with a series of questions. After following the senator for about a minute, Bennett gives him a hard shove from behind.\u003c/p>\n\u003cp>The push happens about 10 minutes into the video. \u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://www.facebook.com/plugins/video.php?href=https%3A%2F%2Fwww.facebook.com%2Fkennethaustin.bennett%2Fvideos%2F2469900373067300%2F&show_text=0&width=560\" width=\"800\" height=\"450\" style=\"border:none;overflow:hidden\" scrolling=\"no\" frameborder=\"0\" allowtransparency=\"true\" allowfullscreen=\"true\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“I probably shouldn’t have done that,” Bennett says in the video a few moments after pushing Pan. \u003c/p>\n\u003cp>The suspect’s Twitter page says he is “fighting against mandatory vaccines, child act care laws” and is “for people’s rights and freedoms.”\u003c/p>\n\u003cp>Pan says Bennett has verbally harassed him in the past.\u003c/p>\n\u003cp>“He’s approached me here in the Capitol and in the district as well,” Pan said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pan’s pro-vaccine leadership in the Legislature has led to other severe reactions.\u003c/p>\n\u003cp>“I get harassed on social media, practically daily,” Pan said. “We’ve got to tone down the rhetoric. Assaulting a public official is the next logical outcome of violence-inciting language.”\u003c/p>\n\u003cp>State Senate President pro Tempore Toni Atkins issued a statement following the assault. \u003c/p>\n\u003cp>“There is absolutely no reason for resorting to violence,” Atkins said. \u003c/p>\n\u003cp>“We may not all agree on every piece of legislation, but that is no reason to resort to aggressive and harmful behavior. There is ample room to discuss differences of opinion within the Legislative process, which is transparent and open to the public, and it is shameful that someone would betray the trust we have placed in that process and physically attack Dr. Pan.”\u003c/p>\n\u003cp>\u003cem>KQED’s Tara Siler contributed reporting to this story. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Destination: Bulgaria. A tiny country in Eastern Europe typically overlooked by American tourists. But my husband’s father grew up in Bulgaria, so it’s long been on our travel list.\u003c/p>\n\u003cp>It’s also on the list of countries with measles outbreaks. Bulgaria has had almost 800 cases this year, \u003ca href=\"https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/\" target=\"_blank\" rel=\"noopener\">according to the World Health Organization\u003c/a>.\u003c/p>\n\u003cp>In California, four of the five outbreaks that occurred in the state this year were linked to international travel. Most travelers were infected in the Philippines or Ukraine, which are experiencing severe outbreaks, and 37% of cases were imported from Europe overall. New measles infections continue to be reported, with California now at 65 cases \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">as of Aug. 14\u003c/a>.\u003c/p>\n\u003cp>[aside tag='measles' label='More on measles']\u003c/p>\n\u003cp>Measles is highly contagious. If someone who’s sick visits a popular tourist site and coughs, or rides the subway and sneezes, the virus can live in the air for two hours after they leave. If people who are unvaccinated pass through the same place, 90% of them will get sick.\u003c/p>\n\u003cp>That’s why my travel nurse wanted to check on my vaccination status before I left for Bulgaria. This is routine for Gen Xers and Millennials born in the ’70s and ’80s because when the measles, mumps, rubella vaccine (MMR) was first introduced in 1971, scientists recommended just one dose. But over the years, they noticed some kids still got measles. It wasn’t until 1989 that they \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm\" target=\"_blank\" rel=\"noopener\">changed the guidelines\u003c/a> to two doses.\u003c/p>\n\u003cp>But a lot of people, like me, who are now in their 30s and 40s, aren’t sure if they ever got the second dose.\u003c/p>\n\u003cp>So my travel nurse recommended I go to the lab to get a blood test to check my immunity. It’s a basic test that looks for antibodies to measles and should come back positive or negative, yes or no.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>Vaccinated, But Still Getting Sick?\u003c/b>\n\u003cp>\u003cspan style=\"font-weight: normal\">\u003cbr>\nIn California, the vast majority of measles cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">in adults – 77%\u003c/a>. What’s more, a majority of cases – 51% – have been in people who were already vaccinated: 44% had two doses of the measles vaccine and 7% had one. How is this possible?\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">Back in the 1970s, when the current measles vaccine was first developed, health officials recommended people get one dose. But over the years, they noticed it only worked for 93% of people who got it – about 7% still got sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">So, in 1989, they recommended people get two doses of the vaccine. And that worked for 97% of people. But that still leaves 3% of people who are fully vaccinated susceptible to the disease.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“We do believe that there are some people who get two doses of measles vaccine and were never immune,” said Dr. James Watt, chief of communicable disease control at the California Department of Public Health. “For some reason their body just didn’t respond to the vaccine. And that’s why the vaccine is 97% effective and not 100% effective.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">That’s why you can have people who are fully vaccinated still get measles. And in California, we have a high vaccination rate. So because we have more vaccinated people, they make up a higher proportion of those who get sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“Just an illustration of that is that some of the adult cases we have had have been in health care workers, who tend to have a higher vaccination coverage than the general population,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">The takeaway, Watt said, is that the measles vaccine is still one of the most effective vaccines we have. It’s the reason measles was declared eradicated from the U.S. almost 20 years ago. Today, most measles cases we see here are imported from other countries.\u003cbr>\n\u003c/span>\u003c/p>\u003c/aside>\n\u003c/div>\n\u003cp>But my results came back “borderline.” In other words, maybe I’m immune, maybe I’m not.\u003c/p>\n\u003cp>“The blood test is imperfect,” said Dr. Art Reingold, a professor of epidemiology at UC Berkeley. “If you have antibodies, then we’re pretty certain you’re immune. But if you don’t have antibodies you may still be immune, but your antibodies are not detectable by the test.”\u003c/p>\n\u003cp>So it’s possible I got a false negative. But there’s no way to know for sure.\u003c/p>\n\u003cp>“I know a lot of people who would say that’s a good reason not to do testing,” Reingold said with a laugh. “Because you get these results, you don’t know how to interpret them, people worry.”\u003c/p>\n\u003cp>So now what? My doctor suggested getting another dose of measles vaccine. It’s safe. But when I look into it, it turns out, there are some side effects in adults that don’t occur in babies: \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK234372/\" target=\"_blank\" rel=\"noopener\">25% of women and teenage girls\u003c/a> get acute arthritis one to three weeks after getting the vaccine.\u003c/p>\n\u003cp>That would be right in the middle of my trip, right when my husband and I are due to arrive at Bulgaria’s Black Sea Coast.\u003c/p>\n\u003cp>I imagined lying on the beach, meditating on the rolling waves — wracked with joint pain.\u003c/p>\n\u003cp>“That would suck,” I said to my husband, when we talked it through.\u003c/p>\n\u003cp>“Yeah,” he replied. “But wouldn’t it be more of a bummer to get measles?”\u003c/p>\n\u003cp>So I went back to the experts. This time I spoke with Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital.\u003c/p>\n\u003cp>“I can fully appreciate getting measles is not something you want,” she said.\u003c/p>\n\u003cp>She tells me not to worry about the acute arthritis, which really means sudden onset and short lived. And she says the joint pain is typically mild, nothing a couple ibuprofen wouldn’t take care of.\u003c/p>\n\u003cp>On top of that, the side effect is caused by the rubella part of the measles, mumps, rubella vaccine, and rarely occurs in women who have had one dose of MMR already.\u003c/p>\n\u003cp>“I would say that if the choice is between ‘I’m a little worried that I may get this arthritis or some joint pain,’ versus ‘I’m going someplace where I’m really going to be at risk for measles,’ the balance would swing towards being vaccinated for sure,” Winston said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital']‘I would say that if the choice is between “I’m a little worried that I may get this arthritis or some joint pain,” versus “I’m going someplace where I’m really going to be at risk for measles,” the balance would swing towards being vaccinated for sure.’[/pullquote]\u003c/p>\n\u003cp>But before I went through the trouble of another medical visit, I wanted to make sure I really needed it. My mom was a nurse, and she kept my pediatric vaccine records. Squeezed in the margin, scrawled in black pen, it says that I got a second dose of the vaccine when I was 11. But the handwriting is hard to read and it looks so … unofficial. This is why I got the blood test.\u003c/p>\n\u003cp>Winston tells me, in general, medical records are more reliable than the blood test.\u003c/p>\n\u003cp>“For somebody who knows that they have been vaccinated, who has their history, you would actually be considered immune regardless of what your blood test shows,” she said.\u003c/p>\n\u003cp>Bottom line, if you’re not sure what your vaccination status is and you’re traveling to a country with a known measles outbreak, there’s no harm getting a second dose of vaccine. But if you know you’ve had two doses, there’s no benefit to getting a third.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Destination: Bulgaria. A tiny country in Eastern Europe typically overlooked by American tourists. But my husband’s father grew up in Bulgaria, so it’s long been on our travel list.\u003c/p>\n\u003cp>It’s also on the list of countries with measles outbreaks. Bulgaria has had almost 800 cases this year, \u003ca href=\"https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/\" target=\"_blank\" rel=\"noopener\">according to the World Health Organization\u003c/a>.\u003c/p>\n\u003cp>In California, four of the five outbreaks that occurred in the state this year were linked to international travel. Most travelers were infected in the Philippines or Ukraine, which are experiencing severe outbreaks, and 37% of cases were imported from Europe overall. New measles infections continue to be reported, with California now at 65 cases \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">as of Aug. 14\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Measles is highly contagious. If someone who’s sick visits a popular tourist site and coughs, or rides the subway and sneezes, the virus can live in the air for two hours after they leave. If people who are unvaccinated pass through the same place, 90% of them will get sick.\u003c/p>\n\u003cp>That’s why my travel nurse wanted to check on my vaccination status before I left for Bulgaria. This is routine for Gen Xers and Millennials born in the ’70s and ’80s because when the measles, mumps, rubella vaccine (MMR) was first introduced in 1971, scientists recommended just one dose. But over the years, they noticed some kids still got measles. It wasn’t until 1989 that they \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm\" target=\"_blank\" rel=\"noopener\">changed the guidelines\u003c/a> to two doses.\u003c/p>\n\u003cp>But a lot of people, like me, who are now in their 30s and 40s, aren’t sure if they ever got the second dose.\u003c/p>\n\u003cp>So my travel nurse recommended I go to the lab to get a blood test to check my immunity. It’s a basic test that looks for antibodies to measles and should come back positive or negative, yes or no.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>Vaccinated, But Still Getting Sick?\u003c/b>\n\u003cp>\u003cspan style=\"font-weight: normal\">\u003cbr>\nIn California, the vast majority of measles cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">in adults – 77%\u003c/a>. What’s more, a majority of cases – 51% – have been in people who were already vaccinated: 44% had two doses of the measles vaccine and 7% had one. How is this possible?\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">Back in the 1970s, when the current measles vaccine was first developed, health officials recommended people get one dose. But over the years, they noticed it only worked for 93% of people who got it – about 7% still got sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">So, in 1989, they recommended people get two doses of the vaccine. And that worked for 97% of people. But that still leaves 3% of people who are fully vaccinated susceptible to the disease.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“We do believe that there are some people who get two doses of measles vaccine and were never immune,” said Dr. James Watt, chief of communicable disease control at the California Department of Public Health. “For some reason their body just didn’t respond to the vaccine. And that’s why the vaccine is 97% effective and not 100% effective.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">That’s why you can have people who are fully vaccinated still get measles. And in California, we have a high vaccination rate. So because we have more vaccinated people, they make up a higher proportion of those who get sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“Just an illustration of that is that some of the adult cases we have had have been in health care workers, who tend to have a higher vaccination coverage than the general population,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">The takeaway, Watt said, is that the measles vaccine is still one of the most effective vaccines we have. It’s the reason measles was declared eradicated from the U.S. almost 20 years ago. Today, most measles cases we see here are imported from other countries.\u003cbr>\n\u003c/span>\u003c/p>\u003c/aside>\n\u003c/div>\n\u003cp>But my results came back “borderline.” In other words, maybe I’m immune, maybe I’m not.\u003c/p>\n\u003cp>“The blood test is imperfect,” said Dr. Art Reingold, a professor of epidemiology at UC Berkeley. “If you have antibodies, then we’re pretty certain you’re immune. But if you don’t have antibodies you may still be immune, but your antibodies are not detectable by the test.”\u003c/p>\n\u003cp>So it’s possible I got a false negative. But there’s no way to know for sure.\u003c/p>\n\u003cp>“I know a lot of people who would say that’s a good reason not to do testing,” Reingold said with a laugh. “Because you get these results, you don’t know how to interpret them, people worry.”\u003c/p>\n\u003cp>So now what? My doctor suggested getting another dose of measles vaccine. It’s safe. But when I look into it, it turns out, there are some side effects in adults that don’t occur in babies: \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK234372/\" target=\"_blank\" rel=\"noopener\">25% of women and teenage girls\u003c/a> get acute arthritis one to three weeks after getting the vaccine.\u003c/p>\n\u003cp>That would be right in the middle of my trip, right when my husband and I are due to arrive at Bulgaria’s Black Sea Coast.\u003c/p>\n\u003cp>I imagined lying on the beach, meditating on the rolling waves — wracked with joint pain.\u003c/p>\n\u003cp>“That would suck,” I said to my husband, when we talked it through.\u003c/p>\n\u003cp>“Yeah,” he replied. “But wouldn’t it be more of a bummer to get measles?”\u003c/p>\n\u003cp>So I went back to the experts. This time I spoke with Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital.\u003c/p>\n\u003cp>“I can fully appreciate getting measles is not something you want,” she said.\u003c/p>\n\u003cp>She tells me not to worry about the acute arthritis, which really means sudden onset and short lived. And she says the joint pain is typically mild, nothing a couple ibuprofen wouldn’t take care of.\u003c/p>\n\u003cp>On top of that, the side effect is caused by the rubella part of the measles, mumps, rubella vaccine, and rarely occurs in women who have had one dose of MMR already.\u003c/p>\n\u003cp>“I would say that if the choice is between ‘I’m a little worried that I may get this arthritis or some joint pain,’ versus ‘I’m going someplace where I’m really going to be at risk for measles,’ the balance would swing towards being vaccinated for sure,” Winston said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I would say that if the choice is between “I’m a little worried that I may get this arthritis or some joint pain,” versus “I’m going someplace where I’m really going to be at risk for measles,” the balance would swing towards being vaccinated for sure.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But before I went through the trouble of another medical visit, I wanted to make sure I really needed it. My mom was a nurse, and she kept my pediatric vaccine records. Squeezed in the margin, scrawled in black pen, it says that I got a second dose of the vaccine when I was 11. But the handwriting is hard to read and it looks so … unofficial. This is why I got the blood test.\u003c/p>\n\u003cp>Winston tells me, in general, medical records are more reliable than the blood test.\u003c/p>\n\u003cp>“For somebody who knows that they have been vaccinated, who has their history, you would actually be considered immune regardless of what your blood test shows,” she said.\u003c/p>\n\u003cp>Bottom line, if you’re not sure what your vaccination status is and you’re traveling to a country with a known measles outbreak, there’s no harm getting a second dose of vaccine. But if you know you’ve had two doses, there’s no benefit to getting a third.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Diabetics skipping regular checkups. Young asthmatics not getting preventive care. A surge in expensive emergency room visits.\u003c/p>\n\u003cp>Doctors and public health experts warn of poor health and rising costs they say will come from sweeping Trump administration changes that would deny green cards to many immigrants who use Medicaid, as well as food stamps and other forms of public assistance.\u003c/p>\n\u003cp>Some advocates say they’re already seeing the fallout even before the complex 837-page rule takes effect in October.\u003c/p>\n\u003cp>President Donald Trump’s administration trumpeted its aggressive \u003ca href=\"https://apnews.com/f440cbe61eb642c99f4d9a47e437c526\" target=\"_blank\" rel=\"noopener\">approach\u003c/a> this past week as a way to keep only self-sufficient immigrants in the country, but health experts argue it could force potentially millions of low-income migrants to choose between needed services and their bid to stay legally in the U.S.\u003c/p>\n\u003cp>“People are going to be sicker. They’re not going to go get health care, or not until they have to go to an emergency room,” said Lisa David, president and CEO of Public Health Solutions, New York’s largest public health organization. “It’s going to cost the system a lot of money.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Immigrants who want permanent legal status, commonly called a green card, have long been required to prove they won’t be “a public charge.”\u003c/p>\n\u003cp>The Trump administration announced Monday that would redefine the term to mean those who are “more likely than not” to receive public benefits over a certain period. U.S. Citizenship and Immigration Services will also now consider other factors, including income, education and English proficiency.\u003c/p>\n\u003cp>“We want to see people coming to this country who are self-sufficient,” said Ken Cuccinelli, the agency’s acting director. “That’s a core principle of the American dream. It’s deeply embedded in our history, and particularly our history related to legal immigration.”\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/21e2d0d8ebad45d5932f400184a566fd\" target=\"_blank\" rel=\"noopener\">Two\u003c/a> California counties and attorneys general in 13 states sued, \u003ca href=\"https://apnews.com/a185c08acfd84c548e8a679f57b07305\" target=\"_blank\" rel=\"noopener\">saying\u003c/a> the changes will increase public health risks.\u003c/p>\n\u003cp>There are signs that is already happening in cities including Chicago, Detroit and New York, immigrant advocates say.\u003c/p>\n\u003cp>Within hours of the announcement, a Minnesota immigration attorney said she received a flurry of calls from worried clients about whether to leave Medicaid.\u003c/p>\n\u003cp>A Detroit nonprofit helping Latinos and immigrants with social services said its usually jam-packed lobby was empty the day after the rules were unveiled.\u003c/p>\n\u003cp>New York’s largest public health organization, Public Health Solutions, which serves a large immigrant population, reported a 20% drop in food stamps enrollment since the rule was first proposed in the fall.\u003c/p>\n\u003cp>There is precedent for such a chilling effect.\u003c/p>\n\u003cp>After 1996 welfare and immigration changes that limited public assistance for some immigrants, the use of benefits dropped steeply among U.S. citizen children and refugees, groups who were still eligible.\u003c/p>\n\u003cp>Studies based on data following that change showed people disenrolled from Medicaid at rates ranging from 15% to 35%, according to Harvard University’s François-Bagnoud Center for Health and Human Rights. And, it found, this came at a high cost: Asthma-related school absences in 1996 led to $719 million in lost parental productivity.\u003c/p>\n\u003cp>Federico Mason, who emigrated from Mexico over two decades ago, said he is worried about the new criteria because he is low-income and doesn’t speak English well. The Chicago resident said he has no immediate plans to remove his 8- and 15-year-old sons, who are U.S. citizens, from Medicaid, but the new rule has made him more fearful about providing for his family and about applying for a green card.\u003c/p>\n\u003cp>“If one day I want to adjust my status, it will be more difficult because of these unfair policies that continue to discriminate against me,” he said in Spanish.\u003c/p>\n\u003cp>Overall, non-citizen low-income immigrants use public benefits at a much \u003ca href=\"https://www.apnews.com/460423ab286a4014bfe458a6989cc3f9\" target=\"_blank\" rel=\"noopener\">lower rate\u003c/a> than low-income U.S.-born citizens, but there’s the possibility that millions of people could drop benefits out of fear or confusion.\u003c/p>\n\u003cp>Estimates vary. It could be as high as 24 million people, according to the nonpartisan Fiscal Policy Institute, which includes in its count anyone in a family that has received food, health or housing support and where at least one person is a non-citizen.\u003c/p>\n\u003cp>Dr. Deanna Behrens, a pediatric critical-care physician in suburban Chicago who wrote public testimony opposing the rule change, said children are the most vulnerable.\u003c/p>\n\u003cp>She said non-citizen parents might hesitate to apply for their children who are U.S. citizens, mistakenly fearing that if their children get benefits it will destroy their own chances of getting a green card and tear their families apart.\u003c/p>\n\u003cp>That will lead to people being unable to afford care for chronic diseases like asthma and diabetes, as well as preventative measures. Instead, they’ll rely on far more costly emergency rooms.\u003c/p>\n\u003cp>“This has forced the immigrant families into an impossible choice,” Behrens said. Roughly 544,000 people apply for green cards annually, with about 382,000 falling into categories that would be subject to the new review, according to the government.\u003c/p>\n\u003cp>Esperanza Health Centers, which runs four Chicago-based clinics that serve low-income and largely immigrant populations, has seen an increase in the number of uninsured children. Since a draft of the new rule was released in the fall, the clinics report having 600 children without insurance, including those who have disenrolled from Medicaid. Typically, it’s about 200, according to Jessica Boland, director of behavioral health.\u003c/p>\n\u003cp>“We’re condemning people to having a much more unhealthy lifestyles because we believe that there is something awful about their request for what we think for most people is a right and not a privilege: health care,” said Dr. Kenneth Davis, president and CEO of Mount Sinai Health System, which covers eight hospitals in New York.\u003c/p>\n\u003cp>Over a dozen major patient groups, including the March of Dimes and the American Heart Association, have written fierce opposition to the rule.\u003c/p>\n\u003cp>The issue is personal for Dr. Jasmine Saavedra, a pediatrician who works at an Esperanza clinic in a heavily Latino Chicago neighborhood.\u003c/p>\n\u003cp>She is convinced that if new Trump administration criteria were in effect for her parents three decades ago, she would have had a far different future. Her parents emigrated from Mexico in the 1980s unable to speak English and with little education.\u003c/p>\n\u003cp>While working low-wage jobs, they relied on food stamps for a short time to get by. Her mother later quit public assistance because of the stigma, but Saavedra said there were days when her mother wouldn’t eat so her children could. She believes that helped her become a doctor and her two sisters become an accountant and a nurse.\u003c/p>\n\u003cp>“Maybe when certain people think about immigrant families, they do think of it as a burden on this country, the way people would tell my mom she was when she was receiving assistance,” Saavedra said.\u003c/p>\n\u003cp>“But my parents, with no education, not speaking this language, being impoverished with a little bit assistance when they could, got us out and they have three successful daughters.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Associated Press video journalist Mike Householder in Detroit contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Diabetics skipping regular checkups. Young asthmatics not getting preventive care. A surge in expensive emergency room visits.\u003c/p>\n\u003cp>Doctors and public health experts warn of poor health and rising costs they say will come from sweeping Trump administration changes that would deny green cards to many immigrants who use Medicaid, as well as food stamps and other forms of public assistance.\u003c/p>\n\u003cp>Some advocates say they’re already seeing the fallout even before the complex 837-page rule takes effect in October.\u003c/p>\n\u003cp>President Donald Trump’s administration trumpeted its aggressive \u003ca href=\"https://apnews.com/f440cbe61eb642c99f4d9a47e437c526\" target=\"_blank\" rel=\"noopener\">approach\u003c/a> this past week as a way to keep only self-sufficient immigrants in the country, but health experts argue it could force potentially millions of low-income migrants to choose between needed services and their bid to stay legally in the U.S.\u003c/p>\n\u003cp>“People are going to be sicker. They’re not going to go get health care, or not until they have to go to an emergency room,” said Lisa David, president and CEO of Public Health Solutions, New York’s largest public health organization. “It’s going to cost the system a lot of money.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Immigrants who want permanent legal status, commonly called a green card, have long been required to prove they won’t be “a public charge.”\u003c/p>\n\u003cp>The Trump administration announced Monday that would redefine the term to mean those who are “more likely than not” to receive public benefits over a certain period. U.S. Citizenship and Immigration Services will also now consider other factors, including income, education and English proficiency.\u003c/p>\n\u003cp>“We want to see people coming to this country who are self-sufficient,” said Ken Cuccinelli, the agency’s acting director. “That’s a core principle of the American dream. It’s deeply embedded in our history, and particularly our history related to legal immigration.”\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/21e2d0d8ebad45d5932f400184a566fd\" target=\"_blank\" rel=\"noopener\">Two\u003c/a> California counties and attorneys general in 13 states sued, \u003ca href=\"https://apnews.com/a185c08acfd84c548e8a679f57b07305\" target=\"_blank\" rel=\"noopener\">saying\u003c/a> the changes will increase public health risks.\u003c/p>\n\u003cp>There are signs that is already happening in cities including Chicago, Detroit and New York, immigrant advocates say.\u003c/p>\n\u003cp>Within hours of the announcement, a Minnesota immigration attorney said she received a flurry of calls from worried clients about whether to leave Medicaid.\u003c/p>\n\u003cp>A Detroit nonprofit helping Latinos and immigrants with social services said its usually jam-packed lobby was empty the day after the rules were unveiled.\u003c/p>\n\u003cp>New York’s largest public health organization, Public Health Solutions, which serves a large immigrant population, reported a 20% drop in food stamps enrollment since the rule was first proposed in the fall.\u003c/p>\n\u003cp>There is precedent for such a chilling effect.\u003c/p>\n\u003cp>After 1996 welfare and immigration changes that limited public assistance for some immigrants, the use of benefits dropped steeply among U.S. citizen children and refugees, groups who were still eligible.\u003c/p>\n\u003cp>Studies based on data following that change showed people disenrolled from Medicaid at rates ranging from 15% to 35%, according to Harvard University’s François-Bagnoud Center for Health and Human Rights. And, it found, this came at a high cost: Asthma-related school absences in 1996 led to $719 million in lost parental productivity.\u003c/p>\n\u003cp>Federico Mason, who emigrated from Mexico over two decades ago, said he is worried about the new criteria because he is low-income and doesn’t speak English well. The Chicago resident said he has no immediate plans to remove his 8- and 15-year-old sons, who are U.S. citizens, from Medicaid, but the new rule has made him more fearful about providing for his family and about applying for a green card.\u003c/p>\n\u003cp>“If one day I want to adjust my status, it will be more difficult because of these unfair policies that continue to discriminate against me,” he said in Spanish.\u003c/p>\n\u003cp>Overall, non-citizen low-income immigrants use public benefits at a much \u003ca href=\"https://www.apnews.com/460423ab286a4014bfe458a6989cc3f9\" target=\"_blank\" rel=\"noopener\">lower rate\u003c/a> than low-income U.S.-born citizens, but there’s the possibility that millions of people could drop benefits out of fear or confusion.\u003c/p>\n\u003cp>Estimates vary. It could be as high as 24 million people, according to the nonpartisan Fiscal Policy Institute, which includes in its count anyone in a family that has received food, health or housing support and where at least one person is a non-citizen.\u003c/p>\n\u003cp>Dr. Deanna Behrens, a pediatric critical-care physician in suburban Chicago who wrote public testimony opposing the rule change, said children are the most vulnerable.\u003c/p>\n\u003cp>She said non-citizen parents might hesitate to apply for their children who are U.S. citizens, mistakenly fearing that if their children get benefits it will destroy their own chances of getting a green card and tear their families apart.\u003c/p>\n\u003cp>That will lead to people being unable to afford care for chronic diseases like asthma and diabetes, as well as preventative measures. Instead, they’ll rely on far more costly emergency rooms.\u003c/p>\n\u003cp>“This has forced the immigrant families into an impossible choice,” Behrens said. Roughly 544,000 people apply for green cards annually, with about 382,000 falling into categories that would be subject to the new review, according to the government.\u003c/p>\n\u003cp>Esperanza Health Centers, which runs four Chicago-based clinics that serve low-income and largely immigrant populations, has seen an increase in the number of uninsured children. Since a draft of the new rule was released in the fall, the clinics report having 600 children without insurance, including those who have disenrolled from Medicaid. Typically, it’s about 200, according to Jessica Boland, director of behavioral health.\u003c/p>\n\u003cp>“We’re condemning people to having a much more unhealthy lifestyles because we believe that there is something awful about their request for what we think for most people is a right and not a privilege: health care,” said Dr. Kenneth Davis, president and CEO of Mount Sinai Health System, which covers eight hospitals in New York.\u003c/p>\n\u003cp>Over a dozen major patient groups, including the March of Dimes and the American Heart Association, have written fierce opposition to the rule.\u003c/p>\n\u003cp>The issue is personal for Dr. Jasmine Saavedra, a pediatrician who works at an Esperanza clinic in a heavily Latino Chicago neighborhood.\u003c/p>\n\u003cp>She is convinced that if new Trump administration criteria were in effect for her parents three decades ago, she would have had a far different future. Her parents emigrated from Mexico in the 1980s unable to speak English and with little education.\u003c/p>\n\u003cp>While working low-wage jobs, they relied on food stamps for a short time to get by. Her mother later quit public assistance because of the stigma, but Saavedra said there were days when her mother wouldn’t eat so her children could. She believes that helped her become a doctor and her two sisters become an accountant and a nurse.\u003c/p>\n\u003cp>“Maybe when certain people think about immigrant families, they do think of it as a burden on this country, the way people would tell my mom she was when she was receiving assistance,” Saavedra said.\u003c/p>\n\u003cp>“But my parents, with no education, not speaking this language, being impoverished with a little bit assistance when they could, got us out and they have three successful daughters.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>U.S. Sen. Kamala Harris walked onstage Wednesday night for her second presidential debate with a lot of pressure and high expectations hanging over her head — and she mostly delivered.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Former Vice President Joe Biden']‘This is not a Republican talking point; Republicans are trying to kill Obamacare.’[/pullquote]Harris, who is viewed as one of a few frontrunners in the crowded Democratic field, found herself at the center of the stage alongside former Vice President Joe Biden — and at the center of many attacks from her fellow Democrats on issues ranging from health care to her record as a prosecutor.\u003c/p>\n\u003cp>Biden, especially, came out swinging at Harris, a turnaround from his lackluster response to her attacks in the first debate in June.\u003c/p>\n\u003cp>“The senator has had several plans,” Biden said, referring to Harris’ flip-flopping on whether she supports eliminating private insurance coverage. “You can’t beat Donald Trump with double-talk on this.”\u003c/p>\n\u003cp>Harris — whose \u003ca href=\"https://www.kqed.org/news/11757814/kamala-harris-swings-at-joe-biden-while-eric-swalwell-strives-to-stand-out-in-democratic-debate\">standout performance\u003c/a> during the first debate boosted her poll numbers and breathed life into her campaign — appeared a bit nervous as the night began, but seemed to pick up steam as the debate wore on.\u003c/p>\n\u003cp>After greeting Biden casually — “Hey, Joe,” she said, with him responding, “Go easy on me, kid” — Harris quickly pivoted to attacking the vice president.\u003c/p>\n\u003cfigure id=\"attachment_11764808\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11764808\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-800x533.jpg\" alt=\"Democratic presidential hopefuls wave from the stage ahead of the second Democratic primary debate of the 2020 presidential campaign season hosted by CNN at the Fox Theatre in Detroit, Michigan, on July 31, 2019.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Democratic presidential hopefuls wave from the stage ahead of the second Democratic primary debate of the 2020 presidential campaign season hosted by CNN at the Fox Theatre in Detroit, Michigan, on July 31, 2019. \u003ccite>(Jim Watson/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The first portion of the debate focused heavily on health care, with Biden and Harris sparring over their competing proposals. But neither candidate seemed as fluent talking about the complicated policy issue as Sens. Elizabeth Warren and Bernie Sanders did Tuesday night.\u003c/p>\n\u003cp>Still, Harris did land some punches. She \u003ca href=\"https://www.vox.com/2019/7/29/8933257/kamala-harris-medicare-for-all-bernie-sanders-private-insurance\">unveiled her own health care plan this week\u003c/a> — a proposal she calls “Medicare for All,” but that would still include private insurers — and spent a significant amount of time attacking Biden for his more \u003ca href=\"https://www.vox.com/2019/7/16/20694598/joe-biden-health-care-plan-public-option\">modest proposal,\u003c/a> which would keep the current health care structure in place but let people buy into a public option.\u003c/p>\n\u003cp>“Your plan does not cover everyone in America — by your staff’s, and everyone’s, definition — 10 million people will not have access to health care,” Harris told Biden. “In 2018, in America, for a Democrat to be running on a health care plan that doesn’t cover everyone is without excuse.”\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='U.S. Sen. Kamala Harris']‘I think you can judge people by when they are under fire and it’s not about some fancy opinion on a stage, but when they’re in the position to actually make a decision — what do they do.’[/pullquote]Harris, as she did in the last debate, also sought to rise above the rest of the field as they bickered. This time, it was during the health care debate when she told the other candidates, “We cannot keep going with the Republican talking points on this. You gotta stop.”\u003c/p>\n\u003cp>Biden pushed back: “This is not a Republican talking point; Republicans are trying to kill Obamacare.”\u003c/p>\n\u003cp>Harris also found herself on the defensive over her record as a prosecutor and California attorney general, with both Biden and Hawaii Rep. Tulsi Gabbard taking her to task over problems that arose during her tenure — like a \u003ca href=\"https://www.washingtonpost.com/politics/crime-lab-scandal-rocked-kamala-harriss-term-as-san-francisco-district-attorney/2019/03/06/825df094-392b-11e9-a06c-3ec8ed509d15_story.html?utm_term=.9b3cfde54ca0\">drug lab scandal\u003c/a> that resulted in hundreds of criminal cases being dismissed.\u003c/p>\n\u003cp>[aside tag='election-2020' label='Election 2020 Coverage']But it was Gabbard’s accusation that Harris “blocked evidence from being revealed” in a death row case — an apparent reference to the Kevin Cooper appeals — that led the California senator to push back.\u003c/p>\n\u003cp>Harris said she has been opposed to the death penalty her entire career.\u003c/p>\n\u003cp>“That is my background, that is my work. I am proud of it. I think you can judge people by when they are under fire and it’s not about some fancy opinion on a stage, but when they’re in the position to actually make a decision — what do they do,” she said. “When I was in the position of having to decide whether or not to seek a death penalty on cases I prosecuted, I made a very difficult decision that was not popular to not seek the death penalty.”\u003c/p>\n\u003cp>Overall, Harris had a good night, but not a stellar one that could significantly change the tenor of the race in any significant way.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Harris, who is viewed as one of a few frontrunners in the crowded Democratic field, found herself at the center of the stage alongside former Vice President Joe Biden — and at the center of many attacks from her fellow Democrats on issues ranging from health care to her record as a prosecutor.\u003c/p>\n\u003cp>Biden, especially, came out swinging at Harris, a turnaround from his lackluster response to her attacks in the first debate in June.\u003c/p>\n\u003cp>“The senator has had several plans,” Biden said, referring to Harris’ flip-flopping on whether she supports eliminating private insurance coverage. “You can’t beat Donald Trump with double-talk on this.”\u003c/p>\n\u003cp>Harris — whose \u003ca href=\"https://www.kqed.org/news/11757814/kamala-harris-swings-at-joe-biden-while-eric-swalwell-strives-to-stand-out-in-democratic-debate\">standout performance\u003c/a> during the first debate boosted her poll numbers and breathed life into her campaign — appeared a bit nervous as the night began, but seemed to pick up steam as the debate wore on.\u003c/p>\n\u003cp>After greeting Biden casually — “Hey, Joe,” she said, with him responding, “Go easy on me, kid” — Harris quickly pivoted to attacking the vice president.\u003c/p>\n\u003cfigure id=\"attachment_11764808\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11764808\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-800x533.jpg\" alt=\"Democratic presidential hopefuls wave from the stage ahead of the second Democratic primary debate of the 2020 presidential campaign season hosted by CNN at the Fox Theatre in Detroit, Michigan, on July 31, 2019.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/07312019_democratic-primary-debate_detroit_election-2020-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Democratic presidential hopefuls wave from the stage ahead of the second Democratic primary debate of the 2020 presidential campaign season hosted by CNN at the Fox Theatre in Detroit, Michigan, on July 31, 2019. \u003ccite>(Jim Watson/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The first portion of the debate focused heavily on health care, with Biden and Harris sparring over their competing proposals. But neither candidate seemed as fluent talking about the complicated policy issue as Sens. Elizabeth Warren and Bernie Sanders did Tuesday night.\u003c/p>\n\u003cp>Still, Harris did land some punches. She \u003ca href=\"https://www.vox.com/2019/7/29/8933257/kamala-harris-medicare-for-all-bernie-sanders-private-insurance\">unveiled her own health care plan this week\u003c/a> — a proposal she calls “Medicare for All,” but that would still include private insurers — and spent a significant amount of time attacking Biden for his more \u003ca href=\"https://www.vox.com/2019/7/16/20694598/joe-biden-health-care-plan-public-option\">modest proposal,\u003c/a> which would keep the current health care structure in place but let people buy into a public option.\u003c/p>\n\u003cp>“Your plan does not cover everyone in America — by your staff’s, and everyone’s, definition — 10 million people will not have access to health care,” Harris told Biden. “In 2018, in America, for a Democrat to be running on a health care plan that doesn’t cover everyone is without excuse.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Harris, as she did in the last debate, also sought to rise above the rest of the field as they bickered. This time, it was during the health care debate when she told the other candidates, “We cannot keep going with the Republican talking points on this. You gotta stop.”\u003c/p>\n\u003cp>Biden pushed back: “This is not a Republican talking point; Republicans are trying to kill Obamacare.”\u003c/p>\n\u003cp>Harris also found herself on the defensive over her record as a prosecutor and California attorney general, with both Biden and Hawaii Rep. Tulsi Gabbard taking her to task over problems that arose during her tenure — like a \u003ca href=\"https://www.washingtonpost.com/politics/crime-lab-scandal-rocked-kamala-harriss-term-as-san-francisco-district-attorney/2019/03/06/825df094-392b-11e9-a06c-3ec8ed509d15_story.html?utm_term=.9b3cfde54ca0\">drug lab scandal\u003c/a> that resulted in hundreds of criminal cases being dismissed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But it was Gabbard’s accusation that Harris “blocked evidence from being revealed” in a death row case — an apparent reference to the Kevin Cooper appeals — that led the California senator to push back.\u003c/p>\n\u003cp>Harris said she has been opposed to the death penalty her entire career.\u003c/p>\n\u003cp>“That is my background, that is my work. I am proud of it. I think you can judge people by when they are under fire and it’s not about some fancy opinion on a stage, but when they’re in the position to actually make a decision — what do they do,” she said. “When I was in the position of having to decide whether or not to seek a death penalty on cases I prosecuted, I made a very difficult decision that was not popular to not seek the death penalty.”\u003c/p>\n\u003cp>Overall, Harris had a good night, but not a stellar one that could significantly change the tenor of the race in any significant way.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When Daniel Giles blinks, it looks like he might be wearing eye makeup. He has a tattoo across each of his eyelids that says “Born Dead.”\u003c/p>\n\u003cp>“It’s kind of like an existential reminder not to live in the past and to remember that I’m not always promised a tomorrow,” he says of his ink. “They’re a symbol of where I’ve been and what I’ve been through.”\u003c/p>\n\u003cp>[aside postID=\"news_11760625,news_11754493\" label=\"Related Coverage\"]\u003c/p>\n\u003cp>Giles was working in a redwood lumber mill in Humboldt County when his hand got crushed in an accident. He got hooked on the opiate pills the doctor prescribed for pain. Then he graduated to heroin. As he watched his friends overdose, he was afraid he was next.\u003c/p>\n\u003cp>But the drug treatment options there were slim. A friend told him about some great services in San Francisco.\u003c/p>\n\u003cp>“So I came down here. I raised a white flag of surrender, and I just came down here and checked myself in,” he says.\u003c/p>\n\u003cp>Giles has been in treatment since last November. San Francisco is one of the first counties in the state to roll out new updates to the Drug Medi-Cal program. Now the state gets more federal money to provide residential treatment for more people. But each county is responsible for running its own program. So while some bigger counties have gone all in, many rural counties, for financial or political reasons, have implemented the changes on a smaller scale; 18 opted out altogether.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“That creates a really perverse incentive,” says Stanford psychiatry professor Keith Humphreys, warning that some counties could exploit others’ willingness to act by doing nothing.\u003c/p>\n\u003cp>In Santa Clara County, where he lives, services are so generous that patients refer to it as Santa Claus County.\u003c/p>\n\u003cp>“So if you are a county that decides to invest a lot in addiction and mental health, does that lead other counties to say, ‘Why don’t we just give people bus tickets, rather than putting up our own money?’ ” Humphreys says.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Keith Humphreys, Stanford University psychiatry professor \"]“So if you are a county that decides to invest a lot in addiction and mental health, does that lead other counties to say, ‘Why don’t we just give people bus tickets, rather than putting up our own money?’ “[/pullquote]\u003c/p>\n\u003cp>San Francisco was afraid of this. It considered a rule that said people who wanted to come here for treatment had to establish residency in the county first. That can take 60 days.\u003c/p>\n\u003cp>Treatment providers flipped.\u003c/p>\n\u003cp>“They could die! They could literally die between today and tomorrow,” says Vitka Eisen, CEO of HealthRIGHT 360, which has been testing the new Drug Medi-Cal program at its treatment centers in San Francisco for two years.\u003c/p>\n\u003cp>“A person who comes in for substance use disorder treatment today needs it today,” she says. “Because if they don’t, if we put any barrier up, they’re not going to get that treatment. What they might do is go around the corner and use drugs.”\u003c/p>\n\u003cp>In the end, San Francisco decided to admit people from other counties into residential treatment right away, as long as they agree to transfer their Medi-Cal benefits from their home county to San Francisco. But the state doesn’t pay until the transfer goes through, leaving San Francisco on the hook for those bills during the 60-day interim.\u003c/p>\n\u003cp>It’s unclear if other counties in a similar position will be that generous.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Vitka Eisen, CEO of HealthRIGHT 360\"]“A person who comes in for substance use disorder treatment today needs it today. Because if they don’t, if we put any barrier up, they’re not going to get that treatment. What they might do is go around the corner and use drugs.”[/pullquote]\u003c/p>\n\u003cp>“There’s a lot of both confusion and tension around this county-by-county thing, particularly services that not every county has, like methadone treatment for opioid addiction,” says Margaret Kisliuk, the behavioral health administrator at Partnership HealthPlan, the insurer that is working to implement the new Drug Medi-Cal program in rural counties in Northern California. “It’s really hard if some counties are in and some are out.”\u003c/p>\n\u003cp>Humboldt County has an aggressive plan to implement the new program, she says, but it hasn’t yet. So residential treatment wasn’t available to Daniel Giles there when he decided he was ready to get sober. But he says he didn’t really want to do it in Humboldt anyway.\u003c/p>\n\u003cp>“Because I had two years on the streets. I knew a lot of people, and I know myself,” Giles says. “So, when I got out I think that it would have been really hard for me to separate myself in a small town from the people I’d gotten to know.”\u003c/p>\n\u003cp>He was in treatment for seven months — three in intensive residential treatment and four in outpatient treatment while he lived in one of San Francisco’s county-funded transitional housing units. He says, for him, starting his life over was best to do someplace far from home.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Daniel Giles blinks, it looks like he might be wearing eye makeup. He has a tattoo across each of his eyelids that says “Born Dead.”\u003c/p>\n\u003cp>“It’s kind of like an existential reminder not to live in the past and to remember that I’m not always promised a tomorrow,” he says of his ink. “They’re a symbol of where I’ve been and what I’ve been through.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Giles was working in a redwood lumber mill in Humboldt County when his hand got crushed in an accident. He got hooked on the opiate pills the doctor prescribed for pain. Then he graduated to heroin. As he watched his friends overdose, he was afraid he was next.\u003c/p>\n\u003cp>But the drug treatment options there were slim. A friend told him about some great services in San Francisco.\u003c/p>\n\u003cp>“So I came down here. I raised a white flag of surrender, and I just came down here and checked myself in,” he says.\u003c/p>\n\u003cp>Giles has been in treatment since last November. San Francisco is one of the first counties in the state to roll out new updates to the Drug Medi-Cal program. Now the state gets more federal money to provide residential treatment for more people. But each county is responsible for running its own program. So while some bigger counties have gone all in, many rural counties, for financial or political reasons, have implemented the changes on a smaller scale; 18 opted out altogether.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That creates a really perverse incentive,” says Stanford psychiatry professor Keith Humphreys, warning that some counties could exploit others’ willingness to act by doing nothing.\u003c/p>\n\u003cp>In Santa Clara County, where he lives, services are so generous that patients refer to it as Santa Claus County.\u003c/p>\n\u003cp>“So if you are a county that decides to invest a lot in addiction and mental health, does that lead other counties to say, ‘Why don’t we just give people bus tickets, rather than putting up our own money?’ ” Humphreys says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "“So if you are a county that decides to invest a lot in addiction and mental health, does that lead other counties to say, ‘Why don’t we just give people bus tickets, rather than putting up our own money?’ “",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>San Francisco was afraid of this. It considered a rule that said people who wanted to come here for treatment had to establish residency in the county first. That can take 60 days.\u003c/p>\n\u003cp>Treatment providers flipped.\u003c/p>\n\u003cp>“They could die! They could literally die between today and tomorrow,” says Vitka Eisen, CEO of HealthRIGHT 360, which has been testing the new Drug Medi-Cal program at its treatment centers in San Francisco for two years.\u003c/p>\n\u003cp>“A person who comes in for substance use disorder treatment today needs it today,” she says. “Because if they don’t, if we put any barrier up, they’re not going to get that treatment. What they might do is go around the corner and use drugs.”\u003c/p>\n\u003cp>In the end, San Francisco decided to admit people from other counties into residential treatment right away, as long as they agree to transfer their Medi-Cal benefits from their home county to San Francisco. But the state doesn’t pay until the transfer goes through, leaving San Francisco on the hook for those bills during the 60-day interim.\u003c/p>\n\u003cp>It’s unclear if other counties in a similar position will be that generous.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "“A person who comes in for substance use disorder treatment today needs it today. Because if they don’t, if we put any barrier up, they’re not going to get that treatment. What they might do is go around the corner and use drugs.”",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There’s a lot of both confusion and tension around this county-by-county thing, particularly services that not every county has, like methadone treatment for opioid addiction,” says Margaret Kisliuk, the behavioral health administrator at Partnership HealthPlan, the insurer that is working to implement the new Drug Medi-Cal program in rural counties in Northern California. “It’s really hard if some counties are in and some are out.”\u003c/p>\n\u003cp>Humboldt County has an aggressive plan to implement the new program, she says, but it hasn’t yet. So residential treatment wasn’t available to Daniel Giles there when he decided he was ready to get sober. But he says he didn’t really want to do it in Humboldt anyway.\u003c/p>\n\u003cp>“Because I had two years on the streets. I knew a lot of people, and I know myself,” Giles says. “So, when I got out I think that it would have been really hard for me to separate myself in a small town from the people I’d gotten to know.”\u003c/p>\n\u003cp>He was in treatment for seven months — three in intensive residential treatment and four in outpatient treatment while he lived in one of San Francisco’s county-funded transitional housing units. He says, for him, starting his life over was best to do someplace far from home.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "A Black Mother Told Not to Scream in Labor Asks: Can California Fix Racism in Maternity Care?",
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"content": "\u003cp>Bettye Jean Ford was in her second trimester when the pressure she had been feeling in her abdomen for weeks turned to excruciating pain. She rushed to a Los Angeles emergency room, where she was diagnosed with a urinary tract infection and sent home with antibiotics. Still cramping severely, the first-time expectant mother spent the next 24 hours trying to sleep.\u003c/p>\n\u003cp>The next morning, her obstetrician found her dilated and sent her to the hospital next door where an ultrasound confirmed she was in labor. Rather than being admitted, she was sent back to the clinic with paperwork to finish.\u003c/p>\n\u003cp>Finally, at 23 weeks and six days, Ford gave birth to a premature baby girl while a nurse told her to close her mouth so as not to scream while pushing. After delivery, the new mother was sedated; her child, whom she had named Kally, had died by the time she awoke.\u003c/p>\n\u003cp>That was 2006. Since then, California has worked hard to improve health care for pregnant women—so hard, in fact, that the state is now often held up as a national success story in improving maternal outcomes.\u003c/p>\n\u003cp>But for African American mothers, that improvement has remained elusive. \u003ca href=\"https://www.youtube.com/watch?v=FSjHIr1Z7kc&feature=youtu.be\">Statewide\u003c/a> as well as \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm?s_cid=mm6818e1_w\">nationally\u003c/a>, black women are substantially more likely than white women to suffer life-threatening complications during pregnancy, give birth prematurely, die in childbirth and lose their babies.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/8e172bc0-8640-4937-9869-c974fddc198a?src=embed\" title=\"Maternal Morbidity\" width=\"800\" height=\"752\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n Mortality rates among black infants in California are triple those of white infants, according to state birth records. California Department of Public Health statistics show the rate of preterm births among black mothers to be nearly twice that of white mothers, and the rate of maternal mortality to be quadruple, in part because of complications from underestimated or undiagnosed cardiovascular conditions.\u003c/p>\n\u003cp>A host of factors underlie this health gap, but studies consistently point to an ugly one: the persistence of racial bias in perinatal care \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847630/\">for women of color\u003c/a>.\u003c/p>\n\u003cp>[aside tag='childbirth' label='Maternity in California']Even when studies control for socioeconomic differences, the health care experience for black mothers is particularly—and often lethally—inadequate compared to that of other ethnic groups, not to mention traumatizing.\u003c/p>\n\u003cp>“Giving birth was horrible,” said Ford. “It was just an awful experience emotionally, physically.”\u003c/p>\n\u003cp>Democratic state Sen. Holly Mitchell—who represents Los Angeles, where Ford still lives—is carrying \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201920200SB464\">legislation\u003c/a> that would make California the first state to mandate implicit bias training for obstetricians, delivery nurses and other perinatal health care providers at hospitals and birthing centers. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB464\">Senate Bill 464\u003c/a> would require that providers be taught to spot bias, to communicate across identities and be educated on how racial bias impacts maternal and infant health.\u003c/p>\n\u003cp>Mitchell’s bill, called the Dignity in Pregnancy and Childbirth Act, would also require maternal deaths to be registered more consistently on death certificates by requiring coroners to list whether a woman was pregnant at the time of her death or in the year preceding.\u003c/p>\n\u003cp>Advocacy groups including \u003ca href=\"https://www.bwwla.org/aboutus/\">Black Women for Wellness\u003c/a> and\u003ca href=\"https://wclp.org/about-us/\"> The Western Center on Law and Poverty\u003c/a>, an anti-poverty organization, sponsored the bill after noticing how racial discrimination persists in medicine regardless of a patient’s ability to pay. The issue has also drawn national attention.\u003c/p>\n\u003cfigure id=\"attachment_11760930\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11760930\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bettye Jean Ford holds the tiny urn containing the ashes of her first child Kally. Complications Ford says she wasn’t warned of resulted in a birth so premature that the child died within hours. \u003ccite>(Iris Schneider/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Tennis star \u003ca href=\"https://www.cnn.com/2018/02/20/opinions/protect-mother-pregnancy-williams-opinion/index.html\">Serena Williams\u003c/a> underscored the dangers facing pregnant black women in sharing her labor and delivery experience. Singer Beyoncé echoed her concerns. And in Congress, California Sen. Kamala Harris, a presidential contender, has proposed the \u003ca href=\"https://www.harris.senate.gov/imo/media/doc/ERN18510.pdf\">Maternal Care Access and Reducing Emergencies (CARE) Act\u003c/a>, which would provide $125 million to train for the detection of high-risk pregnancies.\u003c/p>\n\u003cp>Nourbese Flint, policy director at Black Women for Wellness, said supporters of SB 464 drew inspiration in part from Harris’ legislation. Just as civil rights advocates have initiated tough conversations about race in the classroom or in the criminal justice system, she said, moms and nurses believe it’s time to have “the talk” about the doctor’s office.\u003c/p>\n\u003cp>“Delivering a baby is probably a moment in time when you feel the most vulnerable,” Mitchell said. “And to have to layer on top concerns about whether or not your health care provider sees you, hears you, listens to you—is an unfair burden black women are bearing.”\u003c/p>\n\u003cp>Though the bill has influential supporters, including nurses and MomsRising, a multicultural organization with more than 1 million members, physicians say the bill is too abstract and unwieldy to implement.\u003c/p>\n\u003cp>“It’s not a question of whether this training is needed, just how best to do it,” said Anthony York, spokesman for the influential California Medical Association.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/b5579ce1-479e-4be4-b5d1-f4570b28592c?src=embed\" title=\"Physicians by race\" width=\"800\" height=\"817\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n Doctors don’t dispute there’s discrimination. A \u003ca href=\"https://www.pnas.org/content/113/16/4296\">2016 University of Virginia\u003c/a> study found biological myths about black patients still persist among white medical students, such as the notions that African Americans have less sensitive nerve endings, can tolerate more pain and have thicker skin. In other \u003ca href=\"https://www.medscape.com/features/slideshow/lifestyle/2017/womens-health#page=11\">surveys\u003c/a>, one in seven ob/gyns said that a patient’s race impacted treatment.\u003c/p>\n\u003cp>But while the California Hospital Association supported the bill after requesting technical changes, doctors have called Mitchell’s bill unenforceable since \u003ca href=\"https://calmatters.org/economy/2019/06/california-dynamex-gig-worker-classification-independent-contractors-uber-lyft-strippers-truckers-freelancers/\">physicians are not employees\u003c/a>.\u003c/p>\n\u003cp>Researchers agree that a physicans’ employment status is an obstacle.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Monica McLemore, reproductive health researcher at UCSF']‘I think we’ve done a real disservice where you have a health care workforce that does not live, work, play, pray, thrive in the same communities where they actually provide care.’[/pullquote] Doctors throughout the state contract with hospitals so they don’t receive the same oversight or accountability as an employee would, and they cannot be disciplined or rewarded for biased care, said Monica McLemore, a reproductive health researcher at University of California, San Francisco, who has focused on \u003ca href=\"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/s12978-019-0729-2\">inequality and mistreatment during pregnancy and childbirth\u003c/a>.\u003c/p>\n\u003cp>“The same institutions and mechanisms that we use for accountability within organizations don’t exist for contract individuals,” she said. “There’s no established mechanisms to be able to enforce whether or not individuals actually deal with their own bias.”\u003c/p>\n\u003cp>McLemore said that, despite the legislation’s good intentions, it’s naive to believe systemic change will occur by leaving the implementation of implicit bias training up to health care facilities. A better solution, she said, would be more diversity in the health care workforce, with a push similar to campaigns for more \u003ca href=\"https://hechingerreport.org/whats-wrong-white-teachers/\">teachers who reflect the students in their classrooms.\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003cbr>\nA 2018 \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/06/CAPhysicianSupply2018.pdf\">report\u003c/a> by the California Health Care Foundation found that Latinos and African Americans are profoundly underrepresented in the state’s physician workforce. Latinos, for instance, make up 38% of California’s population but only 5% of the state’s active physicians. African Americans make up 3% of the physician workforce, compared to 6% of the state population. And while the proportion of white doctors largely mirrors the rest of the state, Asians are overly represented in the field, with twice their share of the population.\u003c/p>\n\u003cp>“I think we’ve done a real disservice where you have a health care workforce that does not live, work, play, pray, thrive in the same communities where they actually provide care,” McLemore said.\u003c/p>\n\u003cp>And without buy-in from doctors, advocates say, California will continue to have a tough time making experiences like Ford’s a thing of the past for women of all races.\u003c/p>\n\u003cfigure id=\"attachment_11760958\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11760958\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bettye Jean Ford at home with her 11-year-old daughter, Skylar, June 21, 2019. Skylar was born a year and a day after the due date of Ford’s first child. \u003ccite>(Iris Schneider/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since the\u003ca href=\"https://www.cmqcc.org/who-we-are\"> California Maternal Quality of Care Collaborative\u003c/a> was adopted in 2006 to improve health outcomes for mothers and infants in California, the overall maternal mortality rate in the state has declined 55%—far better than most of the U.S. In 2017, the national maternal mortality rate was 21.6 deaths per 100,000 live births compared to 8.7 deaths per 100,000 live births in California.\u003c/p>\n\u003cp>Women of color, however, continue to face worse outcomes.\u003c/p>\n\u003cp>“While we have been somewhat successful, we can’t really be jumping for joy yet,” said Holly Smith of the California Nurse-Midwives Association, which supports mandating racial bias training.\u003c/p>\n\u003cp>During Ford’s preterm delivery, for example, she was unaware that black women are \u003ca href=\"http://www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html\">three times more likely\u003c/a> than white women to have fibroids, which can have a harmful impact on \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874080/\">fertility and pregnancy\u003c/a>. Ford said her doctor never warned her that the ones resting on her uterus could complicate her own childbirth.\u003c/p>\n\u003cp>[aside tag='women-of-color' label='More on women of color']\u003c/p>\n\u003cp>When Ford did get pregnant again, she took extra precautions fearing she would have to relive her trauma. It wasn’t until she was 27 weeks along that she and her husband felt comfortable enough to bring the crib intended for her first daughter back into their home.\u003c/p>\n\u003cp>A year and one day after Kally’s due date, Ford gave birth to her daughter Skylar, who is now 11.\u003c/p>\n\u003cp>“I really appreciate every day with my daughter,” says the therapist, who sought help to cope with her own grief and anger. “But I have a niece and a goddaughter who were born right around the time that Kally was born. So watching the three of these girls grow up, I always have this feeling of like there should be one more.”\u003c/p>\n\u003cp>Her first born, she said, is never far from memory. Her remains rest in a tiny urn at Ford’s home.\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\">\u003cem>CALmatters.org\u003c/em>\u003c/a>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bettye Jean Ford was in her second trimester when the pressure she had been feeling in her abdomen for weeks turned to excruciating pain. She rushed to a Los Angeles emergency room, where she was diagnosed with a urinary tract infection and sent home with antibiotics. Still cramping severely, the first-time expectant mother spent the next 24 hours trying to sleep.\u003c/p>\n\u003cp>The next morning, her obstetrician found her dilated and sent her to the hospital next door where an ultrasound confirmed she was in labor. Rather than being admitted, she was sent back to the clinic with paperwork to finish.\u003c/p>\n\u003cp>Finally, at 23 weeks and six days, Ford gave birth to a premature baby girl while a nurse told her to close her mouth so as not to scream while pushing. After delivery, the new mother was sedated; her child, whom she had named Kally, had died by the time she awoke.\u003c/p>\n\u003cp>That was 2006. Since then, California has worked hard to improve health care for pregnant women—so hard, in fact, that the state is now often held up as a national success story in improving maternal outcomes.\u003c/p>\n\u003cp>But for African American mothers, that improvement has remained elusive. \u003ca href=\"https://www.youtube.com/watch?v=FSjHIr1Z7kc&feature=youtu.be\">Statewide\u003c/a> as well as \u003ca href=\"https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm?s_cid=mm6818e1_w\">nationally\u003c/a>, black women are substantially more likely than white women to suffer life-threatening complications during pregnancy, give birth prematurely, die in childbirth and lose their babies.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/8e172bc0-8640-4937-9869-c974fddc198a?src=embed\" title=\"Maternal Morbidity\" width=\"800\" height=\"752\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n Mortality rates among black infants in California are triple those of white infants, according to state birth records. California Department of Public Health statistics show the rate of preterm births among black mothers to be nearly twice that of white mothers, and the rate of maternal mortality to be quadruple, in part because of complications from underestimated or undiagnosed cardiovascular conditions.\u003c/p>\n\u003cp>A host of factors underlie this health gap, but studies consistently point to an ugly one: the persistence of racial bias in perinatal care \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847630/\">for women of color\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Even when studies control for socioeconomic differences, the health care experience for black mothers is particularly—and often lethally—inadequate compared to that of other ethnic groups, not to mention traumatizing.\u003c/p>\n\u003cp>“Giving birth was horrible,” said Ford. “It was just an awful experience emotionally, physically.”\u003c/p>\n\u003cp>Democratic state Sen. Holly Mitchell—who represents Los Angeles, where Ford still lives—is carrying \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201920200SB464\">legislation\u003c/a> that would make California the first state to mandate implicit bias training for obstetricians, delivery nurses and other perinatal health care providers at hospitals and birthing centers. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB464\">Senate Bill 464\u003c/a> would require that providers be taught to spot bias, to communicate across identities and be educated on how racial bias impacts maternal and infant health.\u003c/p>\n\u003cp>Mitchell’s bill, called the Dignity in Pregnancy and Childbirth Act, would also require maternal deaths to be registered more consistently on death certificates by requiring coroners to list whether a woman was pregnant at the time of her death or in the year preceding.\u003c/p>\n\u003cp>Advocacy groups including \u003ca href=\"https://www.bwwla.org/aboutus/\">Black Women for Wellness\u003c/a> and\u003ca href=\"https://wclp.org/about-us/\"> The Western Center on Law and Poverty\u003c/a>, an anti-poverty organization, sponsored the bill after noticing how racial discrimination persists in medicine regardless of a patient’s ability to pay. The issue has also drawn national attention.\u003c/p>\n\u003cfigure id=\"attachment_11760930\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11760930\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38059_BLACK-MOTHERS-PHOTO-1-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bettye Jean Ford holds the tiny urn containing the ashes of her first child Kally. Complications Ford says she wasn’t warned of resulted in a birth so premature that the child died within hours. \u003ccite>(Iris Schneider/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Tennis star \u003ca href=\"https://www.cnn.com/2018/02/20/opinions/protect-mother-pregnancy-williams-opinion/index.html\">Serena Williams\u003c/a> underscored the dangers facing pregnant black women in sharing her labor and delivery experience. Singer Beyoncé echoed her concerns. And in Congress, California Sen. Kamala Harris, a presidential contender, has proposed the \u003ca href=\"https://www.harris.senate.gov/imo/media/doc/ERN18510.pdf\">Maternal Care Access and Reducing Emergencies (CARE) Act\u003c/a>, which would provide $125 million to train for the detection of high-risk pregnancies.\u003c/p>\n\u003cp>Nourbese Flint, policy director at Black Women for Wellness, said supporters of SB 464 drew inspiration in part from Harris’ legislation. Just as civil rights advocates have initiated tough conversations about race in the classroom or in the criminal justice system, she said, moms and nurses believe it’s time to have “the talk” about the doctor’s office.\u003c/p>\n\u003cp>“Delivering a baby is probably a moment in time when you feel the most vulnerable,” Mitchell said. “And to have to layer on top concerns about whether or not your health care provider sees you, hears you, listens to you—is an unfair burden black women are bearing.”\u003c/p>\n\u003cp>Though the bill has influential supporters, including nurses and MomsRising, a multicultural organization with more than 1 million members, physicians say the bill is too abstract and unwieldy to implement.\u003c/p>\n\u003cp>“It’s not a question of whether this training is needed, just how best to do it,” said Anthony York, spokesman for the influential California Medical Association.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/b5579ce1-479e-4be4-b5d1-f4570b28592c?src=embed\" title=\"Physicians by race\" width=\"800\" height=\"817\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n Doctors don’t dispute there’s discrimination. A \u003ca href=\"https://www.pnas.org/content/113/16/4296\">2016 University of Virginia\u003c/a> study found biological myths about black patients still persist among white medical students, such as the notions that African Americans have less sensitive nerve endings, can tolerate more pain and have thicker skin. In other \u003ca href=\"https://www.medscape.com/features/slideshow/lifestyle/2017/womens-health#page=11\">surveys\u003c/a>, one in seven ob/gyns said that a patient’s race impacted treatment.\u003c/p>\n\u003cp>But while the California Hospital Association supported the bill after requesting technical changes, doctors have called Mitchell’s bill unenforceable since \u003ca href=\"https://calmatters.org/economy/2019/06/california-dynamex-gig-worker-classification-independent-contractors-uber-lyft-strippers-truckers-freelancers/\">physicians are not employees\u003c/a>.\u003c/p>\n\u003cp>Researchers agree that a physicans’ employment status is an obstacle.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I think we’ve done a real disservice where you have a health care workforce that does not live, work, play, pray, thrive in the same communities where they actually provide care.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Doctors throughout the state contract with hospitals so they don’t receive the same oversight or accountability as an employee would, and they cannot be disciplined or rewarded for biased care, said Monica McLemore, a reproductive health researcher at University of California, San Francisco, who has focused on \u003ca href=\"https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/s12978-019-0729-2\">inequality and mistreatment during pregnancy and childbirth\u003c/a>.\u003c/p>\n\u003cp>“The same institutions and mechanisms that we use for accountability within organizations don’t exist for contract individuals,” she said. “There’s no established mechanisms to be able to enforce whether or not individuals actually deal with their own bias.”\u003c/p>\n\u003cp>McLemore said that, despite the legislation’s good intentions, it’s naive to believe systemic change will occur by leaving the implementation of implicit bias training up to health care facilities. A better solution, she said, would be more diversity in the health care workforce, with a push similar to campaigns for more \u003ca href=\"https://hechingerreport.org/whats-wrong-white-teachers/\">teachers who reflect the students in their classrooms.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nA 2018 \u003ca href=\"https://www.chcf.org/wp-content/uploads/2018/06/CAPhysicianSupply2018.pdf\">report\u003c/a> by the California Health Care Foundation found that Latinos and African Americans are profoundly underrepresented in the state’s physician workforce. Latinos, for instance, make up 38% of California’s population but only 5% of the state’s active physicians. African Americans make up 3% of the physician workforce, compared to 6% of the state population. And while the proportion of white doctors largely mirrors the rest of the state, Asians are overly represented in the field, with twice their share of the population.\u003c/p>\n\u003cp>“I think we’ve done a real disservice where you have a health care workforce that does not live, work, play, pray, thrive in the same communities where they actually provide care,” McLemore said.\u003c/p>\n\u003cp>And without buy-in from doctors, advocates say, California will continue to have a tough time making experiences like Ford’s a thing of the past for women of all races.\u003c/p>\n\u003cfigure id=\"attachment_11760958\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11760958\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/07/RS38061_BLACK-MOTHERS-PHOTO-3-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bettye Jean Ford at home with her 11-year-old daughter, Skylar, June 21, 2019. Skylar was born a year and a day after the due date of Ford’s first child. \u003ccite>(Iris Schneider/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Since the\u003ca href=\"https://www.cmqcc.org/who-we-are\"> California Maternal Quality of Care Collaborative\u003c/a> was adopted in 2006 to improve health outcomes for mothers and infants in California, the overall maternal mortality rate in the state has declined 55%—far better than most of the U.S. In 2017, the national maternal mortality rate was 21.6 deaths per 100,000 live births compared to 8.7 deaths per 100,000 live births in California.\u003c/p>\n\u003cp>Women of color, however, continue to face worse outcomes.\u003c/p>\n\u003cp>“While we have been somewhat successful, we can’t really be jumping for joy yet,” said Holly Smith of the California Nurse-Midwives Association, which supports mandating racial bias training.\u003c/p>\n\u003cp>During Ford’s preterm delivery, for example, she was unaware that black women are \u003ca href=\"http://www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html\">three times more likely\u003c/a> than white women to have fibroids, which can have a harmful impact on \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874080/\">fertility and pregnancy\u003c/a>. Ford said her doctor never warned her that the ones resting on her uterus could complicate her own childbirth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When Ford did get pregnant again, she took extra precautions fearing she would have to relive her trauma. It wasn’t until she was 27 weeks along that she and her husband felt comfortable enough to bring the crib intended for her first daughter back into their home.\u003c/p>\n\u003cp>A year and one day after Kally’s due date, Ford gave birth to her daughter Skylar, who is now 11.\u003c/p>\n\u003cp>“I really appreciate every day with my daughter,” says the therapist, who sought help to cope with her own grief and anger. “But I have a niece and a goddaughter who were born right around the time that Kally was born. So watching the three of these girls grow up, I always have this feeling of like there should be one more.”\u003c/p>\n\u003cp>Her first born, she said, is never far from memory. Her remains rest in a tiny urn at Ford’s home.\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\">\u003cem>CALmatters.org\u003c/em>\u003c/a>\u003cem> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A controversial ballot measure that would give San Franciscans universal mental health care is being pushed from the November 2019 ballot to the March 2020 ballot to give lawmakers more time to come to an agreement as to how it should be implemented.\u003c/p>\n\u003cp>\u003ca href=\"https://sfgov.legistar.com/View.ashx?M=F&ID=7293146&GUID=0878CB8C-6BDA-4380-A39B-5F88AF974CD1\">The measure\u003c/a>, dubbed “Mental Health SF”, was announced in May. After the announcement, Mayor London Breed and the San Francisco Department of Public Health, which would be in charge of implementing the program, expressed concern about the high costs of implementation and a lack of input from the city’s health experts.\u003c/p>\n\u003cp>Now it seems that all parties are working together to come up with a compromise for the March 2020 ballot. \u003c/p>\n\u003cp>“It is important that we take a comprehensive, inclusive process to build on the progress we have made to strengthen our mental health system,” Breed said in a press release. She also emphasized the advancements already made this year including the passing of a contentious conservatorship law and the opening of 200 new behavioral health beds. \u003c/p>\n\u003cp>If passed by residents, the program would provide free and immediate access to mental health care to San Franciscans with or without insurance. It would also require the creation of a new 24 hours a day, 7 days a week drop-in center for people seeking psychological help or help with substance abuse. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The city controller and city’s economist gave preliminary numbers that annual costs would be as high as $100 million per year, not including start-up costs for building the drop-in center. \u003c/p>\n\u003cp>San Francisco Supervisor Hillary Ronen says she’s hopeful but not positive that the supervisors will come to a consensus with the mayor and DPH about how to address the problem, although they plan to meet weekly to negotiate.\u003c/p>\n\u003cp>[aside tag=\"mental-health-sf\" label=\"More on Mental Health SF.\"]\u003c/p>\n\u003cp>Ronen said she didn’t initially consult with the DPH because in early hearings about the problem, representatives were initially “obfuscating and denying that the problem was as grave as it is.”\u003c/p>\n\u003cp>She said if the supervisors can’t come to a consensus, she and Supervisor Matt Haney, the co-author of the bill, will still put the measure on the ballot.\u003c/p>\n\u003cp>Ultimately Ronen said the legislation is crucially important to address San Francisco’s mental health and homelessness crisis, and the delay is necessary to get the bill right. \u003c/p>\n\u003cp>“What we’re proposing is a complete overhaul and creation of a new universal system, and that doesn’t happen overnight,” she said. \u003c/p>\n\u003cp>The measure would be financed through the city’s proposed Excessive CEO Salary Tax — another ballot measure that would be imposed on CEOs making more than 100 times the median wage worker. That proposal will also be on the March 2020 ballot, having been moved from the November 2019 ballot. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The San Francisco Chamber of Commerce didn’t immediately respond to a request for comment on the Excessive CEO Salary Tax. \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A controversial ballot measure that would give San Franciscans universal mental health care is being pushed from the November 2019 ballot to the March 2020 ballot to give lawmakers more time to come to an agreement as to how it should be implemented.\u003c/p>\n\u003cp>\u003ca href=\"https://sfgov.legistar.com/View.ashx?M=F&ID=7293146&GUID=0878CB8C-6BDA-4380-A39B-5F88AF974CD1\">The measure\u003c/a>, dubbed “Mental Health SF”, was announced in May. After the announcement, Mayor London Breed and the San Francisco Department of Public Health, which would be in charge of implementing the program, expressed concern about the high costs of implementation and a lack of input from the city’s health experts.\u003c/p>\n\u003cp>Now it seems that all parties are working together to come up with a compromise for the March 2020 ballot. \u003c/p>\n\u003cp>“It is important that we take a comprehensive, inclusive process to build on the progress we have made to strengthen our mental health system,” Breed said in a press release. She also emphasized the advancements already made this year including the passing of a contentious conservatorship law and the opening of 200 new behavioral health beds. \u003c/p>\n\u003cp>If passed by residents, the program would provide free and immediate access to mental health care to San Franciscans with or without insurance. It would also require the creation of a new 24 hours a day, 7 days a week drop-in center for people seeking psychological help or help with substance abuse. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"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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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"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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"soldout": {
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"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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"tagline": "Local news to keep you rooted",
"info": "Host Devin Katayama walks you through the biggest story of the day with reporters and newsmakers.",
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