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"content": "\u003cp>A fiery debate is breaking out across Beverly Hills as people at tony hair salons, gas stations and stores weigh in on whether the city of the rich and famous should become the first in the U.S. to outlaw the sale of tobacco products everywhere except for a few cigar lounges.\u003c/p>\n\u003cp>The City Council decided Tuesday night to make some changes to the proposal, such as allowing guests in the city’s luxury hotels to acquire cigarettes through their concierge or room service. Members indicated they plan to pass the amended measure May 21.\u003c/p>\n\u003cp>Abstainers have said yes to the idea, and the sooner the better, while smokers protested, no way.\u003c/p>\n\u003cp>“It’s a ridiculous idea,” hair stylist Giuseppe Franco shouted soon after lighting up a Marlboro Light on a breezeway just outside the upscale hair salon that bears his name.\u003c/p>\n\u003cp>“First off, let’s be honest. Smoking is bad. I don’t let my daughter smoke,” he said during a sometimes profane tirade delivered between puffs. “But it’s going to hurt my friends,” he said, pointing out that a 24-hour Rite Aid pharmacy down the street does big business in cigarettes that go for about $8 a pack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So does the Union 76 gas station a couple blocks away, where the cashier says they sell about 50 packs a day at $12 apiece.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Retired businessman John Davis']‘They’re going to chase the tourists out of here.’[/pullquote]\u003c/p>\n\u003cp>California is among at least 25 states that outlaw smoking in workplaces, restaurants and bars. It also has one of the highest cigarette taxes in the country at nearly $3 a pack.\u003c/p>\n\u003cp>Beverly Hills already restricts the sale of menthol cigarettes and other flavored tobacco products.\u003c/p>\n\u003cp>But the proposed ordinance would go much further, banning all tobacco products from grocery stores, pharmacies, hotels and gas stations in the city of 34,000 people between West Hollywood and Los Angeles.\u003c/p>\n\u003cp>“My celebrity clients smoke,” Franco fumed.\u003c/p>\n\u003cp>Like most Beverly Hills business people, Franco won’t name them, but he did pull out a copy of the hotel magazine Concierge featuring a photo of him with his buddy Arnold Schwarzenegger, a cigar aficionado.\u003c/p>\n\u003cp>Cigar smokers most likely won’t have to sacrifice if the ordinance is adopted. A city staff report recommends exempting three tony cigar lounges in Beverly Hills.\u003c/p>\n\u003cp>Still, the folks at one of them, Nazareth’s Fine Cigars, weren’t happy.\u003c/p>\n\u003cp>“They’re going to chase the tourists out of here,” said retired businessman John Davis as he relaxed in a lounge chair, cigar in hand.\u003c/p>\n\u003cp>The decision came after the five-member council heard two hours of sometimes emotional but always polite testimony from scores of people on both sides of the issue.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Councilman Julian Gold']‘We are charged with providing for the public health and that’s really what this conversation is about.’[/pullquote]Owners of gas stations and other small businesses said the ban could force them to lay-off people. Health advocates said while they regretted that possibility, people’s health was more important.\u003c/p>\n\u003cp>Scott McGuff, a regional manager for Rite Aide, said the Beverly Hills pharmacy draws many customers from nearby luxury hotels who pick up both cigarettes and other items and it will lose them with the ban.\u003c/p>\n\u003cp>“It’s going to affect layoffs, that’s how big of a deal it is for me,” he said.\u003c/p>\n\u003cp>While council members sympathized, they said the public’s health was too important for Beverly Hills not to take action.\u003c/p>\n\u003cp>“We are charged with providing for the public health and that’s really what this conversation is about, said Councilman Julian Gold.\u003c/p>\n\u003cp>[aside tag='smoking-bans' label='More Coverage of Smoking Bans']These days, many people visit Beverly Hills from Asia and Europe, where smoking is commonplace, Davis said earlier from the cigar lounge. They’ll have to head to West Hollywood to buy their smokes because cigarette sales would be banned in famous places like the Beverly Wilshire, the hotel where Julia Roberts’ character stayed in “Pretty Woman.”\u003c/p>\n\u003cp>Not everyone in Beverly Hills is a wealthy celebrity, of course. While the median price of a home is more than $2 million and the median annual income is more than $103,000, about 9% of the population falls below the poverty line, according to the U.S. Census.\u003c/p>\n\u003cp>The gas stations, pharmacies and other places offering modest jobs and cigarettes are tucked into corners just off Rodeo Drive and other fashionable streets. Only 28 sell tobacco products, according to the city staff report.\u003c/p>\n\u003cp>The city report cites the hazards of smoking and the desire of Beverly Hills to be a healthy city as reasons for the ban on tobacco sales.\u003c/p>\n\u003cp>For non-smokers Oscar Melendez and Cezar Diaz, that’s reason enough to support it.\u003c/p>\n\u003cp>“I can pick up cigarette smoke from 30 feet away,” Melendez said.\u003c/p>\n\u003cp>At the fashionable Sarah Pacini clothing store, it gets so bad that Diaz, the manager, said he sometimes has to close the door and ask smokers not to stand on the sidewalk out front.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Most, he said, respond politely.\u003c/p>\n\n",
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"content": "\u003cp>\u003cem>Editor’s note: The following story was produced for \u003ca href=\"https://www.kqed.org/news/tag/youth-takeover\">Youth Takeover\u003c/a> week at KQED.\u003c/em>\u003c/p>\n\u003cp>I never expected to hear that my childhood best friend was pregnant.\u003c/p>\n\u003cp>My family and I were at the table eating dinner just like any other day. I notice my parents talking among themselves and think to myself that something’s a lil’ sus[picious].\u003c/p>\n\u003cp>“Your friend is pregnant.” Those were their words. I couldn’t fathom this information. My friend was only 15.\u003c/p>\n\u003cp>I rested my head in my hands and stared down at the table, thinking a billion thoughts, surrounded with fear.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>When will she have the baby? What will she name her baby? How will she finish school? Who’s the father? How could she be so stupid? What was she experiencing in her life that she wanted to avoid and not feel? Will she have time for me? How is our friendship going to change? I’m not a good friend. I could’ve done more. I should’ve done more. I regret not being there for her more. \u003c/em>\u003c/p>\n\u003cp>All these thoughts haunted my conscience, mind and spirit.\u003c/p>\n\u003cp>I was disappointed in her, and saddened by her poor decision-making. I even reached a point where I was angry. I felt justified about my feelings of anger toward her. I found a reason to be mad: she wasn’t thinking about how she could affect her whole family and friends.\u003c/p>\n\u003cp>It was selfish and proud of her to think nothing would happen. When we saw each other on Sundays at church, I couldn’t bring myself to even talk to her and say hi. I cried for the next two weeks, every day, until I let myself accept reality: My friend, who was just a few months younger than I, was pregnant.\u003c/p>\n\u003cp>Night and day I worried about my relationship with her. We had more or less drifted apart in middle school and high school, so in the moment it felt like this situation would only make our relationship more complicated.\u003cbr>\n[aside postID='news_11744347,news_11744837,news_11744489' label='more stories from the youth takeover']\u003cbr>\nI knew she was going to have to mature and grow up quicker for her son. In my mind, that meant that we couldn’t relate to each other, because she was going to be a mom, and I was just a teen in high school.\u003c/p>\n\u003cp>On top of that, we already had our differences. She was a very social, popular girl in school; I wasn’t as popular. Our personalities were very different; I was more reserved and quiet, while she was a lover of talking and making people laugh. She was going to be a mom, and I wasn’t.\u003c/p>\n\u003cp>Through this difficult time for both of us, I was able to get help from many, many friends who advised me on letting go of my anger and disappointment, loving her, and being her close friend again.\u003c/p>\n\u003cp>I couldn’t afford to make room for my anger and hurt anymore if it meant that I would lose my close relationship with her again. I knew she needed me to understand her, and all the embarrassment and shame she felt.\u003c/p>\n\u003cp>Though this situation was difficult, it ultimately brought us closer together. Because she lives so close to my school, I visit her more often. We have great talks over boba tea, and our friendship overall has turned into something I never I thought I’d have with her again: intimacy.\u003c/p>\n\u003cp>Since her son was born, we spend more time with each other. Her son is now 1 year old, and I’m happy to say he has been a great miracle for her family and mine. He has brought so much joy into our lives, and I’m glad my friend has a living, breathing being she can call hers for the rest of her life.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The three of us have walking lessons and little dance parties, and plenty of smiling and laughter. And I’m happy to say that my friend will be graduating this spring, and attending the University of San Francisco in the fall.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor’s note: The following story was produced for \u003ca href=\"https://www.kqed.org/news/tag/youth-takeover\">Youth Takeover\u003c/a> week at KQED.\u003c/em>\u003c/p>\n\u003cp>I never expected to hear that my childhood best friend was pregnant.\u003c/p>\n\u003cp>My family and I were at the table eating dinner just like any other day. I notice my parents talking among themselves and think to myself that something’s a lil’ sus[picious].\u003c/p>\n\u003cp>“Your friend is pregnant.” Those were their words. I couldn’t fathom this information. My friend was only 15.\u003c/p>\n\u003cp>I rested my head in my hands and stared down at the table, thinking a billion thoughts, surrounded with fear.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>When will she have the baby? What will she name her baby? How will she finish school? Who’s the father? How could she be so stupid? What was she experiencing in her life that she wanted to avoid and not feel? Will she have time for me? How is our friendship going to change? I’m not a good friend. I could’ve done more. I should’ve done more. I regret not being there for her more. \u003c/em>\u003c/p>\n\u003cp>All these thoughts haunted my conscience, mind and spirit.\u003c/p>\n\u003cp>I was disappointed in her, and saddened by her poor decision-making. I even reached a point where I was angry. I felt justified about my feelings of anger toward her. I found a reason to be mad: she wasn’t thinking about how she could affect her whole family and friends.\u003c/p>\n\u003cp>It was selfish and proud of her to think nothing would happen. When we saw each other on Sundays at church, I couldn’t bring myself to even talk to her and say hi. I cried for the next two weeks, every day, until I let myself accept reality: My friend, who was just a few months younger than I, was pregnant.\u003c/p>\n\u003cp>Night and day I worried about my relationship with her. We had more or less drifted apart in middle school and high school, so in the moment it felt like this situation would only make our relationship more complicated.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nI knew she was going to have to mature and grow up quicker for her son. In my mind, that meant that we couldn’t relate to each other, because she was going to be a mom, and I was just a teen in high school.\u003c/p>\n\u003cp>On top of that, we already had our differences. She was a very social, popular girl in school; I wasn’t as popular. Our personalities were very different; I was more reserved and quiet, while she was a lover of talking and making people laugh. She was going to be a mom, and I wasn’t.\u003c/p>\n\u003cp>Through this difficult time for both of us, I was able to get help from many, many friends who advised me on letting go of my anger and disappointment, loving her, and being her close friend again.\u003c/p>\n\u003cp>I couldn’t afford to make room for my anger and hurt anymore if it meant that I would lose my close relationship with her again. I knew she needed me to understand her, and all the embarrassment and shame she felt.\u003c/p>\n\u003cp>Though this situation was difficult, it ultimately brought us closer together. Because she lives so close to my school, I visit her more often. We have great talks over boba tea, and our friendship overall has turned into something I never I thought I’d have with her again: intimacy.\u003c/p>\n\u003cp>Since her son was born, we spend more time with each other. Her son is now 1 year old, and I’m happy to say he has been a great miracle for her family and mine. He has brought so much joy into our lives, and I’m glad my friend has a living, breathing being she can call hers for the rest of her life.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The three of us have walking lessons and little dance parties, and plenty of smiling and laughter. And I’m happy to say that my friend will be graduating this spring, and attending the University of San Francisco in the fall.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When it comes to treating opioid addiction, most health care experts say nurses have a critical role to play in prescribing the lifesaving medication buprenorphine.\u003c/p>\n\u003cp>Buprenorphine can be prescribed by both doctors and nurses who have taken specific training and received a license from the Drug Enforcement Administration.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Dr.David Aizuss, California Medical Association']‘What we don’t support is sending nurse practitioners out into individual communities, opening up storefronts to practice essentially independent medicine, when they’re not trained for that.’[/pullquote]\u003c/p>\n\u003cp>In California, however, the role of nurses is limited: They can prescribe the medicine, but only under the oversight of a doctor. That requirement is controversial. Some say it is an extra hurdle that restricts access to medications, while others say it is an appropriate limit of a nurse’s scope of care.\u003c/p>\n\u003cp>A\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2730102?resultClick=1\" target=\"_blank\" rel=\"noopener\"> study\u003c/a> published in the medical journal JAMA in April found that states without a physician-oversight requirement to prescribe buprenorphine have more nurses getting licensed to distribute the medication — 75% more than nurse practitioners in states with the restriction.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“An important part of addressing the opioid crisis is helping people access treatment when they need it,” said \u003ca href=\"https://healthforce.ucsf.edu/about-us/joanne-spetz\" target=\"_blank\" rel=\"noopener\">Joanne Spetz,\u003c/a> associate director of research at UCSF’s Healthforce Center, who co-authored the study.\u003c/p>\n\u003cp>And nurses play a big role in that.\u003c/p>\n\u003cp>“There are numerous studies that show that the quality of nurse practitioner care for primary care and for the areas in which they are trained and prepared is as good as a physician,” Spetz said.\u003c/p>\n\u003cp>[aside tag='opioids' label='More Coverage of the Opioid Crisis']\u003c/p>\n\u003cp>More than 47,000 people died from an opioid overdose nationwide in 2017, according to \u003ca href=\"https://www.cdc.gov/drugoverdose/data/index.html\" target=\"_blank\" rel=\"noopener\">the most recent data\u003c/a>. The gold standard for treating this addiction is medication and counseling. Yet the majority of the roughly 2 million people with opioid addiction \u003ca href=\"https://www.nap.edu/resource/25310/032019_OUDhighlights.pdf\" target=\"_blank\" rel=\"noopener\">cannot access these medications\u003c/a>, like buprenorphine.\u003c/p>\n\u003cp>California is the only Western state with this doctor supervision requirement as it applies to buprenorphine.\u003c/p>\n\u003cp>\u003ca href=\"https://a02.asmdc.org/\" target=\"_blank\" rel=\"noopener\">Assemblyman Jim Wood\u003c/a> authored \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB890\" target=\"_blank\" rel=\"noopener\">a bill\u003c/a> that would authorize a nationally certified nurse practitioner to provide specific medical services without physician oversight, including prescribing buprenorphine.\u003c/p>\n\u003cp>Wood represents counties in the northwest part of the state, where opioid overdose death rates are \u003ca href=\"https://discovery.cdph.ca.gov/CDIC/ODdash/\" target=\"_blank\" rel=\"noopener\">higher than the national average\u003c/a>.\u003c/p>\n\u003cp>Some of the rural counties Wood represents have a dearth of health care providers.\u003c/p>\n\u003cp>“We’ve had primary care shortages, and over the last seven or eight years it’s actually gotten worse,” Wood said.\u003c/p>\n\u003cp>He sees nurse practitioners as an important way to fill that gap: “We need that workforce.”\u003c/p>\n\u003cp>Wood’s bill follows recommendations made by the \u003ca href=\"https://futurehealthworkforce.org/\" target=\"_blank\" rel=\"noopener\">California Future Health Workforce Commission\u003c/a>, a group of experts in the fields of health, labor and education. The coalition released \u003ca href=\"https://futurehealthworkforce.org/wp-content/uploads/2019/02/ExecutiveSummaryFinalReportCFHWC.pdf\" target=\"_blank\" rel=\"noopener\">a report\u003c/a> in February highlighting a mismatch between the state’s health care needs, and both the supply and type of health care workers available.\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Joanne Spetz, UCSF’s Healthforce Center']‘An important part of addressing the opioid crisis is helping people access treatment when they need it.’[/pullquote]\u003c/p>\n\u003cp>The report predicts California will be short more than 4,000 doctors in the next decade. One of the group’s suggestions to address the deficiency in primary care? Expand the authority of nurse practitioners.\u003c/p>\n\u003cp>But Dr. David Aizuss, president of the California Medical Association, said the legislation was not the way to plug that gap.\u003c/p>\n\u003cp>“There’s no doubt in my mind that nurse practitioners have a role as part of team-based medical care for providing care for patients,” he said. “What we don’t support is sending nurse practitioners out into individual communities, opening up storefronts to practice essentially independent medicine, when they’re not trained for that.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Aizuss said his group has worked on other solutions to the rural health care shortage, like creating more positions for primary care residents in California, and loan forgiveness programs for doctors who work with high numbers of low-income patients who rely on Medi-Cal.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“An important part of addressing the opioid crisis is helping people access treatment when they need it,” said \u003ca href=\"https://healthforce.ucsf.edu/about-us/joanne-spetz\" target=\"_blank\" rel=\"noopener\">Joanne Spetz,\u003c/a> associate director of research at UCSF’s Healthforce Center, who co-authored the study.\u003c/p>\n\u003cp>And nurses play a big role in that.\u003c/p>\n\u003cp>“There are numerous studies that show that the quality of nurse practitioner care for primary care and for the areas in which they are trained and prepared is as good as a physician,” Spetz said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>More than 47,000 people died from an opioid overdose nationwide in 2017, according to \u003ca href=\"https://www.cdc.gov/drugoverdose/data/index.html\" target=\"_blank\" rel=\"noopener\">the most recent data\u003c/a>. The gold standard for treating this addiction is medication and counseling. Yet the majority of the roughly 2 million people with opioid addiction \u003ca href=\"https://www.nap.edu/resource/25310/032019_OUDhighlights.pdf\" target=\"_blank\" rel=\"noopener\">cannot access these medications\u003c/a>, like buprenorphine.\u003c/p>\n\u003cp>California is the only Western state with this doctor supervision requirement as it applies to buprenorphine.\u003c/p>\n\u003cp>\u003ca href=\"https://a02.asmdc.org/\" target=\"_blank\" rel=\"noopener\">Assemblyman Jim Wood\u003c/a> authored \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB890\" target=\"_blank\" rel=\"noopener\">a bill\u003c/a> that would authorize a nationally certified nurse practitioner to provide specific medical services without physician oversight, including prescribing buprenorphine.\u003c/p>\n\u003cp>Wood represents counties in the northwest part of the state, where opioid overdose death rates are \u003ca href=\"https://discovery.cdph.ca.gov/CDIC/ODdash/\" target=\"_blank\" rel=\"noopener\">higher than the national average\u003c/a>.\u003c/p>\n\u003cp>Some of the rural counties Wood represents have a dearth of health care providers.\u003c/p>\n\u003cp>“We’ve had primary care shortages, and over the last seven or eight years it’s actually gotten worse,” Wood said.\u003c/p>\n\u003cp>He sees nurse practitioners as an important way to fill that gap: “We need that workforce.”\u003c/p>\n\u003cp>Wood’s bill follows recommendations made by the \u003ca href=\"https://futurehealthworkforce.org/\" target=\"_blank\" rel=\"noopener\">California Future Health Workforce Commission\u003c/a>, a group of experts in the fields of health, labor and education. The coalition released \u003ca href=\"https://futurehealthworkforce.org/wp-content/uploads/2019/02/ExecutiveSummaryFinalReportCFHWC.pdf\" target=\"_blank\" rel=\"noopener\">a report\u003c/a> in February highlighting a mismatch between the state’s health care needs, and both the supply and type of health care workers available.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The report predicts California will be short more than 4,000 doctors in the next decade. One of the group’s suggestions to address the deficiency in primary care? Expand the authority of nurse practitioners.\u003c/p>\n\u003cp>But Dr. David Aizuss, president of the California Medical Association, said the legislation was not the way to plug that gap.\u003c/p>\n\u003cp>“There’s no doubt in my mind that nurse practitioners have a role as part of team-based medical care for providing care for patients,” he said. “What we don’t support is sending nurse practitioners out into individual communities, opening up storefronts to practice essentially independent medicine, when they’re not trained for that.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Aizuss said his group has worked on other solutions to the rural health care shortage, like creating more positions for primary care residents in California, and loan forgiveness programs for doctors who work with high numbers of low-income patients who rely on Medi-Cal.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>More than 700 measles cases have been confirmed in 22 states so far this year, with 78 of those cases reported in the previous week, \u003ca href=\"https://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">according to Monday’s update from the Centers for Disease Control and Prevention.\u003c/a> That’s the highest number reported in the U.S. since 1994.\u003c/p>\n\u003cp>[aside label=\"Related\" tag=\"measles\"]\u003c/p>\n\u003cp>Of those cases, more than 500 have been found in people who had not been vaccinated, the federal agency said, including about 400 in mostly Orthodox Jewish communities in the New York region. And late last week, a quarantine order was issued for \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">hundreds of students and staff at two Los Angeles universities\u003c/a> who may have been exposed to measles and don’t have vaccination records.\u003c/p>\n\u003cp>With this latest outbreak comes plenty of angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves) against the highly contagious, yet preventable, disease.\u003c/p>\n\u003cp>As recently as three decades ago, measles was listed by the World Health Organization as one of the five leading causes of death on Earth. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely due to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported what was then the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>\u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx\" target=\"_blank\" rel=\"noopener\">Forty-seven\u003c/a> states still permit parents to opt out of vaccinating their children on religious grounds, and 18 states allow exemptions based on personal or philosophical beliefs (until 2015, \u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements/california.aspx\" target=\"_blank\" rel=\"noopener\">California allowed\u003c/a> both exemptions). Many parents who go this route say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even though no medical evidence actually supports these theories.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://apps.npr.org/dailygraphics/graphics/measles-20190429/\" width=\"700\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>These holdouts mark just the latest chapter in a long, robust history of anti-vaccination movements. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of vaccinations were given more than 200 years ago.\u003c/p>\n\u003cp>Most interesting are the striking cultural similarities and motives of today’s prototypical “anti-vaxers” and their 19th century forebears: Both have typically been cast as either deeply religious or affluent, well-educated and politically progressive, and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner’s the guy to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire civilizations and claiming millions of lives — particularly those of young children — during its sporadic outbreaks. Highly infectious, the disease typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals and can be transmitted to human handlers. \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Jenner extracted pus from a cowpox scab\u003c/a> and inserted it into an incision on the arm of an 8-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cp>Jenner subsequently coined the term “vaccine,” from “vacca,” Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner’s findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the following two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the \u003ca href=\"https://www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization in 1980\u003c/a> declared it the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for it; vaccination is the only means of prevention.\u003c/p>\n\u003ch3>Birth of the Backlash\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: Who wouldn’t raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-16227 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: “This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.” (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure became increasingly accepted by the medical establishment in much of Europe.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>These measures, though, were met with staunch resistance, inciting a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cp>The group’s seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>“As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.”\u003c/em>\u003c/p>\n\u003cp>By the 1870s and ’80s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease’s spread, anti-vaccination campaigns continued to gain momentum in the U.K. and elsewhere. Propaganda literature proliferated as leaders of the movement adeptly tapped into the public’s understandable anxieties about the still nascent procedure. Some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744701\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744701\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\" alt=\"\" width=\"720\" height=\"405\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405-160x90.jpg 160w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from a 1894 anti-vaccination publication. \u003ccite>(Courtesy of the Historical Medical Library of the College of Physicians of Philadelphia)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the largest demonstrations, in Leicester, England, in 1885, drew upward of 100,000 people, with a child’s coffin and an effigy of Jenner among the props exhibited.\u003c/p>\n\u003cp>The rally prompted a government commission to investigate the protesters’ grievances, which eventually concluded that the vaccine was safe and effective. But in a political move to pacify detractors, the report also recommended the abolition of penalties for violators. In 1898, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">the passage of a new national vaccination act\u003c/a> removed such penalties and included a “conscientious objector” clause, allowing parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003ch3>The anti-vax fever spreads to America\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the United States spurred a number of local government vaccine campaigns. That, in turn, prompted fierce opposition, including a visit from William Tebb, a prominent British anti-vaccine activist. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cp>In a response that inflamed tensions and helped further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, inconsistent enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, writes \u003ca href=\"https://www.tulsaworld.com/opinion/columnists/stephen-mihm-how-to-eradicate-outbreaks-of-anti-vaccine-fever/article_4660b867-3b84-58b1-8e2e-73e631c0bdd5.html\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11744718\" class=\"wp-caption alignnone\" style=\"max-width: 758px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744718\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\" alt=\"\" width=\"758\" height=\"441\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg 758w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902-160x93.jpg 160w\" sizes=\"(max-width: 758px) 100vw, 758px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Anti-Vaccination Society of America advertisement from 1902. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fears were also legitimately stoked by the lack of oversight in the production of vaccines, a process primarily controlled by private industry that was loosely regulated and at times resulted in questionable, unsafe products. In one of the worst incidents, nine children in Camden, New Jersey, died after being inoculated with a batch of smallpox vaccine that had been contaminated with tetanus. News of the tragedy prompted Congress to pass the \u003ca href=\"https://history.nih.gov/exhibits/history/docs/page_03.html\" target=\"_blank\" rel=\"noopener\">Biologics Control Act\u003c/a> of 1902, increasing government oversight of the manufacturing process.s\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Massachusetts, mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> — eventually made its way to the U.S. Supreme Court, which ultimately sided with the state, ruling that it was within its power to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">The decision\u003c/a> marked the first Supreme Court case determining the extent of state power in enacting public health law.\u003c/p>\n\u003ch3>Modern times\u003c/h3>\n\u003cp>Anti-vaccination fervor erupted again in England and spread abroad in the latter half of the 20th century, this time after an errant 1970s medical study alleged that the diphtheria, tetanus and pertussis (DTP) vaccine had caused neurological disorders in children. The report fueled a wave of public outcry and subsequent false analyses, leading to decreased vaccination rates and three major outbreaks of pertussis (whooping cough), despite an independent advisory committee confirming the safety of the immunization.\u003c/p>\n\u003cp>The controversy over DTP reached the United States after a 1982 documentary, “DPT: Vaccination Roulette,” and a 1991 book, “A Shot in the Dark,” alleged adverse reactions to the vaccine and questioned its effectiveness. Amid the ensuing media storm, scores of parents formed advocacy groups opposing the immunization and, in several cases, sued vaccine manufacturers. Hoping to not repeat England’s example, U.S. medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention, aggressively countered the false claims, and more effectively stemmed the decrease in vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744712\" class=\"wp-caption alignnone\" style=\"max-width: 2048px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744712\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1920x1280.jpg 1920w\" sizes=\"(max-width: 2048px) 100vw, 2048px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An anti-vaccination parent holds up a prescription document as she waits to enter a hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill in Washington, D.C., on March 5, 2019. \u003ccite>(Jim WATSON/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And then came the \u003cem>anti\u003c/em> anti-measles movement.\u003c/p>\n\u003cp>Despite the MMR vaccine’s safe and effective application since it was introduced in the 1960s, fear over the inoculation spread like wildfire after a 1998 medical study, and a subsequent flurry of media coverage, suggested a connection between the vaccine and the onset of autism. The study was later discredited, and an independent medical board determined that its author, British doctor Andrew Wakefield, had a “fatal conflict of interest” \u003ca href=\"https://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">after revelations\u003c/a> that he had been paid by lawyers representing parents who believed the vaccine had harmed their children.\u003c/p>\n\u003cp>More than a decade later, after numerous subsequent studies that found no evidence of any link between the vaccine and autism, the paper was formally retracted by The Lancet, the journal that first published it, and \u003ca href=\"https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper\" target=\"_blank\" rel=\"noopener\">labeled “utterly false.”\u003c/a> Wakefield \u003ca href=\"https://www.mdmag.com/medical-news/autism_doctor/\" target=\"_blank\" rel=\"noopener\">was also stripped of his medical license\u003c/a>.\u003c/p>\n\u003cp>But the seed had been planted, and parents already skeptical about immunizing their children were further motivated to avoid the vaccine at all costs.\u003c/p>\n\u003cp>Since then, fears have been further inflamed by a number of anti-vaccination campaigns suggesting the linkage to an increased incidence of autism. Perhaps most well-known is the ongoing activism of \u003ca href=\"https://www.cnbc.com/2018/05/10/jenny-mccarthy-talks-to-cnbc-about-autism-and-her-family.html\" target=\"_blank\" rel=\"noopener\">actress and model Jenny McCarthy\u003c/a>, who became the veritable poster child of the anti-vax movement when she began publicly questioning the safety of vaccines after her 2-year-old son was diagnosed with autism.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A nationwide measles outbreak has prompted angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves). Here’s some history.",
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"title": "The Feverish Roots of Today's Anti-Vaccine Movement | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than 700 measles cases have been confirmed in 22 states so far this year, with 78 of those cases reported in the previous week, \u003ca href=\"https://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">according to Monday’s update from the Centers for Disease Control and Prevention.\u003c/a> That’s the highest number reported in the U.S. since 1994.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of those cases, more than 500 have been found in people who had not been vaccinated, the federal agency said, including about 400 in mostly Orthodox Jewish communities in the New York region. And late last week, a quarantine order was issued for \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">hundreds of students and staff at two Los Angeles universities\u003c/a> who may have been exposed to measles and don’t have vaccination records.\u003c/p>\n\u003cp>With this latest outbreak comes plenty of angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves) against the highly contagious, yet preventable, disease.\u003c/p>\n\u003cp>As recently as three decades ago, measles was listed by the World Health Organization as one of the five leading causes of death on Earth. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely due to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported what was then the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>\u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx\" target=\"_blank\" rel=\"noopener\">Forty-seven\u003c/a> states still permit parents to opt out of vaccinating their children on religious grounds, and 18 states allow exemptions based on personal or philosophical beliefs (until 2015, \u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements/california.aspx\" target=\"_blank\" rel=\"noopener\">California allowed\u003c/a> both exemptions). Many parents who go this route say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even though no medical evidence actually supports these theories.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://apps.npr.org/dailygraphics/graphics/measles-20190429/\" width=\"700\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>These holdouts mark just the latest chapter in a long, robust history of anti-vaccination movements. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of vaccinations were given more than 200 years ago.\u003c/p>\n\u003cp>Most interesting are the striking cultural similarities and motives of today’s prototypical “anti-vaxers” and their 19th century forebears: Both have typically been cast as either deeply religious or affluent, well-educated and politically progressive, and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner’s the guy to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire civilizations and claiming millions of lives — particularly those of young children — during its sporadic outbreaks. Highly infectious, the disease typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals and can be transmitted to human handlers. \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Jenner extracted pus from a cowpox scab\u003c/a> and inserted it into an incision on the arm of an 8-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cp>Jenner subsequently coined the term “vaccine,” from “vacca,” Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner’s findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the following two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the \u003ca href=\"https://www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization in 1980\u003c/a> declared it the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for it; vaccination is the only means of prevention.\u003c/p>\n\u003ch3>Birth of the Backlash\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: Who wouldn’t raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-16227 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: “This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.” (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure became increasingly accepted by the medical establishment in much of Europe.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>These measures, though, were met with staunch resistance, inciting a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cp>The group’s seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>“As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.”\u003c/em>\u003c/p>\n\u003cp>By the 1870s and ’80s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease’s spread, anti-vaccination campaigns continued to gain momentum in the U.K. and elsewhere. Propaganda literature proliferated as leaders of the movement adeptly tapped into the public’s understandable anxieties about the still nascent procedure. Some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744701\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744701\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\" alt=\"\" width=\"720\" height=\"405\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405-160x90.jpg 160w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from a 1894 anti-vaccination publication. \u003ccite>(Courtesy of the Historical Medical Library of the College of Physicians of Philadelphia)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the largest demonstrations, in Leicester, England, in 1885, drew upward of 100,000 people, with a child’s coffin and an effigy of Jenner among the props exhibited.\u003c/p>\n\u003cp>The rally prompted a government commission to investigate the protesters’ grievances, which eventually concluded that the vaccine was safe and effective. But in a political move to pacify detractors, the report also recommended the abolition of penalties for violators. In 1898, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">the passage of a new national vaccination act\u003c/a> removed such penalties and included a “conscientious objector” clause, allowing parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003ch3>The anti-vax fever spreads to America\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the United States spurred a number of local government vaccine campaigns. That, in turn, prompted fierce opposition, including a visit from William Tebb, a prominent British anti-vaccine activist. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cp>In a response that inflamed tensions and helped further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, inconsistent enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, writes \u003ca href=\"https://www.tulsaworld.com/opinion/columnists/stephen-mihm-how-to-eradicate-outbreaks-of-anti-vaccine-fever/article_4660b867-3b84-58b1-8e2e-73e631c0bdd5.html\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11744718\" class=\"wp-caption alignnone\" style=\"max-width: 758px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744718\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\" alt=\"\" width=\"758\" height=\"441\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg 758w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902-160x93.jpg 160w\" sizes=\"(max-width: 758px) 100vw, 758px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Anti-Vaccination Society of America advertisement from 1902. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fears were also legitimately stoked by the lack of oversight in the production of vaccines, a process primarily controlled by private industry that was loosely regulated and at times resulted in questionable, unsafe products. In one of the worst incidents, nine children in Camden, New Jersey, died after being inoculated with a batch of smallpox vaccine that had been contaminated with tetanus. News of the tragedy prompted Congress to pass the \u003ca href=\"https://history.nih.gov/exhibits/history/docs/page_03.html\" target=\"_blank\" rel=\"noopener\">Biologics Control Act\u003c/a> of 1902, increasing government oversight of the manufacturing process.s\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Massachusetts, mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> — eventually made its way to the U.S. Supreme Court, which ultimately sided with the state, ruling that it was within its power to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">The decision\u003c/a> marked the first Supreme Court case determining the extent of state power in enacting public health law.\u003c/p>\n\u003ch3>Modern times\u003c/h3>\n\u003cp>Anti-vaccination fervor erupted again in England and spread abroad in the latter half of the 20th century, this time after an errant 1970s medical study alleged that the diphtheria, tetanus and pertussis (DTP) vaccine had caused neurological disorders in children. The report fueled a wave of public outcry and subsequent false analyses, leading to decreased vaccination rates and three major outbreaks of pertussis (whooping cough), despite an independent advisory committee confirming the safety of the immunization.\u003c/p>\n\u003cp>The controversy over DTP reached the United States after a 1982 documentary, “DPT: Vaccination Roulette,” and a 1991 book, “A Shot in the Dark,” alleged adverse reactions to the vaccine and questioned its effectiveness. Amid the ensuing media storm, scores of parents formed advocacy groups opposing the immunization and, in several cases, sued vaccine manufacturers. Hoping to not repeat England’s example, U.S. medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention, aggressively countered the false claims, and more effectively stemmed the decrease in vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744712\" class=\"wp-caption alignnone\" style=\"max-width: 2048px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744712\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1920x1280.jpg 1920w\" sizes=\"(max-width: 2048px) 100vw, 2048px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An anti-vaccination parent holds up a prescription document as she waits to enter a hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill in Washington, D.C., on March 5, 2019. \u003ccite>(Jim WATSON/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And then came the \u003cem>anti\u003c/em> anti-measles movement.\u003c/p>\n\u003cp>Despite the MMR vaccine’s safe and effective application since it was introduced in the 1960s, fear over the inoculation spread like wildfire after a 1998 medical study, and a subsequent flurry of media coverage, suggested a connection between the vaccine and the onset of autism. The study was later discredited, and an independent medical board determined that its author, British doctor Andrew Wakefield, had a “fatal conflict of interest” \u003ca href=\"https://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">after revelations\u003c/a> that he had been paid by lawyers representing parents who believed the vaccine had harmed their children.\u003c/p>\n\u003cp>More than a decade later, after numerous subsequent studies that found no evidence of any link between the vaccine and autism, the paper was formally retracted by The Lancet, the journal that first published it, and \u003ca href=\"https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper\" target=\"_blank\" rel=\"noopener\">labeled “utterly false.”\u003c/a> Wakefield \u003ca href=\"https://www.mdmag.com/medical-news/autism_doctor/\" target=\"_blank\" rel=\"noopener\">was also stripped of his medical license\u003c/a>.\u003c/p>\n\u003cp>But the seed had been planted, and parents already skeptical about immunizing their children were further motivated to avoid the vaccine at all costs.\u003c/p>\n\u003cp>Since then, fears have been further inflamed by a number of anti-vaccination campaigns suggesting the linkage to an increased incidence of autism. Perhaps most well-known is the ongoing activism of \u003ca href=\"https://www.cnbc.com/2018/05/10/jenny-mccarthy-talks-to-cnbc-about-autism-and-her-family.html\" target=\"_blank\" rel=\"noopener\">actress and model Jenny McCarthy\u003c/a>, who became the veritable poster child of the anti-vax movement when she began publicly questioning the safety of vaccines after her 2-year-old son was diagnosed with autism.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>The following story was produced for \u003ca href=\"https://www.kqed.org/news/tag/youth-takeover\" target=\"_blank\" rel=\"noopener\">Youth Takeover\u003c/a> week at KQED.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11744190\" class=\"wp-caption alignright\" style=\"max-width: 283px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Copy-of-Genevieve-Schweitzer-e1556735157404.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-11744190\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Copy-of-Genevieve-Schweitzer-e1556735157404.jpg\" alt=\"\" width=\"283\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Genevieve Schweitzer is a 10th-grader at El Cerrito High School.\u003c/figcaption>\u003c/figure>\n\u003cp>When I was a young girl, I started donating general hygiene products to a women’s shelter in Berkeley. I would drop off things like soap, lotion and toothbrushes. But it never really crossed my mind that women in shelters might be in need of menstrual products too.\u003c/p>\n\u003cp>That changed when I started a feminist club with my friend at our high school. As I began to spend more time learning about relevant feminist issues, I found out about the real but rarely addressed issue of period poverty, in which poor women lack access to menstrual products.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.slu.edu/news/2019/january/menstrual-products-access-research.php\" target=\"_blank\" rel=\"noopener\">recent survey\u003c/a> conducted by St. Louis University found that nearly two-thirds of low-income women in that city over the last year couldn’t afford menstrual hygiene products like tampons or pads. Respondents said they instead sometimes resorted to using cloth, rags, tissues, toilet paper and sometimes even diapers or paper towels from public bathrooms. Nearly half the women in the survey also said that there were times in the past year when they couldn’t afford both food and period products.\u003c/p>\n\u003cp>“I do know of women who have talked about using toilet tissue paper or paper towels,” said Wanda Johnson, a nurse practitioner at Alameda County Health Care for the Homeless. “One woman, she was telling me that she had a sock and she wrapped the paper towel around the sock because that was the best way to wick it away.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nadya Okamoto, a Harvard University student on leave, started the organization \u003ca href=\"https://www.period.org/\" target=\"_blank\" rel=\"noopener\">PERIOD: The Menstrual Movement\u003c/a> when she was 16 to raise greater awareness about this issue.\u003c/p>\n\u003cp>“People don’t talk about it and it’s not really something that people know about or think about beyond their own experiences with it,” she said.\u003c/p>\n\u003cp>Women feel ashamed asking for products because of this unspoken rule that they shouldn’t talk about their periods with other people, Okamoto explained.\u003c/p>\n\u003cp>[aside label=\"More Youth Takeover stories\" tag=\"youth-takeover\"]\u003c/p>\n\u003cp>“A big barrier, too, is that food stamps don’t cover period products as necessities,” Okamoto said. “So a lot of the time it makes it even less affordable for people who really can’t afford those necessities.”\u003c/p>\n\u003cp>Period products are \u003ca href=\"https://www.npr.org/sections/money/2019/03/06/700876425/tampons-that-bloody-sales-tax\" target=\"_blank\" rel=\"noopener\">currently taxed in 35 states\u003c/a> in the country, including California, which makes them even less affordable for people with limited incomes. Meanwhile, items that are considered basic necessities, like most food products and sunscreen, are often tax exempt.\u003c/p>\n\u003cp>Wanda Johnson’s experience has taught her that the medical field doesn’t adequately address the issue of menstrual hygiene, but notes that she’s noticed some positive changes.\u003c/p>\n\u003cp>“We offer hygiene kits,” she said, adding that she has seen a growing number of shelters starting to offer period products to women in need, including one that recently placed a basket of products in its bathroom.\u003c/p>\n\u003cp>Meanwhile, an increasing number of states are considering abolishing taxes on menstrual products, \u003ca href=\"https://www.sfchronicle.com/politics/article/Repealing-California-s-tampon-tax-Gender-13707290.php\" target=\"_blank\" rel=\"noopener\">including California\u003c/a>, where a bill to repeal the tax is being taken up in the state Legislature. Most recently, \u003ca href=\"https://www.vox.com/2018/11/7/18056648/nevada-question-2-tampon-tax-results\" target=\"_blank\" rel=\"noopener\">Nevada voters\u003c/a> in 2018 approved scrapping the “tampon tax,” making it the 10th state in the country to do so (five other states don’t have any sales taxes). And \u003ca href=\"https://www.bloomberg.com/graphics/2018-tampon-cost/\" target=\"_blank\" rel=\"noopener\">a growing list of countries\u003c/a> around the world, including Canada, India, Kenya and Ireland, have eliminated these taxes altogether.\u003c/p>\n\u003cp>These developments are a sure sign that women are making their voices heard and driving home the message that period poverty is a human rights issue. Period.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Genevieve Schweizer is a 10th-grader at El Cerrito High School.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>The following story was produced for \u003ca href=\"https://www.kqed.org/news/tag/youth-takeover\" target=\"_blank\" rel=\"noopener\">Youth Takeover\u003c/a> week at KQED.\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_11744190\" class=\"wp-caption alignright\" style=\"max-width: 283px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Copy-of-Genevieve-Schweitzer-e1556735157404.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-11744190\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Copy-of-Genevieve-Schweitzer-e1556735157404.jpg\" alt=\"\" width=\"283\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Genevieve Schweitzer is a 10th-grader at El Cerrito High School.\u003c/figcaption>\u003c/figure>\n\u003cp>When I was a young girl, I started donating general hygiene products to a women’s shelter in Berkeley. I would drop off things like soap, lotion and toothbrushes. But it never really crossed my mind that women in shelters might be in need of menstrual products too.\u003c/p>\n\u003cp>That changed when I started a feminist club with my friend at our high school. As I began to spend more time learning about relevant feminist issues, I found out about the real but rarely addressed issue of period poverty, in which poor women lack access to menstrual products.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.slu.edu/news/2019/january/menstrual-products-access-research.php\" target=\"_blank\" rel=\"noopener\">recent survey\u003c/a> conducted by St. Louis University found that nearly two-thirds of low-income women in that city over the last year couldn’t afford menstrual hygiene products like tampons or pads. Respondents said they instead sometimes resorted to using cloth, rags, tissues, toilet paper and sometimes even diapers or paper towels from public bathrooms. Nearly half the women in the survey also said that there were times in the past year when they couldn’t afford both food and period products.\u003c/p>\n\u003cp>“I do know of women who have talked about using toilet tissue paper or paper towels,” said Wanda Johnson, a nurse practitioner at Alameda County Health Care for the Homeless. “One woman, she was telling me that she had a sock and she wrapped the paper towel around the sock because that was the best way to wick it away.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nadya Okamoto, a Harvard University student on leave, started the organization \u003ca href=\"https://www.period.org/\" target=\"_blank\" rel=\"noopener\">PERIOD: The Menstrual Movement\u003c/a> when she was 16 to raise greater awareness about this issue.\u003c/p>\n\u003cp>“People don’t talk about it and it’s not really something that people know about or think about beyond their own experiences with it,” she said.\u003c/p>\n\u003cp>Women feel ashamed asking for products because of this unspoken rule that they shouldn’t talk about their periods with other people, Okamoto explained.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“A big barrier, too, is that food stamps don’t cover period products as necessities,” Okamoto said. “So a lot of the time it makes it even less affordable for people who really can’t afford those necessities.”\u003c/p>\n\u003cp>Period products are \u003ca href=\"https://www.npr.org/sections/money/2019/03/06/700876425/tampons-that-bloody-sales-tax\" target=\"_blank\" rel=\"noopener\">currently taxed in 35 states\u003c/a> in the country, including California, which makes them even less affordable for people with limited incomes. Meanwhile, items that are considered basic necessities, like most food products and sunscreen, are often tax exempt.\u003c/p>\n\u003cp>Wanda Johnson’s experience has taught her that the medical field doesn’t adequately address the issue of menstrual hygiene, but notes that she’s noticed some positive changes.\u003c/p>\n\u003cp>“We offer hygiene kits,” she said, adding that she has seen a growing number of shelters starting to offer period products to women in need, including one that recently placed a basket of products in its bathroom.\u003c/p>\n\u003cp>Meanwhile, an increasing number of states are considering abolishing taxes on menstrual products, \u003ca href=\"https://www.sfchronicle.com/politics/article/Repealing-California-s-tampon-tax-Gender-13707290.php\" target=\"_blank\" rel=\"noopener\">including California\u003c/a>, where a bill to repeal the tax is being taken up in the state Legislature. Most recently, \u003ca href=\"https://www.vox.com/2018/11/7/18056648/nevada-question-2-tampon-tax-results\" target=\"_blank\" rel=\"noopener\">Nevada voters\u003c/a> in 2018 approved scrapping the “tampon tax,” making it the 10th state in the country to do so (five other states don’t have any sales taxes). And \u003ca href=\"https://www.bloomberg.com/graphics/2018-tampon-cost/\" target=\"_blank\" rel=\"noopener\">a growing list of countries\u003c/a> around the world, including Canada, India, Kenya and Ireland, have eliminated these taxes altogether.\u003c/p>\n\u003cp>These developments are a sure sign that women are making their voices heard and driving home the message that period poverty is a human rights issue. Period.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Genevieve Schweizer is a 10th-grader at El Cerrito High School.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Most people who are blind or visually impaired weren’t born without vision. They lose it, often over time and in adulthood.\u003c/p>\n\u003cp>That can be an extremely difficult change, requiring you to embrace a new way of navigating and experiencing the world. For insight on making this transition, reporter Chris Hoff of the World According to Sound podcast visited the \u003ca href=\"https://earlebaum.org/\">Earle Baum Center of the Blind\u003c/a> in Santa Rosa.\u003c/p>\n\u003cp>Find the play button above to listen to what he discovered and heard on his trip there. This story, like all of the pieces in this series, is better with headphones.\u003c/p>\n\u003cp>\u003cem>This story is part of a series by Chris Hoff and Sam Harnett of the podcast \u003ca href=\"http://www.theworldaccordingtosound.org\">The World According to Sound\u003c/a>. They’re teaming up with the \u003ca href=\"http://lighthouse-sf.org/\">LightHouse for the Blind and Visually Impaired\u003c/a> in San Francisco to help us reimagine California in the rich ways blind people experience it every day. The project has additional support from California Humanities.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>A quarantine order was issued Thursday for hundreds of students and staff at two Los Angeles universities who may have been exposed to measles and either have not been vaccinated or cannot verify that they have immunity.\u003c/p>\n\u003cp>Measles in the United States has \u003ca href=\"https://www.npr.org/2019/04/24/716953746/cdc-reports-largest-u-s-measles-outbreak-since-year-2000\" rel=\"noopener\" target=\"_blank\">climbed to its highest level in 25 years\u003c/a>, closing in on 700 cases this year in a resurgence largely attributed to misinformation that is turning parents against vaccines. Roughly three-quarters of this year’s illnesses in the U.S. have been in New York state.\u003c/p>\n\u003cp>[aside postID=news_11742525 label='Related Coverage']\u003c/p>\n\u003cp>The University of California, Los Angeles, said that as of Wednesday there were 119 students and 8 faculty members under quarantine. Seventy-one students and 127 staff members are quarantined at California State University, Los Angeles after a possible measles exposure at a campus library, school officials said.\u003c/p>\n\u003cp>“The Department of Public Health has determined that there is no known current risk related to measles at the library at this time,” Cal State said in a statement.\u003c/p>\n\u003cp>UCLA said some people could remain in quarantines for up to 48 hours before they prove immunity. A few may need to remain in quarantine for up to seven days, officials said.\u003c/p>\n\u003cp>Such an order mandates that the exposed people stay home and notify authorities “if they develop symptoms of measles, and to avoid contact with others until the end of their quarantine period or until they provide evidence of immunity,” the Los Angeles County Department of Public Health said in a statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The orders come as a small outbreak of measles is occurring in Los Angeles County involving five confirmed cases linked to overseas travel. The state recorded 38 measles cases as of Thursday, versus 11 around the same time last year, said Dr. Karen Smith, director of the California Department of Public Health.\u003c/p>\n\u003cp>The state typically sees fewer than two dozen cases a year, she said.\u003c/p>\n\u003cp>This year, California’s cases stretch across 11 counties and affect patients from 5 months to 55 years of age.\u003c/p>\n\u003cp>More than 76% of patients were not vaccinated or didn’t receive the recommended two doses of vaccine, Smith said. Fourteen of those infected had traveled overseas to countries including Philippines, Thailand, India and Ukraine.\u003c/p>\n\u003cp>Measles in most people causes fever, runny nose, cough and a rash all over the body. However, a very small fraction of those infected can suffer complications such as pneumonia and a dangerous swelling of the brain.\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention recommends the vaccine for everyone over a year old, except for people who had the disease as children. Those who have had measles are immune.\u003c/p>\n\u003cp>The vaccine, which became available in the 1960s, is considered safe and highly effective, and because of it, measles was declared all but eliminated in the U.S. in 2000.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The University of California, Los Angeles, said that as of Wednesday there were 119 students and 8 faculty members under quarantine. Seventy-one students and 127 staff members are quarantined at California State University, Los Angeles after a possible measles exposure at a campus library, school officials said.\u003c/p>\n\u003cp>“The Department of Public Health has determined that there is no known current risk related to measles at the library at this time,” Cal State said in a statement.\u003c/p>\n\u003cp>UCLA said some people could remain in quarantines for up to 48 hours before they prove immunity. A few may need to remain in quarantine for up to seven days, officials said.\u003c/p>\n\u003cp>Such an order mandates that the exposed people stay home and notify authorities “if they develop symptoms of measles, and to avoid contact with others until the end of their quarantine period or until they provide evidence of immunity,” the Los Angeles County Department of Public Health said in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Lawmakers Consider Crackdown on Fake Medical Exemptions for Vaccines",
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"content": "\u003cp>State lawmakers launched debate Wednesday on a new bill targeting doctors who write fraudulent medical notes to excuse children from getting vaccinations required to enter school. The hearing coincided with the recent declaration of measles outbreaks in Los Angeles and Butte County, bringing the number of cases of the virus to more than 30 statewide this year.\u003c/p>\n\u003cp>State Sen. Richard Pan (D-Sacramento) made his case for \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, saying families are skirting existing California law that forbids exemptions from vaccines for religious or personal objections by finding doctors willing to make up bogus medical excuses.\u003c/p>\n\u003cp>“We witnessed physicians who advertised exemptions for cash on social media and the internet,” Pan said. “We’d see some parents post on social media that their child’s regular physician refused to grant their child a medical exemption so they traveled to go purchase one from a distant physician.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='State Sen. Richard Pan, who is also a pediatrician']‘We witnessed physicians who advertised exemptions for cash on social media and the internet.’[/pullquote]\u003c/p>\n\u003cp>The new legislation would require the state health department to review all medical exemptions and either approve or deny them. It would also create a database to track which doctors are issuing a disproportionate number of medical exemptions. About a hundred doctors, medical students, parents and representatives of hospital and insurance groups lined up to state their support of the bill.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Critics flooded the state Capitol to voice their opposition to the proposal, with hundreds and hundreds of parents, and a handful doctors, lining up for hours to complain of government overreach and interference in the doctor-patient relationship.\u003c/p>\n\u003cp>“I believe in vaccines. I vaccinate my patients and my own children,” said Dr. Nicole Shorrock, a pediatrician from Sacramento. “But I cannot support this bill because it is too extreme. Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Nicole Shorrock']‘Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.’[/pullquote]\u003c/p>\n\u003cp>The new bill is a follow-up to Sen. Pan’s earlier law, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener\">SB 277\u003c/a>, passed in 2015, which outlawed personal belief exemptions from vaccinations. Since then, the number of children getting medical exemptions more than tripled, from .2 percent to .7 percent.\u003c/p>\n\u003cp>Two other states – West Virginia and Mississippi – do not allow exemptions from vaccines for religious or personal reasons. West Virginia requires its state health department to vet medical exemptions.\u003c/p>\n\u003cp>Overall, California’s vaccination rate among children entering kindergarten went up in recent years to 95.6 percent, a level public health experts say is needed to create community immunity — when enough of the population is immunized to protect people who cannot be vaccinated, such as infants and people with compromised immune systems.\u003c/p>\n\u003cp>[aside tag='immunizations' label='Coverage of vaccines and immunizations']\u003c/p>\n\u003cp>However, the rising number of medical exemptions is showing up in clusters around the state — in concentrations inconsistent with the number of people who legitimately cannot be vaccinated — and that is leaving some schools with vaccination rates lower than 50 percent.\u003c/p>\n\u003cp>“Students at these schools are at risk for a major outbreak,” said Sen. Pan, who is also a pediatrician. “These schools, with these low vaccination rates, represent the tinder for a disease wildfire that can harm the broader community. California cannot allow a handful of unscrupulous physicians to put our children in danger.”\u003c/p>\n\u003cp>Most doctors in California support vaccination and emphasize the safety and efficacy of vaccines. The California Medical Association, a powerful physician trade group that has often resisted efforts to track or control doctors, endorsed the bill last month.\u003c/p>\n\u003cp>“This new legislation will close a loophole in the current law that has allowed a small handful of rogue doctors to skirt the spirit of the original law and has put millions of Californians at risk,” said Dr. David Aizuss, the medical association president. “All physicians must do their part to protect the health of children and the public at large.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Health Committee passed the bill on Wednesday. It goes next to Senate Appropriations, then faces several more committee votes to pass the Legislature.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State lawmakers launched debate Wednesday on a new bill targeting doctors who write fraudulent medical notes to excuse children from getting vaccinations required to enter school. The hearing coincided with the recent declaration of measles outbreaks in Los Angeles and Butte County, bringing the number of cases of the virus to more than 30 statewide this year.\u003c/p>\n\u003cp>State Sen. Richard Pan (D-Sacramento) made his case for \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, saying families are skirting existing California law that forbids exemptions from vaccines for religious or personal objections by finding doctors willing to make up bogus medical excuses.\u003c/p>\n\u003cp>“We witnessed physicians who advertised exemptions for cash on social media and the internet,” Pan said. “We’d see some parents post on social media that their child’s regular physician refused to grant their child a medical exemption so they traveled to go purchase one from a distant physician.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We witnessed physicians who advertised exemptions for cash on social media and the internet.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new legislation would require the state health department to review all medical exemptions and either approve or deny them. It would also create a database to track which doctors are issuing a disproportionate number of medical exemptions. About a hundred doctors, medical students, parents and representatives of hospital and insurance groups lined up to state their support of the bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Critics flooded the state Capitol to voice their opposition to the proposal, with hundreds and hundreds of parents, and a handful doctors, lining up for hours to complain of government overreach and interference in the doctor-patient relationship.\u003c/p>\n\u003cp>“I believe in vaccines. I vaccinate my patients and my own children,” said Dr. Nicole Shorrock, a pediatrician from Sacramento. “But I cannot support this bill because it is too extreme. Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new bill is a follow-up to Sen. Pan’s earlier law, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener\">SB 277\u003c/a>, passed in 2015, which outlawed personal belief exemptions from vaccinations. Since then, the number of children getting medical exemptions more than tripled, from .2 percent to .7 percent.\u003c/p>\n\u003cp>Two other states – West Virginia and Mississippi – do not allow exemptions from vaccines for religious or personal reasons. West Virginia requires its state health department to vet medical exemptions.\u003c/p>\n\u003cp>Overall, California’s vaccination rate among children entering kindergarten went up in recent years to 95.6 percent, a level public health experts say is needed to create community immunity — when enough of the population is immunized to protect people who cannot be vaccinated, such as infants and people with compromised immune systems.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, the rising number of medical exemptions is showing up in clusters around the state — in concentrations inconsistent with the number of people who legitimately cannot be vaccinated — and that is leaving some schools with vaccination rates lower than 50 percent.\u003c/p>\n\u003cp>“Students at these schools are at risk for a major outbreak,” said Sen. Pan, who is also a pediatrician. “These schools, with these low vaccination rates, represent the tinder for a disease wildfire that can harm the broader community. California cannot allow a handful of unscrupulous physicians to put our children in danger.”\u003c/p>\n\u003cp>Most doctors in California support vaccination and emphasize the safety and efficacy of vaccines. The California Medical Association, a powerful physician trade group that has often resisted efforts to track or control doctors, endorsed the bill last month.\u003c/p>\n\u003cp>“This new legislation will close a loophole in the current law that has allowed a small handful of rogue doctors to skirt the spirit of the original law and has put millions of Californians at risk,” said Dr. David Aizuss, the medical association president. “All physicians must do their part to protect the health of children and the public at large.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Health Committee passed the bill on Wednesday. It goes next to Senate Appropriations, then faces several more committee votes to pass the Legislature.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "overlooked-mental-health-catastrophe-vanishing-board-and-care-homes-leave-residents-with-few-options",
"title": "Mental Health 'Catastrophe': Few Options for Residents as Care Homes Close",
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"content": "\u003cp>This summer, Tom Gray will lose his home.\u003c/p>\n\u003cp>A slim man with hunched shoulders and a halting voice, Gray, 72, has schizophrenia. Before he landed in Carmen Palarca’s board-and-care home 11 years ago, he spent 20 years living on the streets, many of them huddled in a doorway across from a San Francisco Whole Foods.\u003c/p>\n\u003cp>“I feel kind of sad and worried a little bit,” Gray said quietly, sitting in the home’s small kitchen one recent afternoon.\u003c/p>\n\u003cp>He hadn’t yet received official notice from Palarca of her plans to close, but knew it was likely. She had, in fact, sent a letter to the city a few days earlier outlining her intent to shutter the home.\u003c/p>\n\u003cp>The planned closure of yet another board-and-care home—this one nestled near Golden Gate Park—reflects a broader trend affecting thousands of low-income Californians with serious mental illness. While housing values soar and minimum-wage increases drive up staffing costs, state reimbursement rates to board-and-cares have remained stagnant. The result: more facilities are shutting their doors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There are no reliable statewide data on the decrease of homes serving this specific population. But since 2012, San Francisco has lost more than a third of licensed residential facilities that serve people under 60, and more than a quarter of those serving older clients. Much of the decline has been in small, homelike facilities like Palarca’s, which provide food, laundry and medication help—and are more likely to accept low-income people with mental illnesses.\u003c/p>\n\u003cp>Los Angeles, which has a large portion of the state’s board-and-cares, has lost more than 200 beds for low-income people with serious mental illness in the past year.\u003c/p>\n\u003cp>Advocates say the state needs to collect better data—and significantly increase reimbursement rates—if it hopes to save the remaining facilities.\u003c/p>\n\u003cp>“If legislators don’t get onto this, we’re in big trouble,” said Lisa Kodmur, who is contracting with Los Angeles County on the issue. “We will see more homelessness, more incarceration, more institutionalization, more people living on the streets.”\u003c/p>\n\u003cp>[pullquote size='medium' align='left' citation='Sacramento Mayor Darrell Steinberg']The losses here are only making an already horrendous problem worse.’[/pullquote]\u003c/p>\n\u003cp>The housing crisis has placed those concerned about board-and-care residents with mental illness in a strange predicament: Many now find themselves advocating for facilities they consider to be of poor quality and outmoded. That’s because the alternatives they see—homelessness, incarceration, long-term placement in nursing homes or locked facilities—are worse.\u003c/p>\n\u003cp>“Our inventory is so dire that we are now trying to save an industry that is not a darling,” said Adriana Ruelas, legislative affairs director of \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener\">The Steinberg Institute\u003c/a>, which advocates for better mental health policies.\u003c/p>\n\u003cp>Sacramento Mayor Darrell Steinberg is a former state senate leader who founded the institute and was recently appointed by Gov. Gavin Newsom to lead a new commission on homelessness and supportive housing. He calls the closures “catastrophic.”\u003c/p>\n\u003cp>“They are not the perfect solution for everybody,” he said. “But, perspective here: it’s real shelter with care. The losses here are only making an already horrendous problem worse.”\u003c/p>\n\u003cp>At the root of the problem is money. Many facilities are closing because owners are selling the properties, or because operators are aging and their children don’t want to inherit a business that is not financially sound.\u003c/p>\n\u003cp>Licensed board-and-cares, also known as adult residential facilities, receive a government-set monthly rent of $1058—just under $35 a day—from tenants to pay for housing, 24-hour-care and three daily meals. The tenants cover that cost with their monthly \u003ca href=\"https://www.ssa.gov/ssi/\" target=\"_blank\" rel=\"noopener\">Supplemental Security Income\u003c/a> (SSI) checks, a combination of federal and state funds for people with serious mental illness, among others.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.ltcccsf.org/wp-content/uploads/2019/02/LTCCC-Assisted-Living-Workgroup-Final-Report-January-2019.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> published in January by San Francisco’s Long-Term Care Coordinating Council noted the minimum wage there has increased by 46% since 2012, while the SSI rate for assisted living residents has increased by just 8%. The report estimated the monthly break-even rate for board-and-cares at more than $2,000 per bed, more than double what low-income residents currently pay.\u003c/p>\n\u003cp>Some counties, including San Francisco and Los Angeles, pay a “patch” using local and state funds to boost this rate to about $1,700 a month. Operators say that’s still not enough.\u003c/p>\n\u003cfigure id=\"attachment_11741845\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741845\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-800x545.jpg\" alt=\"\" width=\"800\" height=\"545\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-800x545.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1020x695.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1200x817.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1920x1308.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831.jpg 2000w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Resident Concepcion Wedell makes her way to the kitchen while walking past Setsuko Letchford in the living room at Palarca’s Rest Home in San Francisco. \u003ccite>(Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Jonathan Sherin, director of the Los Angeles Department of Mental Health, says he’s been “ranting and raving” for years about the “alarming rate” of disappearance of board-and-cares in his city.\u003c/p>\n\u003cp>“It’s a broken business model,” he said. When homes close, his county scrambles to place the residents elsewhere. But that worsens the backlog for people in jails, hospitals or locked psychiatric facilities waiting for housing in the community.\u003c/p>\n\u003cp>And once homes are sold, NIMBYism—the “Not in My Backyard” attitude—can make it difficult to open new facilities in the same locations.\u003c/p>\n\u003cp>Ideally, Palarca said she would like to sell the home where Tom Gray lives to someone willing to maintain it as a board-and-care. But so far, she says, no potential buyer has seen a way to make the numbers work.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Larry Mateo']‘We had to call the sheriff to move them out because they just didn’t want to move….They said, ‘This is my home. Why are you moving me out?’”‘[/pullquote]\u003c/p>\n\u003cp>Larry Mateo, 59, once operated five board-and-care homes in San Francisco. By the end of last year, he’d closed them all. Now one is for sale and two others are being rented to young people—“they call them millennials”—who can pay the high rates commanded in the city.\u003c/p>\n\u003cp>“That’s an easy no-brainer decision,” Mateo said. “I don’t have payroll, I don’t have to go buy groceries, I don’t have to deal with clientele.”\u003c/p>\n\u003cp>There were residents, however, who initially refused to leave.\u003c/p>\n\u003cp>“Some said, ‘I have no place to go. I love this place,’” Mateo said. “We had to call the sheriff to move them out because they just didn’t want to move. I’m not sure if it was part of their mental illness, but they didn’t want to adapt to change. They said, ‘This is my home. Why are you moving me out?’ ”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11741850 alignleft\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225.jpg 300w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225-160x120.jpg 160w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\">\u003c/p>\n\u003cp>About a third of homeless individuals have serious mental illness, according to the \u003ca href=\"https://www.treatmentadvocacycenter.org/\" target=\"_blank\" rel=\"noopener\">Treatment Advocacy Center\u003c/a>, a nonprofit that advocates for expanded psychiatric services. With California’s homeless population nearing \u003ca href=\"https://www.usich.gov/homelessness-statistics/ca/\" target=\"_blank\" rel=\"noopener\">130,000\u003c/a>, an estimated 43,000 of them may be suffering from serious mental illness. As tent encampments proliferate, efforts to house these people have gained traction. Last fall, voters passed the \u003ca href=\"https://elections.calmatters.org/2018/california-ballot-measures/proposition-2-mental-health-money-for-housing/\" target=\"_blank\" rel=\"noopener\">No Place Like Home Act\u003c/a>, allowing the state to borrow $2 billion to increase the supply of permanent supportive housing, which pairs affordable housing with mental health services.\u003c/p>\n\u003cp>But not everyone with a serious mental illness is independent enough to thrive in permanent supportive housing. Some still need help with meals and laundry and medications. The disappearance of board-and-cares leaves these vulnerable people without an option, said Ruelas of The Steinberg Institute.\u003c/p>\n\u003cp>“The folks we’re talking about, they’re not ready to be successful in supportive housing,” she said. “And they need to start somewhere.”\u003c/p>\n\u003cp>After landing in hospitals due to psychosis, paranoia, and hallucinations in his early 20s, Tristan Scremin was discharged to board-and-care homes. Without this option, Scremin, now 45, speculates he might have ended up on the streets. Instead, he was able to stabilize and now works as a community liaison for \u003ca href=\"https://paintedbrain.org/\" target=\"_blank\" rel=\"noopener\">Painted Brain\u003c/a>, an arts-based mental health agency in Los Angeles.\u003c/p>\n\u003cp>“I see a lot of seriously mentally ill people on the street who are obviously having difficulty figuring out basic things,” he said. “If I had lost my chance to be in a board-and-care home, if I’d become homeless, I think it would have been very difficult.”\u003c/p>\n\u003cp>“We’re just really failing this population,” says Molly Davies, Los Angeles County’s long-term care ombudsman. She worries that funding gaps are not only forcing closures, but worsening conditions at board-and-cares that can be “inhumane.”\u003c/p>\n\u003cp>She’s seen bedbug and rat infestations, and a typhus outbreak.\u003c/p>\n\u003cp>Regulators are sometimes lenient, she said, because they don’t want to lose more beds. They know that as licensed homes close, unlicensed ones proliferate—with no oversight whatsoever.\u003c/p>\n\u003cp>At Carmen Palarca’s board-and-care, residents now face the possibility of being relocated to Central Valley communities they’ve never visited.\u003c/p>\n\u003cp>“I’m settled here. I’m used to it here,” said Setsuko Letchford, 70, who has frizzy gray hair and is missing teeth, and who says she hears voices that constantly badger her. “I don’t have any place to go,” she said. “They should find me some place to go.”\u003c/p>\n\u003cp>Palarca, 77, and her husband, Domingo, 87, bought the seven-bedroom home for $96,000 in 1976, after they moved to San Francisco from the Philippines. Carmen was working as a benefits eligibility worker for the city of San Francisco; Domingo was a mechanic for United Airlines. They wanted additional income to pay for their kids’ college educations.\u003c/p>\n\u003cp>Now, they want to relax and travel. Still, Palarca worries for Letchford and Gray and the home’s seven other residents. Clients in the home she closed in 2016 were farmed out to other facilities, some outside of the city.\u003c/p>\n\u003cp>“They didn’t have a choice,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11741847\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-800x546.jpg\" alt=\"\" width=\"800\" height=\"546\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-800x546.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1020x696.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1200x818.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1920x1309.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555.jpg 2000w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Carmen Palarca checks in on resident Sandy Pemberton as she eats lunch at Palarca’s Rest Home in San Francisco. \u003ccite>( Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kelly Hiramoto, director of transitions for the San Francisco Health Network, says the city is aware closures can be stressful for residents, although she wouldn’t label it a crisis because she said the city is generally able to find alternative placements.\u003c/p>\n\u003cp>The city subsidizes board-and-care beds for about 500 individuals, she said, starting at an additional $22 a day on top of the SSI rate, with half of those located outside of the county.\u003c/p>\n\u003cp>Benson Nadell, San Francisco’s long-term care ombudsman, says he expects the city’s remaining board-and-care homes to disappear in the next 15 years, if not sooner, given the current funding model. But he says he’d like to see new models, ones that prioritize programming and independence for the residents, while also addressing the squalor and neglect endemic in many facilities.\u003c/p>\n\u003cp>Ruelas of the Steinberg Institute also would like to see a dynamic system that provides life skills and activities, not just medication, laundry and food. She thinks \u003ca href=\"http://www.progressfoundation.org/\" target=\"_blank\" rel=\"noopener\">Progress Foundation\u003c/a>, which offers residential treatment options in San Francisco, Napa and Sonoma, is one model to consider.\u003c/p>\n\u003cp>Steve Fields, the nonprofit’s executive director, says board-and-care homes should be saved—and transformed into something better. Otherwise, he said, “counties without any imagination go back and reinvent the thing we don’t need anymore.”\u003c/p>\n\u003cp>Across the city from Palarca’s closing home, Aurora Concepción is trying to keep hers open.\u003c/p>\n\u003cp>She’s closed two homes in recent years because of staffing costs, but still has three others.\u003c/p>\n\u003cp>Brightly lit, with immaculate blonde wood floors and big windows that look out on the Financial District, the homes, perched on a hill in the Portola neighborhood, are much nicer than most board-and-cares, says city ombudsman Nadell.\u003c/p>\n\u003cfigure id=\"attachment_11741848\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741848\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-800x551.jpg\" alt=\"\" width=\"800\" height=\"551\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-800x551.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-160x110.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1020x703.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1200x827.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1920x1323.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Resident Maureen Pinell relaxes in a chair in the living room at Aurora Concepcion’s Residential Care Home in San Francisco. \u003ccite>(Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Concepción, 70, lives among her clients and says she feels driven by a mission.\u003c/p>\n\u003cp>“What I have is what they have; what I eat is what they eat,” she said. “I always tell them, we are a family here.”\u003c/p>\n\u003cp>Arriving from the Philippines in 1972, she took a bank job doing data entry. After her daughter was born with multiple sclerosis, she decided to stay home to care for her. She opened her first board-and-care in 1978, then another, then another. At her peak, she cared for 30 people. With the closures, she’s down to 16.\u003c/p>\n\u003cp>[pullquote size='large' align='right' citation='Aurora Concepción']‘“I make a joke all the time: We’re the cheapest hotel in town.’[/pullquote]\u003c/p>\n\u003cp>To stay open, she has reduced paid staff from four to one. She and her ex-husband and kids handle shopping, cooking and medications. She washes the laundry at night when utility rates are cheaper, buys food in bulk on sale, and said she hasn’t taken a real vacation in 40 years.\u003c/p>\n\u003cp>“We’re pinching pennies,” she said. “I make a joke all the time: We’re the cheapest hotel in town.”\u003c/p>\n\u003cp>On a recent morning, residents gathered to eat the lunch Concepción had prepared: salami-and-cheese sandwiches, chicken tomato soup and chocolate sandwich cookies. Silvia Velarde, 59, who has paranoid schizophrenia, said she loves the home, which feels clean and safe and orderly to her. The previous board-and-care she lived in—now closed—was “terrible, really nasty,” she said, and infested with bedbugs.\u003c/p>\n\u003cp>After lunch, Lori Loo, 56, who has schizophrenia and bipolar disorder and has been living here nine years, waited patiently for Velarde and the others to finish eating. She wanted to set the table for dinner. She said she feels comfortable here, and always volunteers to help clean up because there’s not much else to do.\u003c/p>\n\u003cp>After lunch, Concepción offered a tour of one of the homes she’s closed. The brightly lit upstairs looks out onto a city panorama. It will doubtless command a fortune in rent on the private market. But Concepción laments that she couldn’t keep it open for residents with mental illness.\u003c/p>\n\u003cp>“They deserve a second chance,” she said. “They deserve a home.”\u003c/p>\n\u003cp>\u003cem>Jocelyn Wiener is a contributing writer to CALmatters. Photos by Jessica Christian, San Francisco Chronicle. This story, the third in our series “Breakdown: Mental Health in California,” was supported by a grant from the California Health Care Foundation.\u003c/em>\u003c/p>\n\u003cp>Part 1: \u003cem>\u003ca href=\"https://calmatters.org/articles/california-mental-health-treatment-in-prisons/\" target=\"_blank\" rel=\"noopener\">All too often, California’s default mental institutions are now jails and prisons\u003c/a>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Part 2: \u003ca href=\"https://calmatters.org/articles/californians-struggle-to-get-mental-health-care/\" target=\"_blank\" rel=\"noopener\">\u003cem>For families across California, a desperate struggle to get mental health care\u003c/em>\u003c/a>\u003c/p>\n\n",
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"excerpt": "While housing values soar and minimum-wage increases drive up staffing costs, state reimbursement rates to board-and-cares have remained stagnant. The result: more facilities are shutting their doors.",
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"title": "Mental Health 'Catastrophe': Few Options for Residents as Care Homes Close | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This summer, Tom Gray will lose his home.\u003c/p>\n\u003cp>A slim man with hunched shoulders and a halting voice, Gray, 72, has schizophrenia. Before he landed in Carmen Palarca’s board-and-care home 11 years ago, he spent 20 years living on the streets, many of them huddled in a doorway across from a San Francisco Whole Foods.\u003c/p>\n\u003cp>“I feel kind of sad and worried a little bit,” Gray said quietly, sitting in the home’s small kitchen one recent afternoon.\u003c/p>\n\u003cp>He hadn’t yet received official notice from Palarca of her plans to close, but knew it was likely. She had, in fact, sent a letter to the city a few days earlier outlining her intent to shutter the home.\u003c/p>\n\u003cp>The planned closure of yet another board-and-care home—this one nestled near Golden Gate Park—reflects a broader trend affecting thousands of low-income Californians with serious mental illness. While housing values soar and minimum-wage increases drive up staffing costs, state reimbursement rates to board-and-cares have remained stagnant. The result: more facilities are shutting their doors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There are no reliable statewide data on the decrease of homes serving this specific population. But since 2012, San Francisco has lost more than a third of licensed residential facilities that serve people under 60, and more than a quarter of those serving older clients. Much of the decline has been in small, homelike facilities like Palarca’s, which provide food, laundry and medication help—and are more likely to accept low-income people with mental illnesses.\u003c/p>\n\u003cp>Los Angeles, which has a large portion of the state’s board-and-cares, has lost more than 200 beds for low-income people with serious mental illness in the past year.\u003c/p>\n\u003cp>Advocates say the state needs to collect better data—and significantly increase reimbursement rates—if it hopes to save the remaining facilities.\u003c/p>\n\u003cp>“If legislators don’t get onto this, we’re in big trouble,” said Lisa Kodmur, who is contracting with Los Angeles County on the issue. “We will see more homelessness, more incarceration, more institutionalization, more people living on the streets.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "The losses here are only making an already horrendous problem worse.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The housing crisis has placed those concerned about board-and-care residents with mental illness in a strange predicament: Many now find themselves advocating for facilities they consider to be of poor quality and outmoded. That’s because the alternatives they see—homelessness, incarceration, long-term placement in nursing homes or locked facilities—are worse.\u003c/p>\n\u003cp>“Our inventory is so dire that we are now trying to save an industry that is not a darling,” said Adriana Ruelas, legislative affairs director of \u003ca href=\"https://steinberginstitute.org/\" target=\"_blank\" rel=\"noopener\">The Steinberg Institute\u003c/a>, which advocates for better mental health policies.\u003c/p>\n\u003cp>Sacramento Mayor Darrell Steinberg is a former state senate leader who founded the institute and was recently appointed by Gov. Gavin Newsom to lead a new commission on homelessness and supportive housing. He calls the closures “catastrophic.”\u003c/p>\n\u003cp>“They are not the perfect solution for everybody,” he said. “But, perspective here: it’s real shelter with care. The losses here are only making an already horrendous problem worse.”\u003c/p>\n\u003cp>At the root of the problem is money. Many facilities are closing because owners are selling the properties, or because operators are aging and their children don’t want to inherit a business that is not financially sound.\u003c/p>\n\u003cp>Licensed board-and-cares, also known as adult residential facilities, receive a government-set monthly rent of $1058—just under $35 a day—from tenants to pay for housing, 24-hour-care and three daily meals. The tenants cover that cost with their monthly \u003ca href=\"https://www.ssa.gov/ssi/\" target=\"_blank\" rel=\"noopener\">Supplemental Security Income\u003c/a> (SSI) checks, a combination of federal and state funds for people with serious mental illness, among others.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.ltcccsf.org/wp-content/uploads/2019/02/LTCCC-Assisted-Living-Workgroup-Final-Report-January-2019.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> published in January by San Francisco’s Long-Term Care Coordinating Council noted the minimum wage there has increased by 46% since 2012, while the SSI rate for assisted living residents has increased by just 8%. The report estimated the monthly break-even rate for board-and-cares at more than $2,000 per bed, more than double what low-income residents currently pay.\u003c/p>\n\u003cp>Some counties, including San Francisco and Los Angeles, pay a “patch” using local and state funds to boost this rate to about $1,700 a month. Operators say that’s still not enough.\u003c/p>\n\u003cfigure id=\"attachment_11741845\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741845\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-800x545.jpg\" alt=\"\" width=\"800\" height=\"545\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-800x545.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1020x695.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1200x817.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831-1920x1308.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.05-e1555102729831.jpg 2000w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Resident Concepcion Wedell makes her way to the kitchen while walking past Setsuko Letchford in the living room at Palarca’s Rest Home in San Francisco. \u003ccite>(Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Jonathan Sherin, director of the Los Angeles Department of Mental Health, says he’s been “ranting and raving” for years about the “alarming rate” of disappearance of board-and-cares in his city.\u003c/p>\n\u003cp>“It’s a broken business model,” he said. When homes close, his county scrambles to place the residents elsewhere. But that worsens the backlog for people in jails, hospitals or locked psychiatric facilities waiting for housing in the community.\u003c/p>\n\u003cp>And once homes are sold, NIMBYism—the “Not in My Backyard” attitude—can make it difficult to open new facilities in the same locations.\u003c/p>\n\u003cp>Ideally, Palarca said she would like to sell the home where Tom Gray lives to someone willing to maintain it as a board-and-care. But so far, she says, no potential buyer has seen a way to make the numbers work.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We had to call the sheriff to move them out because they just didn’t want to move….They said, ‘This is my home. Why are you moving me out?’”‘",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Larry Mateo, 59, once operated five board-and-care homes in San Francisco. By the end of last year, he’d closed them all. Now one is for sale and two others are being rented to young people—“they call them millennials”—who can pay the high rates commanded in the city.\u003c/p>\n\u003cp>“That’s an easy no-brainer decision,” Mateo said. “I don’t have payroll, I don’t have to go buy groceries, I don’t have to deal with clientele.”\u003c/p>\n\u003cp>There were residents, however, who initially refused to leave.\u003c/p>\n\u003cp>“Some said, ‘I have no place to go. I love this place,’” Mateo said. “We had to call the sheriff to move them out because they just didn’t want to move. I’m not sure if it was part of their mental illness, but they didn’t want to adapt to change. They said, ‘This is my home. Why are you moving me out?’ ”\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11741850 alignleft\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225.jpg 300w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/copy-break-down-californias-mental-health-system-in-crisis-big-breakdown-2-300x225-160x120.jpg 160w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\">\u003c/p>\n\u003cp>About a third of homeless individuals have serious mental illness, according to the \u003ca href=\"https://www.treatmentadvocacycenter.org/\" target=\"_blank\" rel=\"noopener\">Treatment Advocacy Center\u003c/a>, a nonprofit that advocates for expanded psychiatric services. With California’s homeless population nearing \u003ca href=\"https://www.usich.gov/homelessness-statistics/ca/\" target=\"_blank\" rel=\"noopener\">130,000\u003c/a>, an estimated 43,000 of them may be suffering from serious mental illness. As tent encampments proliferate, efforts to house these people have gained traction. Last fall, voters passed the \u003ca href=\"https://elections.calmatters.org/2018/california-ballot-measures/proposition-2-mental-health-money-for-housing/\" target=\"_blank\" rel=\"noopener\">No Place Like Home Act\u003c/a>, allowing the state to borrow $2 billion to increase the supply of permanent supportive housing, which pairs affordable housing with mental health services.\u003c/p>\n\u003cp>But not everyone with a serious mental illness is independent enough to thrive in permanent supportive housing. Some still need help with meals and laundry and medications. The disappearance of board-and-cares leaves these vulnerable people without an option, said Ruelas of The Steinberg Institute.\u003c/p>\n\u003cp>“The folks we’re talking about, they’re not ready to be successful in supportive housing,” she said. “And they need to start somewhere.”\u003c/p>\n\u003cp>After landing in hospitals due to psychosis, paranoia, and hallucinations in his early 20s, Tristan Scremin was discharged to board-and-care homes. Without this option, Scremin, now 45, speculates he might have ended up on the streets. Instead, he was able to stabilize and now works as a community liaison for \u003ca href=\"https://paintedbrain.org/\" target=\"_blank\" rel=\"noopener\">Painted Brain\u003c/a>, an arts-based mental health agency in Los Angeles.\u003c/p>\n\u003cp>“I see a lot of seriously mentally ill people on the street who are obviously having difficulty figuring out basic things,” he said. “If I had lost my chance to be in a board-and-care home, if I’d become homeless, I think it would have been very difficult.”\u003c/p>\n\u003cp>“We’re just really failing this population,” says Molly Davies, Los Angeles County’s long-term care ombudsman. She worries that funding gaps are not only forcing closures, but worsening conditions at board-and-cares that can be “inhumane.”\u003c/p>\n\u003cp>She’s seen bedbug and rat infestations, and a typhus outbreak.\u003c/p>\n\u003cp>Regulators are sometimes lenient, she said, because they don’t want to lose more beds. They know that as licensed homes close, unlicensed ones proliferate—with no oversight whatsoever.\u003c/p>\n\u003cp>At Carmen Palarca’s board-and-care, residents now face the possibility of being relocated to Central Valley communities they’ve never visited.\u003c/p>\n\u003cp>“I’m settled here. I’m used to it here,” said Setsuko Letchford, 70, who has frizzy gray hair and is missing teeth, and who says she hears voices that constantly badger her. “I don’t have any place to go,” she said. “They should find me some place to go.”\u003c/p>\n\u003cp>Palarca, 77, and her husband, Domingo, 87, bought the seven-bedroom home for $96,000 in 1976, after they moved to San Francisco from the Philippines. Carmen was working as a benefits eligibility worker for the city of San Francisco; Domingo was a mechanic for United Airlines. They wanted additional income to pay for their kids’ college educations.\u003c/p>\n\u003cp>Now, they want to relax and travel. Still, Palarca worries for Letchford and Gray and the home’s seven other residents. Clients in the home she closed in 2016 were farmed out to other facilities, some outside of the city.\u003c/p>\n\u003cp>“They didn’t have a choice,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11741847\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-800x546.jpg\" alt=\"\" width=\"800\" height=\"546\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-800x546.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1020x696.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1200x818.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555-1920x1309.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.02-1-e1555103400555.jpg 2000w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Carmen Palarca checks in on resident Sandy Pemberton as she eats lunch at Palarca’s Rest Home in San Francisco. \u003ccite>( Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kelly Hiramoto, director of transitions for the San Francisco Health Network, says the city is aware closures can be stressful for residents, although she wouldn’t label it a crisis because she said the city is generally able to find alternative placements.\u003c/p>\n\u003cp>The city subsidizes board-and-care beds for about 500 individuals, she said, starting at an additional $22 a day on top of the SSI rate, with half of those located outside of the county.\u003c/p>\n\u003cp>Benson Nadell, San Francisco’s long-term care ombudsman, says he expects the city’s remaining board-and-care homes to disappear in the next 15 years, if not sooner, given the current funding model. But he says he’d like to see new models, ones that prioritize programming and independence for the residents, while also addressing the squalor and neglect endemic in many facilities.\u003c/p>\n\u003cp>Ruelas of the Steinberg Institute also would like to see a dynamic system that provides life skills and activities, not just medication, laundry and food. She thinks \u003ca href=\"http://www.progressfoundation.org/\" target=\"_blank\" rel=\"noopener\">Progress Foundation\u003c/a>, which offers residential treatment options in San Francisco, Napa and Sonoma, is one model to consider.\u003c/p>\n\u003cp>Steve Fields, the nonprofit’s executive director, says board-and-care homes should be saved—and transformed into something better. Otherwise, he said, “counties without any imagination go back and reinvent the thing we don’t need anymore.”\u003c/p>\n\u003cp>Across the city from Palarca’s closing home, Aurora Concepción is trying to keep hers open.\u003c/p>\n\u003cp>She’s closed two homes in recent years because of staffing costs, but still has three others.\u003c/p>\n\u003cp>Brightly lit, with immaculate blonde wood floors and big windows that look out on the Financial District, the homes, perched on a hill in the Portola neighborhood, are much nicer than most board-and-cares, says city ombudsman Nadell.\u003c/p>\n\u003cfigure id=\"attachment_11741848\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11741848\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-800x551.jpg\" alt=\"\" width=\"800\" height=\"551\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-800x551.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-160x110.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1020x703.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1200x827.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887-1920x1323.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/closures.12-e1555103177887.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Resident Maureen Pinell relaxes in a chair in the living room at Aurora Concepcion’s Residential Care Home in San Francisco. \u003ccite>(Jessica Christian, San Francisco Chronicle)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Concepción, 70, lives among her clients and says she feels driven by a mission.\u003c/p>\n\u003cp>“What I have is what they have; what I eat is what they eat,” she said. “I always tell them, we are a family here.”\u003c/p>\n\u003cp>Arriving from the Philippines in 1972, she took a bank job doing data entry. After her daughter was born with multiple sclerosis, she decided to stay home to care for her. She opened her first board-and-care in 1978, then another, then another. At her peak, she cared for 30 people. With the closures, she’s down to 16.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To stay open, she has reduced paid staff from four to one. She and her ex-husband and kids handle shopping, cooking and medications. She washes the laundry at night when utility rates are cheaper, buys food in bulk on sale, and said she hasn’t taken a real vacation in 40 years.\u003c/p>\n\u003cp>“We’re pinching pennies,” she said. “I make a joke all the time: We’re the cheapest hotel in town.”\u003c/p>\n\u003cp>On a recent morning, residents gathered to eat the lunch Concepción had prepared: salami-and-cheese sandwiches, chicken tomato soup and chocolate sandwich cookies. Silvia Velarde, 59, who has paranoid schizophrenia, said she loves the home, which feels clean and safe and orderly to her. The previous board-and-care she lived in—now closed—was “terrible, really nasty,” she said, and infested with bedbugs.\u003c/p>\n\u003cp>After lunch, Lori Loo, 56, who has schizophrenia and bipolar disorder and has been living here nine years, waited patiently for Velarde and the others to finish eating. She wanted to set the table for dinner. She said she feels comfortable here, and always volunteers to help clean up because there’s not much else to do.\u003c/p>\n\u003cp>After lunch, Concepción offered a tour of one of the homes she’s closed. The brightly lit upstairs looks out onto a city panorama. It will doubtless command a fortune in rent on the private market. But Concepción laments that she couldn’t keep it open for residents with mental illness.\u003c/p>\n\u003cp>“They deserve a second chance,” she said. “They deserve a home.”\u003c/p>\n\u003cp>\u003cem>Jocelyn Wiener is a contributing writer to CALmatters. Photos by Jessica Christian, San Francisco Chronicle. This story, the third in our series “Breakdown: Mental Health in California,” was supported by a grant from the California Health Care Foundation.\u003c/em>\u003c/p>\n\u003cp>Part 1: \u003cem>\u003ca href=\"https://calmatters.org/articles/california-mental-health-treatment-in-prisons/\" target=\"_blank\" rel=\"noopener\">All too often, California’s default mental institutions are now jails and prisons\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>As Dr. Ibraheem Al Shareef examined the chubby legs of 4-month-old Lexie, he noted that one side of her body seemed abnormally large compared to the other. He whipped out a tape measure and decided to measure one leg to see. Sure enough, it was 2 centimeters wider than the other.\u003c/p>\n\u003cp>“We’ll need to do some testing,” he said to Dao Thao, Lexie’s mom.\u003c/p>\n\u003cp>[aside tag='starting-blocks' label='The Starting Blocks Series']\u003c/p>\n\u003cp>Thao looked worried. “I was thinking maybe everything is fine, [that] she was just born like this,” Thao said.\u003c/p>\n\u003cp>Such developmental screenings in a child’s first year of life are important since they can pick up potentially serious problems early, said Dr. Al Shareef.\u003c/p>\n\u003cp>Thao has been bringing Lexie to the clinic, the Golden Valley Health Centers in Merced, since she was born. Yet across Merced County, where 43 percent of all children under 3 live in impoverished families, according to Kidsdata, health professionals worry that pregnant women and small children are not accessing adequate health care.\u003c/p>\n\u003cp>For a pregnant woman, prenatal care can improve the health of her fetus, and for children under 2, regular wellness checks and early vaccines are critical, said Al Shareef.\u003c/p>\n\u003cp>But impoverished parents are juggling a lot: Finding \u003ca href=\"https://www.kqed.org/news/11737207/without-affordable-child-care-escaping-poverty-is-tough\" target=\"_blank\" rel=\"noopener\">child care\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11737431/with-a-new-uc-campus-and-more-jobs-merced-is-booming-but-that-growth-isnt-for-everyone\" target=\"_blank\" rel=\"noopener\">housing\u003c/a>, getting stable work, putting food on the table. Sometimes, going to the doctor for preventative care falls down the list of immediate priorities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For Dao Thao, the news about Lexie’s growth is troublesome. Testing means having to go to a neighboring county where there is a hospital. She will need to find someone with a car to take her, her husband will have to get time off work, and she will have to find child care for her other four children.\u003c/p>\n\u003cp>Thao is scared: “You don’t know when you go for ultrasound what they’re going to say.”\u003c/p>\n\u003cp>The Central Valley city of Merced is a place where prosperity sits alongside entrenched poverty. Life for nearly half of the county’s littlest residents begins in a family that struggles to pay bills, often does not have stable housing, and might not be accessing critical prenatal or infant health care services.\u003c/p>\n\u003cp>“Early quality care is essential for the best start to life, and early environmental impacts can have lifelong effects,” said the 2016 Community Health Assessment published by the Merced County Department of Public Health. “This includes prenatal and birth outcomes.”\u003c/p>\n\u003cfigure id=\"attachment_11738006\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11738006\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The Central Valley city of Merced is a place where prosperity sits alongside entrenched poverty. Merced has experienced the top personal income growth of any metro area in the country for the past five years, mostly fueled by an expanding UC campus. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But that health care often goes missing in the first three months of pregnancy, experts say. County officials also said nearly one-quarter of women living there in 2012 did not receive adequate prenatal care during their pregnancy, compared to 10 percent of women statewide.\u003c/p>\n\u003cp>That worries Donna Chin, a supervising public health nurse at the Merced County public health department. She said that prenatal care can detect early problems with the fetus and help the mother make informed choices. Regular doctor visits while pregnant also emphasize the critical importance of taking vitamins and eating a healthy diet, something that may be difficult for low-income women.\u003c/p>\n\u003cp>When these things don’t happen, sometimes the baby is affected, Chin said.\u003c/p>\n\u003cp>“Women that are below the poverty line [are] trying to just survive,” she said. “Food security, clothing, housing — it’s hard for them to think about getting good nutrition.”\u003c/p>\n\u003cp>[pullquote]In Merced County, 43 percent of all children under 3 live in impoverished families[/pullquote]\u003c/p>\n\u003cp>Chin has seen too many cases where “mom didn’t get enough protein or good fats to help the [fetus] grow,” she said. Sometimes the babies are small for their gestational age, sometimes born pre-term. “Because the child did not get the good nutrition in utero sometimes we see a delay, we see a neurological delay.”\u003c/p>\n\u003cp>Chin’s team of home visiting nurses aims to help connect impoverished mothers and mothers-to-be with health services and education. They also go out and find mothers who may be off the grid, living in tents or in their cars.\u003c/p>\n\u003cp>“I have driven along canal banks and gotten food to mothers,” Chin said. “That’s what we do because they need it.”\u003c/p>\n\u003cp>Another public health nurse in Merced County, Rebecca Melero, said she sees stable housing as a public health issue, especially for families who have children under the age of 2.\u003c/p>\n\u003cp>“I see a lot of co-housing with multiple family members in a very small space, or sometimes no space at all, so they’re in their vehicle,” Melero said.\u003c/p>\n\u003cfigure id=\"attachment_11739825\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11739825\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-800x547.jpg\" alt=\"Norma Sandoval with her infant son, Alex, at Yosemite High School's child development center in Merced on March 13, 2019.\" width=\"800\" height=\"547\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-800x547.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-1020x698.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-1200x821.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Norma Sandoval with her infant son, Alex, at Yosemite High School’s child development center in Merced on March 13, 2019. \u003ccite>(Matt Rogers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dealing with housing is directly connected to healthy outcomes for children, Melero said.\u003c/p>\n\u003cp>Co-housing is common amid rising housing costs and homelessness statewide, and it can be stressful for families with small children to live in someone else’s home, county officials say.\u003c/p>\n\u003cp>Norma Sandoval grew up in Merced and now lives with her 4-month-old, Alex, in the apartment of her boyfriend’s parents. It’s a small space, and a tense living arrangement for Sandoval.\u003c/p>\n\u003cp>She generally holes up in a tiny room with Alex to avoid confrontations with the parents, but knows this can’t last long since her baby will soon need room to crawl and then walk. Sandoval is hoping to get a Section 8 housing voucher so they can move on. Getting the voucher, however, is one thing; finding a place in Merced will be the bigger challenge, she said.\u003c/p>\n\u003cp>Sandoval also fits another profile that worries public health officials in Merced: At 17, she’s a teen mom.\u003c/p>\n\u003cp>“Many of the births in Merced County are teen pregnancies,” according to the 2016 Community Health Assessment for Merced County. The county’s rate of teen pregnancies is significantly higher than those statewide.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Donna Chin of the Merced County public health department']‘I have driven along canal banks and gotten food to mothers. That’s what we do because they need it.’[/pullquote]\u003c/p>\n\u003cp>Sandoval has many friends who are also young mothers. While she went regularly to see an OB/GYN during her pregnancy, she said none of her friends did.\u003c/p>\n\u003cp>“Maybe because they didn’t have time,” she said. And this is one of the biggest challenges Chin’s public health team faces, emphasizing the importance of prenatal care when women are struggling to get by.\u003c/p>\n\u003cp>“There’s a higher incidence for teen moms to have a pre-term birth,” Chin said.\u003c/p>\n\u003cp>Reaching full gestational age is important, she said, because when babies are born premature, the baby doesn’t have the full time to form in utero and it also affects their respiratory status. A pre-term baby is at higher risk for complications early in life because “they have immature neuro systems,” Chin said. “Things are still forming, it’s very difficult for them.”\u003c/p>\n\u003cp>But Chin’s team can’t get to every pregnant mom, which is one of the problems when the numbers of impoverished families is so high in one place. “We’re trying,” Chin said.\u003c/p>\n\u003cp>Dr. Al Shareef’s clinic, the Golden Valley Health Centers (GVHC), serves primarily impoverished families in Merced and the Central Valley. It has many small outposts and a sprawling, campuslike main facility in downtown Merced. It’s a one-stop shop where medical, dental and mental health care can be obtained.\u003c/p>\n\u003cp>The centers’ patients largely have their medical insurance covered by the state, with some federal and county funds chipped in. Merced’s Health and Human services office counted a monthly average of about 130,000 children receiving Medi-Cal, the government provided health insurance, for 2017-2018 .\u003c/p>\n\u003cp>Like the Merced County public health department, GVHC has a program of community health workers who go into the community and help connect parents with pediatricians. They also go to high schools where teen moms are studying and lead workshops on parenting and managing stress.\u003c/p>\n\u003cp>Al Shareef said he will stay on top of things with Lexie and will make sure her parents have a ride to the hospital to get the tests done. Yet he can’t help with child care for her other four children while they go, nor lost wages for Lexie’s dad, who will have to miss work.\u003c/p>\n\u003cp>“It’s definitely challenging,” he said, as he typed up the referral for Lexie’s ultrasound and other tests.\u003c/p>\n\u003cp>\u003cem>Deepa Fernandes is an Early Childhood reporting fellow at Pacific Oaks College, which is funded in part by First 5 LA.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Thao looked worried. “I was thinking maybe everything is fine, [that] she was just born like this,” Thao said.\u003c/p>\n\u003cp>Such developmental screenings in a child’s first year of life are important since they can pick up potentially serious problems early, said Dr. Al Shareef.\u003c/p>\n\u003cp>Thao has been bringing Lexie to the clinic, the Golden Valley Health Centers in Merced, since she was born. Yet across Merced County, where 43 percent of all children under 3 live in impoverished families, according to Kidsdata, health professionals worry that pregnant women and small children are not accessing adequate health care.\u003c/p>\n\u003cp>For a pregnant woman, prenatal care can improve the health of her fetus, and for children under 2, regular wellness checks and early vaccines are critical, said Al Shareef.\u003c/p>\n\u003cp>But impoverished parents are juggling a lot: Finding \u003ca href=\"https://www.kqed.org/news/11737207/without-affordable-child-care-escaping-poverty-is-tough\" target=\"_blank\" rel=\"noopener\">child care\u003c/a> and \u003ca href=\"https://www.kqed.org/news/11737431/with-a-new-uc-campus-and-more-jobs-merced-is-booming-but-that-growth-isnt-for-everyone\" target=\"_blank\" rel=\"noopener\">housing\u003c/a>, getting stable work, putting food on the table. Sometimes, going to the doctor for preventative care falls down the list of immediate priorities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For Dao Thao, the news about Lexie’s growth is troublesome. Testing means having to go to a neighboring county where there is a hospital. She will need to find someone with a car to take her, her husband will have to get time off work, and she will have to find child care for her other four children.\u003c/p>\n\u003cp>Thao is scared: “You don’t know when you go for ultrasound what they’re going to say.”\u003c/p>\n\u003cp>The Central Valley city of Merced is a place where prosperity sits alongside entrenched poverty. Life for nearly half of the county’s littlest residents begins in a family that struggles to pay bills, often does not have stable housing, and might not be accessing critical prenatal or infant health care services.\u003c/p>\n\u003cp>“Early quality care is essential for the best start to life, and early environmental impacts can have lifelong effects,” said the 2016 Community Health Assessment published by the Merced County Department of Public Health. “This includes prenatal and birth outcomes.”\u003c/p>\n\u003cfigure id=\"attachment_11738006\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11738006\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/RS36410_Starting-Blocks-2-qut-536x402.jpg 536w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The Central Valley city of Merced is a place where prosperity sits alongside entrenched poverty. Merced has experienced the top personal income growth of any metro area in the country for the past five years, mostly fueled by an expanding UC campus. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But that health care often goes missing in the first three months of pregnancy, experts say. County officials also said nearly one-quarter of women living there in 2012 did not receive adequate prenatal care during their pregnancy, compared to 10 percent of women statewide.\u003c/p>\n\u003cp>That worries Donna Chin, a supervising public health nurse at the Merced County public health department. She said that prenatal care can detect early problems with the fetus and help the mother make informed choices. Regular doctor visits while pregnant also emphasize the critical importance of taking vitamins and eating a healthy diet, something that may be difficult for low-income women.\u003c/p>\n\u003cp>When these things don’t happen, sometimes the baby is affected, Chin said.\u003c/p>\n\u003cp>“Women that are below the poverty line [are] trying to just survive,” she said. “Food security, clothing, housing — it’s hard for them to think about getting good nutrition.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Chin has seen too many cases where “mom didn’t get enough protein or good fats to help the [fetus] grow,” she said. Sometimes the babies are small for their gestational age, sometimes born pre-term. “Because the child did not get the good nutrition in utero sometimes we see a delay, we see a neurological delay.”\u003c/p>\n\u003cp>Chin’s team of home visiting nurses aims to help connect impoverished mothers and mothers-to-be with health services and education. They also go out and find mothers who may be off the grid, living in tents or in their cars.\u003c/p>\n\u003cp>“I have driven along canal banks and gotten food to mothers,” Chin said. “That’s what we do because they need it.”\u003c/p>\n\u003cp>Another public health nurse in Merced County, Rebecca Melero, said she sees stable housing as a public health issue, especially for families who have children under the age of 2.\u003c/p>\n\u003cp>“I see a lot of co-housing with multiple family members in a very small space, or sometimes no space at all, so they’re in their vehicle,” Melero said.\u003c/p>\n\u003cfigure id=\"attachment_11739825\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11739825\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-800x547.jpg\" alt=\"Norma Sandoval with her infant son, Alex, at Yosemite High School's child development center in Merced on March 13, 2019.\" width=\"800\" height=\"547\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-800x547.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-1020x698.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut-1200x821.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04122019_Merced-Early-Childhood-Prenatal-Health-Care-Pregnant-Women-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Norma Sandoval with her infant son, Alex, at Yosemite High School’s child development center in Merced on March 13, 2019. \u003ccite>(Matt Rogers/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dealing with housing is directly connected to healthy outcomes for children, Melero said.\u003c/p>\n\u003cp>Co-housing is common amid rising housing costs and homelessness statewide, and it can be stressful for families with small children to live in someone else’s home, county officials say.\u003c/p>\n\u003cp>Norma Sandoval grew up in Merced and now lives with her 4-month-old, Alex, in the apartment of her boyfriend’s parents. It’s a small space, and a tense living arrangement for Sandoval.\u003c/p>\n\u003cp>She generally holes up in a tiny room with Alex to avoid confrontations with the parents, but knows this can’t last long since her baby will soon need room to crawl and then walk. Sandoval is hoping to get a Section 8 housing voucher so they can move on. Getting the voucher, however, is one thing; finding a place in Merced will be the bigger challenge, she said.\u003c/p>\n\u003cp>Sandoval also fits another profile that worries public health officials in Merced: At 17, she’s a teen mom.\u003c/p>\n\u003cp>“Many of the births in Merced County are teen pregnancies,” according to the 2016 Community Health Assessment for Merced County. The county’s rate of teen pregnancies is significantly higher than those statewide.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sandoval has many friends who are also young mothers. While she went regularly to see an OB/GYN during her pregnancy, she said none of her friends did.\u003c/p>\n\u003cp>“Maybe because they didn’t have time,” she said. And this is one of the biggest challenges Chin’s public health team faces, emphasizing the importance of prenatal care when women are struggling to get by.\u003c/p>\n\u003cp>“There’s a higher incidence for teen moms to have a pre-term birth,” Chin said.\u003c/p>\n\u003cp>Reaching full gestational age is important, she said, because when babies are born premature, the baby doesn’t have the full time to form in utero and it also affects their respiratory status. A pre-term baby is at higher risk for complications early in life because “they have immature neuro systems,” Chin said. “Things are still forming, it’s very difficult for them.”\u003c/p>\n\u003cp>But Chin’s team can’t get to every pregnant mom, which is one of the problems when the numbers of impoverished families is so high in one place. “We’re trying,” Chin said.\u003c/p>\n\u003cp>Dr. Al Shareef’s clinic, the Golden Valley Health Centers (GVHC), serves primarily impoverished families in Merced and the Central Valley. It has many small outposts and a sprawling, campuslike main facility in downtown Merced. It’s a one-stop shop where medical, dental and mental health care can be obtained.\u003c/p>\n\u003cp>The centers’ patients largely have their medical insurance covered by the state, with some federal and county funds chipped in. Merced’s Health and Human services office counted a monthly average of about 130,000 children receiving Medi-Cal, the government provided health insurance, for 2017-2018 .\u003c/p>\n\u003cp>Like the Merced County public health department, GVHC has a program of community health workers who go into the community and help connect parents with pediatricians. They also go to high schools where teen moms are studying and lead workshops on parenting and managing stress.\u003c/p>\n\u003cp>Al Shareef said he will stay on top of things with Lexie and will make sure her parents have a ride to the hospital to get the tests done. Yet he can’t help with child care for her other four children while they go, nor lost wages for Lexie’s dad, who will have to miss work.\u003c/p>\n\u003cp>“It’s definitely challenging,” he said, as he typed up the referral for Lexie’s ultrasound and other tests.\u003c/p>\n\u003cp>\u003cem>Deepa Fernandes is an Early Childhood reporting fellow at Pacific Oaks College, which is funded in part by First 5 LA.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Nearly 4,000 nurses who work for Lucile Packard Children’s Hospital and Stanford Hospital are threatening to walk off the job.\u003c/p>\n\u003cp>Their union, the Committee for Recognition of Nursing Achievement (CRONA), announced Thursday afternoon that more than 80 percent of its members voted to authorize a strike.\u003c/p>\n\u003cp>“CRONA nurses have spoken,” said union vice president Kathy Stormberg. “We are ready and willing to strike if that’s what it’s going to take to get a fair deal. We hope this gives us some leverage.”\u003c/p>\n\u003cp>The vote has prompted officials at the hospitals, which are both managed by Stanford Health Care, to prepare for a walkout.\u003c/p>\n\u003cp>“The hospitals have taken precautionary and responsible steps to ensure we are able to deliver the same safe, high-quality care our patients and families have come to expect from us should a strike be called by CRONA,” Patrick Bartosch, a spokesman for Stanford Health Care, said in an emailed statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The nurses’ contract with the hospitals expired on March 31. Talks for a new deal began in late January. A federal mediator is getting involved in the ongoing talks next week.\u003c/p>\n\u003cp>At issue are wages, retiree medical benefits and working conditions for the union’s 3,700 members.\u003c/p>\n\u003cp>“It’s expensive to be able to afford to live here,” said Stormberg. “The cost of living has increased more than what the hospitals are offering for our wages. We need to be able to keep up.”\u003c/p>\n\u003cp>CRONA said the nurses face staffing shortages, long hours and long commutes.\u003c/p>\n\u003cp>But hospital officials say their nurses are paid market-leading wages.\u003c/p>\n\u003cp>“We want to further reward our nurses and have proposed a highly competitive compensation package,” Stanford Health Care representatives said in a statement before the strike authorization results were announced.\u003c/p>\n\u003cp>The company said it’s been able to retain nurses at a rate higher than the national average and can fill open positions, on average, faster than the national benchmark.\u003c/p>\n\u003cp>The issue of nurses’ safety also intensified in recent weeks after a patient at Stanford Hospital’s psychiatric unit \u003ca href=\"https://www.kqed.org/news/11734674/cal-osha-launches-probe-into-attack-that-injured-two-stanford-hospital-psych-nurses\" target=\"_blank\" rel=\"noopener\">attacked a nurse\u003c/a> in her 70s, causing serious injuries. Another nurse who tried to pull the patient away was also hurt. Several agencies are investigating the March 12 attack.\u003c/p>\n\u003cp>“Nurses deserve to be safe at work,” Stormberg said, adding that CRONA is asking hospital managers to allow nurses who are assaulted or threatened to be reassigned. “Incidents of threats or violence against health care providers, including nurses, are alarmingly high.”\u003c/p>\n\u003cp>A walkout could begin 10 days after the union’s leadership issues a formal strike notice.\u003c/p>\n\u003cp>“Given the progress we have made by working constructively with the union, we remain optimistic that an agreement will be reached that will allow us to continue to attract and retain the high caliber of nurses who so meaningfully contribute to our hospitals’ reputation for excellence,” Stanford Health Care said in a statement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The strike would mark the first time in two decades that CRONA members walk off the job. In 2000, its nurses went on strike for 50 days, according to union officials.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly 4,000 nurses who work for Lucile Packard Children’s Hospital and Stanford Hospital are threatening to walk off the job.\u003c/p>\n\u003cp>Their union, the Committee for Recognition of Nursing Achievement (CRONA), announced Thursday afternoon that more than 80 percent of its members voted to authorize a strike.\u003c/p>\n\u003cp>“CRONA nurses have spoken,” said union vice president Kathy Stormberg. “We are ready and willing to strike if that’s what it’s going to take to get a fair deal. We hope this gives us some leverage.”\u003c/p>\n\u003cp>The vote has prompted officials at the hospitals, which are both managed by Stanford Health Care, to prepare for a walkout.\u003c/p>\n\u003cp>“The hospitals have taken precautionary and responsible steps to ensure we are able to deliver the same safe, high-quality care our patients and families have come to expect from us should a strike be called by CRONA,” Patrick Bartosch, a spokesman for Stanford Health Care, said in an emailed statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The nurses’ contract with the hospitals expired on March 31. Talks for a new deal began in late January. A federal mediator is getting involved in the ongoing talks next week.\u003c/p>\n\u003cp>At issue are wages, retiree medical benefits and working conditions for the union’s 3,700 members.\u003c/p>\n\u003cp>“It’s expensive to be able to afford to live here,” said Stormberg. “The cost of living has increased more than what the hospitals are offering for our wages. We need to be able to keep up.”\u003c/p>\n\u003cp>CRONA said the nurses face staffing shortages, long hours and long commutes.\u003c/p>\n\u003cp>But hospital officials say their nurses are paid market-leading wages.\u003c/p>\n\u003cp>“We want to further reward our nurses and have proposed a highly competitive compensation package,” Stanford Health Care representatives said in a statement before the strike authorization results were announced.\u003c/p>\n\u003cp>The company said it’s been able to retain nurses at a rate higher than the national average and can fill open positions, on average, faster than the national benchmark.\u003c/p>\n\u003cp>The issue of nurses’ safety also intensified in recent weeks after a patient at Stanford Hospital’s psychiatric unit \u003ca href=\"https://www.kqed.org/news/11734674/cal-osha-launches-probe-into-attack-that-injured-two-stanford-hospital-psych-nurses\" target=\"_blank\" rel=\"noopener\">attacked a nurse\u003c/a> in her 70s, causing serious injuries. Another nurse who tried to pull the patient away was also hurt. Several agencies are investigating the March 12 attack.\u003c/p>\n\u003cp>“Nurses deserve to be safe at work,” Stormberg said, adding that CRONA is asking hospital managers to allow nurses who are assaulted or threatened to be reassigned. “Incidents of threats or violence against health care providers, including nurses, are alarmingly high.”\u003c/p>\n\u003cp>A walkout could begin 10 days after the union’s leadership issues a formal strike notice.\u003c/p>\n\u003cp>“Given the progress we have made by working constructively with the union, we remain optimistic that an agreement will be reached that will allow us to continue to attract and retain the high caliber of nurses who so meaningfully contribute to our hospitals’ reputation for excellence,” Stanford Health Care said in a statement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The strike would mark the first time in two decades that CRONA members walk off the job. In 2000, its nurses went on strike for 50 days, according to union officials.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "beyond-the-tampon-tax-how-far-will-california-go-to-end-menstrual-inequity",
"title": "Beyond the Tampon Tax: How Far Will California Go to End 'Menstrual Inequity'?",
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"content": "\u003cp>Annie Wang vividly remembers the panic she felt when her period arrived unexpectedly as she sat in her freshman year chemistry class at UC Davis.\u003c/p>\n\u003cp>With no tampons or pads at the ready and nowhere nearby to get them, she tried to focus on the lecture instead.\u003c/p>\n\u003cp>[aside label=\"More on the 'tampon tax'\" tag=\"tampon-tax\"]\u003c/p>\n\u003cp>“I stayed in my seat and prayed it would not be too bad,” Wang said. “When I got up I had left a mark on UC Davis in a very bold way. It was a very embarrassing moment for me.”\u003c/p>\n\u003cp>Wang knew she wasn’t the only one who’d experienced this predicament. “A lot of my classmates had experienced similar situations where they were in class or going to class and suddenly got their period and were not able to go to class or had to scramble,” she said.\u003c/p>\n\u003cp>Now she’s one of many student activists, advocates, experts and officials working toward what is being called “menstrual equity.” In California, that means exempting period products from state sales tax and ensuring that tampons and pads are provided as freely as toilet paper in public schools and universities, as well as government building and prisons.\u003c/p>\n\u003cp>It’s part of a global movement — partially funded by feminine hygiene product manufacturers — to get more policymakers, particularly men, to consider the impacts of menstruation. A \u003ca href=\"https://www.iflscience.com/editors-blog/a-documentary-about-menstruation-won-at-the-2019-oscars/\" target=\"_blank\" rel=\"noopener\">documentary\u003c/a> about “period poverty” — the reality that some women around the world miss work and some girls can’t go to school because of cultural taboos or because they can’t afford period products — won an Oscar this year.\u003c/p>\n\u003cp>Already in California, public schools in low-income areas are required to provide free period products, and college students are petitioning for free products in state universities.\u003c/p>\n\u003cp>But the most closely watched effort is underway in the state Capitol, where lawmakers expect to advance a bill to makes period products tax-free statewide.\u003c/p>\n\u003cp>A few years back, there were a lot of eye rolls and snickers when Democratic Assemblywoman Cristina Garcia of Bell Gardens carried such a bill. Embracing the novelty of it all, she dubbed herself “Tampon Queen” and propped a huge pad and tampon in her office window.\u003c/p>\n\u003cp>“It allowed a conversation to happen that was more than a tax — it’s about menstrual equity and our biology,” she said.\u003c/p>\n\u003cp>Her bill cleared the Legislature in 2016, but Gov. Jerry Brown \u003ca href=\"https://www.kqed.org/news/11086948/gov-brown-vetoes-attempt-to-waive-tampon-tax\" target=\"_blank\" rel=\"noopener\">vetoed it\u003c/a>, saying it should have been addressed within the state budget and that “tax breaks are the same thing as new spending.” That prompted the following tweet retort from Garcia:\u003c/p>\n\u003cp>https://twitter.com/AsmGarcia/status/775764733798383616\u003c/p>\n\u003cp>A subsequent effort in 2018 died in committee.\u003c/p>\n\u003cp>But with a new governor in place, Garcia is trying again. This time, her bill — \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB31\" target=\"_blank\" rel=\"noopener\">AB 31\u003c/a> — is expected to get the support of Gov. Gavin Newsom, and her colleagues have been so eager to back her bill that it has \u003ca href=\"https://calmatters.org/articles/blog/most-popular-bill-california-legislature-bipartisan-coauthors/\" target=\"_blank\" rel=\"noopener\">more co-authors\u003c/a> than any other this legislative session. Last time, she said, “I had to beg them to join me.”\u003c/p>\n\u003cp>Brown, though, was hardly the only critic of getting rid of the period tax. \u003ca href=\"https://www.latimes.com/opinion/editorials/la-ed-sales-tax-20160229-story.html\" target=\"_blank\" rel=\"noopener\">Editorials\u003c/a> in newspapers such as the Los Angeles Times have contended that it’s unwise to carve out exemptions from state sales tax this way — especially when the state taxes items equally as essential, like toilet paper, diapers and toothpaste. The \u003ca href=\"https://www.californiataxreform.org/\" target=\"_blank\" rel=\"noopener\">California Tax Reform Association\u003c/a> has criticized the bill for trying to draw a new line in the state tax code, what it calls “gender necessity.” And the \u003ca href=\"http://www.counties.org/\" target=\"_blank\" rel=\"noopener\">California State Association of Counties\u003c/a> also opposes doing away with the tax on the grounds that counties depend heavily on those revenues for essential services.\u003c/p>\n\u003cp>“I respect the need for California to be fiscally sound,” Garcia countered. “But the state budget should not be balanced by a tax of a person’s uterus. The same goes for local governments; our tax codes should be gender neutral.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The state budget should not be balanced by a tax of a person’s uterus.”\u003ccite>Assemblywoman Cristina Garcia, D-Bell Gardens\u003c/cite>\u003c/aside>\n\u003cp>A legislative \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201920200AB31\" target=\"_blank\" rel=\"noopener\">analysis\u003c/a> said the bill, if enacted, would cost the state $9 million in lost revenue in the first year and $19 million in the second year.\u003c/p>\n\u003cp>To be clear, there is not currently an extra tax on tampons and pads. But unlike food and medicine, they are not exempt from California sales tax because the state considers them not necessities, but luxuries.\u003c/p>\n\u003cp>Thus far, 10 other states including New York, Florida, Connecticut and Nevada and Washington, D.C. have banned sales taxes on period products. Across the globe, Canada, India and Australia have long since eliminated the tax and a battle is underway to end it in the United Kingdom.\u003c/p>\n\u003cp>“Today, the most progressive state in the union is behind the curve in providing a gender neutral tax code that doesn’t profit off of a woman’s basic biological functions,” Garcia said.\u003c/p>\n\u003cp>Menstruation is about equity and engagement as much as it is about health, said Jennifer Weiss-Wolf, vice president of The Brennan Center for Justice, who co-founded Period Equity, which is behind many of the tampon tax campaigns across the county. It produced a glitzy ad featuring model and actress Amber Rose who is fondling a bezel-set diamond pendant from which a bejeweled locket contains a tampon. She asks, “Where else would you keep something 36 states tax as a luxury?” The ad’s kicker: “Tell the government where to stick this tax.”\u003c/p>\n\u003cp>https://youtu.be/VLJ5LzYFKNY\u003c/p>\n\u003cp>“The taxes and the challenges of access are unfair and discriminatory toward women,” said Weiss-Wolf. “It’s an enormous distraction and at worst a hindrance to being fully present.”\u003c/p>\n\u003cp>“The tampon tax is not the issue that will solve period poverty, but it sends a message that menstrual hygiene is necessary and it’s a right,” said Nadya Okamato, who at age 16 founded \u003ca href=\"https://www.period.org/\" target=\"_blank\" rel=\"noopener\">PERIOD. The Menstrual Movement\u003c/a>, a nonprofit that donates menstrual products and works on menstrual policy and education with 350 chapters across the world. “It’s something that happens to the majority of the global population for an average of 40 years of life and it makes human life possible. It’s not something that should be treated with shame and stigma. It should be normalized.”\u003c/p>\n\u003cp>The group, along with a handful of female celebrities and the CEO of period products company THINX, recently \u003ca href=\"https://www.politico.com/f/?id=00000168-81d9-da56-ab7e-bfff8f610001\" target=\"_blank\" rel=\"noopener\">drafted a letter\u003c/a> to U.S. Education Secretary Betsy DeVos asking for free products at all schools.\u003c/p>\n\u003cp>Some critics on social media, however, warn that once the government makes products available at no charge, costs to taxpayers could escalate because some people who can easily afford to buy their own tampons and pads will instead avail themselves of the free ones.\u003c/p>\n\u003cp>“This not about whether I can afford it,” Garcia said, noting that she’s asked for free products to be available in state Capitol bathrooms. “It’s about how my biology does not behave in an expected matter. If I’m tracking down period products I’m missing out on work.”\u003c/p>\n\u003cp>After Wang’s embarrassing moment at school, she started a campus chapter of PERIOD., which is \u003ca href=\"https://www.freetheperiod.com/\" target=\"_blank\" rel=\"noopener\">petitioning\u003c/a> the UC Davis administration to provide free products in all campus bathrooms. The school approved and funded a pilot program to provide free products, stocked by student volunteers, in up to 13 campus bathrooms.\u003c/p>\n\u003cp>The student chapter surveyed female students and reported that 52 percent of respondents said they missed class or work in the last school year because they could not access a tampon or pad.\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\" target=\"_blank\" rel=\"noopener\">\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 fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "Beyond the Tampon Tax: How Far Will California Go to End 'Menstrual Inequity'? | KQED",
"description": "A new bill in the California Legislature would abolish the so-called "tampon tax."",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Annie Wang vividly remembers the panic she felt when her period arrived unexpectedly as she sat in her freshman year chemistry class at UC Davis.\u003c/p>\n\u003cp>With no tampons or pads at the ready and nowhere nearby to get them, she tried to focus on the lecture instead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I stayed in my seat and prayed it would not be too bad,” Wang said. “When I got up I had left a mark on UC Davis in a very bold way. It was a very embarrassing moment for me.”\u003c/p>\n\u003cp>Wang knew she wasn’t the only one who’d experienced this predicament. “A lot of my classmates had experienced similar situations where they were in class or going to class and suddenly got their period and were not able to go to class or had to scramble,” she said.\u003c/p>\n\u003cp>Now she’s one of many student activists, advocates, experts and officials working toward what is being called “menstrual equity.” In California, that means exempting period products from state sales tax and ensuring that tampons and pads are provided as freely as toilet paper in public schools and universities, as well as government building and prisons.\u003c/p>\n\u003cp>It’s part of a global movement — partially funded by feminine hygiene product manufacturers — to get more policymakers, particularly men, to consider the impacts of menstruation. A \u003ca href=\"https://www.iflscience.com/editors-blog/a-documentary-about-menstruation-won-at-the-2019-oscars/\" target=\"_blank\" rel=\"noopener\">documentary\u003c/a> about “period poverty” — the reality that some women around the world miss work and some girls can’t go to school because of cultural taboos or because they can’t afford period products — won an Oscar this year.\u003c/p>\n\u003cp>Already in California, public schools in low-income areas are required to provide free period products, and college students are petitioning for free products in state universities.\u003c/p>\n\u003cp>But the most closely watched effort is underway in the state Capitol, where lawmakers expect to advance a bill to makes period products tax-free statewide.\u003c/p>\n\u003cp>A few years back, there were a lot of eye rolls and snickers when Democratic Assemblywoman Cristina Garcia of Bell Gardens carried such a bill. Embracing the novelty of it all, she dubbed herself “Tampon Queen” and propped a huge pad and tampon in her office window.\u003c/p>\n\u003cp>“It allowed a conversation to happen that was more than a tax — it’s about menstrual equity and our biology,” she said.\u003c/p>\n\u003cp>Her bill cleared the Legislature in 2016, but Gov. Jerry Brown \u003ca href=\"https://www.kqed.org/news/11086948/gov-brown-vetoes-attempt-to-waive-tampon-tax\" target=\"_blank\" rel=\"noopener\">vetoed it\u003c/a>, saying it should have been addressed within the state budget and that “tax breaks are the same thing as new spending.” That prompted the following tweet retort from Garcia:\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>A subsequent effort in 2018 died in committee.\u003c/p>\n\u003cp>But with a new governor in place, Garcia is trying again. This time, her bill — \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB31\" target=\"_blank\" rel=\"noopener\">AB 31\u003c/a> — is expected to get the support of Gov. Gavin Newsom, and her colleagues have been so eager to back her bill that it has \u003ca href=\"https://calmatters.org/articles/blog/most-popular-bill-california-legislature-bipartisan-coauthors/\" target=\"_blank\" rel=\"noopener\">more co-authors\u003c/a> than any other this legislative session. Last time, she said, “I had to beg them to join me.”\u003c/p>\n\u003cp>Brown, though, was hardly the only critic of getting rid of the period tax. \u003ca href=\"https://www.latimes.com/opinion/editorials/la-ed-sales-tax-20160229-story.html\" target=\"_blank\" rel=\"noopener\">Editorials\u003c/a> in newspapers such as the Los Angeles Times have contended that it’s unwise to carve out exemptions from state sales tax this way — especially when the state taxes items equally as essential, like toilet paper, diapers and toothpaste. The \u003ca href=\"https://www.californiataxreform.org/\" target=\"_blank\" rel=\"noopener\">California Tax Reform Association\u003c/a> has criticized the bill for trying to draw a new line in the state tax code, what it calls “gender necessity.” And the \u003ca href=\"http://www.counties.org/\" target=\"_blank\" rel=\"noopener\">California State Association of Counties\u003c/a> also opposes doing away with the tax on the grounds that counties depend heavily on those revenues for essential services.\u003c/p>\n\u003cp>“I respect the need for California to be fiscally sound,” Garcia countered. “But the state budget should not be balanced by a tax of a person’s uterus. The same goes for local governments; our tax codes should be gender neutral.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The state budget should not be balanced by a tax of a person’s uterus.”\u003ccite>Assemblywoman Cristina Garcia, D-Bell Gardens\u003c/cite>\u003c/aside>\n\u003cp>A legislative \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201920200AB31\" target=\"_blank\" rel=\"noopener\">analysis\u003c/a> said the bill, if enacted, would cost the state $9 million in lost revenue in the first year and $19 million in the second year.\u003c/p>\n\u003cp>To be clear, there is not currently an extra tax on tampons and pads. But unlike food and medicine, they are not exempt from California sales tax because the state considers them not necessities, but luxuries.\u003c/p>\n\u003cp>Thus far, 10 other states including New York, Florida, Connecticut and Nevada and Washington, D.C. have banned sales taxes on period products. Across the globe, Canada, India and Australia have long since eliminated the tax and a battle is underway to end it in the United Kingdom.\u003c/p>\n\u003cp>“Today, the most progressive state in the union is behind the curve in providing a gender neutral tax code that doesn’t profit off of a woman’s basic biological functions,” Garcia said.\u003c/p>\n\u003cp>Menstruation is about equity and engagement as much as it is about health, said Jennifer Weiss-Wolf, vice president of The Brennan Center for Justice, who co-founded Period Equity, which is behind many of the tampon tax campaigns across the county. It produced a glitzy ad featuring model and actress Amber Rose who is fondling a bezel-set diamond pendant from which a bejeweled locket contains a tampon. She asks, “Where else would you keep something 36 states tax as a luxury?” The ad’s kicker: “Tell the government where to stick this tax.”\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/VLJ5LzYFKNY'\n title='//www.youtube.com/embed/VLJ5LzYFKNY'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>“The taxes and the challenges of access are unfair and discriminatory toward women,” said Weiss-Wolf. “It’s an enormous distraction and at worst a hindrance to being fully present.”\u003c/p>\n\u003cp>“The tampon tax is not the issue that will solve period poverty, but it sends a message that menstrual hygiene is necessary and it’s a right,” said Nadya Okamato, who at age 16 founded \u003ca href=\"https://www.period.org/\" target=\"_blank\" rel=\"noopener\">PERIOD. The Menstrual Movement\u003c/a>, a nonprofit that donates menstrual products and works on menstrual policy and education with 350 chapters across the world. “It’s something that happens to the majority of the global population for an average of 40 years of life and it makes human life possible. It’s not something that should be treated with shame and stigma. It should be normalized.”\u003c/p>\n\u003cp>The group, along with a handful of female celebrities and the CEO of period products company THINX, recently \u003ca href=\"https://www.politico.com/f/?id=00000168-81d9-da56-ab7e-bfff8f610001\" target=\"_blank\" rel=\"noopener\">drafted a letter\u003c/a> to U.S. Education Secretary Betsy DeVos asking for free products at all schools.\u003c/p>\n\u003cp>Some critics on social media, however, warn that once the government makes products available at no charge, costs to taxpayers could escalate because some people who can easily afford to buy their own tampons and pads will instead avail themselves of the free ones.\u003c/p>\n\u003cp>“This not about whether I can afford it,” Garcia said, noting that she’s asked for free products to be available in state Capitol bathrooms. “It’s about how my biology does not behave in an expected matter. If I’m tracking down period products I’m missing out on work.”\u003c/p>\n\u003cp>After Wang’s embarrassing moment at school, she started a campus chapter of PERIOD., which is \u003ca href=\"https://www.freetheperiod.com/\" target=\"_blank\" rel=\"noopener\">petitioning\u003c/a> the UC Davis administration to provide free products in all campus bathrooms. The school approved and funded a pilot program to provide free products, stocked by student volunteers, in up to 13 campus bathrooms.\u003c/p>\n\u003cp>The student chapter surveyed female students and reported that 52 percent of respondents said they missed class or work in the last school year because they could not access a tampon or pad.\u003c/p>\n\u003cp>\u003ca href=\"http://calmatters.org/\" target=\"_blank\" rel=\"noopener\">\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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"apple": "https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Magazine-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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},
"hidden-brain": {
"id": "hidden-brain",
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "One of public radio's most dynamic voices, Sam Sanders helped launch The NPR Politics Podcast and hosted NPR's hit show It's Been A Minute. Now, the award-winning host returns with something brand new, The Sam Sanders Show. Every week, Sam Sanders and friends dig into the culture that shapes our lives: what's driving the biggest trends, how artists really think, and even the memes you can't stop scrolling past. Sam is beloved for his way of unpacking the world and bringing you up close to fresh currents and engaging conversations. The Sam Sanders Show is smart, funny and always a good time.",
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"youthMediaReducer": {},
"checkPleaseReducer": {
"filterData": {
"region": {
"key": "Restaurant Region",
"filters": [
"Any Region"
]
},
"cuisine": {
"key": "Restaurant Cuisine",
"filters": [
"Any Cuisine"
]
}
},
"restaurantDataById": {},
"restaurantIdsSorted": [],
"error": null
},
"userAgentReducer": {
"userAgent": "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)",
"isBot": true
}
}
