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"content": "\u003cdiv class=\"post-body\">\u003cp>\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\u003c/div>\u003c/p>",
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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": "\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": "\u003cdiv class=\"post-body\">\u003cp>\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\u003c/div>\u003c/p>",
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"title": "Why It's Hard for Poor Pregnant Women and Moms to Get Health Care in Merced",
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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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"headline": "Why It's Hard for Poor Pregnant Women and Moms to Get Health Care in Merced",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\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>\u003c/p>\u003c/div>",
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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": "‘I have driven along canal banks and gotten food to mothers. That’s what we do because they need it.’",
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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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"title": "Nurses at Stanford and Lucile Packard Hospitals Vote Overwhelmingly to Authorize Strike",
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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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"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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"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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"content": "\u003cp>Psychotherapist Orit Weksler operates out of a bright office in Berkeley outfitted with a big, yellow couch, a box filled with sand and shelves stocked with small plastic figurines for patients to play with.\u003c/p>\n\u003cp>“Take whatever speaks to you, put it in the sand, and it creates a kind of picture, kind of like a dream scene,” Weksler said. “It’s just a way to start a conversation.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley\u003c/a> students make up about a third of Weksler’s practice. Navigating things like the red-tape imposed by insurance companies and erratic student schedules makes the job tough. “It’s a very big commitment on our part,” Weksler said. “We do this because we love working with students.”\u003c/p>\n\u003cfigure id=\"attachment_11737674\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737674\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg\" alt=\"Psychotherapist Orit Weksler poses in her Berkeley office with her sand tray and shelves of figurines.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychotherapist Orit Weksler in her Berkeley office with her sand tray and shelves of figurines. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, Berkeley’s decision to change up its health insurance provider — for the third time in six years — is putting that love to the test.\u003c/p>\n\u003cp>The main issue is the choice of insurance provider: \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\" rel=\"noopener\">Blue Shield\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Weksler is one of five mental health professionals interviewed for this story in person, on the phone or via email. All of them complained about the company’s low reimbursement rates and slow, bureaucratic processes.\u003c/p>\n\u003cp>“\u003ca href=\"https://www.anthem.com/\" target=\"_blank\" rel=\"noopener\">Anthem\u003c/a> and \u003ca href=\"https://www.aetna.com/\" target=\"_blank\" rel=\"noopener\">Aetna\u003c/a> before them only pay us about 50 percent of our regular full fee,” Weksler said of UC Berkeley’s current and previous two student medical insurance partners. “Blue Shield will offer even less, which will make it impossible for most of us to offer more than one or two slots per week for students, due to the cost of living.”\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Shana Charles, an assistant professor at Cal State Fullerton in the public health department']‘The UC system is a public system, and it does have a charge to take care of its students. This calls for possible government intervention or regulation of some kind.’[/pullquote]\u003c/p>\n\u003cp>Weksler said many of her colleagues have voiced their concerns on a community listserv about what the switch to Blue Shield might mean for students’ access to services going forward, in a climate where there are more students seeking therapy than there are therapists to provide it.\u003c/p>\n\u003cp>“People are going to get on the Blue Shield list to be able to continue to provide care for students who are currently on their caseload,” Weksler says. “But they’re not going to open any slots for new students.”\u003c/p>\n\u003cp>The new plan will serve around 20,000 students and is scheduled to begin Aug. 1.\u003c/p>\n\u003cp>Blue Shield spokeswoman Amanda Wardell said her company plans to make the transition as easy as possible and provide a high level of care.\u003c/p>\n\u003cp>“As a nonprofit health plan, Blue Shield of California is dedicated to meeting the healthcare needs of UC Berkeley students with our extensive network of providers,” Wardell said in a statement. “We are committed to working with UC Berkeley Student Health Insurance Plan (SHIP) to make this transition easy and ensuring access to high-quality care that is worthy of our family and friends.”\u003c/p>\n\u003cfigure id=\"attachment_11737676\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737676\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg\" alt=\"Bahar Navab, associate director of insurance and business development for UC Berkeley's University Health Services.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bahar Navab, associate director of insurance and business development for UC Berkeley’s University Health Services. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley \u003ca href=\"https://uhs.berkeley.edu/home\" target=\"_blank\" rel=\"noopener\">University Health Services\u003c/a>’ (UHS) associate director of insurance and business development, Bahar Navab, defended the switch as being necessary in the face of ever-escalating healthcare costs.\u003c/p>\n\u003cp>“We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable,” Navab said.\u003c/p>\n\u003cp>Navab said UHS considered bids from 10 insurance providers, and engaged students, the Berkeley administration and other campus stakeholders during the five-month-long bidding and evaluation process, before settling on Blue Shield. (The California-based provider is offering its services in collaboration with \u003ca href=\"https://wellfleetinsurance.com\" target=\"_blank\" rel=\"noopener\">Wellfleet\u003c/a>, a Massachusetts-based insurance firm that specializes in student insurance plans.)\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Bahar Navab, University Health Services at UC Berkeley']‘We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable.’[/pullquote]\u003c/p>\n\u003cp>Navab said her department has been working closely with Blue Shield to advocate for reimbursement rates on par with what the current insurer, Anthem, paid healthcare providers. She also said the new plan will not require doctors and other specialists to join the standard Blue Shield network. Instead, UHS has negotiated a special “carve out” for healthcare providers to work with UC Berkeley students.\u003c/p>\n\u003cp>“The carve out will offer providers more consistent rates,” Navab said. “Additionally, we have been working with Blue Shield to reduce administrative barriers, figure out how to streamline the transition and make it as seamless and painless as possible.”\u003c/p>\n\u003cp>Weksler is skeptical of phrases like “carve out”: “It’s just words,” she said.\u003c/p>\n\u003cp>She wants UHS leaders to engage health practitioners in more conversations about policy and best practices in order to serve students’ healthcare needs in a way that makes financial sense for the university, students and providers.\u003c/p>\n\u003cp>\u003cb>\u003c/b>“I want to see that they understand what the actual problems are and that they’re committed to helping us,” Weksler said.\u003c/p>\n\u003cfigure id=\"attachment_11737675\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737675\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg\" alt=\"UC Berkeley senior, Nuha Khalfay.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1200x800.jpeg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay.jpeg 1600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley senior, Nuha Khalfay. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley student Nuha Khalfay, who studies public health, said she’s confident the university has students’ best interests at heart and is happy about some aspects of the new plan — such as the coverage of facial feminization surgery for transgender students for the first time.\u003c/p>\n\u003cp>[aside tag='mental-health' label='Mental Health Care in California']\u003c/p>\n\u003cp>But Khalfay said some of her friends on campus have had to travel far to find in-network providers willing to see them in recent months, and worries about the situation getting worse.\u003c/p>\n\u003cp>“If providers can’t be reimbursed at the rates that they need to take students who go to UC Berkeley, then UC Berkeley students will lose out on the diversity of providers that they could have access to,” Khalfay said.\u003c/p>\n\u003cp>According to Didi Wu, president of \u003ca href=\"https://sspc.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Student-to-Student Peer Counseling\u003c/a>, a network of Berkeley students offering counseling services to their fellow students, the need for mental health care on campus has never been greater. “There has definitely been increasing demand for counseling among students,” Wu said.\u003c/p>\n\u003cp>A UC system spokeswoman said Berkeley was the only campus in the system to offer Blue Shield as a primary provider.\u003c/p>\n\u003cp>“To switch providers multiple times within a few years is kind of unusual,” said Shana Charles, an assistant professor at \u003ca href=\"http://www.fullerton.edu/\" target=\"_blank\" rel=\"noopener\">Cal State Fullerton\u003c/a> in the public health department and a faculty associate with the \u003ca href=\"https://healthpolicy.ucla.edu\" target=\"_blank\" rel=\"noopener\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Charles said the fact that mental health specialists are speaking out against the new plan before it’s even been put into motion suggests “a broken system.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cb>\u003c/b>“The UC system is a public system, and it does have a charge to take care of its students,” Charles said. “This calls for possible government intervention or regulation of some kind.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Psychotherapist Orit Weksler operates out of a bright office in Berkeley outfitted with a big, yellow couch, a box filled with sand and shelves stocked with small plastic figurines for patients to play with.\u003c/p>\n\u003cp>“Take whatever speaks to you, put it in the sand, and it creates a kind of picture, kind of like a dream scene,” Weksler said. “It’s just a way to start a conversation.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley\u003c/a> students make up about a third of Weksler’s practice. Navigating things like the red-tape imposed by insurance companies and erratic student schedules makes the job tough. “It’s a very big commitment on our part,” Weksler said. “We do this because we love working with students.”\u003c/p>\n\u003cfigure id=\"attachment_11737674\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737674\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg\" alt=\"Psychotherapist Orit Weksler poses in her Berkeley office with her sand tray and shelves of figurines.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychotherapist Orit Weksler in her Berkeley office with her sand tray and shelves of figurines. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, Berkeley’s decision to change up its health insurance provider — for the third time in six years — is putting that love to the test.\u003c/p>\n\u003cp>The main issue is the choice of insurance provider: \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\" rel=\"noopener\">Blue Shield\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Weksler is one of five mental health professionals interviewed for this story in person, on the phone or via email. All of them complained about the company’s low reimbursement rates and slow, bureaucratic processes.\u003c/p>\n\u003cp>“\u003ca href=\"https://www.anthem.com/\" target=\"_blank\" rel=\"noopener\">Anthem\u003c/a> and \u003ca href=\"https://www.aetna.com/\" target=\"_blank\" rel=\"noopener\">Aetna\u003c/a> before them only pay us about 50 percent of our regular full fee,” Weksler said of UC Berkeley’s current and previous two student medical insurance partners. “Blue Shield will offer even less, which will make it impossible for most of us to offer more than one or two slots per week for students, due to the cost of living.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Weksler said many of her colleagues have voiced their concerns on a community listserv about what the switch to Blue Shield might mean for students’ access to services going forward, in a climate where there are more students seeking therapy than there are therapists to provide it.\u003c/p>\n\u003cp>“People are going to get on the Blue Shield list to be able to continue to provide care for students who are currently on their caseload,” Weksler says. “But they’re not going to open any slots for new students.”\u003c/p>\n\u003cp>The new plan will serve around 20,000 students and is scheduled to begin Aug. 1.\u003c/p>\n\u003cp>Blue Shield spokeswoman Amanda Wardell said her company plans to make the transition as easy as possible and provide a high level of care.\u003c/p>\n\u003cp>“As a nonprofit health plan, Blue Shield of California is dedicated to meeting the healthcare needs of UC Berkeley students with our extensive network of providers,” Wardell said in a statement. “We are committed to working with UC Berkeley Student Health Insurance Plan (SHIP) to make this transition easy and ensuring access to high-quality care that is worthy of our family and friends.”\u003c/p>\n\u003cfigure id=\"attachment_11737676\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737676\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg\" alt=\"Bahar Navab, associate director of insurance and business development for UC Berkeley's University Health Services.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bahar Navab, associate director of insurance and business development for UC Berkeley’s University Health Services. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley \u003ca href=\"https://uhs.berkeley.edu/home\" target=\"_blank\" rel=\"noopener\">University Health Services\u003c/a>’ (UHS) associate director of insurance and business development, Bahar Navab, defended the switch as being necessary in the face of ever-escalating healthcare costs.\u003c/p>\n\u003cp>“We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable,” Navab said.\u003c/p>\n\u003cp>Navab said UHS considered bids from 10 insurance providers, and engaged students, the Berkeley administration and other campus stakeholders during the five-month-long bidding and evaluation process, before settling on Blue Shield. (The California-based provider is offering its services in collaboration with \u003ca href=\"https://wellfleetinsurance.com\" target=\"_blank\" rel=\"noopener\">Wellfleet\u003c/a>, a Massachusetts-based insurance firm that specializes in student insurance plans.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Navab said her department has been working closely with Blue Shield to advocate for reimbursement rates on par with what the current insurer, Anthem, paid healthcare providers. She also said the new plan will not require doctors and other specialists to join the standard Blue Shield network. Instead, UHS has negotiated a special “carve out” for healthcare providers to work with UC Berkeley students.\u003c/p>\n\u003cp>“The carve out will offer providers more consistent rates,” Navab said. “Additionally, we have been working with Blue Shield to reduce administrative barriers, figure out how to streamline the transition and make it as seamless and painless as possible.”\u003c/p>\n\u003cp>Weksler is skeptical of phrases like “carve out”: “It’s just words,” she said.\u003c/p>\n\u003cp>She wants UHS leaders to engage health practitioners in more conversations about policy and best practices in order to serve students’ healthcare needs in a way that makes financial sense for the university, students and providers.\u003c/p>\n\u003cp>\u003cb>\u003c/b>“I want to see that they understand what the actual problems are and that they’re committed to helping us,” Weksler said.\u003c/p>\n\u003cfigure id=\"attachment_11737675\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737675\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg\" alt=\"UC Berkeley senior, Nuha Khalfay.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1200x800.jpeg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay.jpeg 1600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley senior, Nuha Khalfay. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley student Nuha Khalfay, who studies public health, said she’s confident the university has students’ best interests at heart and is happy about some aspects of the new plan — such as the coverage of facial feminization surgery for transgender students for the first time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Khalfay said some of her friends on campus have had to travel far to find in-network providers willing to see them in recent months, and worries about the situation getting worse.\u003c/p>\n\u003cp>“If providers can’t be reimbursed at the rates that they need to take students who go to UC Berkeley, then UC Berkeley students will lose out on the diversity of providers that they could have access to,” Khalfay said.\u003c/p>\n\u003cp>According to Didi Wu, president of \u003ca href=\"https://sspc.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Student-to-Student Peer Counseling\u003c/a>, a network of Berkeley students offering counseling services to their fellow students, the need for mental health care on campus has never been greater. “There has definitely been increasing demand for counseling among students,” Wu said.\u003c/p>\n\u003cp>A UC system spokeswoman said Berkeley was the only campus in the system to offer Blue Shield as a primary provider.\u003c/p>\n\u003cp>“To switch providers multiple times within a few years is kind of unusual,” said Shana Charles, an assistant professor at \u003ca href=\"http://www.fullerton.edu/\" target=\"_blank\" rel=\"noopener\">Cal State Fullerton\u003c/a> in the public health department and a faculty associate with the \u003ca href=\"https://healthpolicy.ucla.edu\" target=\"_blank\" rel=\"noopener\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Charles said the fact that mental health specialists are speaking out against the new plan before it’s even been put into motion suggests “a broken system.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>\u003c/b>“The UC system is a public system, and it does have a charge to take care of its students,” Charles said. “This calls for possible government intervention or regulation of some kind.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In a community center in a low-income area of Merced, Monica Adrian of the county education office and a few teachers played games and held story time for parents and children.\u003c/p>\n\u003cp>[aside tag='starting-blocks' label='The Starting Blocks Series']\u003c/p>\n\u003cp>As they sang “The Wheels on the Bus,” they showed parents how to engage children beyond singing. “What color is the bus?” asked one teacher. “Yellow,” called out the chorus of kids. “And show me your hands, what do the tires do?” “They go round and round,” the children replied.\u003c/p>\n\u003cp>Instantly, the kids made giant circles with their arms. Their faces shone with excitement as they looked around at peers and their parents.\u003c/p>\n\u003cp>The teachers were trying to model brain-building games and activities for parents since many of them are stuck at home with young children due to the drastic shortage of child care options for low-income families in the region. The playgroup is a gap filler of sorts, a once-a-week outing for children who cannot get a seat in preschool. Merced County in the Central Valley uses federal and state dollars to provide infant, toddler and preschool care, but the majority of children still miss out.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lack of access to quality child care is felt hard in Merced County, where early childhood poverty is particularly acute. In the county, \u003ca href=\"https://www.kidsdata.org/blog/?p=8727\" target=\"_blank\" rel=\"noopener\">43 percent\u003c/a> of all children under the age of 3 — or nearly 4,800 youth — are impoverished, according to Kidsdata. Statewide, \u003ca href=\"https://www.kidsdata.org/blog/?p=8727\" target=\"_blank\" rel=\"noopener\">285,000 families\u003c/a> with children under 5 live in poverty, according to data from the Population Reference Bureau and Kidsdata that’s based on U.S. Census statistics for 2017.\u003c/p>\n\u003cfigure id=\"attachment_11737744\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11737744 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-800x508.jpg\" alt=\"Ayla, 9, Alorra, 3, Aden, 6, Alilith, 5, enjoy the trampoline their mother, Bobbie Allison, recently bought and assembled for them. Allison said she had to leave Merced to find a landlord willing to accept her Section 8 housing voucher. It's far from child care and work in Merced, but in Atwater her children have a backyard where the trampoline and several rescued factory chickens provide the main entertainment.\" width=\"800\" height=\"508\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-800x508.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-1020x648.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-1200x762.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ayla, 9, Alorra, 3, Aden, 6, and Alilith, 5, enjoy the trampoline their mother, Bobbie Allison, recently bought and assembled for them. Allison said she had to leave Merced for Atwater to find a landlord willing to accept her Section 8 housing voucher. Merced is where child care is, but in Atwater her children have a backyard where the trampoline and several rescued factory chickens provide the main entertainment. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Merced County, however, is booming: It is home to the newest UC school, it has experienced the top personal income growth of any region in the country over the last five years, and manufacturing is making a comeback, resulting in new jobs. What these economic indicators leave out is children like the ones attending the county-run playgroup. Merced is a place where prosperity sits alongside entrenched poverty.\u003c/p>\n\u003cp>So officials like Adrian, of the Merced County Office of Education, are doing their best with limited resources. Adrian wants parents to know how easy it is to stimulate and engage their little ones and give them critical brain development skills.\u003c/p>\n\u003cp>“We want to make sure that parents are getting support and education, so that they can be providing the same kinds of support and early experiences [as a preschool],” she said.\u003c/p>\n\u003cfigure id=\"attachment_11737746\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737746\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-800x573.jpg\" alt=\"Bobbie Allison, a single mom, prepares dinner for her four children. Making her meager budget stretch to buy fresh food is a challenge. She relies on the milk and cheese the WIC program gives her for her youngest, Alorra.\" width=\"800\" height=\"573\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-800x573.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-160x115.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-1020x730.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-1200x859.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bobbie Allison prepares dinner for her four children. Making her meager budget stretch to buy fresh food is a challenge. She relies on the milk and cheese the WIC program gives her for her youngest, Alorra. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Limited Spots in Government-Subsidized Child Care\u003c/strong>\u003c/p>\n\u003cp>There are limited spots in government-subsidized child care programs in the county. In 2017, government-licensed child care slots were available for only 19 percent of children with working parents in the area.\u003c/p>\n\u003cp>Alorra Allison, 3, and her sister, Alilith, 4, are on waiting lists for the highly coveted spots. “I’m hoping she’ll [Alorra] be able to get into a Head Start [program] next year,” said her mother, Bobbie Allison.\u003c/p>\n\u003cp>For Allison, a single mother raising four kids, solving the child care piece of her puzzle could dramatically alter her chances of finding better-paying work. Right now, the family lives in Atwater, a 30-minute drive from Merced in the Central Valley, because that’s where they can find an affordable rental — and a landlord who will accept their Section 8 housing voucher — amid the state’s housing crisis. But the child care is in Merced, as is Allison’s occasional work at 7-Eleven.\u003c/p>\n\u003cp>“It’s so stressful as a parent, any parent, regardless of your economic situation, to balance child care and work,” said Adrian.\u003c/p>\n\u003cfigure id=\"attachment_11737747\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737747\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-800x690.jpg\" alt=\"Aden, 6, with one of the family's several rescued factory chickens in Atwater.\" width=\"800\" height=\"690\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-800x690.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-160x138.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-1020x880.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-1200x1035.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Aden, 6, with one of the family’s several rescued factory chickens in Atwater. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bobbie Allison feels lucky to have found a house with a yard in Atwater. And while they don’t have much else, her children have a trampoline and some chickens in the yard to provide some entertainment.\u003c/p>\n\u003cp>But what they don’t always have is water and electricity. Those utility bills add up and no welfare program helps to cover them.\u003c/p>\n\u003cp>“I’ve had to borrow money from family and friends about three times since we moved here to pay for [utilities] or to turn it back on,” Allison said.\u003c/p>\n\u003cp>Allison can’t afford to buy any of her kids’ school photos, nor a new pair of shoes for 6-year-old Aden, who runs everywhere and wears out shoes constantly. Her children don’t do extracurricular activities since there is no money for dance classes or gymnastics. Allison doesn’t own a computer and can’t afford internet service, so when she applies for jobs she relies on the data plan that comes with her cellphone.\u003c/p>\n\u003cp>But a computer, dance classes and new shoes are just nice frills. What Allison wants most is a stable job and quality child care for her two youngest children, both of whom are “ready for it,” she said. “They count, they (say) their colors, they know their ABCs.”\u003c/p>\n\u003cfigure id=\"attachment_11737745\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737745\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-800x546.jpg\" alt=\"A scene from Atwater in the Central Valley in early 2019.\" width=\"800\" height=\"546\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-800x546.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-1020x696.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-1200x819.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A scene from Atwater in the Central Valley in early 2019. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘Mom Could Use a Break Every Now and Again’\u003c/strong>\u003c/p>\n\u003cp>The reality of being a single mom, holding down a job and looking after four kids with limited child care can be overwhelming.\u003c/p>\n\u003cp>“Mom could use a break every now and again,” Allison told her kids with a chuckle.\u003c/p>\n\u003cp>Parents do need a break: Stress builds up and even a baby will absorb it, said David Lockridge, an expert in childhood trauma.\u003c/p>\n\u003cp>“The nervous system is either set up to be soothed and to be calm or it is set up to be constantly on fight, flight or freeze,” said Lockridge, whose work is based on a \u003ca href=\"https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html\" target=\"_blank\" rel=\"noopener\">major study\u003c/a> done in the mid-1990s by the Centers for Disease Control and Prevention and Kaiser Permanente.\u003c/p>\n\u003cfigure id=\"attachment_11737748\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737748\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-800x632.jpg\" alt=\"Allison family in a group hug on a recent afternoon in the backyard of their rental home in Atwater.\" width=\"800\" height=\"632\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-800x632.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-160x126.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-1020x806.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-1200x948.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Allison family in a group hug on a recent afternoon in the backyard of their rental home in Atwater. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The findings showed that childhood traumas lead to long-term and lingering bad health outcomes later in life. Lockridge’s organization in Merced, ACE Overcomers, works to educate people about childhood trauma.\u003c/p>\n\u003cp>“If that poverty affects the stress level of the parents, that’s going to be felt by the children,” he said. “People are actually wearing out years earlier because their homeostasis, their thermometer, was ramped up too high because of early childhood adversity.”\u003c/p>\n\u003cp>It might seem that babies and toddlers are too young and won’t remember their early impoverished years, but the impacts get stored in the body, Lockridge said. “Whether or not a child is cognitively aware of what is going on, their body keeps score.”\u003c/p>\n\u003cp>Bobbie Allison said she doesn’t feel good about the life that she is providing for her children, but she doesn’t know what more she can do. She hopes to figure out a job with Foster Farms in the area, get her children into Head Start, and begin to get ahead.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Deepa Fernandes is an Early Childhood reporting fellow at Pacific Oaks College. The fellowship is funded in part by First 5 LA.\u003c/em>\u003c/p>\n\n",
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"excerpt": "In Merced County, 43 percent of children under age 3 — or nearly 4,800 youth — are impoverished. The county uses federal and state dollars to provide infant, toddler and preschool care, but most children still miss out.\r\n\r\nLack of access to quality child care is felt hard in Merced County, where early childhood poverty is particularly acute. In the county, \u003ca href=\"https://www.kidsdata.org/blog/?p=8727\" target=\"_blank\" rel=\"noopener\">43 percent\u003c/a> of all children under the age of three — or nearly 4,800 youth — are impoverished",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As they sang “The Wheels on the Bus,” they showed parents how to engage children beyond singing. “What color is the bus?” asked one teacher. “Yellow,” called out the chorus of kids. “And show me your hands, what do the tires do?” “They go round and round,” the children replied.\u003c/p>\n\u003cp>Instantly, the kids made giant circles with their arms. Their faces shone with excitement as they looked around at peers and their parents.\u003c/p>\n\u003cp>The teachers were trying to model brain-building games and activities for parents since many of them are stuck at home with young children due to the drastic shortage of child care options for low-income families in the region. The playgroup is a gap filler of sorts, a once-a-week outing for children who cannot get a seat in preschool. Merced County in the Central Valley uses federal and state dollars to provide infant, toddler and preschool care, but the majority of children still miss out.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lack of access to quality child care is felt hard in Merced County, where early childhood poverty is particularly acute. In the county, \u003ca href=\"https://www.kidsdata.org/blog/?p=8727\" target=\"_blank\" rel=\"noopener\">43 percent\u003c/a> of all children under the age of 3 — or nearly 4,800 youth — are impoverished, according to Kidsdata. Statewide, \u003ca href=\"https://www.kidsdata.org/blog/?p=8727\" target=\"_blank\" rel=\"noopener\">285,000 families\u003c/a> with children under 5 live in poverty, according to data from the Population Reference Bureau and Kidsdata that’s based on U.S. Census statistics for 2017.\u003c/p>\n\u003cfigure id=\"attachment_11737744\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11737744 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-800x508.jpg\" alt=\"Ayla, 9, Alorra, 3, Aden, 6, Alilith, 5, enjoy the trampoline their mother, Bobbie Allison, recently bought and assembled for them. Allison said she had to leave Merced to find a landlord willing to accept her Section 8 housing voucher. It's far from child care and work in Merced, but in Atwater her children have a backyard where the trampoline and several rescued factory chickens provide the main entertainment.\" width=\"800\" height=\"508\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-800x508.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-160x102.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-1020x648.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut-1200x762.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_trampoline-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ayla, 9, Alorra, 3, Aden, 6, and Alilith, 5, enjoy the trampoline their mother, Bobbie Allison, recently bought and assembled for them. Allison said she had to leave Merced for Atwater to find a landlord willing to accept her Section 8 housing voucher. Merced is where child care is, but in Atwater her children have a backyard where the trampoline and several rescued factory chickens provide the main entertainment. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Merced County, however, is booming: It is home to the newest UC school, it has experienced the top personal income growth of any region in the country over the last five years, and manufacturing is making a comeback, resulting in new jobs. What these economic indicators leave out is children like the ones attending the county-run playgroup. Merced is a place where prosperity sits alongside entrenched poverty.\u003c/p>\n\u003cp>So officials like Adrian, of the Merced County Office of Education, are doing their best with limited resources. Adrian wants parents to know how easy it is to stimulate and engage their little ones and give them critical brain development skills.\u003c/p>\n\u003cp>“We want to make sure that parents are getting support and education, so that they can be providing the same kinds of support and early experiences [as a preschool],” she said.\u003c/p>\n\u003cfigure id=\"attachment_11737746\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737746\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-800x573.jpg\" alt=\"Bobbie Allison, a single mom, prepares dinner for her four children. Making her meager budget stretch to buy fresh food is a challenge. She relies on the milk and cheese the WIC program gives her for her youngest, Alorra.\" width=\"800\" height=\"573\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-800x573.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-160x115.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-1020x730.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut-1200x859.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_bobbie-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bobbie Allison prepares dinner for her four children. Making her meager budget stretch to buy fresh food is a challenge. She relies on the milk and cheese the WIC program gives her for her youngest, Alorra. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Limited Spots in Government-Subsidized Child Care\u003c/strong>\u003c/p>\n\u003cp>There are limited spots in government-subsidized child care programs in the county. In 2017, government-licensed child care slots were available for only 19 percent of children with working parents in the area.\u003c/p>\n\u003cp>Alorra Allison, 3, and her sister, Alilith, 4, are on waiting lists for the highly coveted spots. “I’m hoping she’ll [Alorra] be able to get into a Head Start [program] next year,” said her mother, Bobbie Allison.\u003c/p>\n\u003cp>For Allison, a single mother raising four kids, solving the child care piece of her puzzle could dramatically alter her chances of finding better-paying work. Right now, the family lives in Atwater, a 30-minute drive from Merced in the Central Valley, because that’s where they can find an affordable rental — and a landlord who will accept their Section 8 housing voucher — amid the state’s housing crisis. But the child care is in Merced, as is Allison’s occasional work at 7-Eleven.\u003c/p>\n\u003cp>“It’s so stressful as a parent, any parent, regardless of your economic situation, to balance child care and work,” said Adrian.\u003c/p>\n\u003cfigure id=\"attachment_11737747\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737747\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-800x690.jpg\" alt=\"Aden, 6, with one of the family's several rescued factory chickens in Atwater.\" width=\"800\" height=\"690\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-800x690.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-160x138.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-1020x880.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut-1200x1035.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_chicken-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Aden, 6, with one of the family’s several rescued factory chickens in Atwater. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bobbie Allison feels lucky to have found a house with a yard in Atwater. And while they don’t have much else, her children have a trampoline and some chickens in the yard to provide some entertainment.\u003c/p>\n\u003cp>But what they don’t always have is water and electricity. Those utility bills add up and no welfare program helps to cover them.\u003c/p>\n\u003cp>“I’ve had to borrow money from family and friends about three times since we moved here to pay for [utilities] or to turn it back on,” Allison said.\u003c/p>\n\u003cp>Allison can’t afford to buy any of her kids’ school photos, nor a new pair of shoes for 6-year-old Aden, who runs everywhere and wears out shoes constantly. Her children don’t do extracurricular activities since there is no money for dance classes or gymnastics. Allison doesn’t own a computer and can’t afford internet service, so when she applies for jobs she relies on the data plan that comes with her cellphone.\u003c/p>\n\u003cp>But a computer, dance classes and new shoes are just nice frills. What Allison wants most is a stable job and quality child care for her two youngest children, both of whom are “ready for it,” she said. “They count, they (say) their colors, they know their ABCs.”\u003c/p>\n\u003cfigure id=\"attachment_11737745\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737745\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-800x546.jpg\" alt=\"A scene from Atwater in the Central Valley in early 2019.\" width=\"800\" height=\"546\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-800x546.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-1020x696.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut-1200x819.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_Atwater-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A scene from Atwater in the Central Valley in early 2019. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘Mom Could Use a Break Every Now and Again’\u003c/strong>\u003c/p>\n\u003cp>The reality of being a single mom, holding down a job and looking after four kids with limited child care can be overwhelming.\u003c/p>\n\u003cp>“Mom could use a break every now and again,” Allison told her kids with a chuckle.\u003c/p>\n\u003cp>Parents do need a break: Stress builds up and even a baby will absorb it, said David Lockridge, an expert in childhood trauma.\u003c/p>\n\u003cp>“The nervous system is either set up to be soothed and to be calm or it is set up to be constantly on fight, flight or freeze,” said Lockridge, whose work is based on a \u003ca href=\"https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html\" target=\"_blank\" rel=\"noopener\">major study\u003c/a> done in the mid-1990s by the Centers for Disease Control and Prevention and Kaiser Permanente.\u003c/p>\n\u003cfigure id=\"attachment_11737748\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737748\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-800x632.jpg\" alt=\"Allison family in a group hug on a recent afternoon in the backyard of their rental home in Atwater.\" width=\"800\" height=\"632\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-800x632.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-160x126.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-1020x806.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut-1200x948.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/04042019_Without-Affordable-Child-Care-Escaping-Poverty-is-Tough_hug-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Allison family in a group hug on a recent afternoon in the backyard of their rental home in Atwater. \u003ccite>(Matt Rogers for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The findings showed that childhood traumas lead to long-term and lingering bad health outcomes later in life. Lockridge’s organization in Merced, ACE Overcomers, works to educate people about childhood trauma.\u003c/p>\n\u003cp>“If that poverty affects the stress level of the parents, that’s going to be felt by the children,” he said. “People are actually wearing out years earlier because their homeostasis, their thermometer, was ramped up too high because of early childhood adversity.”\u003c/p>\n\u003cp>It might seem that babies and toddlers are too young and won’t remember their early impoverished years, but the impacts get stored in the body, Lockridge said. “Whether or not a child is cognitively aware of what is going on, their body keeps score.”\u003c/p>\n\u003cp>Bobbie Allison said she doesn’t feel good about the life that she is providing for her children, but she doesn’t know what more she can do. She hopes to figure out a job with Foster Farms in the area, get her children into Head Start, and begin to get ahead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Deepa Fernandes is an Early Childhood reporting fellow at Pacific Oaks College. The fellowship is funded in part by First 5 LA.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cb>Congressman Adam Schiff\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">U.S. Rep. Adam Schiff (D-Burbank), who chairs the House Intelligence Committee, joins us in the studio to talk about recent developments in his committee’s probe of President Trump’s financial dealings and possible collusion between the Trump election campaign and Russia. \u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Editor’s note: We spoke with Congressman Schiff this morning before the Justice Department informed Congress that it had received special counsel Robert Mueller’s long-anticipated report on Russian interference in the 2016 presidential election. \u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cb>California’s New Surgeon General\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">In January, Gov. Gavin Newsom announced the appointment of Nadine Burke Harris as California’s first surgeon general. A pediatrician by training, Dr. Burke Harris gained national renown for raising awareness about how exposure to toxic stress and traumatic events in childhood can lead to poor health through adulthood. In 2012, she founded the Center for Youth Wellness in San Francisco to improve the health and outcomes of children and adolescents exposed to adverse childhood experiences. She shares with us her goals and priorities as California’s top public health official. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest\u003c/b>\u003cspan style=\"font-weight: 400\">: Dr. Nadine Burke Harris, California surgeon general\u003c/span>\u003c/p>\n\u003cp>\u003cb>E-Cigarettes and Teen Health\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, San Francisco City Attorney Dennis Herrera and Supervisor Shamann Walton announced legislation that would prohibit the sale of all electronic cigarettes until they’ve been reviewed by the FDA and would bar tobacco companies, including Juul — which makes a brand of e-cigarettes popular among youth — from renting city-owned property in the future. According to a recent survey by the CDC, more than 20 percent of middle and high school students reported using an e-cigarette in the past 30 days. Meanwhile, scientists at UCSF are revealing that teens who vape are being exposed to cancer-causing toxins. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003cspan style=\"font-weight: 400\"> Danielle Ramo, Ph.D., adjunct associate professor of psychiatry, UCSF\u003c/span>\u003c/p>\n\u003cp>\u003cb>Isaac Mizrahi\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Fore more than three decades, Isaac Mizrahi has been one of the fashion world’s most iconic designers. \u003c/span>\u003cspan style=\"font-weight: 400\">Since 2012, he has appeared on the hit cable show, “Project Runway All Stars.” Mizrahi is also a skilled storyteller and entertainer, with a new memoir and a jazzy cabaret show featuring him singing, joking and reflecting on his rich, colorful life.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest: \u003c/b>\u003cspan style=\"font-weight: 400\">Isaac Mizrahi, author, “I.M.: A Memoir” \u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Congressman Adam Schiff\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">U.S. Rep. Adam Schiff (D-Burbank), who chairs the House Intelligence Committee, joins us in the studio to talk about recent developments in his committee’s probe of President Trump’s financial dealings and possible collusion between the Trump election campaign and Russia. \u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Editor’s note: We spoke with Congressman Schiff this morning before the Justice Department informed Congress that it had received special counsel Robert Mueller’s long-anticipated report on Russian interference in the 2016 presidential election. \u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cb>California’s New Surgeon General\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">In January, Gov. Gavin Newsom announced the appointment of Nadine Burke Harris as California’s first surgeon general. A pediatrician by training, Dr. Burke Harris gained national renown for raising awareness about how exposure to toxic stress and traumatic events in childhood can lead to poor health through adulthood. In 2012, she founded the Center for Youth Wellness in San Francisco to improve the health and outcomes of children and adolescents exposed to adverse childhood experiences. She shares with us her goals and priorities as California’s top public health official. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest\u003c/b>\u003cspan style=\"font-weight: 400\">: Dr. Nadine Burke Harris, California surgeon general\u003c/span>\u003c/p>\n\u003cp>\u003cb>E-Cigarettes and Teen Health\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, San Francisco City Attorney Dennis Herrera and Supervisor Shamann Walton announced legislation that would prohibit the sale of all electronic cigarettes until they’ve been reviewed by the FDA and would bar tobacco companies, including Juul — which makes a brand of e-cigarettes popular among youth — from renting city-owned property in the future. According to a recent survey by the CDC, more than 20 percent of middle and high school students reported using an e-cigarette in the past 30 days. Meanwhile, scientists at UCSF are revealing that teens who vape are being exposed to cancer-causing toxins. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003cspan style=\"font-weight: 400\"> Danielle Ramo, Ph.D., adjunct associate professor of psychiatry, UCSF\u003c/span>\u003c/p>\n\u003cp>\u003cb>Isaac Mizrahi\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Fore more than three decades, Isaac Mizrahi has been one of the fashion world’s most iconic designers. \u003c/span>\u003cspan style=\"font-weight: 400\">Since 2012, he has appeared on the hit cable show, “Project Runway All Stars.” Mizrahi is also a skilled storyteller and entertainer, with a new memoir and a jazzy cabaret show featuring him singing, joking and reflecting on his rich, colorful life.\u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest: \u003c/b>\u003cspan style=\"font-weight: 400\">Isaac Mizrahi, author, “I.M.: A Memoir” \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A California woman who says Johnson & Johnson baby powder caused her to develop mesothelioma was awarded $29 million by a jury Wednesday. J&J says it will appeal the judgment.\u003c/p>\n\u003cp>The plaintiff, Terry Leavitt, said she regularly used two J&J products in the 1960s and ’70s containing talc. In 2017, she was diagnosed with mesothelioma, a kind of cancer linked to asbestos exposure.\u003c/p>\n\u003cp>After two days of deliberation, the jury found that J&J talc-based products were defective and caused Leavitt’s mesothelioma, and that the company had failed to warn consumers about the risks. The jury, in the California Superior Court in Oakland, awarded Leavitt and her husband $29.4 million in damages.\u003c/p>\n\u003cp>J&J faces thousands of lawsuits alleging its talc-based products harmed consumers. This suit is the first to go to trial since articles by Reuters and The New York Times alleged the company feared for years that its baby powder might contain asbestos. J&J denies that its talc powder contains asbestos or is responsible for health problems.\u003c/p>\n\u003cp>J&J said it would appeal, pointing to “serious procedural and evidentiary errors,” Reuters reported. “The jury verdicts are not medical, scientific or regulatory conclusions about a product,” it said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In December, documents came to light showing J&J \u003ca href=\"https://www.reuters.com/investigates/special-report/johnsonandjohnson-cancer/\">worried for decades\u003c/a> that its baby powder might be laced with small amounts of asbestos, which can occur naturally underground near talc. A company executive in the 1970s warned that J&J’s talc mines might not be free of asbestos. Some of its talc products sometimes contained materials that “might be classified as asbestos powder,” The \u003ca href=\"https://www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html\">New York Times\u003c/a> reported, quoting an internal company memo.\u003c/p>\n\u003cp>Recent cases have focused on talc’s link to mesothelioma, but many additional cases allege the powder has caused ovarian cancer. All told, the pharmaceutical company faces more than 13,000 talc-related lawsuits nationwide, Reuters reports.\u003c/p>\n\u003cp>Last year, 22 women \u003ca href=\"https://www.npr.org/2018/07/13/628684038/jury-awards-4-7-billion-to-women-in-johnson-johnson-talcum-powder-suit\">were awarded\u003c/a> $4.7 billion after they sued J&J, alleging they developed ovarian cancer because of the company’s products. More than $4 billion of the jury award consisted of punitive damages, which are meant to punish a defendant for wrongdoing. J&J \u003ca href=\"https://www.nytimes.com/2018/12/19/business/johnson-johnson-baby-powder-verdict.html\">failed \u003c/a>in December to convince a judge to throw out that verdict but told The Times it would appeal that decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Research, clinical evidence and nearly 40 years of studies by independent medical experts around the world continue to support the safety of talc,” the company \u003ca href=\"https://www.jnj.com/our-products/5-important-facts-about-the-safety-of-talc\">says\u003c/a>. “Talc does not cause cancer.”\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Johnson+%26+Johnson+Hit+With+%2429+Million+Verdict+In+Mesothelioma+Case&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A California woman who says Johnson & Johnson baby powder caused her to develop mesothelioma was awarded $29 million by a jury Wednesday. J&J says it will appeal the judgment.\u003c/p>\n\u003cp>The plaintiff, Terry Leavitt, said she regularly used two J&J products in the 1960s and ’70s containing talc. In 2017, she was diagnosed with mesothelioma, a kind of cancer linked to asbestos exposure.\u003c/p>\n\u003cp>After two days of deliberation, the jury found that J&J talc-based products were defective and caused Leavitt’s mesothelioma, and that the company had failed to warn consumers about the risks. The jury, in the California Superior Court in Oakland, awarded Leavitt and her husband $29.4 million in damages.\u003c/p>\n\u003cp>J&J faces thousands of lawsuits alleging its talc-based products harmed consumers. This suit is the first to go to trial since articles by Reuters and The New York Times alleged the company feared for years that its baby powder might contain asbestos. J&J denies that its talc powder contains asbestos or is responsible for health problems.\u003c/p>\n\u003cp>J&J said it would appeal, pointing to “serious procedural and evidentiary errors,” Reuters reported. “The jury verdicts are not medical, scientific or regulatory conclusions about a product,” it said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In December, documents came to light showing J&J \u003ca href=\"https://www.reuters.com/investigates/special-report/johnsonandjohnson-cancer/\">worried for decades\u003c/a> that its baby powder might be laced with small amounts of asbestos, which can occur naturally underground near talc. A company executive in the 1970s warned that J&J’s talc mines might not be free of asbestos. Some of its talc products sometimes contained materials that “might be classified as asbestos powder,” The \u003ca href=\"https://www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html\">New York Times\u003c/a> reported, quoting an internal company memo.\u003c/p>\n\u003cp>Recent cases have focused on talc’s link to mesothelioma, but many additional cases allege the powder has caused ovarian cancer. All told, the pharmaceutical company faces more than 13,000 talc-related lawsuits nationwide, Reuters reports.\u003c/p>\n\u003cp>Last year, 22 women \u003ca href=\"https://www.npr.org/2018/07/13/628684038/jury-awards-4-7-billion-to-women-in-johnson-johnson-talcum-powder-suit\">were awarded\u003c/a> $4.7 billion after they sued J&J, alleging they developed ovarian cancer because of the company’s products. More than $4 billion of the jury award consisted of punitive damages, which are meant to punish a defendant for wrongdoing. J&J \u003ca href=\"https://www.nytimes.com/2018/12/19/business/johnson-johnson-baby-powder-verdict.html\">failed \u003c/a>in December to convince a judge to throw out that verdict but told The Times it would appeal that decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Research, clinical evidence and nearly 40 years of studies by independent medical experts around the world continue to support the safety of talc,” the company \u003ca href=\"https://www.jnj.com/our-products/5-important-facts-about-the-safety-of-talc\">says\u003c/a>. “Talc does not cause cancer.”\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Johnson+%26+Johnson+Hit+With+%2429+Million+Verdict+In+Mesothelioma+Case&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Assemblyman David Chiu and state Sen. Scott Wiener, both of San Francisco, announced a bill Monday that would prevent public hospitals from charging emergency room patients whose insurance won’t cover their medical bills. This practice is called “balance billing,” and according to Chiu, it’s costing Californians thousands of dollars.\u003c/p>\n\u003cp>Even if a patient has private insurance, an ambulance might transport them to an out-of-network hospital that doesn’t accept it — like Zuckerberg San Francisco General Hospital. Then, a month after getting treatment, they’re hit with a surprise from the hospital.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">Report: Zuckerberg San Francisco General Leaves Privately Insured Patients on the Hook for Thousands\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/wp-content/uploads/sites/43/2018/11/zuckberghospitalcropped-1180x664.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>“I got this atrocious bill for $13,000,” said Nicki Pogue, who was treated at SFGH after experiencing a severe reaction to bronchitis medication. To her shock, UnitedHealthcare would only cover $3,000 of the bill.\u003c/p>\n\u003cp>Pogue said she left the hospital within five hours, but spent the next five months trying to fight the charges.\u003c/p>\n\u003cp>“I went into the underworld of our health care system,” she said. Her weeknights and weekends were consumed by writing appeal letters, researching state legislation and talking to lawyers.\u003c/p>\n\u003cp>Ultimately, UnitedHealthcare covered her bill, but she’s not done campaigning yet. \u003c/p>\n\u003cp>“I will drive to Sacramento, I don’t care how many times, to make sure this bill gets passed,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Pogue has been working with Chiu, Wiener, San Francisco Supervisor Norman Yee and other patients to rally for the bill, Assembly Bill 1611. \u003c/p>\n\u003cp>She warns, “Until this bill passes, I don’t recommend anybody with insurance visit S.F. General.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to.’\u003ccite>Assemblyman David Chiu\u003c/cite>\u003c/aside>\n\u003cp>However, Chiu said choosing hospitals isn’t always easy. \u003c/p>\n\u003cp>“If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to,” Chiu said.\u003c/p>\n\u003cp>He said the problem of balance billing first came to his attention after \u003ca href=\"https://www.vox.com/policy-and-politics/2019/1/7/18137967/er-bills-zuckerberg-san-francisco-general-hospital\" rel=\"noopener\" target=\"_blank\">Vox\u003c/a> and the San Francisco Chronicle reported it last month.\u003c/p>\n\u003cp>“Until these stories surfaced, many of us had thought the practice of balance billing had been addressed by a decades old Supreme Court case and a 2016 California law,” Chiu said. In reaction to these news stories, ZSFGH said \u003ca href=\"https://www.vox.com/2019/2/1/18206893/zuckerberg-hospital-er-surprise-billing-suspension\" rel=\"noopener\" target=\"_blank\">they’ve halted balance billing\u003c/a> to review the policy.\u003c/p>\n\u003cp>Now, Chiu is searching for other public hospitals in California that might be balance billing. He expects it could be impacting millions of Californians. If it passes, AB 1611 will go into effect next year.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Assemblyman David Chiu and state Sen. Scott Wiener, both of San Francisco, announced a bill Monday that would prevent public hospitals from charging emergency room patients whose insurance won’t cover their medical bills. This practice is called “balance billing,” and according to Chiu, it’s costing Californians thousands of dollars.\u003c/p>\n\u003cp>Even if a patient has private insurance, an ambulance might transport them to an out-of-network hospital that doesn’t accept it — like Zuckerberg San Francisco General Hospital. Then, a month after getting treatment, they’re hit with a surprise from the hospital.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">Report: Zuckerberg San Francisco General Leaves Privately Insured Patients on the Hook for Thousands\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/wp-content/uploads/sites/43/2018/11/zuckberghospitalcropped-1180x664.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>“I got this atrocious bill for $13,000,” said Nicki Pogue, who was treated at SFGH after experiencing a severe reaction to bronchitis medication. To her shock, UnitedHealthcare would only cover $3,000 of the bill.\u003c/p>\n\u003cp>Pogue said she left the hospital within five hours, but spent the next five months trying to fight the charges.\u003c/p>\n\u003cp>“I went into the underworld of our health care system,” she said. Her weeknights and weekends were consumed by writing appeal letters, researching state legislation and talking to lawyers.\u003c/p>\n\u003cp>Ultimately, UnitedHealthcare covered her bill, but she’s not done campaigning yet. \u003c/p>\n\u003cp>“I will drive to Sacramento, I don’t care how many times, to make sure this bill gets passed,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pogue has been working with Chiu, Wiener, San Francisco Supervisor Norman Yee and other patients to rally for the bill, Assembly Bill 1611. \u003c/p>\n\u003cp>She warns, “Until this bill passes, I don’t recommend anybody with insurance visit S.F. General.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to.’\u003ccite>Assemblyman David Chiu\u003c/cite>\u003c/aside>\n\u003cp>However, Chiu said choosing hospitals isn’t always easy. \u003c/p>\n\u003cp>“If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to,” Chiu said.\u003c/p>\n\u003cp>He said the problem of balance billing first came to his attention after \u003ca href=\"https://www.vox.com/policy-and-politics/2019/1/7/18137967/er-bills-zuckerberg-san-francisco-general-hospital\" rel=\"noopener\" target=\"_blank\">Vox\u003c/a> and the San Francisco Chronicle reported it last month.\u003c/p>\n\u003cp>“Until these stories surfaced, many of us had thought the practice of balance billing had been addressed by a decades old Supreme Court case and a 2016 California law,” Chiu said. In reaction to these news stories, ZSFGH said \u003ca href=\"https://www.vox.com/2019/2/1/18206893/zuckerberg-hospital-er-surprise-billing-suspension\" rel=\"noopener\" target=\"_blank\">they’ve halted balance billing\u003c/a> to review the policy.\u003c/p>\n\u003cp>Now, Chiu is searching for other public hospitals in California that might be balance billing. He expects it could be impacting millions of Californians. If it passes, AB 1611 will go into effect next year.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California has never had a surgeon general, but that will change today. Dr. Nadine Burke Harris, a San Francisco-based pediatrician, has pioneered research into the effect that childhood traumas have on health. As the state’s top doctor, Burke Harris will act in an advisory capacity to Gov. Gavin Newsom.\u003c/p>\n\u003cp>Burke Harris will also work to promote programs like \u003ca href=\"http://www.sjteeth.org/\">SJ TEETH\u003c/a>, which provides dental cleanings to low-income kids. It partners with organizations like \u003ca href=\"http://www.sjckids.org/\" target=\"_blank\" rel=\"noopener\">First 5 San Joaquin\u003c/a>, which supports early childhood development programs, including a preschool program in Lathrop.\u003c/p>\n\u003cfigure id=\"attachment_11724886\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11724886\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/02/Demostration-qut-800x600.jpg\" alt=\"Dental hygienist Deborah Delfino shows a group of preschoolers in Lathrop, California how to brush their teeth by demonstrating with a puppet named Bob.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dental hygienist Deborah Delfino shows a group of preschoolers in Lathrop, California, how to brush their teeth by demonstrating with a puppet named Bob. \u003ccite>(Katie Orr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On this particular day, dental hygienist Deborah Delfino sits in front of the class and uses a puppet named Bob to teach the kids how to brush their teeth.\u003c/p>\n\u003cp>“OK now Bob, I want you to open real big. Can we all help Bob open big? Help him go, ‘Awwww!’ ” she tells the kids\u003c/p>\n\u003cp>The 4- and 5-year-olds respond by eagerly opening their mouths and showing off their teeth.\u003c/p>\n\u003cfigure id=\"attachment_11724889\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11724889\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/02/Cleaning-qut-800x600.jpg\" alt=\"Dental hygienist Deborah Delfino cleans the teeth of a preschooler in Lathrop, CA.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dental hygienist Deborah Delfino cleans the teeth of a preschooler in Lathrop, California. \u003ccite>(Katie Orr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After the lesson Delfino gives some of the kids a quick teeth cleaning in a corner of the room. During the exams she makes sure to clearly explain to them what she’s doing.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I love brushing my teeth,” says 5-year-old Valentina, the first patient, shyly as she mimics brushing her teeth. “I love doing up and down.”\u003c/p>\n\u003cp>First 5 San Joaquin Executive Director Lani Schiff-Ross said it’s important to make sure the kids have a good experience with the dentist. Otherwise, they might not come back. The clinicians try to be especially aware of possible traumas children may have experienced, she said.\u003c/p>\n\u003cp>“If a child is not told what’s going on and a professional is touching their body and not asking for permission or explaining what they’re about to do, that can trigger some issues that they’ve had when someone has abused them,” said Schiff-Ross.\u003c/p>\n\u003cp>That’s exactly the awareness Burke Harris wants to promote as surgeon general. As a pediatrician, she studied the 10 categories of \u003ca href=\"https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Findex.html\" target=\"_blank\" rel=\"noopener\">adverse childhood experiences\u003c/a>. They include things like physical and sexual abuse, neglect, or having a parent in jail affect long-term health. All of that can increase stress. She also envisions earlier interventions to help detect and treat toxic stress.\u003c/p>\n\u003cp>“Without the buffering care of a nurturing adult, these stress hormones can continue to stay at high levels and lead to harm,” she said.\u003c/p>\n\u003cp>Burke Harris said 61 percent of Californians have had at least one adverse childhood experience, and she said ignoring trauma hurts kids long-term.\u003c/p>\n\u003cp>“A lot of these kids, especially if they’re low-income, especially if they are from a community of color, they’re being labeled as behavior problems. They’re being suspended or expelled,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Newsom’s budget\u003ca href=\"http://www.ebudget.ca.gov/2019-20/pdf/BudgetSummary/EarlyChildhood.pdf\" target=\"_blank\" rel=\"noopener\"> proposes $45 million\u003c/a> to screen children and adults for adverse experiences. Another $60 million would go toward developmental screenings for kids.\u003c/p>\n\n",
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"excerpt": "Dr. Nadine Burke Harris wants the state to be more proactive in dealing with what she calls the effects of toxic stress on kids.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California has never had a surgeon general, but that will change today. Dr. Nadine Burke Harris, a San Francisco-based pediatrician, has pioneered research into the effect that childhood traumas have on health. As the state’s top doctor, Burke Harris will act in an advisory capacity to Gov. Gavin Newsom.\u003c/p>\n\u003cp>Burke Harris will also work to promote programs like \u003ca href=\"http://www.sjteeth.org/\">SJ TEETH\u003c/a>, which provides dental cleanings to low-income kids. It partners with organizations like \u003ca href=\"http://www.sjckids.org/\" target=\"_blank\" rel=\"noopener\">First 5 San Joaquin\u003c/a>, which supports early childhood development programs, including a preschool program in Lathrop.\u003c/p>\n\u003cfigure id=\"attachment_11724886\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11724886\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/02/Demostration-qut-800x600.jpg\" alt=\"Dental hygienist Deborah Delfino shows a group of preschoolers in Lathrop, California how to brush their teeth by demonstrating with a puppet named Bob.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Demostration-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dental hygienist Deborah Delfino shows a group of preschoolers in Lathrop, California, how to brush their teeth by demonstrating with a puppet named Bob. \u003ccite>(Katie Orr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On this particular day, dental hygienist Deborah Delfino sits in front of the class and uses a puppet named Bob to teach the kids how to brush their teeth.\u003c/p>\n\u003cp>“OK now Bob, I want you to open real big. Can we all help Bob open big? Help him go, ‘Awwww!’ ” she tells the kids\u003c/p>\n\u003cp>The 4- and 5-year-olds respond by eagerly opening their mouths and showing off their teeth.\u003c/p>\n\u003cfigure id=\"attachment_11724889\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11724889\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/02/Cleaning-qut-800x600.jpg\" alt=\"Dental hygienist Deborah Delfino cleans the teeth of a preschooler in Lathrop, CA.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/02/Cleaning-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dental hygienist Deborah Delfino cleans the teeth of a preschooler in Lathrop, California. \u003ccite>(Katie Orr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After the lesson Delfino gives some of the kids a quick teeth cleaning in a corner of the room. During the exams she makes sure to clearly explain to them what she’s doing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I love brushing my teeth,” says 5-year-old Valentina, the first patient, shyly as she mimics brushing her teeth. “I love doing up and down.”\u003c/p>\n\u003cp>First 5 San Joaquin Executive Director Lani Schiff-Ross said it’s important to make sure the kids have a good experience with the dentist. Otherwise, they might not come back. The clinicians try to be especially aware of possible traumas children may have experienced, she said.\u003c/p>\n\u003cp>“If a child is not told what’s going on and a professional is touching their body and not asking for permission or explaining what they’re about to do, that can trigger some issues that they’ve had when someone has abused them,” said Schiff-Ross.\u003c/p>\n\u003cp>That’s exactly the awareness Burke Harris wants to promote as surgeon general. As a pediatrician, she studied the 10 categories of \u003ca href=\"https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Findex.html\" target=\"_blank\" rel=\"noopener\">adverse childhood experiences\u003c/a>. They include things like physical and sexual abuse, neglect, or having a parent in jail affect long-term health. All of that can increase stress. She also envisions earlier interventions to help detect and treat toxic stress.\u003c/p>\n\u003cp>“Without the buffering care of a nurturing adult, these stress hormones can continue to stay at high levels and lead to harm,” she said.\u003c/p>\n\u003cp>Burke Harris said 61 percent of Californians have had at least one adverse childhood experience, and she said ignoring trauma hurts kids long-term.\u003c/p>\n\u003cp>“A lot of these kids, especially if they’re low-income, especially if they are from a community of color, they’re being labeled as behavior problems. They’re being suspended or expelled,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Newsom’s budget\u003ca href=\"http://www.ebudget.ca.gov/2019-20/pdf/BudgetSummary/EarlyChildhood.pdf\" target=\"_blank\" rel=\"noopener\"> proposes $45 million\u003c/a> to screen children and adults for adverse experiences. Another $60 million would go toward developmental screenings for kids.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"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 />",
"airtime": "SUN 9pm-10pm",
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"meta": {
"site": "radio",
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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",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"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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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"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": {
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"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"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/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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"id": "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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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
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"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"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",
"subscribe": {
"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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"rss": "https://feeds.npr.org/510313/podcast.xml"
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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",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"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",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"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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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"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": {
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"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)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"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": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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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": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"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",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
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