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"content": "\u003cp>Shaima Swileh will be able to\u003ca href=\"http://bit.ly/fioretravelbanwaiver\" target=\"_blank\" rel=\"noopener\"> visit her 2-year-old dying son\u003c/a> in Oakland after the U.S. State Department granted her a travel ban visa waiver.\u003c/p>\n\u003cp>Swileh is expected to join her husband, Ali Hassan, Wednesday to say their last goodbyes to son Abdullah at UCSF Benioff Children’s Hospital Oakland.\u003c/p>\n\u003cp>Abdullah was born in war-torn Yemen in 2016 during a conflict that has involved \u003ca href=\"https://www.npr.org/2018/09/20/650052820/u-s-support-of-saudi-bombing-campaign-in-yemen-comes-under-scrutiny\" target=\"_blank\" rel=\"noopener\">U.S.-made bombs\u003c/a> dropped by Saudi jet fighters, \u003ca href=\"https://www.npr.org/2018/08/28/642508732/u-n-experts-some-saudi-led-airstrikes-in-yemen-could-be-war-crimes\" target=\"_blank\" rel=\"noopener\">war crimes\u003c/a> and a growing \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2018/11/01/662634864/a-call-for-a-ceasefire-in-yemen-makes-news-its-catastrophe-doesnt\" target=\"_blank\" rel=\"noopener\">humanitarian crisis\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>\u003cem>Updated Saturday, 5:30 p.m.\u003c/em>\u003c/p>\n\u003cp>California’s health care marketplace has extended the deadline for people to sign up for insurance that will start on Jan. 1, 2019, in response to a federal court ruling handed down on Friday that invalidated the Affordable Care Act.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch2>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">6 Things To Know About Covered California Open Enrollment for 2019\u003c/a>\u003c/h2>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS11278_479421059-800x534.jpg\">\u003c/a>\u003cbr>\n\u003c/p>\u003c/aside>\n\u003cp>Saturday was supposed to be the cutoff for Californians looking to \u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">enroll in health coverage\u003c/a> through Covered California that would kick in at the beginning of the year. But that deadline has been extended nearly a week to Friday, Dec. 21 after a federal district court judge in Texas declared the Affordable Care Act (often referred to as Obamacare) \u003ca href=\"https://www.kqed.org/news/11712827/federal-judge-strikes-down-affordable-care-act-as-unconstitutional\" rel=\"noopener\" target=\"_blank\">unconstitutional\u003c/a>.\u003c/p>\n\u003cp>Covered California chose to extend the deadline after the extensive media coverage of the court decision led to fears that it could cause confusion for Californians over how it would impact their coverage. \u003c/p>\n\u003cp>“We have seen tens of thousands of people flood into Covered California over the past week, and we want to make sure everyone can start the new year off right by being covered,” said Peter Lee, executive director of \u003ca href=\"https://www.coveredca.com/\" rel=\"noopener\" target=\"_blank\">Covered California\u003c/a>, in a statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Open enrollment in Covered California runs through Jan. 15, 2019, making it one of seven marketplaces that has a longer open enrollment period than the federal one, which ends today. Anyone enrolling between Dec. 22 and Jan. 15 will see their coverage start on Feb. 1. \u003c/p>\n\u003cp>U.S. District Judge Reed O’Connor ruled that the landmark health care law was unconstitutional because Congress earlier this year repealed the tax penalty for people who did not buy health insurance, often referred to as the individual mandate. \u003c/p>\n\u003cp>U.S. Supreme Court Chief Justice John Roberts had upheld the constitutionality of the law in 2012 in part based on it falling under Congress’ power to tax. With the mandate repealed, O’Connor sided with 19 Republican attorneys general and one governor who argued that the law was no longer constitutional.\u003c/p>\n\u003cp>“For the forseeable future, this ruling has absolutely no effect,” Lee told KQED. “If people are thinking about signing up for coverage in 2019, now is the time to do it, and their coverage will go live and apply throughout next year.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch2>\u003ca href=\"https://www.kqed.org/news/11711387/the-obamacare-mandate-is-ending-if-california-does-nothing-1-million-could-lose-health-care\" rel=\"noopener\" target=\"_blank\">The Obamacare Mandate Is Ending. If California Does Nothing, 1 Million Could Lose Health Care\u003c/a>\u003c/h2>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11711387/the-obamacare-mandate-is-ending-if-california-does-nothing-1-million-could-lose-health-care\" rel=\"noopener\" target=\"_blank\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/12/Doctor.jpg\">\u003c/a>\u003cbr>\n\u003c/p>\u003c/aside>\n\u003cp>The insurance marketplace had already been considering extending the deadline due to a surge in last-minute sign ups. According to Lee, 58,000 people have signed up in the past week, and nearly 180,000 people have enrolled for 2019 coverage overall, in addition to another 1.2 million who have renewed their existing plans for 2019.\u003c/p>\n\u003cp>But enrollment is down about 10 percent compared to last year, which Lee attributes to some healthy Californians choosing not to buy insurance because Congress repealed the individual mandate.\u003c/p>\n\u003cp>“I want to be really clear: every one of those people is rolling the dice because some of them are going to end up in the emergency room and walking out with a $150,000 debt,” Lee said.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra, who has led a group of Democratic attorneys general defending the ACA, said in a statement Friday that “our coalition will continue to fight in court” to \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-denounces-court-ruling-declaring-aca-unconstitutional\" rel=\"noopener\" target=\"_blank\">defend the law\u003c/a>, which the White House said will stay in effect pending appeal.\u003c/p>\n\u003cp>The case is expected to end up in front of the U.S. Supreme Court, a process that could take months. Lee said if the decision is upheld, it would have devastating consequences for Californians covered by all types of insurance: private, Medicare and Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This is really a decision which is truly beyond the pale,” Lee said.\u003c/p>\n\n",
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"excerpt": "The deadline to secure coverage starting Jan. 1 was supposed to be today, but it has been extended to Friday, Dec. 21.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Saturday, 5:30 p.m.\u003c/em>\u003c/p>\n\u003cp>California’s health care marketplace has extended the deadline for people to sign up for insurance that will start on Jan. 1, 2019, in response to a federal court ruling handed down on Friday that invalidated the Affordable Care Act.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch2>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">6 Things To Know About Covered California Open Enrollment for 2019\u003c/a>\u003c/h2>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS11278_479421059-800x534.jpg\">\u003c/a>\u003cbr>\n\u003c/p>\u003c/aside>\n\u003cp>Saturday was supposed to be the cutoff for Californians looking to \u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\" rel=\"noopener\" target=\"_blank\">enroll in health coverage\u003c/a> through Covered California that would kick in at the beginning of the year. But that deadline has been extended nearly a week to Friday, Dec. 21 after a federal district court judge in Texas declared the Affordable Care Act (often referred to as Obamacare) \u003ca href=\"https://www.kqed.org/news/11712827/federal-judge-strikes-down-affordable-care-act-as-unconstitutional\" rel=\"noopener\" target=\"_blank\">unconstitutional\u003c/a>.\u003c/p>\n\u003cp>Covered California chose to extend the deadline after the extensive media coverage of the court decision led to fears that it could cause confusion for Californians over how it would impact their coverage. \u003c/p>\n\u003cp>“We have seen tens of thousands of people flood into Covered California over the past week, and we want to make sure everyone can start the new year off right by being covered,” said Peter Lee, executive director of \u003ca href=\"https://www.coveredca.com/\" rel=\"noopener\" target=\"_blank\">Covered California\u003c/a>, in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Open enrollment in Covered California runs through Jan. 15, 2019, making it one of seven marketplaces that has a longer open enrollment period than the federal one, which ends today. Anyone enrolling between Dec. 22 and Jan. 15 will see their coverage start on Feb. 1. \u003c/p>\n\u003cp>U.S. District Judge Reed O’Connor ruled that the landmark health care law was unconstitutional because Congress earlier this year repealed the tax penalty for people who did not buy health insurance, often referred to as the individual mandate. \u003c/p>\n\u003cp>U.S. Supreme Court Chief Justice John Roberts had upheld the constitutionality of the law in 2012 in part based on it falling under Congress’ power to tax. With the mandate repealed, O’Connor sided with 19 Republican attorneys general and one governor who argued that the law was no longer constitutional.\u003c/p>\n\u003cp>“For the forseeable future, this ruling has absolutely no effect,” Lee told KQED. “If people are thinking about signing up for coverage in 2019, now is the time to do it, and their coverage will go live and apply throughout next year.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch2>\u003ca href=\"https://www.kqed.org/news/11711387/the-obamacare-mandate-is-ending-if-california-does-nothing-1-million-could-lose-health-care\" rel=\"noopener\" target=\"_blank\">The Obamacare Mandate Is Ending. If California Does Nothing, 1 Million Could Lose Health Care\u003c/a>\u003c/h2>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11711387/the-obamacare-mandate-is-ending-if-california-does-nothing-1-million-could-lose-health-care\" rel=\"noopener\" target=\"_blank\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/12/Doctor.jpg\">\u003c/a>\u003cbr>\n\u003c/p>\u003c/aside>\n\u003cp>The insurance marketplace had already been considering extending the deadline due to a surge in last-minute sign ups. According to Lee, 58,000 people have signed up in the past week, and nearly 180,000 people have enrolled for 2019 coverage overall, in addition to another 1.2 million who have renewed their existing plans for 2019.\u003c/p>\n\u003cp>But enrollment is down about 10 percent compared to last year, which Lee attributes to some healthy Californians choosing not to buy insurance because Congress repealed the individual mandate.\u003c/p>\n\u003cp>“I want to be really clear: every one of those people is rolling the dice because some of them are going to end up in the emergency room and walking out with a $150,000 debt,” Lee said.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra, who has led a group of Democratic attorneys general defending the ACA, said in a statement Friday that “our coalition will continue to fight in court” to \u003ca href=\"https://oag.ca.gov/news/press-releases/attorney-general-becerra-denounces-court-ruling-declaring-aca-unconstitutional\" rel=\"noopener\" target=\"_blank\">defend the law\u003c/a>, which the White House said will stay in effect pending appeal.\u003c/p>\n\u003cp>The case is expected to end up in front of the U.S. Supreme Court, a process that could take months. Lee said if the decision is upheld, it would have devastating consequences for Californians covered by all types of insurance: private, Medicare and Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This is really a decision which is truly beyond the pale,” Lee said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>[dropcap]I[/dropcap]n a scramble to keep people enrolled in health care plans, what did New Jersey, Vermont and the District of Columbia do earlier this year that California has not done?\u003c/p>\n\u003cp>They began requiring that their residents carry health coverage or face a state penalty for going without it. Such “individual mandates” aim to replace the federal mandate—perhaps the most controversial but essential part of the Affordable Care Act, often called Obamacare—that sought to force people to sign up for health insurance or pay a tax penalty. The Republican Congress and the Trump administration have repealed that federal penalty, effective next year.\u003c/p>\n\u003cp>The clock is ticking. Obamacare has led to a record number of Californians having medical coverage. But a new study warns that if the state does nothing to counteract the Trump administration’s moves to undermine Obamacare, up to 1 million more Californians could be without health insurance within the next five years.\u003c/p>\n\u003cp>What’s kept California from enacting its own mandate? Some state Democratic leaders are wary of enacting a state mandate without also making health insurance cheaper for Californians.\u003c/p>\n\u003cp>“Providing subsidies is a better reality for members of our community than providing penalties,” said Assemblyman Joaquin Arambula, a Fresno Democrat who co-chaired the select committee on universal health care that conducted town halls across the state last summer. “It’s the carrot versus the stick.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sacramento state Sen. Richard Pan, a Democrat who chairs the Senate Health Committee, said the Legislature is focused on keeping the state’s insurance market exchange, known as Covered California, strong. Some 2 million Californians buy health coverage through the exchange, which provides federal subsidies to low-income purchasers.\u003c/p>\n\u003cp>“We are going to do what we can in California to stabilize the insurance market, to do what we can to make health insurance, particularly on Covered California, affordable,” said Pan, who has not yet endorsed any particular remedy. “We are up against a federal administration that is doing the opposite and forcing people to pay higher premiums.\u003c/p>\n\u003cp>“As we look at options, like do we want to do an individual mandate, we also need to recognize part of what is driving that is not only the removal of the federal mandate, but also actions taken to increase insurance premiums,” Pan continued.\u003c/p>\n\u003cp>Since the Affordable Care Act was implemented in 2013, the state’s uninsured rate has dropped from 20 percent to 7 percent. Currently 3.4 million Californians are uninsured, undocumented immigrant adults making up the majority of that group.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We don’t want to require people to buy coverage that they can’t afford.”\u003cbr>\n— \u003cspan style=\"font-style: italic\">Anthony Wright, executive director of HealthAccess, which advocates for consumers\u003c/span>\u003c/aside>\n\u003cp>But without more aggressive state intervention to counter Washington’s retreat from the program, an estimated 500,000 to 800,000 more Californians under 65 will be uninsured by 2023, according to a new study from the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.\u003c/p>\n\u003cp>A mandate and state subsidies are among options the Legislature will be exploring to combat the expected exodus from insurance. But both are controversial. An Economist/YouGov poll found that 66 percent of Americans oppose a mandate. And although a few other states such as Vermont and Massachusetts do offer state subsidies, in California state subsidies could cost up to an estimated $500 million, at a time when an incoming Democratic governor and Democratic supermajorities in the Legislature have promised pricey programs such as universal health care and universal preschool.\u003c/p>\n\u003cp>So far, Covered California enrollment, now underway through Jan. 15, is meeting projections—with a big caveat. As of the end of November, more than 90,000 newly insured people signed up, said Peter Lee, its executive director. But those projections already were lowered by 10 to 12 percent compared to last year because it was unknown what effect the removal of the penalty would have on sign-ups.\u003c/p>\n\u003cp>“There’s no question that a penalty imposed on individuals for whom health insurance is affordable is a good policy,” said Lee, who said he would follow whatever rules the Legislature adopts. “The penalty encourages people to participate in a system that, if they don’t, we all bear the cost. And it encourages people to do the right thing for themselves.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\">6 Things To Know About Covered California Open Enrollment for 2019\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS11278_479421059-1038x576.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Covered California is working on a report commissioned by the Legislature on how to best bolster the system. It’s due in February, and Lee said a variety of options are on the table, including a mandate, expanding subsidies and using state money to lower premiums, a process called reinsurance.\u003c/p>\n\u003cp>Some of those ideas echo the recommendations UC researchers offered in their study: incorporate a state mandate with penalty funds going toward making insurance more affordable, state-funded subsidies in addition to the existing federal subsidies, and a Medi-Cal expansion to include low-income undocumented immigrants.\u003c/p>\n\u003cp>These are not new ideas but they are politically and financially costly, said Gerald Kominski, a fellow at the UCLA Center for Health Policy Research.“We know that the mandate drives people into the market,” said Kominski. “If you’re going to pay a tax penalty and not have health insurance, why not look for insurance when almost 90 percent of those who buy in through Covered California received some sort of subsidy.”\u003c/p>\n\u003cp>“The state could consider bringing the whole threshold down for everybody,” he continued. “The point is to lower the thresholds and make people pay less out of pocket. That would increase affordability for lots of families.” Some advocates agree that a potential state mandate must also include a mechanism for making insurance more attainable.\u003c/p>\n\u003cfigure id=\"attachment_11712113\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11712113\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/12/HealthCareSignups-800x535.jpg\" alt=\"People wait to register for helath care insurance during an enrollment fair on March 28, 2014 in Bay Point.\" width=\"800\" height=\"535\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-800x535.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-1020x682.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-1200x802.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">People wait to register for health care insurance during an enrollment fair on March 28, 2014, in Bay Point. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We don’t want to require people to buy coverage that they can’t afford. And what they can afford may be different in a high-cost-of-living state like California,” said Anthony Wright, executive director of HealthAccess, which advocates for consumers. “That’s why it’s hard to have a conversation about a mandate without affordability assistance.”\u003c/p>\n\u003cp>Under the federal mandate, Americans were compelled to carry health insurance or pay a penalty of $695 per adult or 2.5 percent of household income, whichever is higher, unless insurance costs more than 8 percent of a household’s income.\u003c/p>\n\u003cp>With the repeal of that ultimatum, California is bracing for the biggest dropouts among its residents who have been buying insurance through the subsidized Covered California program. The program projects it could lose 10 to 30 percent of its participants.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There’s no question that a penalty imposed on individuals for whom health insurance is affordable is a good policy.” \u003ccite>Peter Lee, executive director for Covered California\u003c/cite>\u003c/aside>\n\u003cp>But the state also expects wider losses, including among the 46 percent of Californians who get insurance through employers, because they also will no longer be required to have it. Even Medi-Cal, the state-paid program for low-income Californians, will lose about 350,000 people, the study estimates, because the lack of a federal mandate may deter people from seeking health coverage at all—meaning they’ll never discover if they qualify for Medi-Cal. Last year the California Legislature considered creating a state mandate as part of budget discussions that included making insurance more affordable, but neither idea made it into the final budget proposal submitted to the governor.\u003c/p>\n\u003cp>Experts and advocates are hopeful that these ideas may gain traction under Gov.-elect Gavin Newsom, who has talked a big game on health care and access, pledging during his campaign to support single payer and universal coverage. If more Californians drop their health insurance, everyone pays. People most likely to drop out are the young and the healthy, experts say. But they are critical to keeping the whole operation afloat because the system cannot be made up of only sick people.\u003c/p>\n\u003cp>California already has taken steps to shore up the Affordable Care Act: banning short-term health plans, adopting legislation barring work requirements for Medi-Cal and offering a longer open enrollment period.\u003c/p>\n\u003cp>“Legislators tell us to expect a fresh look at state initiatives to stabilize the insurance market,” said Richard Cauchi who oversees health initiatives for the National Conference of State Legislatures. “So ‘stay tuned’ to see how many states will create their own solutions.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/\">CALmatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/p>\n\n",
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"excerpt": "Obamacare required people to sign up for health insurance or pay a penalty. Congress has repealed that federal penalty, effective next year. And the clock is ticking.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">I\u003c/span>\u003c/p>\u003cp>n a scramble to keep people enrolled in health care plans, what did New Jersey, Vermont and the District of Columbia do earlier this year that California has not done?\u003c/p>\n\u003cp>They began requiring that their residents carry health coverage or face a state penalty for going without it. Such “individual mandates” aim to replace the federal mandate—perhaps the most controversial but essential part of the Affordable Care Act, often called Obamacare—that sought to force people to sign up for health insurance or pay a tax penalty. The Republican Congress and the Trump administration have repealed that federal penalty, effective next year.\u003c/p>\n\u003cp>The clock is ticking. Obamacare has led to a record number of Californians having medical coverage. But a new study warns that if the state does nothing to counteract the Trump administration’s moves to undermine Obamacare, up to 1 million more Californians could be without health insurance within the next five years.\u003c/p>\n\u003cp>What’s kept California from enacting its own mandate? Some state Democratic leaders are wary of enacting a state mandate without also making health insurance cheaper for Californians.\u003c/p>\n\u003cp>“Providing subsidies is a better reality for members of our community than providing penalties,” said Assemblyman Joaquin Arambula, a Fresno Democrat who co-chaired the select committee on universal health care that conducted town halls across the state last summer. “It’s the carrot versus the stick.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sacramento state Sen. Richard Pan, a Democrat who chairs the Senate Health Committee, said the Legislature is focused on keeping the state’s insurance market exchange, known as Covered California, strong. Some 2 million Californians buy health coverage through the exchange, which provides federal subsidies to low-income purchasers.\u003c/p>\n\u003cp>“We are going to do what we can in California to stabilize the insurance market, to do what we can to make health insurance, particularly on Covered California, affordable,” said Pan, who has not yet endorsed any particular remedy. “We are up against a federal administration that is doing the opposite and forcing people to pay higher premiums.\u003c/p>\n\u003cp>“As we look at options, like do we want to do an individual mandate, we also need to recognize part of what is driving that is not only the removal of the federal mandate, but also actions taken to increase insurance premiums,” Pan continued.\u003c/p>\n\u003cp>Since the Affordable Care Act was implemented in 2013, the state’s uninsured rate has dropped from 20 percent to 7 percent. Currently 3.4 million Californians are uninsured, undocumented immigrant adults making up the majority of that group.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We don’t want to require people to buy coverage that they can’t afford.”\u003cbr>\n— \u003cspan style=\"font-style: italic\">Anthony Wright, executive director of HealthAccess, which advocates for consumers\u003c/span>\u003c/aside>\n\u003cp>But without more aggressive state intervention to counter Washington’s retreat from the program, an estimated 500,000 to 800,000 more Californians under 65 will be uninsured by 2023, according to a new study from the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.\u003c/p>\n\u003cp>A mandate and state subsidies are among options the Legislature will be exploring to combat the expected exodus from insurance. But both are controversial. An Economist/YouGov poll found that 66 percent of Americans oppose a mandate. And although a few other states such as Vermont and Massachusetts do offer state subsidies, in California state subsidies could cost up to an estimated $500 million, at a time when an incoming Democratic governor and Democratic supermajorities in the Legislature have promised pricey programs such as universal health care and universal preschool.\u003c/p>\n\u003cp>So far, Covered California enrollment, now underway through Jan. 15, is meeting projections—with a big caveat. As of the end of November, more than 90,000 newly insured people signed up, said Peter Lee, its executive director. But those projections already were lowered by 10 to 12 percent compared to last year because it was unknown what effect the removal of the penalty would have on sign-ups.\u003c/p>\n\u003cp>“There’s no question that a penalty imposed on individuals for whom health insurance is affordable is a good policy,” said Lee, who said he would follow whatever rules the Legislature adopts. “The penalty encourages people to participate in a system that, if they don’t, we all bear the cost. And it encourages people to do the right thing for themselves.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\">6 Things To Know About Covered California Open Enrollment for 2019\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/news/11698852/6-things-to-know-about-covered-california-open-enrollment-for-2019\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS11278_479421059-1038x576.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Covered California is working on a report commissioned by the Legislature on how to best bolster the system. It’s due in February, and Lee said a variety of options are on the table, including a mandate, expanding subsidies and using state money to lower premiums, a process called reinsurance.\u003c/p>\n\u003cp>Some of those ideas echo the recommendations UC researchers offered in their study: incorporate a state mandate with penalty funds going toward making insurance more affordable, state-funded subsidies in addition to the existing federal subsidies, and a Medi-Cal expansion to include low-income undocumented immigrants.\u003c/p>\n\u003cp>These are not new ideas but they are politically and financially costly, said Gerald Kominski, a fellow at the UCLA Center for Health Policy Research.“We know that the mandate drives people into the market,” said Kominski. “If you’re going to pay a tax penalty and not have health insurance, why not look for insurance when almost 90 percent of those who buy in through Covered California received some sort of subsidy.”\u003c/p>\n\u003cp>“The state could consider bringing the whole threshold down for everybody,” he continued. “The point is to lower the thresholds and make people pay less out of pocket. That would increase affordability for lots of families.” Some advocates agree that a potential state mandate must also include a mechanism for making insurance more attainable.\u003c/p>\n\u003cfigure id=\"attachment_11712113\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11712113\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/12/HealthCareSignups-800x535.jpg\" alt=\"People wait to register for helath care insurance during an enrollment fair on March 28, 2014 in Bay Point.\" width=\"800\" height=\"535\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-800x535.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-1020x682.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups-1200x802.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/12/HealthCareSignups.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">People wait to register for health care insurance during an enrollment fair on March 28, 2014, in Bay Point. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We don’t want to require people to buy coverage that they can’t afford. And what they can afford may be different in a high-cost-of-living state like California,” said Anthony Wright, executive director of HealthAccess, which advocates for consumers. “That’s why it’s hard to have a conversation about a mandate without affordability assistance.”\u003c/p>\n\u003cp>Under the federal mandate, Americans were compelled to carry health insurance or pay a penalty of $695 per adult or 2.5 percent of household income, whichever is higher, unless insurance costs more than 8 percent of a household’s income.\u003c/p>\n\u003cp>With the repeal of that ultimatum, California is bracing for the biggest dropouts among its residents who have been buying insurance through the subsidized Covered California program. The program projects it could lose 10 to 30 percent of its participants.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There’s no question that a penalty imposed on individuals for whom health insurance is affordable is a good policy.” \u003ccite>Peter Lee, executive director for Covered California\u003c/cite>\u003c/aside>\n\u003cp>But the state also expects wider losses, including among the 46 percent of Californians who get insurance through employers, because they also will no longer be required to have it. Even Medi-Cal, the state-paid program for low-income Californians, will lose about 350,000 people, the study estimates, because the lack of a federal mandate may deter people from seeking health coverage at all—meaning they’ll never discover if they qualify for Medi-Cal. Last year the California Legislature considered creating a state mandate as part of budget discussions that included making insurance more affordable, but neither idea made it into the final budget proposal submitted to the governor.\u003c/p>\n\u003cp>Experts and advocates are hopeful that these ideas may gain traction under Gov.-elect Gavin Newsom, who has talked a big game on health care and access, pledging during his campaign to support single payer and universal coverage. If more Californians drop their health insurance, everyone pays. People most likely to drop out are the young and the healthy, experts say. But they are critical to keeping the whole operation afloat because the system cannot be made up of only sick people.\u003c/p>\n\u003cp>California already has taken steps to shore up the Affordable Care Act: banning short-term health plans, adopting legislation barring work requirements for Medi-Cal and offering a longer open enrollment period.\u003c/p>\n\u003cp>“Legislators tell us to expect a fresh look at state initiatives to stabilize the insurance market,” said Richard Cauchi who oversees health initiatives for the National Conference of State Legislatures. “So ‘stay tuned’ to see how many states will create their own solutions.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/\">CALmatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The Trump administration is pushing back on a \u003ca href=\"https://www.washingtonpost.com/national/health-science/trump-administration-threatens-future-of-hiv-research-hub/2018/12/04/f2e8e0ec-f7dd-11e8-863c-9e2f864d47e7_story.html?utm_term=.cfbea3c76cb7\">Washington Post story\u003c/a> that the federal government is moving to eliminate funding for a major UCSF research lab that tests new HIV treatments using fetal tissue.\u003c/p>\n\u003cp>The Post, citing anonymous sources outside the federal government, reported that the administration was ending the seven-year contract and that the decision was coming from the “highest levels.” That information reportedly came from an official with the National Institutes of Health.\u003c/p>\n\u003cp>“Unfortunately, the Washington Post chose to report assertions that are completely false,” said Caitlin Oakley, spokeswoman for the Department of Health and Human Services.\u003c/p>\n\u003cp>The HHS statement says no decision has been made about whether to extend or cancel the lab’s $2 million NIH contract. It said the story is based on “anonymous sources providing inaccurate information.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments\">Big Data Gives a Boost to Immunology Research and Potentially, Treatments\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/iStock-824219476-1180x787.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>However, the statement does confirm the UCSF contract is being audited for its compliance with regulations governing fetal tissue, which is mostly obtained from abortions.\u003c/p>\n\u003cp>The contract is set to expire today, and according to the Post, the NIH now says the contract would continue for 90 days while the review is underway.\u003c/p>\n\u003cp>The bottom line is that the laboratory’s future is “very much in limbo,” according to Amy Goldstein, the Post’s national health care policy writer. She describes the lab as being central to nearly all early testing of HIV therapies approved by the Food and Drug Administration since the 1990s.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In September, \u003ca href=\"https://www.hhs.gov/about/news/2018/09/24/statement-from-the-department-of-health-and-human-services.html\">HHS announced a broad audit\u003c/a> of all acquisitions involving fetal tissue to ensure all laws and regulations are being followed.\u003c/p>\n\u003cp>This comes amid stepped-up efforts by social conservatives to get the administration to end government support of fetal tissue research.\u003c/p>\n\u003cp>Goldstein describes the UCSF lab as a “central testing platform for assessing in animals the effectiveness and safety of chemical compounds” that seem promising for HIV treatments.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices\">FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/iStock-700219242-1180x787.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>The mice are implanted with small amounts of fetal tissue from the thymus glands. The thymus is critical because it produce T-cells — which become depleted in people and mice infected with HIV.\u003c/p>\n\u003cp>Eventually, the mice grow the equivalent of a human thymus, which researchers can use to test drugs to see which are effective and safe. Goldstein reports that this is the only lab doing this work under an NIH grant — and this grant is the sole source of funding for the lab.\u003c/p>\n\u003cp>In a statement, UCSF would not comment on the Post’s story, but the UC Office of the President called fetal tissue “vital to finding treatment and cures for a wide variety of adult and childhood diseases and medical conditions.”\u003c/p>\n\u003cp>Fetal tissue research has long been controversial. Federal funding of this type of research was banned in the 1980s.\u003c/p>\n\u003cp>The tissue comes from women who have had elective abortions. Opponents of this research argue the use of fetal tissue increases the rate of abortions in the country. Researchers counter that there is no evidence to back up that claim, according to Goldstein.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Trump administration is pushing back on a \u003ca href=\"https://www.washingtonpost.com/national/health-science/trump-administration-threatens-future-of-hiv-research-hub/2018/12/04/f2e8e0ec-f7dd-11e8-863c-9e2f864d47e7_story.html?utm_term=.cfbea3c76cb7\">Washington Post story\u003c/a> that the federal government is moving to eliminate funding for a major UCSF research lab that tests new HIV treatments using fetal tissue.\u003c/p>\n\u003cp>The Post, citing anonymous sources outside the federal government, reported that the administration was ending the seven-year contract and that the decision was coming from the “highest levels.” That information reportedly came from an official with the National Institutes of Health.\u003c/p>\n\u003cp>“Unfortunately, the Washington Post chose to report assertions that are completely false,” said Caitlin Oakley, spokeswoman for the Department of Health and Human Services.\u003c/p>\n\u003cp>The HHS statement says no decision has been made about whether to extend or cancel the lab’s $2 million NIH contract. It said the story is based on “anonymous sources providing inaccurate information.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments\">Big Data Gives a Boost to Immunology Research and Potentially, Treatments\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/futureofyou/444953/big-data-gives-a-boost-to-immunology-research-and-potentially-treatments\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/iStock-824219476-1180x787.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>However, the statement does confirm the UCSF contract is being audited for its compliance with regulations governing fetal tissue, which is mostly obtained from abortions.\u003c/p>\n\u003cp>The contract is set to expire today, and according to the Post, the NIH now says the contract would continue for 90 days while the review is underway.\u003c/p>\n\u003cp>The bottom line is that the laboratory’s future is “very much in limbo,” according to Amy Goldstein, the Post’s national health care policy writer. She describes the lab as being central to nearly all early testing of HIV therapies approved by the Food and Drug Administration since the 1990s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In September, \u003ca href=\"https://www.hhs.gov/about/news/2018/09/24/statement-from-the-department-of-health-and-human-services.html\">HHS announced a broad audit\u003c/a> of all acquisitions involving fetal tissue to ensure all laws and regulations are being followed.\u003c/p>\n\u003cp>This comes amid stepped-up efforts by social conservatives to get the administration to end government support of fetal tissue research.\u003c/p>\n\u003cp>Goldstein describes the UCSF lab as a “central testing platform for assessing in animals the effectiveness and safety of chemical compounds” that seem promising for HIV treatments.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices\">FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/iStock-700219242-1180x787.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>The mice are implanted with small amounts of fetal tissue from the thymus glands. The thymus is critical because it produce T-cells — which become depleted in people and mice infected with HIV.\u003c/p>\n\u003cp>Eventually, the mice grow the equivalent of a human thymus, which researchers can use to test drugs to see which are effective and safe. Goldstein reports that this is the only lab doing this work under an NIH grant — and this grant is the sole source of funding for the lab.\u003c/p>\n\u003cp>In a statement, UCSF would not comment on the Post’s story, but the UC Office of the President called fetal tissue “vital to finding treatment and cures for a wide variety of adult and childhood diseases and medical conditions.”\u003c/p>\n\u003cp>Fetal tissue research has long been controversial. Federal funding of this type of research was banned in the 1980s.\u003c/p>\n\u003cp>The tissue comes from women who have had elective abortions. Opponents of this research argue the use of fetal tissue increases the rate of abortions in the country. Researchers counter that there is no evidence to back up that claim, according to Goldstein.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"headTitle": "Ag Official: E. Coli Outbreak Could Hurt Salinas Valley Lettuce Growers for Years | KQED",
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"content": "\u003cp>The E. coli outbreak linked to romaine lettuce that has sickened dozens of people in the United States and Canada could hurt the Central Coast’s farming industry for years, according to one of the region’s top agricultural officials.\u003c/p>\n\u003cp>The Food and Drug Administration announced on Monday that the romaine tied to the outbreak appears to be from the Central Coast, and that romaine produced outside that region is safe to eat as long as it’s labeled correctly.\u003c/p>\n\u003cp>Bob Roach, assistant agricultural commissioner for Monterey County, said that disclosure could keep consumers away from romaine grown in the region even after the outbreak ends.\u003c/p>\n\u003cp>“It’s bad for business and it lingers and it takes literally years for that stigma of a food-borne illness to go away from a product,” Roach said in an interview Tuesday.\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention is investigating the outbreak that has sickened 65 people: 43 in 12 states that include 16 people who were hospitalized, along with 22 cases in Canada.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In California there have been 11 reported cases. Of those, nine are in Los Angeles County, one in Orange County and one in El Dorado County, according to the California Department of Public Health.\u003c/p>\n\u003cp>The Central Coast is one of the nation’s major production areas for romaine lettuce. Hundreds of farms in Monterey County produce it.\u003c/p>\n\u003cp>“Romaine lettuce is a huge crop here. Everyone who is growing cool season vegetable crops in Monterey County is growing romaine lettuce,” Roach said.\u003c/p>\n\u003cp>The value of bulk and fresh romaine lettuce for growers in Monterey County last year was close to $656 million, which is about 15 percent of the total production value of the county’s agricultural industry, according to Monterey’s most recent \u003ca href=\"http://www.co.monterey.ca.us/Home/ShowDocument?id=65737\" target=\"_blank\" rel=\"noopener\">crop report\u003c/a>.\u003c/p>\n\u003cp>“We’re not the only region that was producing romaine lettuce at the time people were consuming it and becoming ill,” Roach said. “But we were definitely responsible for a large percentage of the volume that was being produced.”\u003c/p>\n\u003cp>When the CDC warns people not to eat romaine lettuce, consumers are bound to stay away from all kinds of lettuce, Roach said. And, when federal health officials narrow their warning, like they did on Monday, that still might not change consumer habits, he said.\u003c/p>\n\u003cp>A drop in demand could have ripple effects.\u003c/p>\n\u003cp>“If they plant less lettuce, that translates into less jobs and less money flowing into the local economy” Roach said.\u003c/p>\n\u003cp>Last spring, some 200 people got sick, including five who died, from a separate E. coli outbreak linked to romaine lettuce that is believed to have come from a large cattle feedlot near Yuma, Arizona, one of the nation’s other big lettuce-growing areas.\u003c/p>\n\u003cp>The FDA says the current outbreak is not related to those cases. Instead, the agency says it’s closely related genetically to the E. coli strain that made people sick who ate leafy greens in the U.S. and romaine lettuce in Canada in 2017.\u003c/p>\n\u003cp>In the meantime, lettuce season in Monterey County is practically over, according to Roach. In fact, farmers are barred from growing lettuce in the county between Dec. 7 -21, he said.\u003c/p>\n\u003cp>“We are really ending our production here. It’s shifting to other areas,” like the Imperial Valley and Yuma, Arizona, Roach said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses, according to the CDC.\u003c/p>\n\n",
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"excerpt": "'If they plant less lettuce, that translates into less jobs and less money flowing into the local economy,' says Monterey County's assistant agricultural commissioner.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The E. coli outbreak linked to romaine lettuce that has sickened dozens of people in the United States and Canada could hurt the Central Coast’s farming industry for years, according to one of the region’s top agricultural officials.\u003c/p>\n\u003cp>The Food and Drug Administration announced on Monday that the romaine tied to the outbreak appears to be from the Central Coast, and that romaine produced outside that region is safe to eat as long as it’s labeled correctly.\u003c/p>\n\u003cp>Bob Roach, assistant agricultural commissioner for Monterey County, said that disclosure could keep consumers away from romaine grown in the region even after the outbreak ends.\u003c/p>\n\u003cp>“It’s bad for business and it lingers and it takes literally years for that stigma of a food-borne illness to go away from a product,” Roach said in an interview Tuesday.\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention is investigating the outbreak that has sickened 65 people: 43 in 12 states that include 16 people who were hospitalized, along with 22 cases in Canada.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In California there have been 11 reported cases. Of those, nine are in Los Angeles County, one in Orange County and one in El Dorado County, according to the California Department of Public Health.\u003c/p>\n\u003cp>The Central Coast is one of the nation’s major production areas for romaine lettuce. Hundreds of farms in Monterey County produce it.\u003c/p>\n\u003cp>“Romaine lettuce is a huge crop here. Everyone who is growing cool season vegetable crops in Monterey County is growing romaine lettuce,” Roach said.\u003c/p>\n\u003cp>The value of bulk and fresh romaine lettuce for growers in Monterey County last year was close to $656 million, which is about 15 percent of the total production value of the county’s agricultural industry, according to Monterey’s most recent \u003ca href=\"http://www.co.monterey.ca.us/Home/ShowDocument?id=65737\" target=\"_blank\" rel=\"noopener\">crop report\u003c/a>.\u003c/p>\n\u003cp>“We’re not the only region that was producing romaine lettuce at the time people were consuming it and becoming ill,” Roach said. “But we were definitely responsible for a large percentage of the volume that was being produced.”\u003c/p>\n\u003cp>When the CDC warns people not to eat romaine lettuce, consumers are bound to stay away from all kinds of lettuce, Roach said. And, when federal health officials narrow their warning, like they did on Monday, that still might not change consumer habits, he said.\u003c/p>\n\u003cp>A drop in demand could have ripple effects.\u003c/p>\n\u003cp>“If they plant less lettuce, that translates into less jobs and less money flowing into the local economy” Roach said.\u003c/p>\n\u003cp>Last spring, some 200 people got sick, including five who died, from a separate E. coli outbreak linked to romaine lettuce that is believed to have come from a large cattle feedlot near Yuma, Arizona, one of the nation’s other big lettuce-growing areas.\u003c/p>\n\u003cp>The FDA says the current outbreak is not related to those cases. Instead, the agency says it’s closely related genetically to the E. coli strain that made people sick who ate leafy greens in the U.S. and romaine lettuce in Canada in 2017.\u003c/p>\n\u003cp>In the meantime, lettuce season in Monterey County is practically over, according to Roach. In fact, farmers are barred from growing lettuce in the county between Dec. 7 -21, he said.\u003c/p>\n\u003cp>“We are really ending our production here. It’s shifting to other areas,” like the Imperial Valley and Yuma, Arizona, Roach said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses, according to the CDC.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "overcoming-a-lifetime-of-trauma-then-facing-a-new-one-wildfire",
"title": "Overcoming a Lifetime of Trauma, Then Facing a New One: Wildfire",
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"headTitle": "Overcoming a Lifetime of Trauma, Then Facing a New One: Wildfire | KQED",
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"content": "\u003cp>\u003cem>Sabrina Hanes has faced a lot of trauma in her life, most of it in her childhood. As part of her healing, she moved to a Northern California town called Paradise. There she built strength and community, but that was upended when the Camp Fire tore through Paradise, burning her home and turning her life upside down.\u003c/em>\u003c/p>\n\u003cp>\u003cem>I followed Hanes through her daily routine in Paradise last summer, to learn how she’s developed resilience. I then caught up with Hanes after the fire to find out what happens next.\u003c/em>\u003c/p>\n\u003cp>Sabrina Hanes kicked off the ground, pulling herself up onto a spinning hoop called a lyra, suspended from the ceiling. The studio in Paradise, where Hanes practiced circus arts and aerial dance, erupted in cheers. She moved through a series of gravity-defying spins and contortions. Her blonde hair — the ends rebelliously colored blue and purple — swirled around her.\u003c/p>\n\u003cp>It was a triumphant dance, choreographed to a song called “Conqueror,” and in most aspects of Hanes’ life she seems like one: she’s a full-time student at California State University, Chico, on track to get her bachelor’s degree in child development, she volunteers teaching toddlers and their caretakers at a local nonprofit, and she’s raising a lively, happy four-year-old daughter on her own.\u003c/p>\n\u003cp>But behind the assertive exterior, behind her toned biceps, 33-year-old Hanes has the medical record of a woman twice her age. She’s had eight surgeries for various ailments. She suffers from migraines, multiple food allergies and degenerating spinal discs. Her pregnancy was high-risk. She spent five years addicted to methamphetamines.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many doctors and researchers would not be surprised by Hanes’ health record, given one risk factor from her childhood: serious, ongoing trauma.\u003c/p>\n\u003cp>Hanes recalls moments of emotional neglect and abuse, finding her mother passed out in the bathtub from a drug overdose, and being raped at five-years-old.\u003c/p>\n\u003cp>“You think it’s your fault,” she said. “What did I do wrong?”\u003c/p>\n\u003cp>Doctors began quantifying this kind of trauma \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0749379798000178\" target=\"_blank\" rel=\"noopener\">in the 1990s\u003c/a>, tallying up the number of adversities a young person experienced, and looking at the correlation between childhood trauma and health later in life. They found that the more adversity someone experienced as a child, the worse their health as an adult. This was not just because people who had faced childhood trauma were more likely to have mental health problems or engage in risky behaviors that are bad for health, which they were.\u003c/p>\n\u003cp>This new research showed the damage was much more widespread than mental pain. People who had traumatic childhoods also had more physical pain and damaged bodies. A person who experienced major childhood trauma has four times the risk for chronic lung disease, two and a half times the risk for stroke, and double the risk for cancer. On average, their life expectancy is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19840693\" target=\"_blank\" rel=\"noopener\">20 years shorter\u003c/a> than for a person without childhood trauma.\u003c/p>\n\u003cp>“Childhood adversity changes the way that our stress response functions,” said \u003ca href=\"https://centerforyouthwellness.org/our-team/\" target=\"_blank\" rel=\"noopener\">Dr. Nadine Burke Harris\u003c/a>, a pediatrician and founder and Chief Executive Officer of the \u003ca href=\"https://centerforyouthwellness.org/\" target=\"_blank\" rel=\"noopener\">Center for Youth Wellness\u003c/a> in San Francisco.\u003c/p>\n\u003cp>“That leads to long term changes in the structure and function of children’s developing brains and our hormonal systems, and our immune systems. Even all the way down to the way our DNA is read and transcribed. And that has nothing to do with behavior.”\u003c/p>\n\u003cp>This initial study, often referred to as the Adverse Childhood Experiences (ACEs) study, is one lens through which to look at trauma. It included emotional, physical, or sexual abuse, emotional or physical neglect, growing up in a household with domestic violence, divorced or separated parents, a family member who was mentally ill, substance-dependent, or incarcerated. For each experienced, a person got a “point.” The total number of points was someone’s “ACE score.”\u003c/p>\n\u003cp>When Hanes looks through the list of ten potential ACEs, she tallies her score at eight.\u003c/p>\n\u003cp>\u003cstrong>“Nobody Really Wanted Me Around”\u003c/strong>\u003c/p>\n\u003cp>Trauma started early for Hanes with her parents’ acrimonious divorce when she was two-years-old, and the resulting custody battle that lasted years.\u003c/p>\n\u003cp>In each parent’s home, Hanes said she encountered challenges: a mother addicted to muscle relaxants and later, methamphetamines, and on the other side a father who, with his new wife and kids, belittled her. In both places, Hanes said she felt her parents weren’t there for her emotionally, which left her vulnerable to older kids and adults. When she spent the night at a neighbor’s house, she said she was raped by their teenage son.\u003c/p>\n\u003cp>“You think it’s your fault: what did I do wrong?” she said about the experience.\u003c/p>\n\u003cp>After years of these continued hardships, Hanes began harming herself.\u003c/p>\n\u003cp>“I just felt like nobody really wanted me around. So, why don’t I just take care of that?” Hanes remembered thinking.\u003c/p>\n\u003cp>Her first suicide attempt was at 12, and over the next several years, she thinks she tried to kill herself 20 more times, her last attempt at age 18. To move away from one kind of self-harm, Hanes started another: she became addicted to methamphetamines.\u003c/p>\n\u003cp>“Basically from 18 to 23, I was addicted to meth and it’s scary. It’s a scary life,” Hanes said.\u003c/p>\n\u003cp>Getting caught and spending time in jail forced her to sober up. She didn’t like the person she was when she was on drugs, and she wanted change.\u003c/p>\n\u003cp>She moved to Paradise.\u003c/p>\n\u003cp>\u003cstrong>“When the Bear Comes Home Every Night”\u003c/strong>\u003c/p>\n\u003cp>Dr. Nadine Burke Harris has made it her mission to raise awareness about the long-term impacts of childhood trauma. In addition to leading the Center for Youth Wellness, she is a pediatrician who works with low income kids in San Francisco’s Bayview Hunter’s Point neighborhood.\u003c/p>\n\u003cp>Her quest started with her young patients, who would come into her office with high rates of health problems like asthma, Attention Deficit Hyperactivity Disorder, and growth failure. She began to see a link between the kids’ illnesses and problems going on in their homes, like an alcoholic mother or a physically abusive father.\u003c/p>\n\u003cfigure id=\"attachment_11704094\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11704094\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-800x519.jpg\" alt=\"Dr. Nadine Burke Harris and a patient. \" width=\"800\" height=\"519\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-160x104.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-1200x779.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Nadine Burke Harris and a patient. \u003ccite>(Courtesy Center for Youth Wellness)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Burke Harris explains the science behind this idea in a \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime\" target=\"_blank\" rel=\"noopener\">popular Ted Talk\u003c/a>. In it, she likens the connection between childhood trauma and bad health to seeing a bear in the forest.\u003c/p>\n\u003cp>“Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, ‘Release stress hormones! Adrenaline! Cortisol!” she explained to her audience. “Your heart starts to pound, your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear… But the problem is what happens when the bear comes home every night?”\u003c/p>\n\u003cp>Dr. Burke Harris said when this hormonal cascade repeats, it seriously harms the body.\u003c/p>\n\u003cp>The results of the \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0749379798000178\" target=\"_blank\" rel=\"noopener\">first ACE study\u003c/a> showed that they were incredibly common: of the people in the study, 67 percent reported at least one adverse childhood experience. What’s more, the population surveyed didn’t have a lot of the external stressors people may associate with a tumultuous home life: the majority were middle-class, 70 percent were white, and 70 percent were college-educated. Participants had access to quality healthcare through Kaiser Permanente.\u003c/p>\n\u003cp>A person with four or more ACEs (which is considered substantial) is more than five times as likely to experience depression, has four times the risk for chronic lung disease, two and a half times the risk for stroke, and double the risk for cancer.\u003c/p>\n\u003cp>In the subsequent years, doctors, educators and social workers have used this study to change their approach to children and adults with difficult behaviors. Instead of asking “what’s wrong with a person,” they’re asking, “what happened to that person.”\u003c/p>\n\u003cp>\u003cstrong>Interrupting Intergenerational Trauma\u003c/strong>\u003c/p>\n\u003cp>To help people recover from trauma, experts encourage a wide range of strategies, like therapy, building healthy relationships, and practicing stress reduction techniques, like mindfulness and exercise. They say that applying these interventions during childhood is the most effective way to improve long term health, but identifying and addressing ACEs at any age can still be helpful.\u003c/p>\n\u003cp>Sabrina Hanes’ life is an experiment in which this will play out.\u003c/p>\n\u003cp>Hanes has been sober since she moved to Paradise, California, ten years ago, and she’s gotten her criminal record expunged. She’s turned things around, working toward educational and life goals.\u003c/p>\n\u003cp>To do these things, she’s had to learn to build healthy relationships with those around her. She’s found mentors in her school programs, and through a community nonprofit called \u003ca href=\"http://www.youth4change.org/\" target=\"_blank\" rel=\"noopener\">Youth for Change\u003c/a> that’s taught her parenting skills. Her motivation has come from her own desire to change, a renewed relationship with her mother, and the help of Youth for Change social workers, who are versed in ACEs.\u003c/p>\n\u003cp>Hanes also enhances her life through other stress reducing behaviors doctors recommend: healthy eating, regular exercise through her dance group, and paying attention to her mental health.\u003c/p>\n\u003cp>Beyond taking care of herself, Hanes has had to learn to parent differently than her mother and father. ACEs are tricky this way — their impact can be passed from one generation to the next.\u003c/p>\n\u003cp>Hanes addresses this through Parent-Child Interaction Therapy (PCIT), which she attends with her daughter Aroara. PCIT is intended to improve communication between kids and their parents, and \u003ca href=\"https://pcit.ucdavis.edu/about-us/\" target=\"_blank\" rel=\"noopener\">minimize behaviors\u003c/a> like tantrums and aggression in kids.\u003c/p>\n\u003cfigure id=\"attachment_11703326\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11703326 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-800x600.jpg\" alt=\"Sabrina Hanes and daughter Aroara during a Parent-Child Interaction Therapy session. Mother and daughter sit on one side of a two-way mirror. A therapist, sitting on the other side of the mirror, coaches Hanes through an earbud she wears.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes and daughter Aroara during a Parent-Child Interaction Therapy session. Mother and daughter sit on one side of a two-way mirror. A therapist, sitting on the other side of the mirror, coaches Hanes through an earbud she wears. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At one of their sessions, mother and daughter sat together in one room, playing with a big stuffed bear, a toy stethoscope and Band-Aids. Therapist Laurie Taylor observed them through a fake mirror. Taylor spoke into a microphone that fed into an earbud Hanes wore. Aroara, however, could only hear her own mother.\u003c/p>\n\u003cfigure id=\"attachment_11703328\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11703328\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-800x600.jpg\" alt=\"Therapist Laurie Taylor observes mother and daughter from behind the two-way mirror.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Therapist Laurie Taylor observes mother and daughter from behind the two-way mirror. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The two worked on addressing fears Aroara has when she goes to the doctor. Taylor coached Hanes through the experience, feeding her helpful lines.\u003c/p>\n\u003cp>“I know that next time we go to the doctor’s office you’re going to be able to keep your body calm,” Taylor whispered to Hanes, who spoke it to her daughter.\u003c/p>\n\u003cp>This kind of therapy is just one tool that helps families who’ve seen trauma.\u003c/p>\n\u003cp>\u003cstrong>“Making It Work”\u003c/strong>\u003c/p>\n\u003cp>Sabrina Hanes said knowing her high ACE score helped her cope with the trauma of her childhood.\u003c/p>\n\u003cp>“I have a score of eight and that’s huge,” she said. “But here I am still, I’m doing it. I’m making it work. I can look at those experiences and say they’re experiences I had. It’s not who I am.”\u003c/p>\n\u003cp>Now Hanes is a mom, a student, a teacher. She volunteers at a local nonprofit teaching classes for toddlers and their parents, incorporating healthy eating, education, and social and emotional growth. She’d like to run her own preschool in the future. She wants to be there for kids who may be going through what she did.\u003c/p>\n\u003cp>At the end of one of the classes she teaches, she reads the children’s book “We’re Going on a Bear Hunt” to a semicircle of mothers with young kids on their laps.\u003c/p>\n\u003cp>The message of the book repeats page after page, that when confronted with an obstacle, the characters can’t skirt around it: they must go right through.\u003c/p>\n\u003cp>\u003cstrong>“Get Out Now”\u003c/strong>\u003c/p>\n\u003cp>On the morning of Thursday, Nov. 8, Hanes smelled the fire. She saw large ash, similar to what she’d seen just months before when the Carr Fire swept through nearby counties. She and Aroara had evacuated their home a handful of times in the past, prompted by an official alert. Receiving none, Hanes slowly packed with Aroara in case they would need to leave. In the past, evacuation traffic had been awful, she said, and she didn’t want to add to it if it was unnecessary.\u003c/p>\n\u003cp>“You don’t think that you’re going to lose your home,” Hanes said, based on the handful of other evacuations she’s been through. “I guess I sat there thinking the firefighters — they got this.”\u003c/p>\n\u003cp>It took a frantic call from a friend to get the pair out. “You can’t wait,” she told Hanes, “get out now.”\u003c/p>\n\u003cp>Five harrowing hours later, Hanes and Aroara arrived at a friend’s house in Chico — that drive would normally take them 20 minutes, Hanes said. Hanes and Aroara were then evacuated a second time around midnight to a more central part of Chico.\u003c/p>\n\u003cp>For the past week, Hanes and Aroara have been staying with friends in Chico. They arrived with two small backpacks of clothing and one photo album. They did not have time to find their cat before leaving.\u003c/p>\n\u003cp>The home Hanes rented for years has completely burned down, and she did not have renters’ insurance because she could not afford it, she said.\u003c/p>\n\u003cfigure id=\"attachment_11706347\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706347\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-800x533.jpg\" alt=\"Sabrina Hanes home on Aug. 13, 2018.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes home on Aug. 13, 2018. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_11706349\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706349\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-800x533.jpg\" alt=\"The site of Sabrina Hanes' home on Nov. 13, 2018.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The site of Sabrina Hanes’ home on Nov. 13, 2018. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I told Aroara that we’re strong and we can do this,” Hanes said over the phone just days after the fire, emotion welling up in her voice. “It’s just so hard. This definitely tops it. Honestly [Aroara] is what is keeping me going because I know I have to be here for her.”\u003c/p>\n\u003cp>“We hear that God doesn’t give you anything more than what you can handle. But I feel like I’m questioning that right now,” she said.\u003c/p>\n\u003cp>\u003ca href=\"https://childtrauma.ucsf.edu/our-team#Chandra\" target=\"_blank\" rel=\"noopener\">Chandra Ghosh Ippen\u003c/a> is a psychologist and Associate Director of the \u003ca href=\"https://childtrauma.ucsf.edu/child-trauma-research-program\" target=\"_blank\" rel=\"noopener\">Child Trauma Research Program\u003c/a> at University of California, San Francisco. In addition to studying childhood trauma, she’s authored several free books for kids and their parents that address traumas, including \u003ca href=\"https://www.nctsn.org/resources/trinka-and-sam-big-fire\" target=\"_blank\" rel=\"noopener\">one about wildfires\u003c/a>.\u003c/p>\n\u003cp>Ghosh Ippen said that while people with high ACE scores will all react differently to new trauma, the fire will likely be worse for them than for those who’ve had less trauma in the past.\u003c/p>\n\u003cp>“If you’ve had a very heavy trauma history another trauma often reawakens symptoms,” she said. “And so they may find themselves experiencing more symptoms than someone would if they had just, and I say ‘just’ in quotes, gone through the fire or a natural disaster.”\u003c/p>\n\u003cp>Ghosh Ippen said it’s important that our community and country respond seriously to those who’ve been impacted by the wildfires. Knowing that people are aware of their loss and reacting to it can help wildfire victims.\u003c/p>\n\u003cp>Ghosh Ippen listed several other ways people can help those impacted by the wildfires: meeting their basic needs through food, clothing and shelter, guiding people through disaster relief systems, holding a space for grief and opportunities to take care of their mental health.\u003c/p>\n\u003cfigure id=\"attachment_11706925\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706925\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-800x533.jpg\" alt=\"Sabrina and Aroara in their friends' living room, where they have stayed since the wildfire reduced their home to ashes.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara in their friends’ living room, where they have stayed since the wildfire reduced their home to ashes. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hanes doesn’t know what will come next for her and her daughter. She feels pulled in many directions, between looking for new housing and helping Aroara process all that they’ve lost, from the big things to the small, like the presents for Aroara’s upcoming birthday.\u003c/p>\n\u003cp>Nearly all the structures that were important to Hanes burned in the fire, except one: the dance studio where she’d spend hours each day. “All the teachers and dancers just keep saying it’s because of all the love that we poured into that studio,” Hanes said. “There was nothing that was going to take it down.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced as a project for the USC \u003ca href=\"https://protect-us.mimecast.com/s/38C0CERPDmID7MQCNFQa3?domain=centerforhealthjournalism.org\" target=\"_blank\" rel=\"noopener\">Center for Health Journalism’s\u003c/a> California Fellowship.\u003c/em>\u003c/p>\n\n",
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"title": "Overcoming a Lifetime of Trauma, Then Facing a New One: Wildfire | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Sabrina Hanes has faced a lot of trauma in her life, most of it in her childhood. As part of her healing, she moved to a Northern California town called Paradise. There she built strength and community, but that was upended when the Camp Fire tore through Paradise, burning her home and turning her life upside down.\u003c/em>\u003c/p>\n\u003cp>\u003cem>I followed Hanes through her daily routine in Paradise last summer, to learn how she’s developed resilience. I then caught up with Hanes after the fire to find out what happens next.\u003c/em>\u003c/p>\n\u003cp>Sabrina Hanes kicked off the ground, pulling herself up onto a spinning hoop called a lyra, suspended from the ceiling. The studio in Paradise, where Hanes practiced circus arts and aerial dance, erupted in cheers. She moved through a series of gravity-defying spins and contortions. Her blonde hair — the ends rebelliously colored blue and purple — swirled around her.\u003c/p>\n\u003cp>It was a triumphant dance, choreographed to a song called “Conqueror,” and in most aspects of Hanes’ life she seems like one: she’s a full-time student at California State University, Chico, on track to get her bachelor’s degree in child development, she volunteers teaching toddlers and their caretakers at a local nonprofit, and she’s raising a lively, happy four-year-old daughter on her own.\u003c/p>\n\u003cp>But behind the assertive exterior, behind her toned biceps, 33-year-old Hanes has the medical record of a woman twice her age. She’s had eight surgeries for various ailments. She suffers from migraines, multiple food allergies and degenerating spinal discs. Her pregnancy was high-risk. She spent five years addicted to methamphetamines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many doctors and researchers would not be surprised by Hanes’ health record, given one risk factor from her childhood: serious, ongoing trauma.\u003c/p>\n\u003cp>Hanes recalls moments of emotional neglect and abuse, finding her mother passed out in the bathtub from a drug overdose, and being raped at five-years-old.\u003c/p>\n\u003cp>“You think it’s your fault,” she said. “What did I do wrong?”\u003c/p>\n\u003cp>Doctors began quantifying this kind of trauma \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0749379798000178\" target=\"_blank\" rel=\"noopener\">in the 1990s\u003c/a>, tallying up the number of adversities a young person experienced, and looking at the correlation between childhood trauma and health later in life. They found that the more adversity someone experienced as a child, the worse their health as an adult. This was not just because people who had faced childhood trauma were more likely to have mental health problems or engage in risky behaviors that are bad for health, which they were.\u003c/p>\n\u003cp>This new research showed the damage was much more widespread than mental pain. People who had traumatic childhoods also had more physical pain and damaged bodies. A person who experienced major childhood trauma has four times the risk for chronic lung disease, two and a half times the risk for stroke, and double the risk for cancer. On average, their life expectancy is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19840693\" target=\"_blank\" rel=\"noopener\">20 years shorter\u003c/a> than for a person without childhood trauma.\u003c/p>\n\u003cp>“Childhood adversity changes the way that our stress response functions,” said \u003ca href=\"https://centerforyouthwellness.org/our-team/\" target=\"_blank\" rel=\"noopener\">Dr. Nadine Burke Harris\u003c/a>, a pediatrician and founder and Chief Executive Officer of the \u003ca href=\"https://centerforyouthwellness.org/\" target=\"_blank\" rel=\"noopener\">Center for Youth Wellness\u003c/a> in San Francisco.\u003c/p>\n\u003cp>“That leads to long term changes in the structure and function of children’s developing brains and our hormonal systems, and our immune systems. Even all the way down to the way our DNA is read and transcribed. And that has nothing to do with behavior.”\u003c/p>\n\u003cp>This initial study, often referred to as the Adverse Childhood Experiences (ACEs) study, is one lens through which to look at trauma. It included emotional, physical, or sexual abuse, emotional or physical neglect, growing up in a household with domestic violence, divorced or separated parents, a family member who was mentally ill, substance-dependent, or incarcerated. For each experienced, a person got a “point.” The total number of points was someone’s “ACE score.”\u003c/p>\n\u003cp>When Hanes looks through the list of ten potential ACEs, she tallies her score at eight.\u003c/p>\n\u003cp>\u003cstrong>“Nobody Really Wanted Me Around”\u003c/strong>\u003c/p>\n\u003cp>Trauma started early for Hanes with her parents’ acrimonious divorce when she was two-years-old, and the resulting custody battle that lasted years.\u003c/p>\n\u003cp>In each parent’s home, Hanes said she encountered challenges: a mother addicted to muscle relaxants and later, methamphetamines, and on the other side a father who, with his new wife and kids, belittled her. In both places, Hanes said she felt her parents weren’t there for her emotionally, which left her vulnerable to older kids and adults. When she spent the night at a neighbor’s house, she said she was raped by their teenage son.\u003c/p>\n\u003cp>“You think it’s your fault: what did I do wrong?” she said about the experience.\u003c/p>\n\u003cp>After years of these continued hardships, Hanes began harming herself.\u003c/p>\n\u003cp>“I just felt like nobody really wanted me around. So, why don’t I just take care of that?” Hanes remembered thinking.\u003c/p>\n\u003cp>Her first suicide attempt was at 12, and over the next several years, she thinks she tried to kill herself 20 more times, her last attempt at age 18. To move away from one kind of self-harm, Hanes started another: she became addicted to methamphetamines.\u003c/p>\n\u003cp>“Basically from 18 to 23, I was addicted to meth and it’s scary. It’s a scary life,” Hanes said.\u003c/p>\n\u003cp>Getting caught and spending time in jail forced her to sober up. She didn’t like the person she was when she was on drugs, and she wanted change.\u003c/p>\n\u003cp>She moved to Paradise.\u003c/p>\n\u003cp>\u003cstrong>“When the Bear Comes Home Every Night”\u003c/strong>\u003c/p>\n\u003cp>Dr. Nadine Burke Harris has made it her mission to raise awareness about the long-term impacts of childhood trauma. In addition to leading the Center for Youth Wellness, she is a pediatrician who works with low income kids in San Francisco’s Bayview Hunter’s Point neighborhood.\u003c/p>\n\u003cp>Her quest started with her young patients, who would come into her office with high rates of health problems like asthma, Attention Deficit Hyperactivity Disorder, and growth failure. She began to see a link between the kids’ illnesses and problems going on in their homes, like an alcoholic mother or a physically abusive father.\u003c/p>\n\u003cfigure id=\"attachment_11704094\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11704094\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-800x519.jpg\" alt=\"Dr. Nadine Burke Harris and a patient. \" width=\"800\" height=\"519\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-800x519.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-160x104.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-1020x662.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut-1200x779.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33641_Nadine-and-Child-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Nadine Burke Harris and a patient. \u003ccite>(Courtesy Center for Youth Wellness)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Burke Harris explains the science behind this idea in a \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime\" target=\"_blank\" rel=\"noopener\">popular Ted Talk\u003c/a>. In it, she likens the connection between childhood trauma and bad health to seeing a bear in the forest.\u003c/p>\n\u003cp>“Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, ‘Release stress hormones! Adrenaline! Cortisol!” she explained to her audience. “Your heart starts to pound, your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear… But the problem is what happens when the bear comes home every night?”\u003c/p>\n\u003cp>Dr. Burke Harris said when this hormonal cascade repeats, it seriously harms the body.\u003c/p>\n\u003cp>The results of the \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0749379798000178\" target=\"_blank\" rel=\"noopener\">first ACE study\u003c/a> showed that they were incredibly common: of the people in the study, 67 percent reported at least one adverse childhood experience. What’s more, the population surveyed didn’t have a lot of the external stressors people may associate with a tumultuous home life: the majority were middle-class, 70 percent were white, and 70 percent were college-educated. Participants had access to quality healthcare through Kaiser Permanente.\u003c/p>\n\u003cp>A person with four or more ACEs (which is considered substantial) is more than five times as likely to experience depression, has four times the risk for chronic lung disease, two and a half times the risk for stroke, and double the risk for cancer.\u003c/p>\n\u003cp>In the subsequent years, doctors, educators and social workers have used this study to change their approach to children and adults with difficult behaviors. Instead of asking “what’s wrong with a person,” they’re asking, “what happened to that person.”\u003c/p>\n\u003cp>\u003cstrong>Interrupting Intergenerational Trauma\u003c/strong>\u003c/p>\n\u003cp>To help people recover from trauma, experts encourage a wide range of strategies, like therapy, building healthy relationships, and practicing stress reduction techniques, like mindfulness and exercise. They say that applying these interventions during childhood is the most effective way to improve long term health, but identifying and addressing ACEs at any age can still be helpful.\u003c/p>\n\u003cp>Sabrina Hanes’ life is an experiment in which this will play out.\u003c/p>\n\u003cp>Hanes has been sober since she moved to Paradise, California, ten years ago, and she’s gotten her criminal record expunged. She’s turned things around, working toward educational and life goals.\u003c/p>\n\u003cp>To do these things, she’s had to learn to build healthy relationships with those around her. She’s found mentors in her school programs, and through a community nonprofit called \u003ca href=\"http://www.youth4change.org/\" target=\"_blank\" rel=\"noopener\">Youth for Change\u003c/a> that’s taught her parenting skills. Her motivation has come from her own desire to change, a renewed relationship with her mother, and the help of Youth for Change social workers, who are versed in ACEs.\u003c/p>\n\u003cp>Hanes also enhances her life through other stress reducing behaviors doctors recommend: healthy eating, regular exercise through her dance group, and paying attention to her mental health.\u003c/p>\n\u003cp>Beyond taking care of herself, Hanes has had to learn to parent differently than her mother and father. ACEs are tricky this way — their impact can be passed from one generation to the next.\u003c/p>\n\u003cp>Hanes addresses this through Parent-Child Interaction Therapy (PCIT), which she attends with her daughter Aroara. PCIT is intended to improve communication between kids and their parents, and \u003ca href=\"https://pcit.ucdavis.edu/about-us/\" target=\"_blank\" rel=\"noopener\">minimize behaviors\u003c/a> like tantrums and aggression in kids.\u003c/p>\n\u003cfigure id=\"attachment_11703326\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11703326 size-medium\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-800x600.jpg\" alt=\"Sabrina Hanes and daughter Aroara during a Parent-Child Interaction Therapy session. Mother and daughter sit on one side of a two-way mirror. A therapist, sitting on the other side of the mirror, coaches Hanes through an earbud she wears.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33574_IMG_8929-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes and daughter Aroara during a Parent-Child Interaction Therapy session. Mother and daughter sit on one side of a two-way mirror. A therapist, sitting on the other side of the mirror, coaches Hanes through an earbud she wears. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At one of their sessions, mother and daughter sat together in one room, playing with a big stuffed bear, a toy stethoscope and Band-Aids. Therapist Laurie Taylor observed them through a fake mirror. Taylor spoke into a microphone that fed into an earbud Hanes wore. Aroara, however, could only hear her own mother.\u003c/p>\n\u003cfigure id=\"attachment_11703328\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11703328\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-800x600.jpg\" alt=\"Therapist Laurie Taylor observes mother and daughter from behind the two-way mirror.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33575_IMG_8948-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Therapist Laurie Taylor observes mother and daughter from behind the two-way mirror. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The two worked on addressing fears Aroara has when she goes to the doctor. Taylor coached Hanes through the experience, feeding her helpful lines.\u003c/p>\n\u003cp>“I know that next time we go to the doctor’s office you’re going to be able to keep your body calm,” Taylor whispered to Hanes, who spoke it to her daughter.\u003c/p>\n\u003cp>This kind of therapy is just one tool that helps families who’ve seen trauma.\u003c/p>\n\u003cp>\u003cstrong>“Making It Work”\u003c/strong>\u003c/p>\n\u003cp>Sabrina Hanes said knowing her high ACE score helped her cope with the trauma of her childhood.\u003c/p>\n\u003cp>“I have a score of eight and that’s huge,” she said. “But here I am still, I’m doing it. I’m making it work. I can look at those experiences and say they’re experiences I had. It’s not who I am.”\u003c/p>\n\u003cp>Now Hanes is a mom, a student, a teacher. She volunteers at a local nonprofit teaching classes for toddlers and their parents, incorporating healthy eating, education, and social and emotional growth. She’d like to run her own preschool in the future. She wants to be there for kids who may be going through what she did.\u003c/p>\n\u003cp>At the end of one of the classes she teaches, she reads the children’s book “We’re Going on a Bear Hunt” to a semicircle of mothers with young kids on their laps.\u003c/p>\n\u003cp>The message of the book repeats page after page, that when confronted with an obstacle, the characters can’t skirt around it: they must go right through.\u003c/p>\n\u003cp>\u003cstrong>“Get Out Now”\u003c/strong>\u003c/p>\n\u003cp>On the morning of Thursday, Nov. 8, Hanes smelled the fire. She saw large ash, similar to what she’d seen just months before when the Carr Fire swept through nearby counties. She and Aroara had evacuated their home a handful of times in the past, prompted by an official alert. Receiving none, Hanes slowly packed with Aroara in case they would need to leave. In the past, evacuation traffic had been awful, she said, and she didn’t want to add to it if it was unnecessary.\u003c/p>\n\u003cp>“You don’t think that you’re going to lose your home,” Hanes said, based on the handful of other evacuations she’s been through. “I guess I sat there thinking the firefighters — they got this.”\u003c/p>\n\u003cp>It took a frantic call from a friend to get the pair out. “You can’t wait,” she told Hanes, “get out now.”\u003c/p>\n\u003cp>Five harrowing hours later, Hanes and Aroara arrived at a friend’s house in Chico — that drive would normally take them 20 minutes, Hanes said. Hanes and Aroara were then evacuated a second time around midnight to a more central part of Chico.\u003c/p>\n\u003cp>For the past week, Hanes and Aroara have been staying with friends in Chico. They arrived with two small backpacks of clothing and one photo album. They did not have time to find their cat before leaving.\u003c/p>\n\u003cp>The home Hanes rented for years has completely burned down, and she did not have renters’ insurance because she could not afford it, she said.\u003c/p>\n\u003cfigure id=\"attachment_11706347\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706347\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-800x533.jpg\" alt=\"Sabrina Hanes home on Aug. 13, 2018.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS32363_ACEs_AW_58-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina Hanes home on Aug. 13, 2018. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cfigure id=\"attachment_11706349\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706349\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-800x533.jpg\" alt=\"The site of Sabrina Hanes' home on Nov. 13, 2018.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33895_paradise_AW_12-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The site of Sabrina Hanes’ home on Nov. 13, 2018. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I told Aroara that we’re strong and we can do this,” Hanes said over the phone just days after the fire, emotion welling up in her voice. “It’s just so hard. This definitely tops it. Honestly [Aroara] is what is keeping me going because I know I have to be here for her.”\u003c/p>\n\u003cp>“We hear that God doesn’t give you anything more than what you can handle. But I feel like I’m questioning that right now,” she said.\u003c/p>\n\u003cp>\u003ca href=\"https://childtrauma.ucsf.edu/our-team#Chandra\" target=\"_blank\" rel=\"noopener\">Chandra Ghosh Ippen\u003c/a> is a psychologist and Associate Director of the \u003ca href=\"https://childtrauma.ucsf.edu/child-trauma-research-program\" target=\"_blank\" rel=\"noopener\">Child Trauma Research Program\u003c/a> at University of California, San Francisco. In addition to studying childhood trauma, she’s authored several free books for kids and their parents that address traumas, including \u003ca href=\"https://www.nctsn.org/resources/trinka-and-sam-big-fire\" target=\"_blank\" rel=\"noopener\">one about wildfires\u003c/a>.\u003c/p>\n\u003cp>Ghosh Ippen said that while people with high ACE scores will all react differently to new trauma, the fire will likely be worse for them than for those who’ve had less trauma in the past.\u003c/p>\n\u003cp>“If you’ve had a very heavy trauma history another trauma often reawakens symptoms,” she said. “And so they may find themselves experiencing more symptoms than someone would if they had just, and I say ‘just’ in quotes, gone through the fire or a natural disaster.”\u003c/p>\n\u003cp>Ghosh Ippen said it’s important that our community and country respond seriously to those who’ve been impacted by the wildfires. Knowing that people are aware of their loss and reacting to it can help wildfire victims.\u003c/p>\n\u003cp>Ghosh Ippen listed several other ways people can help those impacted by the wildfires: meeting their basic needs through food, clothing and shelter, guiding people through disaster relief systems, holding a space for grief and opportunities to take care of their mental health.\u003c/p>\n\u003cfigure id=\"attachment_11706925\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11706925\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-800x533.jpg\" alt=\"Sabrina and Aroara in their friends' living room, where they have stayed since the wildfire reduced their home to ashes.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/11/RS33970_111318_AW_SabrinaHanes_07-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sabrina and Aroara in their friends’ living room, where they have stayed since the wildfire reduced their home to ashes. \u003ccite>(Anne Wernikoff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hanes doesn’t know what will come next for her and her daughter. She feels pulled in many directions, between looking for new housing and helping Aroara process all that they’ve lost, from the big things to the small, like the presents for Aroara’s upcoming birthday.\u003c/p>\n\u003cp>Nearly all the structures that were important to Hanes burned in the fire, except one: the dance studio where she’d spend hours each day. “All the teachers and dancers just keep saying it’s because of all the love that we poured into that studio,” Hanes said. “There was nothing that was going to take it down.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced as a project for the USC \u003ca href=\"https://protect-us.mimecast.com/s/38C0CERPDmID7MQCNFQa3?domain=centerforhealthjournalism.org\" target=\"_blank\" rel=\"noopener\">Center for Health Journalism’s\u003c/a> California Fellowship.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Unhealthy air quality will \u003ca href=\"http://bit.ly/fioreairquality\" target=\"_blank\" rel=\"noopener\">persist at least through Friday\u003c/a>, leading the Bay Area Air Quality Management District to extend the current Spare the Air alert.\u003c/p>\n\u003cp>Smoke from the Camp Fire — now the \u003ca href=\"https://www.kqed.org/news/11705243/california-wildfires-what-you-need-to-know\" rel=\"noopener\" target=\"_blank\">deadliest fire in California history\u003c/a> — has continued to blanket the Bay Area and led schools in Sonoma County to close while many other school districts have kept children inside.\u003c/p>\n\u003cp>If you can’t stay inside, officials recommend wearing an N95 respirator mask to keep dangerous microscopic particles from getting into your lungs.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/news/tag/wildfires/\" target=\"_blank\" rel=\"noopener\">Follow KQED’s ongoing wildfire coverage.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Unhealthy air quality will \u003ca href=\"http://bit.ly/fioreairquality\" target=\"_blank\" rel=\"noopener\">persist at least through Friday\u003c/a>, leading the Bay Area Air Quality Management District to extend the current Spare the Air alert.\u003c/p>\n\u003cp>Smoke from the Camp Fire — now the \u003ca href=\"https://www.kqed.org/news/11705243/california-wildfires-what-you-need-to-know\" rel=\"noopener\" target=\"_blank\">deadliest fire in California history\u003c/a> — has continued to blanket the Bay Area and led schools in Sonoma County to close while many other school districts have kept children inside.\u003c/p>\n\u003cp>If you can’t stay inside, officials recommend wearing an N95 respirator mask to keep dangerous microscopic particles from getting into your lungs.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/news/tag/wildfires/\" target=\"_blank\" rel=\"noopener\">Follow KQED’s ongoing wildfire coverage.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Proposition 8: Revenue Cap on Dialysis Clinics Fails, Supporters to Try Again in 2020",
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"content": "\u003cp>\u003cem>Updated Tuesday, 11:27 p.m.\u003c/em>\u003c/p>\n\u003cp>California voters on Tuesday rejected a first-of-its-kind ballot measure that would have placed a 15 percent revenue cap on private dialysis clinics in the state.\u003c/p>\n\u003cp>“Voters voted to protect patients,” said Kathy Fairbanks, spokeswoman for the No on 8 campaign.\u003c/p>\n\u003cp>Placed on the ballot by SEIU United Healthcare Workers West (SEIU-UHWW), the measure would have limited dialysis clinics’ revenues to 115 percent of “the sum of all direct patient care services costs and all health care quality improvement costs.”\u003c/p>\n\u003cp>According to the Legislative Analyst’s Office, \u003ca href=\"https://lao.ca.gov/BallotAnalysis/Proposition?number=8&year=2018\" target=\"_blank\" rel=\"noopener\">these costs include\u003c/a> “non-managerial” staff wages and benefits, staff training and development, drugs and medical supplies, facilities and electronic health information systems. Other costs, such as administrative overhead, would not be counted toward determining the revenue cap.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Any revenues above that 115 percent threshold would need to be returned to whoever paid for the treatment, either the patient or their insurance provider.\u003c/p>\n\u003cp>“This is only the beginning; we are in this for the long haul,” said Emanuel Gonzales, a dialysis patient care technician, in a statement released by the Yes on 8 campaign. “We intend to re-file this initiative for the 2020 ballot in California, and we are preparing to bring it to other states in the 2020 election cycle. We also plan to file a new version of Senate Bill 1156, which would stop a scheme used by the dialysis corporations to boost their profits, but was vetoed by Gov. Jerry Brown. We are working to file that legislation in a number of other states, too.”\u003c/p>\n\u003cp>About 80,000 Californians get dialysis treatments at private clinics each month, according to the Legislative Analyst’s Office. Dialysis mimics the role of healthy kidneys, filtering a patient’s blood via a machine in a process that lasts several hours and needs to be done three times a week.\u003c/p>\n\u003cp>Both sides of the issue said they were acting in the best interest of dialysis patients.\u003c/p>\n\u003cp>Proponents, led by SEIU-UHWW, pointed to reports of malfunctioning equipment, \u003ca href=\"https://www.dailynews.com/2018/04/07/the-dialysis-industry-needs-reform-in-california/\" target=\"_blank\" rel=\"noopener\">dirty clinics\u003c/a> and \u003ca href=\"https://www.sacbee.com/opinion/op-ed/soapbox/article207146074.html\" target=\"_blank\" rel=\"noopener\">lack of staffing\u003c/a> that they say are emblematic of an industry looking to cut corners at the expense of patient care.\u003c/p>\n\u003cp>“This is an industry that has operated under the radar for too long,” said Sean Wherley, a spokesman for Yes on 8, in an interview before Election Day.\u003c/p>\n\u003cp>Wherley pointed to the fact the DaVita and Fresenius Medical Care, the two large corporations that operate 72 percent of the dialysis clinics in the state, pulled in nearly $4 billion in profits in 2017. He said Proposition 8 would have pushed dialysis clinics to invest more in patient care by increasing hiring, purchasing new equipment and improving facilities.\u003c/p>\n\u003cp>The measure didn’t explicitly force clinics to make these changes, but increasing costs in these areas covered under the umbrella of “direct patient care services costs and all health care quality improvement costs” would help them avoid having to refund revenues.\u003c/p>\n\u003cp>Opponents countered that the cap would force them to close clinics, forcing patients to travel farther to receive life-sustaining care. They argued it would especially hit clinics that serve primarily low-income patients covered by Medicare or Medi-Cal.\u003c/p>\n\u003cp>Dr. Bryan Wong, a nephrologist who serves as the medical director at a Fresenius Medical Care dialysis clinic in Oakland and opposes Proposition 8, compared the situation to the lack of grocery stores in disadvantaged neighborhoods.\u003c/p>\n\u003cp>“The likes of Safeway and Lucky and Ralphs and Whole Foods, they also make lots of profit. Why would they want to operate in a neighborhood that is unprofitable?” he said in an interview before Election Day.\u003c/p>\n\u003cp>It’s unclear how the impacts of the cap would have played out. This would’ve been a first-of-its kind regulation by a state government over a private health care industry. There was also uncertainty over which costs would’ve counted toward the cap, such as staff members who serve both managerial and patient care roles.\u003c/p>\n\u003cp>Proposition 8 was by far the most expensive of the 11 statewide propositions this year. Opponents of the proposition spent more than $110 million, blanketing the airwaves with TV ads encouraging voters to reject the measure. The overwhelmingly majority of that spending—more than $100 million—came from DaVita and Fresenius Medical Care.\u003c/p>\n\u003cp>That dwarfed the $20 million spent by supporters of the measure, who said the dialysis companies used their deep pockets to control the narrative around the proposition.\u003c/p>\n\u003cp>“They succeeded in scaring the newspapers that the industry will collapse,” Wherley said, referring to the fact that every major newspaper in the state opposed Proposition 8.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Editorial boards across the state pointed to the measure’s role as a bargaining chip (SEIU has unsuccessfully tried to unionize dialysis clinic workers), the unforgiving nature of the initiative process and the uncertainty surrounding the impact of the proposition as the reasons for their disapproval.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Tuesday, 11:27 p.m.\u003c/em>\u003c/p>\n\u003cp>California voters on Tuesday rejected a first-of-its-kind ballot measure that would have placed a 15 percent revenue cap on private dialysis clinics in the state.\u003c/p>\n\u003cp>“Voters voted to protect patients,” said Kathy Fairbanks, spokeswoman for the No on 8 campaign.\u003c/p>\n\u003cp>Placed on the ballot by SEIU United Healthcare Workers West (SEIU-UHWW), the measure would have limited dialysis clinics’ revenues to 115 percent of “the sum of all direct patient care services costs and all health care quality improvement costs.”\u003c/p>\n\u003cp>According to the Legislative Analyst’s Office, \u003ca href=\"https://lao.ca.gov/BallotAnalysis/Proposition?number=8&year=2018\" target=\"_blank\" rel=\"noopener\">these costs include\u003c/a> “non-managerial” staff wages and benefits, staff training and development, drugs and medical supplies, facilities and electronic health information systems. Other costs, such as administrative overhead, would not be counted toward determining the revenue cap.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Any revenues above that 115 percent threshold would need to be returned to whoever paid for the treatment, either the patient or their insurance provider.\u003c/p>\n\u003cp>“This is only the beginning; we are in this for the long haul,” said Emanuel Gonzales, a dialysis patient care technician, in a statement released by the Yes on 8 campaign. “We intend to re-file this initiative for the 2020 ballot in California, and we are preparing to bring it to other states in the 2020 election cycle. We also plan to file a new version of Senate Bill 1156, which would stop a scheme used by the dialysis corporations to boost their profits, but was vetoed by Gov. Jerry Brown. We are working to file that legislation in a number of other states, too.”\u003c/p>\n\u003cp>About 80,000 Californians get dialysis treatments at private clinics each month, according to the Legislative Analyst’s Office. Dialysis mimics the role of healthy kidneys, filtering a patient’s blood via a machine in a process that lasts several hours and needs to be done three times a week.\u003c/p>\n\u003cp>Both sides of the issue said they were acting in the best interest of dialysis patients.\u003c/p>\n\u003cp>Proponents, led by SEIU-UHWW, pointed to reports of malfunctioning equipment, \u003ca href=\"https://www.dailynews.com/2018/04/07/the-dialysis-industry-needs-reform-in-california/\" target=\"_blank\" rel=\"noopener\">dirty clinics\u003c/a> and \u003ca href=\"https://www.sacbee.com/opinion/op-ed/soapbox/article207146074.html\" target=\"_blank\" rel=\"noopener\">lack of staffing\u003c/a> that they say are emblematic of an industry looking to cut corners at the expense of patient care.\u003c/p>\n\u003cp>“This is an industry that has operated under the radar for too long,” said Sean Wherley, a spokesman for Yes on 8, in an interview before Election Day.\u003c/p>\n\u003cp>Wherley pointed to the fact the DaVita and Fresenius Medical Care, the two large corporations that operate 72 percent of the dialysis clinics in the state, pulled in nearly $4 billion in profits in 2017. He said Proposition 8 would have pushed dialysis clinics to invest more in patient care by increasing hiring, purchasing new equipment and improving facilities.\u003c/p>\n\u003cp>The measure didn’t explicitly force clinics to make these changes, but increasing costs in these areas covered under the umbrella of “direct patient care services costs and all health care quality improvement costs” would help them avoid having to refund revenues.\u003c/p>\n\u003cp>Opponents countered that the cap would force them to close clinics, forcing patients to travel farther to receive life-sustaining care. They argued it would especially hit clinics that serve primarily low-income patients covered by Medicare or Medi-Cal.\u003c/p>\n\u003cp>Dr. Bryan Wong, a nephrologist who serves as the medical director at a Fresenius Medical Care dialysis clinic in Oakland and opposes Proposition 8, compared the situation to the lack of grocery stores in disadvantaged neighborhoods.\u003c/p>\n\u003cp>“The likes of Safeway and Lucky and Ralphs and Whole Foods, they also make lots of profit. Why would they want to operate in a neighborhood that is unprofitable?” he said in an interview before Election Day.\u003c/p>\n\u003cp>It’s unclear how the impacts of the cap would have played out. This would’ve been a first-of-its kind regulation by a state government over a private health care industry. There was also uncertainty over which costs would’ve counted toward the cap, such as staff members who serve both managerial and patient care roles.\u003c/p>\n\u003cp>Proposition 8 was by far the most expensive of the 11 statewide propositions this year. Opponents of the proposition spent more than $110 million, blanketing the airwaves with TV ads encouraging voters to reject the measure. The overwhelmingly majority of that spending—more than $100 million—came from DaVita and Fresenius Medical Care.\u003c/p>\n\u003cp>That dwarfed the $20 million spent by supporters of the measure, who said the dialysis companies used their deep pockets to control the narrative around the proposition.\u003c/p>\n\u003cp>“They succeeded in scaring the newspapers that the industry will collapse,” Wherley said, referring to the fact that every major newspaper in the state opposed Proposition 8.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Editorial boards across the state pointed to the measure’s role as a bargaining chip (SEIU has unsuccessfully tried to unionize dialysis clinic workers), the unforgiving nature of the initiative process and the uncertainty surrounding the impact of the proposition as the reasons for their disapproval.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When she was in her early 20s, Nicole Veum says she made a lot of mistakes.\u003c/p>\n\u003cp>“I was really sad and I didn’t want to feel my feelings,” she said. “I turned to the most natural way I could find to cover that all up, and I started using drugs: prescription pills, heroin for a little bit of time.”\u003c/p>\n\u003cp>Her family got her into treatment. She’d been sober for nine years when she and her husband decided to have a baby. This was something she wanted to feel.\u003c/p>\n\u003cp>She told her doctor if she needed an epidural, she didn’t want any fentanyl in it. She didn’t want to feel high.\u003c/p>\n\u003cp>“’Cause I remembered seeing other friends, they’d used it, and they were feeling good and stuff,” she said. “I didn’t want that to be a part of my story.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Epidurals are usually a mix of two types of medications: a numbing agent, usually from the lidocaine family, and a painkiller, usually fentanyl. The amount of fentanyl is limited, and little passes into the bloodstream, experts say, but if a woman doesn’t want the fentanyl, it’s easy to formulate an epidural solution without it. Doctors either use a substitute medication or up the concentration of the numbing agent.\u003c/p>\n\u003cp>“There’s no medical reason why someone should be forced to be exposed to opioids if they don’t want to,” said Kelly Pfeifer, a family doctor and addiction expert who now works as director of high-value care at the California Health Care Foundation.\u003c/p>\n\u003cp>Especially for women who are in active treatment for opioid addiction and taking methadone or Suboxone, Pfeifer said there’s another issue to be wary of: Some other narcotics commonly used for pain during labor can immediately reverse the effects of those treatments.\u003c/p>\n\u003cp>“Suddenly, you’re in the middle of labor, which is already painful, and now you’re in the middle of the worst withdrawal of your life,” she said.\u003c/p>\n\u003cp>For Nicole Veum, it was the worst wildfire in California history that \u003ca href=\"https://www.kqed.org/news/11622370/giving-birth-is-hard-enough-now-try-it-in-the-middle-of-a-wildfire\" target=\"_blank\" rel=\"noopener\">interrupted her birth plan\u003c/a>. She was in active labor when the October 2017 wildfires broke out. Those blazes swept through the North Bay and parts of Northern California, burning more than 5,000 homes and killing 44 people.\u003c/p>\n\u003cp>“There was a ton of smoke in the hospital, like, you could visibly see it outside and smell it,” she said.\u003c/p>\n\u003cp>Nurses said everybody had to evacuate. Veum was transferred to another hospital five miles away. And the special instructions for her epidural got lost in the chaos.\u003c/p>\n\u003cp>“Then when they went to change the drug, I saw the tube said fentanyl on it, and by that point I was starting to feel, feel the itchies,” she said, referring to one of the signs that she could feel the opioid in her body.\u003c/p>\n\u003cp>Most women without a history of addiction wouldn’t experience this, said Jennifer Lucero, chief of obstetric anesthesiology at the UCSF Medical Center. Anytime a woman who is not in recovery asks for an epidural without fentanyl, usually out of concern for the baby, Lucero explains why it’s there.\u003c/p>\n\u003cfigure id=\"attachment_11700436\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11700436\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nicole and Ben Veum with 10-month-old Adrian. \u003ccite>(Adam Grossberg/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The fentanyl allows the anesthesiologist to balance out the numbing agent in the solution, she says, so women don’t have as much pain from the contractions, but they can still feel the pressure, and move their legs a bit or shift in bed during labor. When she explains the trade off, and assures women that the opioid will have no effect on their fetus, most of them opt to keep it in the epidural solution.\u003c/p>\n\u003cp>But there are other ways doctors have been trying to cut down on opioids in labor and delivery, namely what they prescribe for after the birth. For years, women who had a normal, vaginal birth were sent home with a 30-day supply of Norco, Percocet or other opioid.\u003c/p>\n\u003cp>“And they would not use it and it’d just be sitting in the bathroom cabinet,” Lucero said. “Some people would think they’re supposed to take them all.”\u003c/p>\n\u003cp>Studies show that even after \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373\">five days of opioid use\u003c/a>, the chance of long-term dependence rises steeply; \u003ca href=\"https://www.uptodate.com/contents/prescription-of-opioids-for-acute-pain-in-opioid-naive-patients\">every week\u003c/a> of opioid use increases the risk of misuse by 20 percent. While most people who get a bottle of pills when leaving the hospital won’t develop an addiction, some will – about 0.6 percent.\u003c/p>\n\u003cp>Now, doctors are trying to prescribe limited amounts of opioids only to women who have had a cesarean section.\u003c/p>\n\u003cp>Women like Nicole Veum. After another 12 hours of labor at the new hospital with little progress, Veum agreed to a C-section. And doctors sent her home with a bottle of Percocet. They told her, if she was worried, to have her husband or a friend hold on to the bottle and control the dosage.\u003c/p>\n\u003cp>Addiction expert Dr. Kelly Pfeifer said, in a situation like this, just a few pills, or even ibuprofen, would’ve been fine.\u003c/p>\n\u003cp>“Any parent will tell you there’s nothing more stressful than the first week of being a parent and having a baby and being in sleep deprivation,” Pfeifer said. “And here you have a little bottle of Vicodin that you used to turn to to make you feel better when you’re stressed.”\u003c/p>\n\u003cp>First the fires. Then the fentanyl in her epidural, then the Percocet. It was Veum’s first test seeing how her sobriety and motherhood would line up.\u003c/p>\n\u003cp>She called a friend who’s also in recovery and talked it all through. She said the Percocet could have sent her down a rabbit hole, but it didn’t. She was fine leaving that behind.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I was OK. I was OK with it. It was just something that happened,” she says as her baby, now 1, played with a new toy. “A lot of people metaphorically felt it as a baby coming out of the ash, the life coming from the ashes. And I feel that. I feel like it was a big time for our community and me personally to be reborn in some way.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Epidurals are usually a mix of two types of medications: a numbing agent, usually from the lidocaine family, and a painkiller, usually fentanyl. The amount of fentanyl is limited, and little passes into the bloodstream, experts say, but if a woman doesn’t want the fentanyl, it’s easy to formulate an epidural solution without it. Doctors either use a substitute medication or up the concentration of the numbing agent.\u003c/p>\n\u003cp>“There’s no medical reason why someone should be forced to be exposed to opioids if they don’t want to,” said Kelly Pfeifer, a family doctor and addiction expert who now works as director of high-value care at the California Health Care Foundation.\u003c/p>\n\u003cp>Especially for women who are in active treatment for opioid addiction and taking methadone or Suboxone, Pfeifer said there’s another issue to be wary of: Some other narcotics commonly used for pain during labor can immediately reverse the effects of those treatments.\u003c/p>\n\u003cp>“Suddenly, you’re in the middle of labor, which is already painful, and now you’re in the middle of the worst withdrawal of your life,” she said.\u003c/p>\n\u003cp>For Nicole Veum, it was the worst wildfire in California history that \u003ca href=\"https://www.kqed.org/news/11622370/giving-birth-is-hard-enough-now-try-it-in-the-middle-of-a-wildfire\" target=\"_blank\" rel=\"noopener\">interrupted her birth plan\u003c/a>. She was in active labor when the October 2017 wildfires broke out. Those blazes swept through the North Bay and parts of Northern California, burning more than 5,000 homes and killing 44 people.\u003c/p>\n\u003cp>“There was a ton of smoke in the hospital, like, you could visibly see it outside and smell it,” she said.\u003c/p>\n\u003cp>Nurses said everybody had to evacuate. Veum was transferred to another hospital five miles away. And the special instructions for her epidural got lost in the chaos.\u003c/p>\n\u003cp>“Then when they went to change the drug, I saw the tube said fentanyl on it, and by that point I was starting to feel, feel the itchies,” she said, referring to one of the signs that she could feel the opioid in her body.\u003c/p>\n\u003cp>Most women without a history of addiction wouldn’t experience this, said Jennifer Lucero, chief of obstetric anesthesiology at the UCSF Medical Center. Anytime a woman who is not in recovery asks for an epidural without fentanyl, usually out of concern for the baby, Lucero explains why it’s there.\u003c/p>\n\u003cfigure id=\"attachment_11700436\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11700436\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2018/10/RS32433_0M6A0122-qut-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nicole and Ben Veum with 10-month-old Adrian. \u003ccite>(Adam Grossberg/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The fentanyl allows the anesthesiologist to balance out the numbing agent in the solution, she says, so women don’t have as much pain from the contractions, but they can still feel the pressure, and move their legs a bit or shift in bed during labor. When she explains the trade off, and assures women that the opioid will have no effect on their fetus, most of them opt to keep it in the epidural solution.\u003c/p>\n\u003cp>But there are other ways doctors have been trying to cut down on opioids in labor and delivery, namely what they prescribe for after the birth. For years, women who had a normal, vaginal birth were sent home with a 30-day supply of Norco, Percocet or other opioid.\u003c/p>\n\u003cp>“And they would not use it and it’d just be sitting in the bathroom cabinet,” Lucero said. “Some people would think they’re supposed to take them all.”\u003c/p>\n\u003cp>Studies show that even after \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373\">five days of opioid use\u003c/a>, the chance of long-term dependence rises steeply; \u003ca href=\"https://www.uptodate.com/contents/prescription-of-opioids-for-acute-pain-in-opioid-naive-patients\">every week\u003c/a> of opioid use increases the risk of misuse by 20 percent. While most people who get a bottle of pills when leaving the hospital won’t develop an addiction, some will – about 0.6 percent.\u003c/p>\n\u003cp>Now, doctors are trying to prescribe limited amounts of opioids only to women who have had a cesarean section.\u003c/p>\n\u003cp>Women like Nicole Veum. After another 12 hours of labor at the new hospital with little progress, Veum agreed to a C-section. And doctors sent her home with a bottle of Percocet. They told her, if she was worried, to have her husband or a friend hold on to the bottle and control the dosage.\u003c/p>\n\u003cp>Addiction expert Dr. Kelly Pfeifer said, in a situation like this, just a few pills, or even ibuprofen, would’ve been fine.\u003c/p>\n\u003cp>“Any parent will tell you there’s nothing more stressful than the first week of being a parent and having a baby and being in sleep deprivation,” Pfeifer said. “And here you have a little bottle of Vicodin that you used to turn to to make you feel better when you’re stressed.”\u003c/p>\n\u003cp>First the fires. Then the fentanyl in her epidural, then the Percocet. It was Veum’s first test seeing how her sobriety and motherhood would line up.\u003c/p>\n\u003cp>She called a friend who’s also in recovery and talked it all through. She said the Percocet could have sent her down a rabbit hole, but it didn’t. She was fine leaving that behind.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I was OK. I was OK with it. It was just something that happened,” she says as her baby, now 1, played with a new toy. “A lot of people metaphorically felt it as a baby coming out of the ash, the life coming from the ashes. And I feel that. I feel like it was a big time for our community and me personally to be reborn in some way.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>\u003cstrong>Editor’s note:\u003c/strong>\u003c/em>\u003cem> This story describes graphic allegations of sexual abuse.\u003c/em>\u003c/p>\n\u003cp>The University of Southern California says it has reached a tentative class action settlement agreement worth $215 million over \u003ca href=\"https://www.kqed.org/news/11671505/criminal-investigation-into-usc-gynecologist-expected-to-grow-2\" rel=\"noopener\" target=\"_blank\">allegations\u003c/a> of sexual harassment and abuse by a gynecologist who used to work at its student health center.\u003c/p>\n\u003cp>Approximately 500 current and former students have accused gynecologist George Tyndall of misconduct, according to The Associated Press.\u003c/p>\n\u003cp>The settlement requires court approval before it is final. USC \u003ca href=\"https://change.usc.edu/faq/\" rel=\"noopener\" target=\"_blank\">says anyone who received treatment from Tyndall\u003c/a> for women’s health issues is eligible to receive compensation of $2,500. They aren’t required to provide additional information about their interaction with Tyndall to receive those funds.\u003c/p>\n\u003cp>Other former patients can seek additional money up to $250,000 by detailing their experience with Tyndall.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The school’s board of trustees \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/05/26/614609644/usc-president-c-l-max-nikias-stepping-down-amid-gynecologist-scandal\" rel=\"noopener\" target=\"_blank\">said in May\u003c/a> that then-\u003ca href=\"https://www.kqed.org/news/11670933/usc-president-c-l-max-nikias-stepping-down-amid-gynecologist-scandal\" rel=\"noopener\" target=\"_blank\">USC President C.L. Max Nikias would step down\u003c/a>, as the Tyndall scandal was unfolding. The interim president, Wanda Austin, \u003ca href=\"https://change.usc.edu/statement-concerning-tyndall-class-action-settlement/\" rel=\"noopener\" target=\"_blank\">said in a statement that the settlement\u003c/a> is intended to provide relief to those impacted by Tyndall’s actions.\u003c/p>\n\u003cp>“By doing so, we hope that we can help our community move collectively toward reconciliation,” said Austin. “I regret that any student ever felt uncomfortable, unsafe, or mistreated in any way as a result of the actions of a university employee.”\u003c/p>\n\u003cp>As \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/05/22/613344526/usc-faces-lawsuits-calls-for-resignation-over-alleged-sexual-abuse-by-gynecologi\" rel=\"noopener\" target=\"_blank\">NPR’s Camila Domonoske reported\u003c/a>, Tyndall and USC reached a deal in 2017 that resulted in his departure from the school. Before that, he was “placed on leave after a 2016 investigation found he made racially discriminatory and sexually inappropriate remarks to patients.”\u003c/p>\n\u003cp>Lawsuits at the state and federal levels have been filed by women alleging abuse by Tyndall. Here’s more from Domonoske:\u003c/p>\n\u003cblockquote>\n\u003cp>“The lawsuits are blistering. They go into graphic detail about Tyndall’s alleged practices, such as fully nude exams that were not medically necessary and digital penetration that did not resemble a routine gynecological exam. In one case, a woman alleges that Tyndall placed his entire ungloved hand inside her vagina.”\u003c/p>\n\u003c/blockquote>\n\u003cp>According to Reuters, a lawyer representing 44 women accusing Tyndall of misconduct in two separate lawsuits says the settlement amount is too modest.\u003c/p>\n\u003cp>“We are continuing to vigorously litigate our state cases for numerous victims and we will insist that each of our clients be properly compensated for what they were forced to endure,” attorney Gloria Allred told the wire service.\u003c/p>\n\u003cp>Tyndall has denied wrongdoing, \u003ca href=\"http://www.latimes.com/local/lanow/la-me-usc-settlement-proposal-20181019-story.html\" rel=\"noopener\" target=\"_blank\">the Los Angeles Times reports\u003c/a>, and has said in interviews that “his exams were in keeping with the standards outlined by textbooks and the American College of Obstetricians and Gynecologists.”\u003c/p>\n\u003cp>While no criminal charges have yet been filed against Tyndall, the \u003cem>Times\u003c/em> reports that “prosecutors in the Los Angeles County district attorney’s sex crimes division are currently evaluating whether to file criminal charges in 56 potential cases.”\u003c/p>\n\u003cp>It likely would take a while for those eligible for money from this settlement to actually receive it — according to USC, the court approval process “can take six to eight months.” The university is also offering free counselling and support services to former patients of Tyndall.\u003c/p>\n\u003cp>The university said in May that an \u003ca href=\"https://pressroom.usc.edu/statement-of-facts-may-15-2018/\" rel=\"noopener\" target=\"_blank\">investigation that went through a former health center director’s files\u003c/a> found that patients had troubling complaints about Tyndall’s clinical practices and conduct as early as 2000.\u003c/p>\n\u003cblockquote>\n\u003cp>“The files contained eight complaints logged between 2000 and 2014 that were concerning. These included racially insensitive and other inappropriate comments, concerns that he was not adequately sensitive to patient privacy, a complaint of feeling ‘uncomfortable,’ another that Tyndall ‘gave me the skeevies,’ and another that he was ‘unprofessional.’ Several of the complaints were concerning enough that it is not clear today why the former health center director permitted Tyndall to remain in his position.”\u003c/p>\n\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Austin stressed that the university recently has made “sweeping changes,” and “we continue to work every day to prevent all forms of misconduct on our campuses, to provide outstanding care to all students, and to ensure we have policies and procedures that prioritize respect for our students and our entire university community.” \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=USC+Reaches+%24215+Million+Settlement+Over+Gynecologist+Abuse+Allegations+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003cstrong>Editor’s note:\u003c/strong>\u003c/em>\u003cem> This story describes graphic allegations of sexual abuse.\u003c/em>\u003c/p>\n\u003cp>The University of Southern California says it has reached a tentative class action settlement agreement worth $215 million over \u003ca href=\"https://www.kqed.org/news/11671505/criminal-investigation-into-usc-gynecologist-expected-to-grow-2\" rel=\"noopener\" target=\"_blank\">allegations\u003c/a> of sexual harassment and abuse by a gynecologist who used to work at its student health center.\u003c/p>\n\u003cp>Approximately 500 current and former students have accused gynecologist George Tyndall of misconduct, according to The Associated Press.\u003c/p>\n\u003cp>The settlement requires court approval before it is final. USC \u003ca href=\"https://change.usc.edu/faq/\" rel=\"noopener\" target=\"_blank\">says anyone who received treatment from Tyndall\u003c/a> for women’s health issues is eligible to receive compensation of $2,500. They aren’t required to provide additional information about their interaction with Tyndall to receive those funds.\u003c/p>\n\u003cp>Other former patients can seek additional money up to $250,000 by detailing their experience with Tyndall.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The school’s board of trustees \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/05/26/614609644/usc-president-c-l-max-nikias-stepping-down-amid-gynecologist-scandal\" rel=\"noopener\" target=\"_blank\">said in May\u003c/a> that then-\u003ca href=\"https://www.kqed.org/news/11670933/usc-president-c-l-max-nikias-stepping-down-amid-gynecologist-scandal\" rel=\"noopener\" target=\"_blank\">USC President C.L. Max Nikias would step down\u003c/a>, as the Tyndall scandal was unfolding. The interim president, Wanda Austin, \u003ca href=\"https://change.usc.edu/statement-concerning-tyndall-class-action-settlement/\" rel=\"noopener\" target=\"_blank\">said in a statement that the settlement\u003c/a> is intended to provide relief to those impacted by Tyndall’s actions.\u003c/p>\n\u003cp>“By doing so, we hope that we can help our community move collectively toward reconciliation,” said Austin. “I regret that any student ever felt uncomfortable, unsafe, or mistreated in any way as a result of the actions of a university employee.”\u003c/p>\n\u003cp>As \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/05/22/613344526/usc-faces-lawsuits-calls-for-resignation-over-alleged-sexual-abuse-by-gynecologi\" rel=\"noopener\" target=\"_blank\">NPR’s Camila Domonoske reported\u003c/a>, Tyndall and USC reached a deal in 2017 that resulted in his departure from the school. Before that, he was “placed on leave after a 2016 investigation found he made racially discriminatory and sexually inappropriate remarks to patients.”\u003c/p>\n\u003cp>Lawsuits at the state and federal levels have been filed by women alleging abuse by Tyndall. Here’s more from Domonoske:\u003c/p>\n\u003cblockquote>\n\u003cp>“The lawsuits are blistering. They go into graphic detail about Tyndall’s alleged practices, such as fully nude exams that were not medically necessary and digital penetration that did not resemble a routine gynecological exam. In one case, a woman alleges that Tyndall placed his entire ungloved hand inside her vagina.”\u003c/p>\n\u003c/blockquote>\n\u003cp>According to Reuters, a lawyer representing 44 women accusing Tyndall of misconduct in two separate lawsuits says the settlement amount is too modest.\u003c/p>\n\u003cp>“We are continuing to vigorously litigate our state cases for numerous victims and we will insist that each of our clients be properly compensated for what they were forced to endure,” attorney Gloria Allred told the wire service.\u003c/p>\n\u003cp>Tyndall has denied wrongdoing, \u003ca href=\"http://www.latimes.com/local/lanow/la-me-usc-settlement-proposal-20181019-story.html\" rel=\"noopener\" target=\"_blank\">the Los Angeles Times reports\u003c/a>, and has said in interviews that “his exams were in keeping with the standards outlined by textbooks and the American College of Obstetricians and Gynecologists.”\u003c/p>\n\u003cp>While no criminal charges have yet been filed against Tyndall, the \u003cem>Times\u003c/em> reports that “prosecutors in the Los Angeles County district attorney’s sex crimes division are currently evaluating whether to file criminal charges in 56 potential cases.”\u003c/p>\n\u003cp>It likely would take a while for those eligible for money from this settlement to actually receive it — according to USC, the court approval process “can take six to eight months.” The university is also offering free counselling and support services to former patients of Tyndall.\u003c/p>\n\u003cp>The university said in May that an \u003ca href=\"https://pressroom.usc.edu/statement-of-facts-may-15-2018/\" rel=\"noopener\" target=\"_blank\">investigation that went through a former health center director’s files\u003c/a> found that patients had troubling complaints about Tyndall’s clinical practices and conduct as early as 2000.\u003c/p>\n\u003cblockquote>\n\u003cp>“The files contained eight complaints logged between 2000 and 2014 that were concerning. These included racially insensitive and other inappropriate comments, concerns that he was not adequately sensitive to patient privacy, a complaint of feeling ‘uncomfortable,’ another that Tyndall ‘gave me the skeevies,’ and another that he was ‘unprofessional.’ Several of the complaints were concerning enough that it is not clear today why the former health center director permitted Tyndall to remain in his position.”\u003c/p>\n\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Austin stressed that the university recently has made “sweeping changes,” and “we continue to work every day to prevent all forms of misconduct on our campuses, to provide outstanding care to all students, and to ensure we have policies and procedures that prioritize respect for our students and our entire university community.” \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=USC+Reaches+%24215+Million+Settlement+Over+Gynecologist+Abuse+Allegations+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
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},
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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.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"hidden-brain": {
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"airtime": "SUN 7:30pm-8pm",
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"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. ",
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"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. ",
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"order": 18
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"id": "latino-usa",
"title": "Latino USA",
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"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/",
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},
"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"
},
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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}
