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"content": "\u003cp>Kaiser Permanente workers will begin voting Monday on whether to \u003ca href=\"http://go.seiu-uhw.org/StrikeVote\" target=\"_blank\" rel=\"noopener\">authorize\u003c/a> a massive strike that would affect Kaiser facilities nationwide, according to the Service Employees International Union, one of the unions representing Kaiser workers.\u003c/p>\n\u003cp>Workers at Kaiser Permanente Medical Center in Oakland will vote on Monday. Voting will go on for more than a month as Kaiser workers in California, Oregon, Washington, Colorado, Virginia and Washington, D.C. cast ballots.\u003c/p>\n\u003cp>If authorized, the strike will begin in early October. If approved, the union said it would be the biggest strike in 20 years. According to the union, Kaiser workers have been without a contract since Sept. 30 and talks stalled on July 12.\u003c/p>\n\u003cp>The union is accusing Kaiser of unfair labor practices, saying that the healthcare company is paying its executives exorbitant salaries while not providing adequate resources to workers and patients.\u003c/p>\n\u003cp>A spokesperson for Kaiser did not immediately return a request for comment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many Kaiser workers have been outspoken about their issues with the company in recent months. Earlier this month, Kaiser mental health care workers in San Francisco staged a \u003ca href=\"https://www.kqed.org/news/11760375/kaiser-permanente-therapists-hold-one-day-strike-in-san-francisco-over-staffing-shortages\" target=\"_blank\" rel=\"noopener\">one-day strike\u003c/a>, saying that staffing reductions have led to severe cutbacks and long delays in service for serious mental health conditions.\u003c/p>\n\u003cp>At a recent Oakland City Council meeting, many Kaiser workers spoke in opposition to the council selling a city-owned parcel to a developer for a massive project on Telegraph Avenue that would eventually serve as Kaiser's new headquarters.\u003c/p>\n\u003cp>While councilmembers encouraged Kaiser to reach a resolution with its workers, the council approved the land sale.\u003c/p>\n\u003cp>Sonia Allen Smith, a radiology technologist at Kaiser's Oakland medical center, said in a statement that Kaiser \"has abandoned its mission to serve communities in favor of earning massive profits and enriching top executives.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser's executives \"are thriving as Kaiser raises prices for patients, undermines quality healthcare, refuses to bargain in good faith and attacks the frontline healthcare workers who have made it successful,\" Smith said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kaiser Permanente workers will begin voting Monday on whether to \u003ca href=\"http://go.seiu-uhw.org/StrikeVote\" target=\"_blank\" rel=\"noopener\">authorize\u003c/a> a massive strike that would affect Kaiser facilities nationwide, according to the Service Employees International Union, one of the unions representing Kaiser workers.\u003c/p>\n\u003cp>Workers at Kaiser Permanente Medical Center in Oakland will vote on Monday. Voting will go on for more than a month as Kaiser workers in California, Oregon, Washington, Colorado, Virginia and Washington, D.C. cast ballots.\u003c/p>\n\u003cp>If authorized, the strike will begin in early October. If approved, the union said it would be the biggest strike in 20 years. According to the union, Kaiser workers have been without a contract since Sept. 30 and talks stalled on July 12.\u003c/p>\n\u003cp>The union is accusing Kaiser of unfair labor practices, saying that the healthcare company is paying its executives exorbitant salaries while not providing adequate resources to workers and patients.\u003c/p>\n\u003cp>A spokesperson for Kaiser did not immediately return a request for comment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many Kaiser workers have been outspoken about their issues with the company in recent months. Earlier this month, Kaiser mental health care workers in San Francisco staged a \u003ca href=\"https://www.kqed.org/news/11760375/kaiser-permanente-therapists-hold-one-day-strike-in-san-francisco-over-staffing-shortages\" target=\"_blank\" rel=\"noopener\">one-day strike\u003c/a>, saying that staffing reductions have led to severe cutbacks and long delays in service for serious mental health conditions.\u003c/p>\n\u003cp>At a recent Oakland City Council meeting, many Kaiser workers spoke in opposition to the council selling a city-owned parcel to a developer for a massive project on Telegraph Avenue that would eventually serve as Kaiser's new headquarters.\u003c/p>\n\u003cp>While councilmembers encouraged Kaiser to reach a resolution with its workers, the council approved the land sale.\u003c/p>\n\u003cp>Sonia Allen Smith, a radiology technologist at Kaiser's Oakland medical center, said in a statement that Kaiser \"has abandoned its mission to serve communities in favor of earning massive profits and enriching top executives.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser's executives \"are thriving as Kaiser raises prices for patients, undermines quality healthcare, refuses to bargain in good faith and attacks the frontline healthcare workers who have made it successful,\" Smith said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Last December, Brighid FitzGibbon’s son, Evan, entered a catatonic state. Acute psychosis had hit suddenly a few weeks earlier, toward the end of fall semester of his sophomore year at Bard College in upstate New York. Gripped by terrifying delusions, his body began to shut down.\u003c/p>\n\u003cp>FitzGibbon and her husband, Taylor, rushed their 20-year-old son to a hospital in Sonoma County, where they live. An acquaintance told them about a promising program for young people experiencing early psychosis. But the family quickly discovered a problem: the program didn’t exist in their county.\u003c/p>\n\u003cp>In California, geography creates significant barriers to people getting early psychosis treatment, as it does for array of other evidence-based mental health treatments. That’s partly because California’s 58 counties have 58 different public mental health programs, each with their own set of covered services.\u003c/p>\n\u003cp>[aside tag='mental-health' label='more on mental health']“If you get on a bus in Northern California and take it to Southern California, you get different services depending on where you step out,” said Carmela Coyle, president and CEO of the California Hospital Association, a lobbying group for the state’s hospitals. “That’s just inequitable.”\u003c/p>\n\u003cp>Dr. Tom Insel, whom Gov. Gavin Newsom recently appointed as his top mental health advisor, has likened the fragmented system to playing the piano with \u003cu>\u003ca href=\"https://calmatters.org/articles/if-you-think-the-system-works-youre-dead-wrong-a-discussion-on-californias-mental-health-system/\" target=\"_blank\" rel=\"noopener\">58 fingers\u003c/a>\u003c/u>.\u003c/p>\n\u003cp>“There’s no central leadership, really,” said Insel, the former director of the National Institute of Mental Health. “If you ask, ‘What are the counties trying to accomplish? What are their goals? What is their North Star?’ I can’t tell you that. There’s a North Star in L.A. County, in San Mateo, in Alameda. They’re not the same.”\u003c/p>\n\u003cp>Insel and many other mental health experts say California offers too little guidance and oversight to ensure fair access to mental health treatment, missing opportunities to spread best practices from individual counties statewide.\u003c/p>\n\u003cp>He wants the state to identify specific goals for mental health outcomes, such as reducing suicides and the incarceration of people with mental illness. He also wants the state to help counties achieve those goals. Among his top priorities: early psychosis intervention.\u003c/p>\n\u003cp>“For most kids who can get that kind of treatment soon after the onset, they’ll do quite well,” Insel said. “They can go on to really have a life that does not happen today with a diagnosis of schizophrenia.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]A[/dropcap]bout 100,000 adolescents and young adults nationwide experience first-episode psychosis each year, \u003cu>\u003ca href=\"https://www.nimh.nih.gov/health/topics/schizophrenia/raise/fact-sheet-first-episode-psychosis.shtml\" target=\"_blank\" rel=\"noopener\">according to federal figures\u003c/a>\u003c/u>—and three out of 100 people will experience psychosis at some point in their lives.\u003c/p>\n\u003cp>In recent years, policymakers and mental health providers have grown enthusiastic about early psychosis intervention programs, which typically involve intensive counseling, psychiatric treatment and peer and family support, with trained providers working closely together to coordinate each patient’s care.\u003c/p>\n\u003cp>In 2016, the federal government set aside 10% of states’ Community Mental Health Block Grants for early psychosis programming; in California, that totals $9.5 million. Legislators this year have proposed allocating $20 million for early psychosis programming in California’s new budget, which is $5 million less than the governor sought.\u003c/p>\n\u003cfigure id=\"attachment_11756756\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11756756\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg\" alt=\"\" width=\"350\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600-160x240.jpg 160w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\">\u003cfigcaption class=\"wp-caption-text\">Christine Marie Frey, 18, attended an early psychosis program in San Diego after she began to hear demons as a 12-year-old. She’s the author of “Brain XP: Living with Mental Illness, A Young Teenager’s Perspective.” \u003ccite>(Family photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Done right, research shows, the programs can dramatically help young people experiencing psychotic symptoms, with lasting benefits. The converse is also true: The longer psychosis goes untreated, the worse the outcome. People with an initial diagnosis of psychosis are approximately \u003cu>\u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2670697\" target=\"_blank\" rel=\"noopener\">eight times\u003c/a>\u003c/u> as likely to die during the year following their diagnosis as people in the general population. The cause is often suicide.\u003c/p>\n\u003cp>According to one national study, clients in early psychosis programs stay in treatment longer, experience fewer symptoms are more involved in work or school, compared with patients in other care settings—provided they get into treatment fast. \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17050480\" target=\"_blank\" rel=\"noopener\">A Canadian study\u003c/a> published last year in the American Journal of Psychiatry showed that people who participated in early psychosis intervention after their first episode were four times less likely to die.\u003c/p>\n\u003cp>In the United States, on average, individuals experiencing psychosis went without treatment for 74 weeks. Other countries have dramatically reduced this number.\u003c/p>\n\u003cp>Christine Marie Frey, now 18, attended a program in San Diego after she began to hear demons as a 12-year-old. It offered personal and occupational therapy, as well as help with mindfulness, medication and school. Frey found comfort in talking with peers in similar circumstances.\u003c/p>\n\u003cp>“They helped me realize, not just how to cope—they helped me feel like my own self again,” she said. “I went in there ready to give up.”\u003c/p>\n\u003cp>Early psychosis interventions can target young people with symptoms that put them at high risk for psychosis, or those who have had their first experience of psychosis. Those in the first group might hear whispers and wonder if their brain is playing tricks on them; the second group is more likely to believe the voices are real.\u003c/p>\n\u003cp>In California, only about two dozen counties have early psychosis programs. Most lack the money or capacity to make them available to all county residents. Often, the only people eligible are those without insurance or on Medi-Cal for low-income Californians, though in some cases private insurers pay for patients.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]G[/dropcap]rowing up, Evan had always been a strong student, and a talented musician and athlete, his mother said. But as he approached the end of his fall sophomore semester, he became increasingly worried about choosing a major and meeting music deadlines.\u003c/p>\n\u003cp>For several nights, he stopped sleeping. On his 20\u003csup>th\u003c/sup> birthday, a friend rushed him to the emergency room. He received medication to help him sleep, but continued to get worse. His father raced across the country to bring him back to Sebastopol, assuming the comfort of home would help. Then the delusions started.\u003c/p>\n\u003cp>After his parents heard about the early psychosis program, they said they begged their insurance provider, Kaiser Permanente, for a referral, but Kaiser refused.\u003c/p>\n\u003cp>In an emailed statement, Dr. Sameer Awsare, associate executive director of Kaiser’s Northern California medical group, said Kaiser is not simply an ‘insurer’” that pays for outside services.\u003c/p>\n\u003cp>“Kaiser Permanente is an integrated health care system that provides expert, evidence-based medical care for our members, including in the area of psychosis,” Awsare said. He added that Kaiser follows federal “best practices” for cognitive behavioral treatment of psychosis and multi-family group treatment, and when clinically appropriate, Kaiser does refer members to outside programs.\u003c/p>\n\u003cp>He cited patient confidentiality in declining to discuss Evan’s case.\u003c/p>\n\u003cfigure id=\"attachment_11756762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11756762\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg\" alt=\"\" width=\"800\" height=\"500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-160x100.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1020x638.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1200x750.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1920x1200.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Brighid Fitzgibbon with her son, Evan, who was a sophomore at Bard College when acute psychosis hit. \u003ccite>(Penni Gladstone/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Evan’s parents didn’t feel that what they said Kaiser was offering—a general intensive outpatient program in which most patients didn’t have psychosis, a meeting with a psychiatrist every few weeks, and therapy every week or so—was enough.\u003c/p>\n\u003cp>So Evan’s father drove him every week or so to the UC Davis Early Diagnosis and Preventive Treatment Clinic, a state-of-the-art program in Sacramento. The drive was about four hours round-trip, and the family paid thousands of dollars for his care, with the help of a GoFundMe account set up by his elementary school teacher.\u003c/p>\n\u003cp>Evan stabilized and began to improve, his mother said. But the long drives wore on her son and his father, who had severe back pain. And the out-of-pocket costs became prohibitive. Coming from so far away, it was difficult for Evan to participate in the peer groups. Although Brighid FitzGibbon said they would have liked to continue, they made the difficult choice to stop a few months into the program in May.\u003c/p>\n\u003cp>“I don’t know,” said FitzGibbon, whose son gave permission for her to share his story. “It’s just disheartening to see how broken the system is. I think we did the best we could.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]B[/dropcap]ill Carter, who recently became Sonoma County’s mental health director, said he is committed to bringing an early psychosis program there, calling it “one of the best things going.”\u003c/p>\n\u003cp>“It’s the kind of thing we in the mental health field have been waiting for,” he said. “Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.”\u003c/p>\n\u003cp>Carter previously worked for the California Institute of Mental Health, leading efforts to disseminate evidence-based practices, including early psychosis treatment. He also served as mental health director of Napa County, which beginning in 2014 has made early psychosis treatment available to any county resident who needed it, regardless of insurance.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Sonoma County mental health director Bill Carter']‘Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.’[/pullquote]Napa managed this in part due to funding from One Mind, a nonprofit founded by the local Staglin family, whose son, Brandon, recovered from schizophrenia in the 1990s and is now the president. The Napa program also receives support from local vintners, a large charity auction and a variety of federal and state funding sources.\u003c/p>\n\u003cp>But despite Carter’s commitment to bringing early psychosis programming to Sonoma County, he has encountered significant obstacles. After 2017’s wildfires, the county is facing huge budget shortfalls—and making steep cuts to mental health care.\u003c/p>\n\u003cp>Convincing the public to invest significantly in a prevention program for relatively few people is challenging, Carter said, especially when so many very sick people are going without care. He’d prefer that the state provide centralized leadership and support to help counties fund and build early psychosis programs.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]W[/dropcap]hy doesn’t that exist? Why do 58 counties do things 58 ways? By design. Back in 1991, the state faced a budget crisis, and in a process known as “realignment,” it shifted responsibility for mental health delivery to counties.\u003c/p>\n\u003cp>It also assigned counties dedicated funding from sales taxes and vehicle license fees, creating formulas based on how much each county was spending at the time. Over the years, these funds have neither kept pace with need nor been adjusted to account for changing populations.\u003c/p>\n\u003cp>In 2004, California voters passed the Mental Health Services Act initiative, levying a tax on the state’s millionaires. It has pumped in about \u003cu>\u003ca href=\"https://mhsoac.ca.gov/act\">$15 billio\u003c/a>\u003ca href=\"https://mhsoac.ca.gov/act\">n more for mental health\u003c/a>\u003c/u>, which the stated doles out to counties to promote flexibility.\u003c/p>\n\u003cp>Counties say they need to be nimble. In a state as vast and varied as California, the issues facing rural Trinity County differ from those of urban Los Angeles. But the approach has disadvantages.\u003c/p>\n\u003cp>[aside tag='kaiser-permanente-mental-health' label='mental healthcare access']“There’s not necessarily rhyme or reason to why a county chooses to provide some services and not others,” said Sheree Lowe, vice president of behavioral health for the California Hospital Association. “The best way to describe it is, it’s a broken delivery system.”\u003c/p>\n\u003cp>What the state needs, Lowe contends, is core services available in every community. Now, she says, the state doesn’t track what services are provided in each county.\u003c/p>\n\u003cp>In 2012, the state shuttered its Department of Mental Health, and moved many of its staff members to the Department of Health Care Services. Some feel the move further sidelined mental health.\u003c/p>\n\u003cp>“I think counties have been cast adrift, really,” said Randall Hagar, government relations director for the California Psychiatric Association, which represents the interests of the state’s psychiatrists. “I would agree with the assessment that there is still no state leadership.”\u003c/p>\n\u003cp>This isn’t true everywhere. Oregon has a comprehensive, state-run early psychosis program. New York state created \u003cu>\u003ca href=\"https://www.ontrackny.org/\">OnTrackNY,\u003c/a>\u003c/u> a state-led effort to provide coordinated early psychosis care to young people. Dr. Insel said he would like to see California implement a similar effort.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>[dropcap]M[/dropcap]any people see hope for the future of early psychosis intervention in California because of the UC Davis clinic that Brighid FitzGibbon’s son Evan attended—and its director, Tara Niendam. In 2008, Dr. Cameron Carter, a prominent psychiatrist with a strong interest in early psychosis, recruited her to the Sacramento clinic he’d founded.\u003c/p>\n\u003cp>Today, the staff includes psychiatrists, therapists, a family advocate and a specialist in education and employment, as well as a worker dedicated to meeting patients’ social needs, such as housing. Patients participate in peer and family support groups.\u003c/p>\n\u003cp>Too often, Niendam says, individuals “just float around in our system receiving sometimes inadequate care.” Effective mental health care doesn’t simply make symptoms go away, she said. It gives individuals and families the tools to pursue meaningful lives.\u003c/p>\n\u003cp>“That’s more than a pill can do,” she said.\u003c/p>\n\u003cp>One of the clinic’s patients, Meheretab — who asked that his last name not be used — began attending Niendam’s clinic after suicidal thoughts and hallucinations. Meheretab, who has Medi-Cal, said the infrequent treatment he was receiving through Kaiser wasn’t working. Niendam’s clinic felt safe. With a combination of medication, counseling, job support and a peer group, he said, his depression subsided and the hallucinations ended.\u003c/p>\n\u003cp>“I feel like I’m in a better place right now,” he said.\u003c/p>\n\u003cp>Niendam helped Napa and Solano counties start early psychosis programs and is currently doing the same with Yolo County. Small counties can struggle to hire and train the staff necessary for a full early psychosis program, so she is developing a way for them to contract with larger counties or use telemedicine. She wants to expand the treatment model statewide.\u003c/p>\n\u003cp>Watching people who have been hospitalized 10 times return to school or hold a fulltime job, and showing them they can recover, “are the things that keep me going every day,” she said. “It’s game-changing for everyone. It’s super exciting to be part of that.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "Lack of Central Leadership Is Complicating Treatment For Mental Illness in California | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last December, Brighid FitzGibbon’s son, Evan, entered a catatonic state. Acute psychosis had hit suddenly a few weeks earlier, toward the end of fall semester of his sophomore year at Bard College in upstate New York. Gripped by terrifying delusions, his body began to shut down.\u003c/p>\n\u003cp>FitzGibbon and her husband, Taylor, rushed their 20-year-old son to a hospital in Sonoma County, where they live. An acquaintance told them about a promising program for young people experiencing early psychosis. But the family quickly discovered a problem: the program didn’t exist in their county.\u003c/p>\n\u003cp>In California, geography creates significant barriers to people getting early psychosis treatment, as it does for array of other evidence-based mental health treatments. That’s partly because California’s 58 counties have 58 different public mental health programs, each with their own set of covered services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“If you get on a bus in Northern California and take it to Southern California, you get different services depending on where you step out,” said Carmela Coyle, president and CEO of the California Hospital Association, a lobbying group for the state’s hospitals. “That’s just inequitable.”\u003c/p>\n\u003cp>Dr. Tom Insel, whom Gov. Gavin Newsom recently appointed as his top mental health advisor, has likened the fragmented system to playing the piano with \u003cu>\u003ca href=\"https://calmatters.org/articles/if-you-think-the-system-works-youre-dead-wrong-a-discussion-on-californias-mental-health-system/\" target=\"_blank\" rel=\"noopener\">58 fingers\u003c/a>\u003c/u>.\u003c/p>\n\u003cp>“There’s no central leadership, really,” said Insel, the former director of the National Institute of Mental Health. “If you ask, ‘What are the counties trying to accomplish? What are their goals? What is their North Star?’ I can’t tell you that. There’s a North Star in L.A. County, in San Mateo, in Alameda. They’re not the same.”\u003c/p>\n\u003cp>Insel and many other mental health experts say California offers too little guidance and oversight to ensure fair access to mental health treatment, missing opportunities to spread best practices from individual counties statewide.\u003c/p>\n\u003cp>He wants the state to identify specific goals for mental health outcomes, such as reducing suicides and the incarceration of people with mental illness. He also wants the state to help counties achieve those goals. Among his top priorities: early psychosis intervention.\u003c/p>\n\u003cp>“For most kids who can get that kind of treatment soon after the onset, they’ll do quite well,” Insel said. “They can go on to really have a life that does not happen today with a diagnosis of schizophrenia.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">A\u003c/span>\u003c/p>\u003cp>bout 100,000 adolescents and young adults nationwide experience first-episode psychosis each year, \u003cu>\u003ca href=\"https://www.nimh.nih.gov/health/topics/schizophrenia/raise/fact-sheet-first-episode-psychosis.shtml\" target=\"_blank\" rel=\"noopener\">according to federal figures\u003c/a>\u003c/u>—and three out of 100 people will experience psychosis at some point in their lives.\u003c/p>\n\u003cp>In recent years, policymakers and mental health providers have grown enthusiastic about early psychosis intervention programs, which typically involve intensive counseling, psychiatric treatment and peer and family support, with trained providers working closely together to coordinate each patient’s care.\u003c/p>\n\u003cp>In 2016, the federal government set aside 10% of states’ Community Mental Health Block Grants for early psychosis programming; in California, that totals $9.5 million. Legislators this year have proposed allocating $20 million for early psychosis programming in California’s new budget, which is $5 million less than the governor sought.\u003c/p>\n\u003cfigure id=\"attachment_11756756\" class=\"wp-caption alignleft\" style=\"max-width: 350px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11756756\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg\" alt=\"\" width=\"350\" height=\"525\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/Dennison17_1-400x600-160x240.jpg 160w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\">\u003cfigcaption class=\"wp-caption-text\">Christine Marie Frey, 18, attended an early psychosis program in San Diego after she began to hear demons as a 12-year-old. She’s the author of “Brain XP: Living with Mental Illness, A Young Teenager’s Perspective.” \u003ccite>(Family photo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Done right, research shows, the programs can dramatically help young people experiencing psychotic symptoms, with lasting benefits. The converse is also true: The longer psychosis goes untreated, the worse the outcome. People with an initial diagnosis of psychosis are approximately \u003cu>\u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2670697\" target=\"_blank\" rel=\"noopener\">eight times\u003c/a>\u003c/u> as likely to die during the year following their diagnosis as people in the general population. The cause is often suicide.\u003c/p>\n\u003cp>According to one national study, clients in early psychosis programs stay in treatment longer, experience fewer symptoms are more involved in work or school, compared with patients in other care settings—provided they get into treatment fast. \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17050480\" target=\"_blank\" rel=\"noopener\">A Canadian study\u003c/a> published last year in the American Journal of Psychiatry showed that people who participated in early psychosis intervention after their first episode were four times less likely to die.\u003c/p>\n\u003cp>In the United States, on average, individuals experiencing psychosis went without treatment for 74 weeks. Other countries have dramatically reduced this number.\u003c/p>\n\u003cp>Christine Marie Frey, now 18, attended a program in San Diego after she began to hear demons as a 12-year-old. It offered personal and occupational therapy, as well as help with mindfulness, medication and school. Frey found comfort in talking with peers in similar circumstances.\u003c/p>\n\u003cp>“They helped me realize, not just how to cope—they helped me feel like my own self again,” she said. “I went in there ready to give up.”\u003c/p>\n\u003cp>Early psychosis interventions can target young people with symptoms that put them at high risk for psychosis, or those who have had their first experience of psychosis. Those in the first group might hear whispers and wonder if their brain is playing tricks on them; the second group is more likely to believe the voices are real.\u003c/p>\n\u003cp>In California, only about two dozen counties have early psychosis programs. Most lack the money or capacity to make them available to all county residents. Often, the only people eligible are those without insurance or on Medi-Cal for low-income Californians, though in some cases private insurers pay for patients.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">G\u003c/span>\u003c/p>\u003cp>rowing up, Evan had always been a strong student, and a talented musician and athlete, his mother said. But as he approached the end of his fall sophomore semester, he became increasingly worried about choosing a major and meeting music deadlines.\u003c/p>\n\u003cp>For several nights, he stopped sleeping. On his 20\u003csup>th\u003c/sup> birthday, a friend rushed him to the emergency room. He received medication to help him sleep, but continued to get worse. His father raced across the country to bring him back to Sebastopol, assuming the comfort of home would help. Then the delusions started.\u003c/p>\n\u003cp>After his parents heard about the early psychosis program, they said they begged their insurance provider, Kaiser Permanente, for a referral, but Kaiser refused.\u003c/p>\n\u003cp>In an emailed statement, Dr. Sameer Awsare, associate executive director of Kaiser’s Northern California medical group, said Kaiser is not simply an ‘insurer’” that pays for outside services.\u003c/p>\n\u003cp>“Kaiser Permanente is an integrated health care system that provides expert, evidence-based medical care for our members, including in the area of psychosis,” Awsare said. He added that Kaiser follows federal “best practices” for cognitive behavioral treatment of psychosis and multi-family group treatment, and when clinically appropriate, Kaiser does refer members to outside programs.\u003c/p>\n\u003cp>He cited patient confidentiality in declining to discuss Evan’s case.\u003c/p>\n\u003cfigure id=\"attachment_11756762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11756762\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg\" alt=\"\" width=\"800\" height=\"500\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-800x500.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-160x100.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1020x638.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1200x750.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800-1920x1200.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/CALMatters-FitzGibbon_015-2880x1800.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Brighid Fitzgibbon with her son, Evan, who was a sophomore at Bard College when acute psychosis hit. \u003ccite>(Penni Gladstone/CALmatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Evan’s parents didn’t feel that what they said Kaiser was offering—a general intensive outpatient program in which most patients didn’t have psychosis, a meeting with a psychiatrist every few weeks, and therapy every week or so—was enough.\u003c/p>\n\u003cp>So Evan’s father drove him every week or so to the UC Davis Early Diagnosis and Preventive Treatment Clinic, a state-of-the-art program in Sacramento. The drive was about four hours round-trip, and the family paid thousands of dollars for his care, with the help of a GoFundMe account set up by his elementary school teacher.\u003c/p>\n\u003cp>Evan stabilized and began to improve, his mother said. But the long drives wore on her son and his father, who had severe back pain. And the out-of-pocket costs became prohibitive. Coming from so far away, it was difficult for Evan to participate in the peer groups. Although Brighid FitzGibbon said they would have liked to continue, they made the difficult choice to stop a few months into the program in May.\u003c/p>\n\u003cp>“I don’t know,” said FitzGibbon, whose son gave permission for her to share his story. “It’s just disheartening to see how broken the system is. I think we did the best we could.”\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">B\u003c/span>\u003c/p>\u003cp>ill Carter, who recently became Sonoma County’s mental health director, said he is committed to bringing an early psychosis program there, calling it “one of the best things going.”\u003c/p>\n\u003cp>“It’s the kind of thing we in the mental health field have been waiting for,” he said. “Historically, schizophrenia and other thought disorders have the potential really just to ravage someone’s life.”\u003c/p>\n\u003cp>Carter previously worked for the California Institute of Mental Health, leading efforts to disseminate evidence-based practices, including early psychosis treatment. He also served as mental health director of Napa County, which beginning in 2014 has made early psychosis treatment available to any county resident who needed it, regardless of insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Napa managed this in part due to funding from One Mind, a nonprofit founded by the local Staglin family, whose son, Brandon, recovered from schizophrenia in the 1990s and is now the president. The Napa program also receives support from local vintners, a large charity auction and a variety of federal and state funding sources.\u003c/p>\n\u003cp>But despite Carter’s commitment to bringing early psychosis programming to Sonoma County, he has encountered significant obstacles. After 2017’s wildfires, the county is facing huge budget shortfalls—and making steep cuts to mental health care.\u003c/p>\n\u003cp>Convincing the public to invest significantly in a prevention program for relatively few people is challenging, Carter said, especially when so many very sick people are going without care. He’d prefer that the state provide centralized leadership and support to help counties fund and build early psychosis programs.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">W\u003c/span>\u003c/p>\u003cp>hy doesn’t that exist? Why do 58 counties do things 58 ways? By design. Back in 1991, the state faced a budget crisis, and in a process known as “realignment,” it shifted responsibility for mental health delivery to counties.\u003c/p>\n\u003cp>It also assigned counties dedicated funding from sales taxes and vehicle license fees, creating formulas based on how much each county was spending at the time. Over the years, these funds have neither kept pace with need nor been adjusted to account for changing populations.\u003c/p>\n\u003cp>In 2004, California voters passed the Mental Health Services Act initiative, levying a tax on the state’s millionaires. It has pumped in about \u003cu>\u003ca href=\"https://mhsoac.ca.gov/act\">$15 billio\u003c/a>\u003ca href=\"https://mhsoac.ca.gov/act\">n more for mental health\u003c/a>\u003c/u>, which the stated doles out to counties to promote flexibility.\u003c/p>\n\u003cp>Counties say they need to be nimble. In a state as vast and varied as California, the issues facing rural Trinity County differ from those of urban Los Angeles. But the approach has disadvantages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“There’s not necessarily rhyme or reason to why a county chooses to provide some services and not others,” said Sheree Lowe, vice president of behavioral health for the California Hospital Association. “The best way to describe it is, it’s a broken delivery system.”\u003c/p>\n\u003cp>What the state needs, Lowe contends, is core services available in every community. Now, she says, the state doesn’t track what services are provided in each county.\u003c/p>\n\u003cp>In 2012, the state shuttered its Department of Mental Health, and moved many of its staff members to the Department of Health Care Services. Some feel the move further sidelined mental health.\u003c/p>\n\u003cp>“I think counties have been cast adrift, really,” said Randall Hagar, government relations director for the California Psychiatric Association, which represents the interests of the state’s psychiatrists. “I would agree with the assessment that there is still no state leadership.”\u003c/p>\n\u003cp>This isn’t true everywhere. Oregon has a comprehensive, state-run early psychosis program. New York state created \u003cu>\u003ca href=\"https://www.ontrackny.org/\">OnTrackNY,\u003c/a>\u003c/u> a state-led effort to provide coordinated early psychosis care to young people. Dr. Insel said he would like to see California implement a similar effort.\u003c/p>\n\u003chr>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">M\u003c/span>\u003c/p>\u003cp>any people see hope for the future of early psychosis intervention in California because of the UC Davis clinic that Brighid FitzGibbon’s son Evan attended—and its director, Tara Niendam. In 2008, Dr. Cameron Carter, a prominent psychiatrist with a strong interest in early psychosis, recruited her to the Sacramento clinic he’d founded.\u003c/p>\n\u003cp>Today, the staff includes psychiatrists, therapists, a family advocate and a specialist in education and employment, as well as a worker dedicated to meeting patients’ social needs, such as housing. Patients participate in peer and family support groups.\u003c/p>\n\u003cp>Too often, Niendam says, individuals “just float around in our system receiving sometimes inadequate care.” Effective mental health care doesn’t simply make symptoms go away, she said. It gives individuals and families the tools to pursue meaningful lives.\u003c/p>\n\u003cp>“That’s more than a pill can do,” she said.\u003c/p>\n\u003cp>One of the clinic’s patients, Meheretab — who asked that his last name not be used — began attending Niendam’s clinic after suicidal thoughts and hallucinations. Meheretab, who has Medi-Cal, said the infrequent treatment he was receiving through Kaiser wasn’t working. Niendam’s clinic felt safe. With a combination of medication, counseling, job support and a peer group, he said, his depression subsided and the hallucinations ended.\u003c/p>\n\u003cp>“I feel like I’m in a better place right now,” he said.\u003c/p>\n\u003cp>Niendam helped Napa and Solano counties start early psychosis programs and is currently doing the same with Yolo County. Small counties can struggle to hire and train the staff necessary for a full early psychosis program, so she is developing a way for them to contract with larger counties or use telemedicine. She wants to expand the treatment model statewide.\u003c/p>\n\u003cp>Watching people who have been hospitalized 10 times return to school or hold a fulltime job, and showing them they can recover, “are the things that keep me going every day,” she said. “It’s game-changing for everyone. It’s super exciting to be part of that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_20683\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167143743&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.\u003c/p>\n\u003cp>The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.\u003c/p>\n\u003cp>Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case.\u003c!--more-->\u003c/p>\n\u003cp>“It’s an admission by Kaiser that it has knowingly violated California mental health laws and shortchanged its patients,” said Clement Papazian, a social worker at Kaiser’s Oakland Medical Center. It’s “a vindication of what Kaiser mental health clinicians have been saying for years.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Papazian was one of several Kaiser clinicians lined up to testify in the hearings, slated to run through early October. The clinicians\u003ca title=\"Therapists, Patients Criticize Kaiser Over Delays\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\" rel=\"noopener\"> have complained \u003c/a>that they weren’t able to offer individual therapy appointments in a timely manner to patients with severe depression, anxiety and other conditions, sometimes leading to wait times of up to four weeks or more between appointments. Others say patients were directed to group therapy, even in cases where the patient wasn’t receptive to group therapy and requested individual care.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents mental health professionals at Kaiser, argued that \u003ca title=\"Patients, Therapists Allege Long Wait Times at Kaiser\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/21/kaiser-therapists-patients-allege-long-waits-for-mental-health-care/\" target=\"_blank\" rel=\"noopener\">these wait times\u003c/a> and policies led to tragic outcomes, even suicide, in some cases.\u003c/p>\n\u003cp>“Kaiser simply does not staff its psychiatry departments with enough psychologists, therapists and social workers to handle the caseload,” said Sal Rosselli, the union’s president, adding that the caseload is only increasing as more and more people sign up for Kaiser’s coverage under the Affordable Care Act.\u003c/p>\n\u003cp>Kaiser issued a lengthy statement saying that even though it agreed to pay the fine, it still disagreed with the penalty and believed it had not violated regulations around timely access.\u003c/p>\n\u003cp>The health plan vowed to make statewide improvements, including more convenient appointment times and locations, and adding more individual therapy. It says that over the years, it has been “continually analyzing our staffing levels throughout our care delivery system, and hiring appropriate mental health providers to meet growth in membership and our members’ needs.”\u003c/p>\n\u003cp>The state’s Department of Managed Health Care says it is currently conducting a follow-up survey of Kaiser’s mental health systems, to be completed this fall. Any remaining deficiencies will be addressed through corrective action plans, penalties or even the installation of a monitor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I am committed to protecting California’s health plan enrollees and ensuring they get timely access to all medically necessary health and mental health care services,” said Shelley Rouillard, the department director, “and will continue to aggressively monitor and take action against health plans that violate the law.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20683\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167143743&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.\u003c/p>\n\u003cp>The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.\u003c/p>\n\u003cp>Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case.\u003c!--more-->\u003c/p>\n\u003cp>“It’s an admission by Kaiser that it has knowingly violated California mental health laws and shortchanged its patients,” said Clement Papazian, a social worker at Kaiser’s Oakland Medical Center. It’s “a vindication of what Kaiser mental health clinicians have been saying for years.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Papazian was one of several Kaiser clinicians lined up to testify in the hearings, slated to run through early October. The clinicians\u003ca title=\"Therapists, Patients Criticize Kaiser Over Delays\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\" rel=\"noopener\"> have complained \u003c/a>that they weren’t able to offer individual therapy appointments in a timely manner to patients with severe depression, anxiety and other conditions, sometimes leading to wait times of up to four weeks or more between appointments. Others say patients were directed to group therapy, even in cases where the patient wasn’t receptive to group therapy and requested individual care.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents mental health professionals at Kaiser, argued that \u003ca title=\"Patients, Therapists Allege Long Wait Times at Kaiser\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/21/kaiser-therapists-patients-allege-long-waits-for-mental-health-care/\" target=\"_blank\" rel=\"noopener\">these wait times\u003c/a> and policies led to tragic outcomes, even suicide, in some cases.\u003c/p>\n\u003cp>“Kaiser simply does not staff its psychiatry departments with enough psychologists, therapists and social workers to handle the caseload,” said Sal Rosselli, the union’s president, adding that the caseload is only increasing as more and more people sign up for Kaiser’s coverage under the Affordable Care Act.\u003c/p>\n\u003cp>Kaiser issued a lengthy statement saying that even though it agreed to pay the fine, it still disagreed with the penalty and believed it had not violated regulations around timely access.\u003c/p>\n\u003cp>The health plan vowed to make statewide improvements, including more convenient appointment times and locations, and adding more individual therapy. It says that over the years, it has been “continually analyzing our staffing levels throughout our care delivery system, and hiring appropriate mental health providers to meet growth in membership and our members’ needs.”\u003c/p>\n\u003cp>The state’s Department of Managed Health Care says it is currently conducting a follow-up survey of Kaiser’s mental health systems, to be completed this fall. Any remaining deficiencies will be addressed through corrective action plans, penalties or even the installation of a monitor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I am committed to protecting California’s health plan enrollees and ensuring they get timely access to all medically necessary health and mental health care services,” said Shelley Rouillard, the department director, “and will continue to aggressively monitor and take action against health plans that violate the law.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"politicalbreakdown": {
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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},
"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
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