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"content": "\u003cp>Combine years of delay, ever-changing rules and requirements, state and federal red tape, and a once mighty company now in deep financial trouble, and what do you get?\u003c/p>\n\u003cp>In California’s case, the junking of a $179 million computer modernization project to process claims for Medi-Cal, the state’s health-payment program for low-income residents.\u003c/p>\n\u003cp>The project, put out to bid in 2007 and still far from completion, was finally put to rest on Monday when the state Department of Health Care Services announced a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Settlement%20Agreement%2003212016%201930%20FINAL%20web.pdf\" target=\"_blank\">legal settlement\u003c/a> with Xerox Corp., the project contractor, under which Xerox will pay the state approximately $120 million.\u003c/p>\n\u003cp>That means Medi-Cal’s existing computer system – creaky, patched-together, and decades old - will continue to operate for however long it takes the state to contract out and build a replacement.\u003c/p>\n\u003cp>According to the settlement, Xerox will continue to run the existing system until 2019.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The DHCS is putting a bright face on the project’s demise, calling it, in a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/Xerox_Settlement.aspx\" target=\"_blank\">press release\u003c/a> issued Monday, an “opportunity” to reevaluate current needs. A fresh start, it went on, will ensure “modern, robust and sustainable system.”\u003c/p>\n\u003cp>DHCS noted it's not the only state with such problems: “Many other states … have adjusted their strategies” toward their Medicaid computer systems, the release said. (Medi-Cal is California’s version of Medicaid.)\u003c/p>\n\u003cp>Indeed, several parties in Texas and Alaska, both public and private, have sued the Xerox subsidiary Xerox State Healthcare over contract problems.\u003c/p>\n\u003cp>The department declined to comment beyond the press release. The settlement requires that DHCS and Xerox both approve in advance any public statement for the next 30 days.\u003c/p>\n\u003cp>In a statement, Xerox said the settlement agreement finalizes the announcement it made last fall \"that it did not expect to complete implementation of the Health Enterprise Platform in California.\" Xerox added that it is \"pleased to work with DHCS to continue processing Medi-Cal claims through September 2019.\"\u003c/p>\n\u003cp>California’s drawn-out competition for the project began in 2007. Xerox won the contract in 2010. By 2012, the project was already in trouble. Delays caused the state to impose on Xerox a “\u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/CAMMIS_Quarterly_July-2012.pdf\" target=\"_blank\">corrective action plan\u003c/a>.”\u003c/p>\n\u003cp>Originally scheduled for completion by the end of this year, the project isn’t close to done, the settlement indicates.\u003c/p>\n\u003cp>Whenever government computer systems fall behind schedule, which is common, critics blame red tape. In this case, the massive Medi-Cal replacement contract with Xerox was inked just five days before President Obama signed the Affordable Care Act into law. As new regulations under the law worked their way through the health care system, requirements for the Medi-Cal project continued to change.\u003c/p>\n\u003cp>Compounding matters, Xerox fell into deep trouble. Its stock has lagged far behind the market in general. The company is under pressure from investor activist Carl Icahn. Late last year, Xerox said it would wind down its Medicaid computer systems business in California and Montana, take a $385 million charge against earnings, and “focus on profitable market segments.” That meant the end of the California project.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/downloads/mmisfacsr.pdf\" target=\"_blank\">Several companies \u003c/a>compete in the Medicaid system market. As of February, Xerox was the number-two provider, covering 11 states. The leader, HP Enterprise Systems, covers 18.\u003c/p>\n\u003cp>Xerox will pay about $103 million in cash, provide computer hardware and software worth $15 million, and abandon payment claims worth roughly $5 million more.\u003c/p>\n\u003cp>DHCS has reported it had paid Xerox $9 million for the replacement system, $8.1 million of that with federal funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems",
"title": "Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems",
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"content": "\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\" rel=\"noopener\">study released this week\u003c/a>. The study — by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality — was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\" rel=\"noopener\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>“We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,” said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>“There may be a higher density of dentists [in urban areas], but they’re still not accepting Medi-Cal patients,” Raven said. “Coverage doesn’t equal access.”\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medi-Cal is California’s Medicaid program, and it did not have adult dental coverage in 2010, when the study’s data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>“We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,” Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>[contextly_sidebar id=”sT9KtJ06HSo5xPfgl6TvmZCmlYYDZAHP”]As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\" rel=\"noopener\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>“One of the important things about the study we did is we looked at provider density,” Raven said. “People say there are plenty of dentists, but there’s a subtler argument we’re trying to make, that there is a low rate of dentists who take Medicaid.”\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers — or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>“It’s too bad provider rates aren’t higher,” she said, “but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\" rel=\"noopener\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n",
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"headline": "Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems",
"datePublished": "2015-08-06T10:01:54-07:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\" rel=\"noopener\">study released this week\u003c/a>. The study — by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality — was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\" rel=\"noopener\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>“We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,” said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>“There may be a higher density of dentists [in urban areas], but they’re still not accepting Medi-Cal patients,” Raven said. “Coverage doesn’t equal access.”\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medi-Cal is California’s Medicaid program, and it did not have adult dental coverage in 2010, when the study’s data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>“We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,” Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\" rel=\"noopener\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>“One of the important things about the study we did is we looked at provider density,” Raven said. “People say there are plenty of dentists, but there’s a subtler argument we’re trying to make, that there is a low rate of dentists who take Medicaid.”\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers — or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>“It’s too bad provider rates aren’t higher,” she said, “but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\" rel=\"noopener\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Legislators Tackle Transportation, Health Care Funding in Special Sessions",
"title": "Legislators Tackle Transportation, Health Care Funding in Special Sessions",
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"content": "\u003cp>The state budget may be cooked, but discussions over how to fund two of the state's most important government services -- health care services and transportation -- are just heating up in Sacramento.\u003c/p>\n\u003cp>As \u003ca href=\"http://ww2.kqed.org/news/2015/06/16/california-budget-deal-struck-governor-jerry-brown-concedes-little/\" target=\"_blank\">he unveiled a $167.6 billion budget deal\u003c/a> for the fiscal year that began July 1, Gov. Jerry Brown also \u003ca href=\"http://www.gov.ca.gov/news.php?id=19005\" target=\"_blank\">announced two \"extraordinary\" legislative sessions\u003c/a>. Brown wants lawmakers to figure out how to pay for repairs to the state's dismally underfunded roads, bridges and highways, and how to make up for a $1 billion hole in the state's Medi-Cal program that will appear next June.\u003c/p>\n\u003cp>He's also asking the Legislature to come up for more funding to pay for higher Medi-Cal rates paid to doctors, to boost services for the developmentally disabled and to pay for an expansion of in-home care for disabled adults.\u003c/p>\n\u003cp>In announcing the special sessions -- which are limited to those specific subjects and run at the same time as normal legislative business in Sacramento -- Brown said he wanted to separate the two issues from broader budget discussions \"so we can really deal with (them) in a thoughtful way.\"\u003c/p>\n\u003cp>\"We have to find more resources for our health care and also for our roads and bridges, so there's plenty to do,\" he said on June 16 in a state Capitol news conference. \"This is difficult, it involves both Republicans and Democrats ... and one way or another we have to find some solutions.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lawmakers of both parties agree that the issues at hand are important. Where they disagree is on how to pay for them: Republicans are loath to raise taxes for anything, and believe that all of this should have been dealt with through the normal budget process. (By contrast, Brown and Democratic lawmakers seem happy to push any tax discussions away from the deadline-driven budget discussions.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">'This is difficult, it involves both Republicans and Democrats ... and one way or another we have to find some solutions.' \u003ccite>Gov. Jerry Brown\u003c/cite>\u003c/aside>\n\u003cp>But in order to raise taxes, Democrats will need some Republican votes.\u003c/p>\n\u003cp>Assembly Republican Leader Kristin Olsen (R-Modesto) said the minority party stands ready to engage but isn't thrilled with the process.\u003c/p>\n\u003cp>\"We are very disappointed,\" she said. \"Here we passed a state budget just two weeks ago, and all the issues in these special sessions -- transportation and health care -- should have and could have been addressed at that time.\"\u003c/p>\n\u003cfigure id=\"attachment_10585815\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut.jpg\">\u003cimg class=\"size-medium wp-image-10585815\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-800x533.jpg\" alt=\"Assembly Republican Leader Kristin Olsen discusses the state budget. \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assembly Republican Leader Kristin Olsen discusses the state budget. \u003ccite>(Max Whittaker/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Transportation Needs Staggering\u003c/strong>\u003c/p>\n\u003cp>State officials say California's 50,000 miles of highways and nearly 13,000 state-owned bridges have racked up $59 billion worth of repair needs, after years of declining funding. Annually, they peg that shortfall at about $5.7 billion -- in part because gas tax revenues \u003ca href=\"http://www.latimes.com/local/politics/la-me-pol-brown-roads-20150701-story.html\" target=\"_blank\">have sharply declined\u003c/a> as cars become more fuel-efficient.\u003c/p>\n\u003cp>Democrats say they need to figure out a way to replace that declining revenue. Assembly Speaker Toni Atkins (D-San Diego) \u003ca href=\"http://asmdc.org/speaker/news-room/press-releases/speaker-atkins-announces-transportation-plan-to-help-fix-california-s-future\" target=\"_blank\">rolled out a $2 billion annual proposal in January\u003c/a> that calls, in part, for a \"road user fee\" that her office says would cost most drivers around $52 a year. State Sen. Jim Beall (D-San Jose), chair of the Senate's transportation committee, \u003ca href=\"http://sd15.senate.ca.gov/news/2015-04-15-beall-s-sb-16-paves-way-california-s-future\" target=\"_blank\">wants to raise around $3 billion a year \u003c/a>with a mix of increases to the gas tax, the vehicle license fee and vehicle registration fee. He also wants to charge the owners of zero-emission vehicles $100 a year to use the roads, an idea that Brown's administration has flatly rejected.\u003c/p>\n\u003cp>Olsen and other Republicans say they can find that funding without raising a cent of new taxes. Assembly Republicans \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article25642582.html\" target=\"_blank\">unveiled their $6.6 billion annual plan last month\u003c/a>, which includes some items the majority party is unlikely to back. Among those provisions: Taking money from the state's cap-and-trade program aimed at climate change; redirecting $1 billion a year from the state's general fund; laying off 3,500 Caltrans workers whose positions the nonpartisan\u003ca href=\"http://www.lao.ca.gov/reports/2014/budget/capital-outlay/capital-outlay-support-program-051414.pdf\" target=\"_blank\"> Legislative Analyst's Office has suggested are redundant\u003c/a>; and eliminating one-quarter of state government's currently vacant positions.\u003c/p>\n\u003cp>Olsen rejects the notion that the GOP's plan could be untenable to Democrats, saying the Republican caucus worked hard to find a \"realistic, credible plan.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'We do not need to raise taxes on hard-working Californians to pay for transportation needs.' \u003ccite>Assembly Republican Leader Kristin Olsen\u003c/cite>\u003c/aside>\n\u003cp>\"We do not need to raise taxes on hardworking Californians to pay for transportation needs,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Health Care Funding Drying Up\u003c/strong>\u003c/p>\n\u003cp>Like the gas tax, another key funding source -- a tax levied on the health plans that manage Medi-Cal -- is also drying up. That tax, which nets $1.1 billion a year to help provide care to one-third of the state's residents, will no longer be allowed under federal rules come next June. The federal government wants the state to assess a more broad-based tax that impacts health plans other than just Medi-Cal.\u003c/p>\n\u003cp>But Brown has also rolled a few other hot-button issues into this special session: The ongoing debate over\u003ca href=\"http://www.mercurynews.com/opinion/ci_28109334/mercury-news-editorial-california-must-raise-medi-cal\" target=\"_blank\"> Medi-Cal reimbursement rates\u003c/a>; the \u003ca href=\"http://www.dailydemocrat.com/general-news/20150610/developmentally-disabled-to-lose-programs-if-state-budget-remains-stagnant\" target=\"_blank\">shortfall in developmental disability service funding \u003c/a>created by cuts made during the depth of the recession; and increasing funding for the state's in-home care program for the blind, disabled and elderly. In the budget he signed last month, Brown\u003ca href=\"http://www.beyondchron.org/in-home-care-recipients-cautiously-applaud-new-budget/\" target=\"_blank\"> included a one-year restoration of cuts made to in-home supportive services during the recession\u003c/a>, but said that the Legislature needs to figure out a long-term funding stream to make that 7 percent boost permanent.\u003c/p>\n\u003cp>Olsen said Republicans are still studying the health care issue but reiterated their opposition to raising taxes \"for priorities that should have been covered in the budget.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The special sessions began last month, and informational hearings have already begun -- but the hard work isn't expected to begin until late August.\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown asks lawmakers to come up with billions of dollars for two key issues.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state budget may be cooked, but discussions over how to fund two of the state's most important government services -- health care services and transportation -- are just heating up in Sacramento.\u003c/p>\n\u003cp>As \u003ca href=\"http://ww2.kqed.org/news/2015/06/16/california-budget-deal-struck-governor-jerry-brown-concedes-little/\" target=\"_blank\">he unveiled a $167.6 billion budget deal\u003c/a> for the fiscal year that began July 1, Gov. Jerry Brown also \u003ca href=\"http://www.gov.ca.gov/news.php?id=19005\" target=\"_blank\">announced two \"extraordinary\" legislative sessions\u003c/a>. Brown wants lawmakers to figure out how to pay for repairs to the state's dismally underfunded roads, bridges and highways, and how to make up for a $1 billion hole in the state's Medi-Cal program that will appear next June.\u003c/p>\n\u003cp>He's also asking the Legislature to come up for more funding to pay for higher Medi-Cal rates paid to doctors, to boost services for the developmentally disabled and to pay for an expansion of in-home care for disabled adults.\u003c/p>\n\u003cp>In announcing the special sessions -- which are limited to those specific subjects and run at the same time as normal legislative business in Sacramento -- Brown said he wanted to separate the two issues from broader budget discussions \"so we can really deal with (them) in a thoughtful way.\"\u003c/p>\n\u003cp>\"We have to find more resources for our health care and also for our roads and bridges, so there's plenty to do,\" he said on June 16 in a state Capitol news conference. \"This is difficult, it involves both Republicans and Democrats ... and one way or another we have to find some solutions.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lawmakers of both parties agree that the issues at hand are important. Where they disagree is on how to pay for them: Republicans are loath to raise taxes for anything, and believe that all of this should have been dealt with through the normal budget process. (By contrast, Brown and Democratic lawmakers seem happy to push any tax discussions away from the deadline-driven budget discussions.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">'This is difficult, it involves both Republicans and Democrats ... and one way or another we have to find some solutions.' \u003ccite>Gov. Jerry Brown\u003c/cite>\u003c/aside>\n\u003cp>But in order to raise taxes, Democrats will need some Republican votes.\u003c/p>\n\u003cp>Assembly Republican Leader Kristin Olsen (R-Modesto) said the minority party stands ready to engage but isn't thrilled with the process.\u003c/p>\n\u003cp>\"We are very disappointed,\" she said. \"Here we passed a state budget just two weeks ago, and all the issues in these special sessions -- transportation and health care -- should have and could have been addressed at that time.\"\u003c/p>\n\u003cfigure id=\"attachment_10585815\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut.jpg\">\u003cimg class=\"size-medium wp-image-10585815\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-800x533.jpg\" alt=\"Assembly Republican Leader Kristin Olsen discusses the state budget. \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2015/07/RS15587_BUDGET_43-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Assembly Republican Leader Kristin Olsen discusses the state budget. \u003ccite>(Max Whittaker/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Transportation Needs Staggering\u003c/strong>\u003c/p>\n\u003cp>State officials say California's 50,000 miles of highways and nearly 13,000 state-owned bridges have racked up $59 billion worth of repair needs, after years of declining funding. Annually, they peg that shortfall at about $5.7 billion -- in part because gas tax revenues \u003ca href=\"http://www.latimes.com/local/politics/la-me-pol-brown-roads-20150701-story.html\" target=\"_blank\">have sharply declined\u003c/a> as cars become more fuel-efficient.\u003c/p>\n\u003cp>Democrats say they need to figure out a way to replace that declining revenue. Assembly Speaker Toni Atkins (D-San Diego) \u003ca href=\"http://asmdc.org/speaker/news-room/press-releases/speaker-atkins-announces-transportation-plan-to-help-fix-california-s-future\" target=\"_blank\">rolled out a $2 billion annual proposal in January\u003c/a> that calls, in part, for a \"road user fee\" that her office says would cost most drivers around $52 a year. State Sen. Jim Beall (D-San Jose), chair of the Senate's transportation committee, \u003ca href=\"http://sd15.senate.ca.gov/news/2015-04-15-beall-s-sb-16-paves-way-california-s-future\" target=\"_blank\">wants to raise around $3 billion a year \u003c/a>with a mix of increases to the gas tax, the vehicle license fee and vehicle registration fee. He also wants to charge the owners of zero-emission vehicles $100 a year to use the roads, an idea that Brown's administration has flatly rejected.\u003c/p>\n\u003cp>Olsen and other Republicans say they can find that funding without raising a cent of new taxes. Assembly Republicans \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article25642582.html\" target=\"_blank\">unveiled their $6.6 billion annual plan last month\u003c/a>, which includes some items the majority party is unlikely to back. Among those provisions: Taking money from the state's cap-and-trade program aimed at climate change; redirecting $1 billion a year from the state's general fund; laying off 3,500 Caltrans workers whose positions the nonpartisan\u003ca href=\"http://www.lao.ca.gov/reports/2014/budget/capital-outlay/capital-outlay-support-program-051414.pdf\" target=\"_blank\"> Legislative Analyst's Office has suggested are redundant\u003c/a>; and eliminating one-quarter of state government's currently vacant positions.\u003c/p>\n\u003cp>Olsen rejects the notion that the GOP's plan could be untenable to Democrats, saying the Republican caucus worked hard to find a \"realistic, credible plan.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'We do not need to raise taxes on hard-working Californians to pay for transportation needs.' \u003ccite>Assembly Republican Leader Kristin Olsen\u003c/cite>\u003c/aside>\n\u003cp>\"We do not need to raise taxes on hardworking Californians to pay for transportation needs,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Health Care Funding Drying Up\u003c/strong>\u003c/p>\n\u003cp>Like the gas tax, another key funding source -- a tax levied on the health plans that manage Medi-Cal -- is also drying up. That tax, which nets $1.1 billion a year to help provide care to one-third of the state's residents, will no longer be allowed under federal rules come next June. The federal government wants the state to assess a more broad-based tax that impacts health plans other than just Medi-Cal.\u003c/p>\n\u003cp>But Brown has also rolled a few other hot-button issues into this special session: The ongoing debate over\u003ca href=\"http://www.mercurynews.com/opinion/ci_28109334/mercury-news-editorial-california-must-raise-medi-cal\" target=\"_blank\"> Medi-Cal reimbursement rates\u003c/a>; the \u003ca href=\"http://www.dailydemocrat.com/general-news/20150610/developmentally-disabled-to-lose-programs-if-state-budget-remains-stagnant\" target=\"_blank\">shortfall in developmental disability service funding \u003c/a>created by cuts made during the depth of the recession; and increasing funding for the state's in-home care program for the blind, disabled and elderly. In the budget he signed last month, Brown\u003ca href=\"http://www.beyondchron.org/in-home-care-recipients-cautiously-applaud-new-budget/\" target=\"_blank\"> included a one-year restoration of cuts made to in-home supportive services during the recession\u003c/a>, but said that the Legislature needs to figure out a long-term funding stream to make that 7 percent boost permanent.\u003c/p>\n\u003cp>Olsen said Republicans are still studying the health care issue but reiterated their opposition to raising taxes \"for priorities that should have been covered in the budget.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The special sessions began last month, and informational hearings have already begun -- but the hard work isn't expected to begin until late August.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State Auditor Slams Medi-Cal Program Over Inadequate Doctor Networks and More",
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"content": "\u003cp>California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging \u003ca href=\"https://www.auditor.ca.gov/reports/summary/2014-134\" target=\"_blank\">report\u003c/a> Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every month.\u003c/p>\n\u003cp>Among the report’s findings:\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Incorrect or missing data on provider networks meant that state health officials had no idea if the plans had sufficient doctors and specialists, or if patients got the care they needed.\u003c/li>\n\u003cli>An average of 12,500 calls to the program’s ombudsman went unanswered each month for nearly a year, frustrating patients’ efforts to resolve problems.\u003c/li>\n\u003cli>Provider directories for three health plans – Health Net in Los Angeles County, Anthem Blue Cross in Fresno County and Partnership HealthPlan of California in Solano County – contained inaccurate or outdated information, ranging from incorrect telephone numbers for providers to listings for providers who no longer participated.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>Overall, state officials failed to verify insurers’ information about their networks of doctors and hospitals.\u003c/p>\n\u003cp>The audit’s findings come as little surprise to health advocates, who have called attention to these problems as California shifted millions of Medi-Cal recipients from traditional fee-for-service care which enabled enrollees to see most Medi-Cal providers, into managed care programs with prescribed networks of doctors and hospitals.\u003c/p>\n\u003cp>About 76 percent of the \u003ca href=\"https://chhs.data.ca.gov/Healthcare/Medi-Cal-Certified-Eligibles-in-Fee-for-Service-FF/t2tc-57iy#column-menu\" target=\"_blank\">12.2 million adults and children\u003c/a> receiving Medi-Cal, California’s Medicaid program, were enrolled in managed care programs as of March 2015.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Eligibility for Medi-Cal, the state-federal health program for the poor, expanded under the Affordable Care Act. Since last year, more than 3.5 million enrollees signed up for the first time. Nearly one in three Californians now receive coverage through the program.\u003c/p>\n\u003cp>“The audit confirms longstanding concerns about issues of oversight of Medicaid managed care plans and of access to Medi-Cal services,” said Anthony Wright, executive director of the statewide advocacy group Health Access. “I think people on Medicaid are very appreciative of the care they get and it’s far preferable to be being uninsured. What’s troubling is the finding that we don’t even know if people have access. We’re two steps away from solving the problems that exist if we don’t know what they are.”\u003c/p>\n\u003cp>The agency “agrees with many of the state auditor’s recommendations” and already has begun to work on improving oversight, Department of Health Care Services Director Jennifer Kent said in a statement.\u003c/p>\n\u003cp>The agency is upgrading the ombudsman’s phone system to handle more calls and is taking other steps to ensure that residents can get medical care when and where they need it, she noted.\u003c/p>\n\u003cp>The state’s Department of Health Care Services contracts with 22 health plans to provide managed health care services to Medi-Cal recipients, who must choose from managed care plans available in their counties.\u003c/p>\n\u003cp>The audit singled out the performance of the Medi-Cal Managed Care Ombudsman’s office, noting that too few staffers, an inadequate telephone system and a glitch-prone computer system kept it from addressing complaints.\u003c/p>\n\u003cp>The telephone system rejected thousands of calls each month, ranging from about 7,000 to more than 45,000, between February 2014 and January 2015.\u003c/p>\n\u003cp>Even when calls got through, staffers were able to answer only a third to a half of them, the audit noted. A database to maintain information on the calls crashed frequently, resulting in further loss of data.\u003c/p>\n\u003cp>Efforts to improve oversight of Medi-Cal managed care plans are underway. The Department of Health Care Services is creating a “dashboard” of plan performance indicators to better identify problems in real time.\u003c/p>\n\u003cp>Pending \u003ca href=\"http://komensandiego.org/wp-content/uploads/2015/03/SB-137-Fact-Sheet.pdf\" target=\"_blank\">legislation\u003c/a> would require health plans to more frequently update their provider lists for all consumers, not just those on Medi-Cal.\u003c/p>\n\u003cp>A new state \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0951-1000/sb_964_bill_20140925_chaptered.pdf\" target=\"_blank\">law\u003c/a> also will require health insurers, including those serving Medi-Cal managed care patients, to provide data to regulators on how much time it takes for patients to get appointments with their physicians.\u003c/p>\n\u003cp>The audit noted that the Department of Health Care Services also needs to improve how it reviews primary care provider directories, which can affect children’s ability to get medical care.\u003c/p>\n\u003cp>“With nearly half of all children in California enrolled in Medi-Cal managed care, the state is responsible for ensuring that children are actually able to access needed health services,” said Alison Buist, director of health policy for the Children’s Defense Fund. “The audit confirms what advocates have long suspected: The state is not effectively monitoring whether health plans have enough providers to serve the Medi-Cal population, and the mechanisms to identify challenges beneficiaries face in accessing care are not working as well as they should.”\u003c/p>\n\u003cp>In a statement, California State Sen. Edward Hernandez, chairman of the Senate’s health committee, cited lack of funding as a key factor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While disappointing, the results of this audit are not surprising,” Hernandez said. “The systematic underfunding of Medi-Cal is making it very difficult for plans to set up adequate networks, and DHCS is not doing enough to make sure the commitments we’ve made to beneficiaries are being honored.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging \u003ca href=\"https://www.auditor.ca.gov/reports/summary/2014-134\" target=\"_blank\">report\u003c/a> Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every month.\u003c/p>\n\u003cp>Among the report’s findings:\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Incorrect or missing data on provider networks meant that state health officials had no idea if the plans had sufficient doctors and specialists, or if patients got the care they needed.\u003c/li>\n\u003cli>An average of 12,500 calls to the program’s ombudsman went unanswered each month for nearly a year, frustrating patients’ efforts to resolve problems.\u003c/li>\n\u003cli>Provider directories for three health plans – Health Net in Los Angeles County, Anthem Blue Cross in Fresno County and Partnership HealthPlan of California in Solano County – contained inaccurate or outdated information, ranging from incorrect telephone numbers for providers to listings for providers who no longer participated.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>Overall, state officials failed to verify insurers’ information about their networks of doctors and hospitals.\u003c/p>\n\u003cp>The audit’s findings come as little surprise to health advocates, who have called attention to these problems as California shifted millions of Medi-Cal recipients from traditional fee-for-service care which enabled enrollees to see most Medi-Cal providers, into managed care programs with prescribed networks of doctors and hospitals.\u003c/p>\n\u003cp>About 76 percent of the \u003ca href=\"https://chhs.data.ca.gov/Healthcare/Medi-Cal-Certified-Eligibles-in-Fee-for-Service-FF/t2tc-57iy#column-menu\" target=\"_blank\">12.2 million adults and children\u003c/a> receiving Medi-Cal, California’s Medicaid program, were enrolled in managed care programs as of March 2015.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Eligibility for Medi-Cal, the state-federal health program for the poor, expanded under the Affordable Care Act. Since last year, more than 3.5 million enrollees signed up for the first time. Nearly one in three Californians now receive coverage through the program.\u003c/p>\n\u003cp>“The audit confirms longstanding concerns about issues of oversight of Medicaid managed care plans and of access to Medi-Cal services,” said Anthony Wright, executive director of the statewide advocacy group Health Access. “I think people on Medicaid are very appreciative of the care they get and it’s far preferable to be being uninsured. What’s troubling is the finding that we don’t even know if people have access. We’re two steps away from solving the problems that exist if we don’t know what they are.”\u003c/p>\n\u003cp>The agency “agrees with many of the state auditor’s recommendations” and already has begun to work on improving oversight, Department of Health Care Services Director Jennifer Kent said in a statement.\u003c/p>\n\u003cp>The agency is upgrading the ombudsman’s phone system to handle more calls and is taking other steps to ensure that residents can get medical care when and where they need it, she noted.\u003c/p>\n\u003cp>The state’s Department of Health Care Services contracts with 22 health plans to provide managed health care services to Medi-Cal recipients, who must choose from managed care plans available in their counties.\u003c/p>\n\u003cp>The audit singled out the performance of the Medi-Cal Managed Care Ombudsman’s office, noting that too few staffers, an inadequate telephone system and a glitch-prone computer system kept it from addressing complaints.\u003c/p>\n\u003cp>The telephone system rejected thousands of calls each month, ranging from about 7,000 to more than 45,000, between February 2014 and January 2015.\u003c/p>\n\u003cp>Even when calls got through, staffers were able to answer only a third to a half of them, the audit noted. A database to maintain information on the calls crashed frequently, resulting in further loss of data.\u003c/p>\n\u003cp>Efforts to improve oversight of Medi-Cal managed care plans are underway. The Department of Health Care Services is creating a “dashboard” of plan performance indicators to better identify problems in real time.\u003c/p>\n\u003cp>Pending \u003ca href=\"http://komensandiego.org/wp-content/uploads/2015/03/SB-137-Fact-Sheet.pdf\" target=\"_blank\">legislation\u003c/a> would require health plans to more frequently update their provider lists for all consumers, not just those on Medi-Cal.\u003c/p>\n\u003cp>A new state \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0951-1000/sb_964_bill_20140925_chaptered.pdf\" target=\"_blank\">law\u003c/a> also will require health insurers, including those serving Medi-Cal managed care patients, to provide data to regulators on how much time it takes for patients to get appointments with their physicians.\u003c/p>\n\u003cp>The audit noted that the Department of Health Care Services also needs to improve how it reviews primary care provider directories, which can affect children’s ability to get medical care.\u003c/p>\n\u003cp>“With nearly half of all children in California enrolled in Medi-Cal managed care, the state is responsible for ensuring that children are actually able to access needed health services,” said Alison Buist, director of health policy for the Children’s Defense Fund. “The audit confirms what advocates have long suspected: The state is not effectively monitoring whether health plans have enough providers to serve the Medi-Cal population, and the mechanisms to identify challenges beneficiaries face in accessing care are not working as well as they should.”\u003c/p>\n\u003cp>In a statement, California State Sen. Edward Hernandez, chairman of the Senate’s health committee, cited lack of funding as a key factor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While disappointing, the results of this audit are not surprising,” Hernandez said. “The systematic underfunding of Medi-Cal is making it very difficult for plans to set up adequate networks, and DHCS is not doing enough to make sure the commitments we’ve made to beneficiaries are being honored.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion",
"title": "Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22069\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-e1413358030830.jpg\">\u003cimg class=\"size-large wp-image-22069\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While the Medicaid expansion \u003ca title=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" href=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" target=\"_blank\">may lead to a dramatic rise\u003c/a> in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to \u003ca title=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" target=\"_blank\">a new analysis\u003c/a> from the UCLA Center for Health Policy Research released Wednesday.\u003c/p>\n\u003cp>Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state's version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law's expansion went into effect earlier this year.\u003c/p>\n\u003cp>Researchers then divided the group into four categories, based on the researchers' assessment of each group's pent-up demand for health care.\u003c/p>\n\u003cp>In July, 2011, after being enrolled in California's \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>, the so-called \"bridge to reform,\" the group with the highest pent-up demand had a rate of costly emergency room visits triple -- or more -- that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained \"relatively constant,\" according to the analysis.\u003c!--more-->\u003c/p>\n\u003cp>\"We were hoping that this would be the case,\" said lead author Jerry Kominski, director of the UCLA Center for Health Policy Research, \"because we think that that's what access to care does for low-income individuals … that there's an additional increase in demand for services and that that demand, or utilization, drops off pretty rapidly.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rates of hospitalization for the \"highest pent-up demand\" group also started high and dropped by almost 80 percent over the two-year period. Curiously, if ER and hospitalization rates were dropping, it's reasonable that outpatient visits might rise. But that wasn't the case; the rate of outpatient visits was largely unchanged during the two-year period.\u003c/p>\n\u003cp>Kominski said that one of the fears of the Medicaid expansion was the potential high cost of low-income patients. He argued that this analysis should ease those fears. \"What our findings say to the country is (that) concerns about Medicaid expansion being financially unsustainable into the future are unfounded.\" Under the Affordable Care Act, the federal government provides 100 percent of the cost of the newly eligible under the Medicaid expansion, but in 2017 that contribution will phase down until it reaches 90 percent in 2020.\u003c/p>\n\u003cp>Twenty-seven states have implemented the Medicaid expansion; 21 have not, and in two states, Indiana and Utah, the question of expansion is an \"open discussion,\" \u003ca title=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" href=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" target=\"_blank\">according to a tally\u003c/a> from the Kaiser Family Foundation.\u003c/p>\n\u003cp>Matt Salo, executive director of the National Association of Medicaid Directors, said the study was \"certainly consistent with what we hope to do\" by expanding health insurance access. He said insurance is \"just the first step, the next step is health care homes so that the individual can actually get better care.\"\u003c/p>\n\u003cp>One factor in helping drive down the higher rates of utilization, Kominski said, is coordinated care initiatives in place for Medi-Cal beneficiaries. For example, virtually all Medi-Cal beneficiaries are now enrolled into a Medi-Cal managed care plan. \"To the extent that other states don't have adequate coordinated care mechanisms in place for their Medicaid populations, then the kinds of drop off that we observed in California may not occur there,\" Kominski said.\u003c/p>\n\u003cp>The UCLA analysis makes explicit reference to -- and rebuts -- a similar study, the \u003ca title=\"http://www.nber.org/oregon/#recent-results\" href=\"http://www.nber.org/oregon/#recent-results\" target=\"_blank\">Oregon Health Insurance Experiment\u003c/a>. In Oregon in 2008, 10,000 residents literally won Medicaid coverage in a lottery, creating a true randomized controlled trial opportunity for researchers who compared those who won coverage with those who didn't, rarely possible to do in social policy research. Researchers later reported \u003ca title=\"http://www.nber.org/oregon/\" href=\"http://www.nber.org/oregon/\" target=\"_blank\">a 40 percent increase in ER visits\u003c/a> in the 18-months after that expansion.\u003c/p>\n\u003cp>Kate Baicker, a health economist at the Harvard School of Public Health, was one of the researchers in the Oregon experiment. She said they did not find \"any evidence of utilization tailing off over that 18-month window\" and stands by her results.\u003c/p>\n\u003cp>Still, Baicker said that an increase in use of health care services, such as emergency room visits or hospitalizations, \"does not mean that Medicaid should not be expanded. Part of the goal is to increase access to health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The UCLA study was funded by the California Department of Health Care Services and Blue Shield of California Foundation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22069\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-e1413358030830.jpg\">\u003cimg class=\"size-large wp-image-22069\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While the Medicaid expansion \u003ca title=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" href=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" target=\"_blank\">may lead to a dramatic rise\u003c/a> in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to \u003ca title=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" target=\"_blank\">a new analysis\u003c/a> from the UCLA Center for Health Policy Research released Wednesday.\u003c/p>\n\u003cp>Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state's version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law's expansion went into effect earlier this year.\u003c/p>\n\u003cp>Researchers then divided the group into four categories, based on the researchers' assessment of each group's pent-up demand for health care.\u003c/p>\n\u003cp>In July, 2011, after being enrolled in California's \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>, the so-called \"bridge to reform,\" the group with the highest pent-up demand had a rate of costly emergency room visits triple -- or more -- that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained \"relatively constant,\" according to the analysis.\u003c!--more-->\u003c/p>\n\u003cp>\"We were hoping that this would be the case,\" said lead author Jerry Kominski, director of the UCLA Center for Health Policy Research, \"because we think that that's what access to care does for low-income individuals … that there's an additional increase in demand for services and that that demand, or utilization, drops off pretty rapidly.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rates of hospitalization for the \"highest pent-up demand\" group also started high and dropped by almost 80 percent over the two-year period. Curiously, if ER and hospitalization rates were dropping, it's reasonable that outpatient visits might rise. But that wasn't the case; the rate of outpatient visits was largely unchanged during the two-year period.\u003c/p>\n\u003cp>Kominski said that one of the fears of the Medicaid expansion was the potential high cost of low-income patients. He argued that this analysis should ease those fears. \"What our findings say to the country is (that) concerns about Medicaid expansion being financially unsustainable into the future are unfounded.\" Under the Affordable Care Act, the federal government provides 100 percent of the cost of the newly eligible under the Medicaid expansion, but in 2017 that contribution will phase down until it reaches 90 percent in 2020.\u003c/p>\n\u003cp>Twenty-seven states have implemented the Medicaid expansion; 21 have not, and in two states, Indiana and Utah, the question of expansion is an \"open discussion,\" \u003ca title=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" href=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" target=\"_blank\">according to a tally\u003c/a> from the Kaiser Family Foundation.\u003c/p>\n\u003cp>Matt Salo, executive director of the National Association of Medicaid Directors, said the study was \"certainly consistent with what we hope to do\" by expanding health insurance access. He said insurance is \"just the first step, the next step is health care homes so that the individual can actually get better care.\"\u003c/p>\n\u003cp>One factor in helping drive down the higher rates of utilization, Kominski said, is coordinated care initiatives in place for Medi-Cal beneficiaries. For example, virtually all Medi-Cal beneficiaries are now enrolled into a Medi-Cal managed care plan. \"To the extent that other states don't have adequate coordinated care mechanisms in place for their Medicaid populations, then the kinds of drop off that we observed in California may not occur there,\" Kominski said.\u003c/p>\n\u003cp>The UCLA analysis makes explicit reference to -- and rebuts -- a similar study, the \u003ca title=\"http://www.nber.org/oregon/#recent-results\" href=\"http://www.nber.org/oregon/#recent-results\" target=\"_blank\">Oregon Health Insurance Experiment\u003c/a>. In Oregon in 2008, 10,000 residents literally won Medicaid coverage in a lottery, creating a true randomized controlled trial opportunity for researchers who compared those who won coverage with those who didn't, rarely possible to do in social policy research. Researchers later reported \u003ca title=\"http://www.nber.org/oregon/\" href=\"http://www.nber.org/oregon/\" target=\"_blank\">a 40 percent increase in ER visits\u003c/a> in the 18-months after that expansion.\u003c/p>\n\u003cp>Kate Baicker, a health economist at the Harvard School of Public Health, was one of the researchers in the Oregon experiment. She said they did not find \"any evidence of utilization tailing off over that 18-month window\" and stands by her results.\u003c/p>\n\u003cp>Still, Baicker said that an increase in use of health care services, such as emergency room visits or hospitalizations, \"does not mean that Medicaid should not be expanded. Part of the goal is to increase access to health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The UCLA study was funded by the California Department of Health Care Services and Blue Shield of California Foundation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Brown Vetoes Adult Day Health Bill; Future of Program Unknown",
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"content": "\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"Kaiser Health News\" href=\"http://capsules.kaiserhealthnews.org/index.php/2014/09/lawsuit-accuses-calif-of-denying-care-to-medi-cal-applicants/#more-30760\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.\u003c/aside>\n\u003cp>The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.\u003c/p>\n\u003cp>Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending.\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit cites several cases, including that of Tulare County resident Robert Rivera, who applied for Medi-Cal in January but died of a pulmonary embolism while the state was determining if he was eligible for the insurance. Two months after his death, Rivera’s mother received a letter saying that the benefits had been approved.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Los Angeles County resident Mark Mullin submitted an application in February 2014, but wasn’t approved until four months later — after he sought legal help. During the time his application was stuck in the backlog, Mullin had to undergo an emergency appendectomy.\u003c/p>\n\u003cp>The suit is asking the state to process cases within 45 days and to grant people Medi-Cal benefits while officials verify applicants’ incomes. The coalition is also asking the state to send notices to Medi-Cal applicants who have been waiting for 45 days notifying them of their right to go before an administrative law judge.\u003c/p>\n\u003cp>The long wait is “unacceptable,” said Katie Murphy, managing attorney at Neighborhood Legal Services of Los Angeles County. Murphy said she is concerned that the problems will get worse as more people apply for Medi-Cal. “If they are not fixed, more people will continue to wait and more will continue to suffer medical emergencies,” she said.\u003c/p>\n\u003cp>California Department of Health Care Services officials said they have been working closely with the counties and have reduced the backlog by 250,000 since early July. Many of the cases are still pending because of incorrect or incomplete information.\u003c/p>\n\u003cp>Department spokesman Tony Cava said people who need immediate care can get in-person assistance with their application at a county social services agency. They also can get their medical bills covered for care received while their applications were pending, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The lawsuit was filed by several organizations throughout California, including Neighborhood Legal Services of Los Angeles County, the National Health Law Program and Bay Area Legal Aid.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"Kaiser Health News\" href=\"http://capsules.kaiserhealthnews.org/index.php/2014/09/lawsuit-accuses-calif-of-denying-care-to-medi-cal-applicants/#more-30760\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.\u003c/aside>\n\u003cp>The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.\u003c/p>\n\u003cp>Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending.\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit cites several cases, including that of Tulare County resident Robert Rivera, who applied for Medi-Cal in January but died of a pulmonary embolism while the state was determining if he was eligible for the insurance. Two months after his death, Rivera’s mother received a letter saying that the benefits had been approved.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Los Angeles County resident Mark Mullin submitted an application in February 2014, but wasn’t approved until four months later — after he sought legal help. During the time his application was stuck in the backlog, Mullin had to undergo an emergency appendectomy.\u003c/p>\n\u003cp>The suit is asking the state to process cases within 45 days and to grant people Medi-Cal benefits while officials verify applicants’ incomes. The coalition is also asking the state to send notices to Medi-Cal applicants who have been waiting for 45 days notifying them of their right to go before an administrative law judge.\u003c/p>\n\u003cp>The long wait is “unacceptable,” said Katie Murphy, managing attorney at Neighborhood Legal Services of Los Angeles County. Murphy said she is concerned that the problems will get worse as more people apply for Medi-Cal. “If they are not fixed, more people will continue to wait and more will continue to suffer medical emergencies,” she said.\u003c/p>\n\u003cp>California Department of Health Care Services officials said they have been working closely with the counties and have reduced the backlog by 250,000 since early July. Many of the cases are still pending because of incorrect or incomplete information.\u003c/p>\n\u003cp>Department spokesman Tony Cava said people who need immediate care can get in-person assistance with their application at a county social services agency. They also can get their medical bills covered for care received while their applications were pending, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The lawsuit was filed by several organizations throughout California, including Neighborhood Legal Services of Los Angeles County, the National Health Law Program and Bay Area Legal Aid.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_21548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\">\u003cimg class=\"size-full wp-image-21548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\" alt=\"Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn\u003c/strong>\u003c/p>\n\u003cp>California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California's low-income health program.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"He's doing things other kids can do. And it's those little moments, it makes you just so grateful.\"\u003c/aside>\n\u003cp>That makes California the first state in the nation to implement new federal standards on autism care.\u003c/p>\n\u003cp>The new benefit includes coverage of the clinical standard of care for autism treatment -- Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.\u003c/p>\n\u003cp>Of the 5 million children on Medi-Cal in California -- that's roughly half the state's total children -- there are an estimated 75,000 who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of those families is Jazzmon Wilson and her son Timothy. I recently met with them at their home in Rancho Cordova, outside of Sacramento. Timothy was playing a video game.\u003c/p>\n\u003cp>For most families, it was a familiar scene, the 6-year-old glued to his Super Mario game, leaping and dodging virtual pitfalls. But his mom, Jazzmon, still couldn't quite believe what she was seeing.\u003c/p>\n\u003cp>\"It's amazing, he's 6 now, and I never thought this was going to happen,\" she said, \"but he plays Mario. He can play it!\"\u003c/p>\n\u003cp>The fact that Timothy can understand how the video game works, and interact with it -- let alone sit still long enough to figure anything out in the game -- is a major accomplishment, she said.\u003c/p>\n\u003cp>\"He's doing things other kids can do, too,\" she said. \"And it's those little moments, it makes you just so grateful.\"\u003c/p>\n\u003cp>It wasn't always this way. Timothy has autism, and his mom described it as having a brain that was wired a little differently. She compared it to one of those frustrating cell phone conversations where there's a couple of seconds delay and people can't communicate with each other. She says her son Timothy had an 8-second delay.\u003c/p>\n\u003cp>And that's not all. At two-years-old he couldn't speak a single word. Not mama, not Dada, nothing. He would spin around. He would yell, constantly.\u003c/p>\n\u003cp>But once he started ABA therapy, his mom says, he was a different kid.\u003c/p>\n\u003cp>\"ABA is giving back to you the typical experiences you dreamed you were going to have when your kid was born,\" Wilson said said. \"All those LITTLE things.\"\u003c/p>\n\u003cp>Little things like sitting still, or making eye contact with his mother.\u003c/p>\n\u003cp>[contextly_sidebar id=\"8HS5mIp1dWbby2CCtkglRASdTy29I9kx\"]\u003c/p>\n\u003cp>The basic idea of ABA therapy is to rewire all the little steps most people take for granted. For example, an ABA therapist will reward a child for sitting down with so-called \"quiet hands\" for two seconds. Then a reward for five seconds, then 10, and so on.\u003c/p>\n\u003cp>After all of that, said Gregory Buch -- a behavorial psychologist in Roseville, north of Sacramento -- comes the arduous process of actually learning words.\u003c/p>\n\u003cp>\"The challenge is, if you have a child who is 3-years-old and has no language whatsoever, you've got about two years' of communications skills at least to teach them,\" Buch said.\u003c/p>\n\u003cp>\"So not only do they have to learn everything that an average child learns that they didn't learn,\" he said, \"they have to learn it faster than the average child learned it.\"\u003c/p>\n\u003cp>When you combine a slow learning process with starting out way behind, you need an intensive program to catch up, Buch said. But, he added, that's what works.\u003c/p>\n\u003cp>\"I think most kids [with autism] will benefit from some kind of ABA intervention,\" he said. \"And for some kids, that's a really dramatic gain.\"\u003c/p>\n\u003cp>This type of therapy has been a clinical standard of care for more than a decade, but that doesn't always mean people could access it.\u003c/p>\n\u003cp>The Legislature had to order private insurance companies two years ago to pay for it. But with Medi-Cal, coverage remained blocked. Until now.\u003c/p>\n\u003cp>\"We are extremely pleased and excited that we're adding this benefit,\" said Toby Douglas, director of the state Department of Health Care Services.\u003c/p>\n\u003cp>Douglas said California is first in the nation to act on new federal rules on autism care. California was just waiting for the federal go-ahead, he said.\u003c/p>\n\u003cp>\"It has been something that stakeholders [and] the state have been exploring for a long time,\" Douglas said.\u003c/p>\n\u003cp>Earlier this month, \u003ca title=\"Details of Autism Benefit Coming\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\">hundreds of stakeholders gathered\u003c/a> in a Sacramento auditorium to hash out the devilish details of implementing the benefit.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167855668&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Kristin Jacobson, president of \u003ca title=\"Autism Deserves Equal Coverage home page\" href=\"http://www.autismdeservesequalcoverage.com\" target=\"_blank\">Autism Deserves Equal Coverage\u003c/a>, was at that meeting, and she says there are still miles to go before everyone eligible for therapy gets the therapy.\u003c/p>\n\u003cp>\"This has been a really, really long struggle. We've been fighting for such a long time. We're encouraged, but we are going to remain very vigilant,\" she said.\u003c/p>\n\u003cp>\"If Medi-Cal doesn't make sure to contract with the vast majority of current existing providers, they will not have enough providers,\" Jacobson said. \"They will not be able to actually provide the benefit that they're saying.\"\u003c/p>\n\u003cp>However, she said, the bottom line is: After years of telling her autism clients \"No, no, no, no,\" now she's finally able to say \"Yes,\" Jacobson said. Her organization has p\u003ca title=\"How-To Guide to ABA Benefit\" href=\"http://autismdeservesequalcoverage.com/uploads/Medi-Cal_Autism_Benefit_How-To-Guide.pdf\" target=\"_blank\">roduced a fact sheet \u003c/a>to answer questions about the new benefit.\u003c/p>\n\u003cp>Jazzmon Wilson, back in her living room with Timothy, said the state's coverage couldn't have come at a better time. Timothy had a short course of therapy paid with proceeds from a legal settlement, but that's about to run out. Without the new Medi-Cal benefit, she said she didn't know what she would have done.\u003c/p>\n\u003cp>\"To have something that can bring a little bit of hope, it makes all the difference in the world,\" Wilson said. \"And so when he can do those things now, it makes … It makes life worth living, which is hard to say. It really is hard to say that.\"\u003c/p>\n\u003cp>The state still has plenty of work to do, as\u003ca title=\"Details Coming in Autism Benefit Rollout\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\"> it hasn't yet set provider rates or eligibility standards\u003c/a>. But for thousands of families across California, the coverage for ABA therapy may mean a taste of fresh hope in their lives.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior news editor with \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/\" target=\"_blank\">California Healthline\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\">\u003cimg class=\"size-full wp-image-21548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\" alt=\"Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn\u003c/strong>\u003c/p>\n\u003cp>California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California's low-income health program.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"He's doing things other kids can do. And it's those little moments, it makes you just so grateful.\"\u003c/aside>\n\u003cp>That makes California the first state in the nation to implement new federal standards on autism care.\u003c/p>\n\u003cp>The new benefit includes coverage of the clinical standard of care for autism treatment -- Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.\u003c/p>\n\u003cp>Of the 5 million children on Medi-Cal in California -- that's roughly half the state's total children -- there are an estimated 75,000 who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of those families is Jazzmon Wilson and her son Timothy. I recently met with them at their home in Rancho Cordova, outside of Sacramento. Timothy was playing a video game.\u003c/p>\n\u003cp>For most families, it was a familiar scene, the 6-year-old glued to his Super Mario game, leaping and dodging virtual pitfalls. But his mom, Jazzmon, still couldn't quite believe what she was seeing.\u003c/p>\n\u003cp>\"It's amazing, he's 6 now, and I never thought this was going to happen,\" she said, \"but he plays Mario. He can play it!\"\u003c/p>\n\u003cp>The fact that Timothy can understand how the video game works, and interact with it -- let alone sit still long enough to figure anything out in the game -- is a major accomplishment, she said.\u003c/p>\n\u003cp>\"He's doing things other kids can do, too,\" she said. \"And it's those little moments, it makes you just so grateful.\"\u003c/p>\n\u003cp>It wasn't always this way. Timothy has autism, and his mom described it as having a brain that was wired a little differently. She compared it to one of those frustrating cell phone conversations where there's a couple of seconds delay and people can't communicate with each other. She says her son Timothy had an 8-second delay.\u003c/p>\n\u003cp>And that's not all. At two-years-old he couldn't speak a single word. Not mama, not Dada, nothing. He would spin around. He would yell, constantly.\u003c/p>\n\u003cp>But once he started ABA therapy, his mom says, he was a different kid.\u003c/p>\n\u003cp>\"ABA is giving back to you the typical experiences you dreamed you were going to have when your kid was born,\" Wilson said said. \"All those LITTLE things.\"\u003c/p>\n\u003cp>Little things like sitting still, or making eye contact with his mother.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The basic idea of ABA therapy is to rewire all the little steps most people take for granted. For example, an ABA therapist will reward a child for sitting down with so-called \"quiet hands\" for two seconds. Then a reward for five seconds, then 10, and so on.\u003c/p>\n\u003cp>After all of that, said Gregory Buch -- a behavorial psychologist in Roseville, north of Sacramento -- comes the arduous process of actually learning words.\u003c/p>\n\u003cp>\"The challenge is, if you have a child who is 3-years-old and has no language whatsoever, you've got about two years' of communications skills at least to teach them,\" Buch said.\u003c/p>\n\u003cp>\"So not only do they have to learn everything that an average child learns that they didn't learn,\" he said, \"they have to learn it faster than the average child learned it.\"\u003c/p>\n\u003cp>When you combine a slow learning process with starting out way behind, you need an intensive program to catch up, Buch said. But, he added, that's what works.\u003c/p>\n\u003cp>\"I think most kids [with autism] will benefit from some kind of ABA intervention,\" he said. \"And for some kids, that's a really dramatic gain.\"\u003c/p>\n\u003cp>This type of therapy has been a clinical standard of care for more than a decade, but that doesn't always mean people could access it.\u003c/p>\n\u003cp>The Legislature had to order private insurance companies two years ago to pay for it. But with Medi-Cal, coverage remained blocked. Until now.\u003c/p>\n\u003cp>\"We are extremely pleased and excited that we're adding this benefit,\" said Toby Douglas, director of the state Department of Health Care Services.\u003c/p>\n\u003cp>Douglas said California is first in the nation to act on new federal rules on autism care. California was just waiting for the federal go-ahead, he said.\u003c/p>\n\u003cp>\"It has been something that stakeholders [and] the state have been exploring for a long time,\" Douglas said.\u003c/p>\n\u003cp>Earlier this month, \u003ca title=\"Details of Autism Benefit Coming\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\">hundreds of stakeholders gathered\u003c/a> in a Sacramento auditorium to hash out the devilish details of implementing the benefit.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167855668&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Kristin Jacobson, president of \u003ca title=\"Autism Deserves Equal Coverage home page\" href=\"http://www.autismdeservesequalcoverage.com\" target=\"_blank\">Autism Deserves Equal Coverage\u003c/a>, was at that meeting, and she says there are still miles to go before everyone eligible for therapy gets the therapy.\u003c/p>\n\u003cp>\"This has been a really, really long struggle. We've been fighting for such a long time. We're encouraged, but we are going to remain very vigilant,\" she said.\u003c/p>\n\u003cp>\"If Medi-Cal doesn't make sure to contract with the vast majority of current existing providers, they will not have enough providers,\" Jacobson said. \"They will not be able to actually provide the benefit that they're saying.\"\u003c/p>\n\u003cp>However, she said, the bottom line is: After years of telling her autism clients \"No, no, no, no,\" now she's finally able to say \"Yes,\" Jacobson said. Her organization has p\u003ca title=\"How-To Guide to ABA Benefit\" href=\"http://autismdeservesequalcoverage.com/uploads/Medi-Cal_Autism_Benefit_How-To-Guide.pdf\" target=\"_blank\">roduced a fact sheet \u003c/a>to answer questions about the new benefit.\u003c/p>\n\u003cp>Jazzmon Wilson, back in her living room with Timothy, said the state's coverage couldn't have come at a better time. Timothy had a short course of therapy paid with proceeds from a legal settlement, but that's about to run out. Without the new Medi-Cal benefit, she said she didn't know what she would have done.\u003c/p>\n\u003cp>\"To have something that can bring a little bit of hope, it makes all the difference in the world,\" Wilson said. \"And so when he can do those things now, it makes … It makes life worth living, which is hard to say. It really is hard to say that.\"\u003c/p>\n\u003cp>The state still has plenty of work to do, as\u003ca title=\"Details Coming in Autism Benefit Rollout\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\"> it hasn't yet set provider rates or eligibility standards\u003c/a>. But for thousands of families across California, the coverage for ABA therapy may mean a taste of fresh hope in their lives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior news editor with \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/\" target=\"_blank\">California Healthline\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Details of Autism Benefits -- Like Provider Rates -- Coming After Rollout",
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"content": "\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/capitol-desk/2014/9/autism-details-to-come-after-rollout\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>At the first stakeholder meeting last week to review California's new autism Medi-Cal coverage, state health officials said many details have yet to be worked out. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003ca title=\"Long-Sought Autism Treatment Now Covered by Medi-Cal\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/long-fought-autism-therapy-a-medi-cal-benefit-state-says/\" target=\"_blank\">New benefits, which include coverage of applied behavior analysis\u003c/a> -- also known as ABA therapy -- begin next week.\u003c/p>\n\u003cp>Department of Health Care Services officials said many details -- including the crucial figure of what the reimbursement rates will be -- still need to be worked out. Rates will be discussed at the next stakeholder meeting Oct. 16, officials said.\u003c!--more-->\u003c/p>\n\u003cp>The department still is on schedule to submit an autism coverage state plan amendment to the Centers for Medicare & Medicaid Services by Sept. 30, officials said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We will talk about rates later. We will have a separate session on rate setting,\" said Sarah Brooks, branch chief of the Medi-Cal managed care division at DHCS. \"We are working with different ABA providers so health plans can build their networks. We will be working with them to make sure we have proper network adequacy.\"\u003c/p>\n\u003cp>According to Laurie Weaver, chief of the benefits division at DHCS, the new benefit will cover the broad area of behavior health treatment, which includes ABA therapy as one type of treatment, but the department first will focus on ABA, since it's at the heart of the new benefit.\u003c/p>\n\u003cp>\"The state plan amendment will address ABA first, and we'll go from there,\" she said.\u003c/p>\n\u003cp>According to Abbie Totten, director of state programs for the California Association of Health Plans, it's unusual to launch a benefit before setting up the network.\u003c/p>\n\u003cp>\"You have to understand,\" Totten said to stakeholders at Thursday's meeting, \"we are implementing this benefit in a backwards manner. Usually when you implement a benefit you have time … you can develop all of those pieces, and we are not being provided that opportunity in this case.\"\u003c/p>\n\u003cp>The health plans will work with the state to implement the benefit as best they can -- but right now, she said, people will need to bear with the process, which may be rocky and a little confusing at first.\u003c/p>\n\u003cp>\"We have no rates, we have no idea what payment looks like, we have no idea what licensing or provider criteria will look like,\" Totten said.\u003c/p>\n\u003cp>\"So, just as a caution, we will work together on this. We are committed with the department to make this work, but we don't even have a [state plan amendment] that's approved yet,\" she said. \"We're going to do our best and try to make sure the providers are reimbursed properly.\"\u003c/p>\n\u003cp>\"This is day one,\" said Rene Mollow, deputy director of health care benefits and eligibility at DHCS.\u003c/p>\n\u003cp>\"You can look at this and say, 'Oh no, there's so much to do,' \" Mollow said. \"Or rather you can say, 'Wow, look at what we're doing here.' \"\u003c/p>\n\u003cp>Mollow said the department is committed to implementing the benefit with full involvement of stakeholders -- and that lengthens the process somewhat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are just starting down this pathway, and we know there will be improvements and there will be efforts to inform what the state of California will be doing,\" she said. \"It's a process. I would look at it as: day one. Woo-hoo!\"\u003c/p>\n\n",
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"excerpt": "New Medi-Cal benefit for autism therapy will roll out next week. But rates won't be set until later.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/capitol-desk/2014/9/autism-details-to-come-after-rollout\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>At the first stakeholder meeting last week to review California's new autism Medi-Cal coverage, state health officials said many details have yet to be worked out. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003ca title=\"Long-Sought Autism Treatment Now Covered by Medi-Cal\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/long-fought-autism-therapy-a-medi-cal-benefit-state-says/\" target=\"_blank\">New benefits, which include coverage of applied behavior analysis\u003c/a> -- also known as ABA therapy -- begin next week.\u003c/p>\n\u003cp>Department of Health Care Services officials said many details -- including the crucial figure of what the reimbursement rates will be -- still need to be worked out. Rates will be discussed at the next stakeholder meeting Oct. 16, officials said.\u003c!--more-->\u003c/p>\n\u003cp>The department still is on schedule to submit an autism coverage state plan amendment to the Centers for Medicare & Medicaid Services by Sept. 30, officials said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We will talk about rates later. We will have a separate session on rate setting,\" said Sarah Brooks, branch chief of the Medi-Cal managed care division at DHCS. \"We are working with different ABA providers so health plans can build their networks. We will be working with them to make sure we have proper network adequacy.\"\u003c/p>\n\u003cp>According to Laurie Weaver, chief of the benefits division at DHCS, the new benefit will cover the broad area of behavior health treatment, which includes ABA therapy as one type of treatment, but the department first will focus on ABA, since it's at the heart of the new benefit.\u003c/p>\n\u003cp>\"The state plan amendment will address ABA first, and we'll go from there,\" she said.\u003c/p>\n\u003cp>According to Abbie Totten, director of state programs for the California Association of Health Plans, it's unusual to launch a benefit before setting up the network.\u003c/p>\n\u003cp>\"You have to understand,\" Totten said to stakeholders at Thursday's meeting, \"we are implementing this benefit in a backwards manner. Usually when you implement a benefit you have time … you can develop all of those pieces, and we are not being provided that opportunity in this case.\"\u003c/p>\n\u003cp>The health plans will work with the state to implement the benefit as best they can -- but right now, she said, people will need to bear with the process, which may be rocky and a little confusing at first.\u003c/p>\n\u003cp>\"We have no rates, we have no idea what payment looks like, we have no idea what licensing or provider criteria will look like,\" Totten said.\u003c/p>\n\u003cp>\"So, just as a caution, we will work together on this. We are committed with the department to make this work, but we don't even have a [state plan amendment] that's approved yet,\" she said. \"We're going to do our best and try to make sure the providers are reimbursed properly.\"\u003c/p>\n\u003cp>\"This is day one,\" said Rene Mollow, deputy director of health care benefits and eligibility at DHCS.\u003c/p>\n\u003cp>\"You can look at this and say, 'Oh no, there's so much to do,' \" Mollow said. \"Or rather you can say, 'Wow, look at what we're doing here.' \"\u003c/p>\n\u003cp>Mollow said the department is committed to implementing the benefit with full involvement of stakeholders -- and that lengthens the process somewhat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are just starting down this pathway, and we know there will be improvements and there will be efforts to inform what the state of California will be doing,\" she said. \"It's a process. I would look at it as: day one. Woo-hoo!\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For Some, Medi-Cal Might Mean Ultimately Losing Their Homes",
"title": "For Some, Medi-Cal Might Mean Ultimately Losing Their Homes",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-e1408992079757.jpg\">\u003cimg class=\"size-large wp-image-21011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-640x478.jpg\" alt=\"Anne-Louise Vernon in front of her home in Campbell. (Photo: Pauline Bartolone)\" width=\"640\" height=\"478\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Anne-Louise Vernon in front of her home in Campbell. She recently enrolled in Medi-Cal then found out the state could use proceeds from her home to recover costs of her health care. (Photo: Pauline Bartolone)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Pauline Bartolone,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/August/28/Calif-Bill-Would-Protect-Estates-Of-Many-Receiving-Medicaid-Services.aspx\" target=\"_blank\">\u003cb>Kaiser Health News\u003c/b>\u003c/a>\u003c/p>\n\u003cp>Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She was hoping to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan.\u003c/p>\n\u003cp>“It never even occurred to me I might be on Medi-Cal,\" she said, in reference to the state's version of Medicaid, \"and I didn’t know anything about it.\"\u003c/p>\n\u003cp>She says she asked whether there were any strings attached.\u003c/p>\n\u003cp>\"And the woman said very cheerfully, \"Oh no, no, it’s all free. There's nothing you have to worry about, this is your lucky day.'” she recounts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55.\u003c!--more-->\u003c/p>\n\u003cp>“So I called Medi-Cal and asked specifically, 'Does this mean what I think it means?'” she says.\u003c/p>\n\u003cp>It means Medi-Cal managers can take part of her estate later for health care costs she’s accruing now. A \u003ca href=\"http://aspe.hhs.gov/daltcp/reports/estaterec.htm\" target=\"_blank\">1993 federal law \u003c/a>requires states to recoup Medicaid money spent on institutional care, such as nursing homes, and it gives states the option to recover all health costs from people 55 and over. California took that option.\u003c/p>\n\u003cp>Vernon says she’s panicked and worried. She doesn’t get a monthly bill –- so she’s not sure what she’ll be accountable for.\u003c/p>\n\u003cp>“I feel as though right now, if I could go to do the doctor and I felt I knew where I stood, there are a number of appointments that I’d be making right now,\" says Vernon. \"But I feel so unsettled about this whole estate recovery thing, that I’m afraid to go to the doctor.\"\u003c/p>\n\u003cp>The California law has now been on the books for two decades. Elizabeth Landsberg of the Western Center on Law and Poverty says it turns what was intended to be a safety net program into a long-term loan program. It undermines the security that families might pass on to the next generation.\u003c/p>\n\u003cp>“So in most cases it's modest family homes that we’re talking about, and so the state will most often come back and put a lien on that home, and unfortunately it does force the kids to sell the homes sometimes, ” says Landsberg.\u003c/p>\n\u003cp>Landsberg says the law is complicating Medi-Cal enrollment. Some people have refused to sign up, or have terminated enrollment for fear of losing their estate. She says it’s unfair because people buying insurance through Covered California aren’t subject to the same rules.\u003c/p>\n\u003cp>“For the first time people have to have health coverage. So it’s created an inequity where the lowest income people could lose their assets, and other higher income people who are also getting publicly-subsidized health coverage have no worries, ” says Landsberg.\u003c/p>\n\u003cp>Over the past 20 years, the state of California has recovered almost a billion dollars that paid for long-term care and basic health services through Medi-Cal.\u003c/p>\n\u003cp>Norman Williams of the California Department of Health Care Services says that’s just a very small fraction of the overall Medi-Cal budget during that time.\u003c/p>\n\u003cp>“The funds are collected and returned to the state general fund and along with federal matching funds, that’s used to provide care for members beyond what we have now,\" says Williams.\u003c/p>\n\u003cp>Williams says the average claim is about $95,000.\u003c/p>\n\u003cp>“But the average amount collected is about $15,000,\" he says. \"There are many exceptions available. Hardship exemptions for instance. If there are children who are living and under 21, there is no claim against the Medi-Cal member's estate.\"\u003c/p>\n\u003cp>A bill in the California legislature, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1124\" target=\"_blank\">SB 1124\u003c/a>, would eliminate state recovery for basic Medi-Cal services for older Californians. It would also require the state to provide health claim information for free, so enrollees can keep track of their expenses.\u003c/p>\n\u003cp>That’s something Anne-Louise Vernon is advocating for.\u003c/p>\n\u003cp>“I don’t understand why someone my age, in my situation has been singled out to be a cash cow for the state of California, when this is not required by the federal government,” says Vernon.\u003c/p>\n\u003cp>If the measure is approved by lawmakers, it might have a tough time getting the governor’s signature. The California Department of Finance says it would remove $30 million in revenue that helps pay for the health care of other low-income Californians.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm\" target=\"_blank\">Medi-Cal Recovery FAQ\u003c/a> (California Advocates for Nursing Home Reform)\u003c/li>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/E/PDF%20EstateRecoveryMediCal.pdf\" target=\"_blank\">Estate Recovery Under Medi-Cal \u003c/a>(California HealthCare Foundation)\u003c/li>\n\u003c/ul>\n\n",
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"excerpt": "Law would change state's ability to recovery homes from estates of some beneficiaries over age 55.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-e1408992079757.jpg\">\u003cimg class=\"size-large wp-image-21011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/PhotoAnne-640x478.jpg\" alt=\"Anne-Louise Vernon in front of her home in Campbell. (Photo: Pauline Bartolone)\" width=\"640\" height=\"478\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Anne-Louise Vernon in front of her home in Campbell. She recently enrolled in Medi-Cal then found out the state could use proceeds from her home to recover costs of her health care. (Photo: Pauline Bartolone)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Pauline Bartolone,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/August/28/Calif-Bill-Would-Protect-Estates-Of-Many-Receiving-Medicaid-Services.aspx\" target=\"_blank\">\u003cb>Kaiser Health News\u003c/b>\u003c/a>\u003c/p>\n\u003cp>Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She was hoping to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan.\u003c/p>\n\u003cp>“It never even occurred to me I might be on Medi-Cal,\" she said, in reference to the state's version of Medicaid, \"and I didn’t know anything about it.\"\u003c/p>\n\u003cp>She says she asked whether there were any strings attached.\u003c/p>\n\u003cp>\"And the woman said very cheerfully, \"Oh no, no, it’s all free. There's nothing you have to worry about, this is your lucky day.'” she recounts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55.\u003c!--more-->\u003c/p>\n\u003cp>“So I called Medi-Cal and asked specifically, 'Does this mean what I think it means?'” she says.\u003c/p>\n\u003cp>It means Medi-Cal managers can take part of her estate later for health care costs she’s accruing now. A \u003ca href=\"http://aspe.hhs.gov/daltcp/reports/estaterec.htm\" target=\"_blank\">1993 federal law \u003c/a>requires states to recoup Medicaid money spent on institutional care, such as nursing homes, and it gives states the option to recover all health costs from people 55 and over. California took that option.\u003c/p>\n\u003cp>Vernon says she’s panicked and worried. She doesn’t get a monthly bill –- so she’s not sure what she’ll be accountable for.\u003c/p>\n\u003cp>“I feel as though right now, if I could go to do the doctor and I felt I knew where I stood, there are a number of appointments that I’d be making right now,\" says Vernon. \"But I feel so unsettled about this whole estate recovery thing, that I’m afraid to go to the doctor.\"\u003c/p>\n\u003cp>The California law has now been on the books for two decades. Elizabeth Landsberg of the Western Center on Law and Poverty says it turns what was intended to be a safety net program into a long-term loan program. It undermines the security that families might pass on to the next generation.\u003c/p>\n\u003cp>“So in most cases it's modest family homes that we’re talking about, and so the state will most often come back and put a lien on that home, and unfortunately it does force the kids to sell the homes sometimes, ” says Landsberg.\u003c/p>\n\u003cp>Landsberg says the law is complicating Medi-Cal enrollment. Some people have refused to sign up, or have terminated enrollment for fear of losing their estate. She says it’s unfair because people buying insurance through Covered California aren’t subject to the same rules.\u003c/p>\n\u003cp>“For the first time people have to have health coverage. So it’s created an inequity where the lowest income people could lose their assets, and other higher income people who are also getting publicly-subsidized health coverage have no worries, ” says Landsberg.\u003c/p>\n\u003cp>Over the past 20 years, the state of California has recovered almost a billion dollars that paid for long-term care and basic health services through Medi-Cal.\u003c/p>\n\u003cp>Norman Williams of the California Department of Health Care Services says that’s just a very small fraction of the overall Medi-Cal budget during that time.\u003c/p>\n\u003cp>“The funds are collected and returned to the state general fund and along with federal matching funds, that’s used to provide care for members beyond what we have now,\" says Williams.\u003c/p>\n\u003cp>Williams says the average claim is about $95,000.\u003c/p>\n\u003cp>“But the average amount collected is about $15,000,\" he says. \"There are many exceptions available. Hardship exemptions for instance. If there are children who are living and under 21, there is no claim against the Medi-Cal member's estate.\"\u003c/p>\n\u003cp>A bill in the California legislature, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1124\" target=\"_blank\">SB 1124\u003c/a>, would eliminate state recovery for basic Medi-Cal services for older Californians. It would also require the state to provide health claim information for free, so enrollees can keep track of their expenses.\u003c/p>\n\u003cp>That’s something Anne-Louise Vernon is advocating for.\u003c/p>\n\u003cp>“I don’t understand why someone my age, in my situation has been singled out to be a cash cow for the state of California, when this is not required by the federal government,” says Vernon.\u003c/p>\n\u003cp>If the measure is approved by lawmakers, it might have a tough time getting the governor’s signature. The California Department of Finance says it would remove $30 million in revenue that helps pay for the health care of other low-income Californians.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm\" target=\"_blank\">Medi-Cal Recovery FAQ\u003c/a> (California Advocates for Nursing Home Reform)\u003c/li>\n\u003cli>\u003ca style=\"font-size: medium\" href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/E/PDF%20EstateRecoveryMediCal.pdf\" target=\"_blank\">Estate Recovery Under Medi-Cal \u003c/a>(California HealthCare Foundation)\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15508\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>Former foster youth lined up at Covered California's last board meeting to complain about the hoops they have to jump through to enroll in Medi-Cal, the state's health plan for the poor.\u003c/p>\n\u003cp>“Navigating adulthood is challenging enough, let alone trying to find insurance to cover your medical needs,” said Vanessa Hernandez, who spent 14 years in foster care. She says her younger brother tried twice to sign up online before he gave up.\u003c/p>\n\u003cp>“Currently the process is very unclear, it’s hard to navigate, and it’s not very accessible,” she said.\u003c!--more-->\u003c/p>\n\u003cp>For most young people, The Affordable Care Act allows them to stay on their parents’ insurance until they turn 26. But when California foster youth \u003ca href=\"http://www.childsworld.ca.gov/res/pdf/AB12FactSheet.pdf\" target=\"_blank\">age out of the system\u003c/a> between ages 18 and 21, they often have no one. So federal lawmakers added a special provision to the health law that allows these young adults to stay on Medicaid -- called Medi-Cal in California -- until age 26, regardless of their income.\u003c/p>\n\u003cp>“Former foster youth are extremely vulnerable,” says Jessica Haspel a policy associate at the advocacy nonprofit Children Now. She says any obstacles or delays to enrollment are especially problematic for foster youth. Many have special health needs stemming from a history of abuse or neglect and may rely on important medication for things like diabetes or anxiety. \u003ca href=\"http://www.ncd.gov/newsroom/PolicyCorner/05062013\" target=\"_blank\">Studies show \u003c/a>nearly one in three former foster youth exhibit signs of post-traumatic stress disorder -- which is itself about twice the rate of American war veterans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160128590&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>“They may have been offered counseling when they were a child, but were not in a position where they were really able or ready to process it,” Haspel says. “As an adult, they want to take advantage of counseling and services to help them deal with everything that they’ve been through.”\u003c/p>\n\u003cp>She says the Covered California website isn't programmed properly to enroll former foster youth into coverage. And call center employees aren't educated about the new provision. As a result, some youth are being told they don't qualify when they do, or they are put in a queue when they should be fast-tracked into coverage.\u003c/p>\n\u003cp>“We are constantly working hard to resolve some of those issues,” says Anne Gonzales, Covered California spokesperson.\u003c/p>\n\u003cp>She says the agency is beefing up training and updating its guide for service center reps. Website fixes are scheduled for the winter.\u003c/p>\n\u003cp>“We are currently urging anyone who thinks they missed out on benefits to sign up now,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But youth advocates are advising young people to sidestep Covered California altogether, and to go to their county social services office instead to sign up for Medi-Cal in person.\u003c/p>\n\n",
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
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"airtime": "SUN 7:30pm-8pm",
"meta": {
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},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
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"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
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