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"content": "\u003cp>Nurses at San Francisco public hospitals and clinics reached a tentative contract agreement with the city, likely averting a potential strike over staffing levels and working conditions, the health care workers’ union announced Tuesday.\u003c/p>\n\u003cp>The deal would add 47 full-time-equivalent positions to San Francisco General Hospital and other clinics, keeping wages ahead of inflation.[aside label=\"related coverage\" tag=\"health-care-workers\"]The potential contract, agreed to on Monday night, is a “huge win” and likely to be approved by union membership, said Aaron Cramer, a registered nurse who works in the cardiac catheterization lab at San Francisco General Hospital.\u003c/p>\n\u003cp>Last week, the more than 2,000 nurses represented by SEIU Local 1021 at San Francisco General, Laguna Honda Hospital and Rehabilitation Center, and a number of community clinics voted 99.5% in favor of authorizing a strike if a deal wasn’t in place by the time the current contract expires June 30.\u003c/p>\n\u003cp>That vote “showed the city that we were united about what we wanted, which was safe staffing for patient care. And they heard us loud and clear,” Cramer told KQED. “They finally showed up to the bargaining table prepared to actually negotiate for what we thought was a fair deal.”\u003c/p>\n\u003cp>The additional staff for “critical service areas that chronically run understaffed” will improve conditions for patients and medical workers, he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This entire contract was about patient care,” Cramer said, noting that understaffing affects the time it takes nurses to complete every aspect of a patient’s care. “Especially when they’re chronically sick, patients need things now, and we want to provide it for them now. But when we’re understaffed, it’s like trying to care for someone with an arm tied behind your back.”\u003c/p>\n\u003cp>The San Francisco Department of Public Health, which operates the city hospitals and clinics, did not immediately respond to a request for comment.\u003c/p>\n\u003cp>A union vote to approve the contract is expected in the next two weeks.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The potential contract, agreed to on Monday night, is a “huge win” and likely to be approved by union membership, said Aaron Cramer, a registered nurse who works in the cardiac catheterization lab at San Francisco General Hospital.\u003c/p>\n\u003cp>Last week, the more than 2,000 nurses represented by SEIU Local 1021 at San Francisco General, Laguna Honda Hospital and Rehabilitation Center, and a number of community clinics voted 99.5% in favor of authorizing a strike if a deal wasn’t in place by the time the current contract expires June 30.\u003c/p>\n\u003cp>That vote “showed the city that we were united about what we wanted, which was safe staffing for patient care. And they heard us loud and clear,” Cramer told KQED. “They finally showed up to the bargaining table prepared to actually negotiate for what we thought was a fair deal.”\u003c/p>\n\u003cp>The additional staff for “critical service areas that chronically run understaffed” will improve conditions for patients and medical workers, he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This entire contract was about patient care,” Cramer said, noting that understaffing affects the time it takes nurses to complete every aspect of a patient’s care. “Especially when they’re chronically sick, patients need things now, and we want to provide it for them now. But when we’re understaffed, it’s like trying to care for someone with an arm tied behind your back.”\u003c/p>\n\u003cp>The San Francisco Department of Public Health, which operates the city hospitals and clinics, did not immediately respond to a request for comment.\u003c/p>\n\u003cp>A union vote to approve the contract is expected in the next two weeks.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Things at the opiate treatment program at San Francisco General Hospital look a good deal different these days from before the pandemic hit.\u003c/p>\n\u003cp>For starters, there’s now an option to pick up methadone from a mobile clinic stationed in the hospital’s shaded parking lot, rather than in the traditional clinic inside Ward 93. More crucially, patients can now get the dosage level they need, when they need it, and are able to take their medications home with them — allowances that were previously restricted.\u003c/p>\n\u003cp>In the spring of 2020, as many medical facilities limited their indoor services, the mobile clinic’s two vans set up shop, enabling patients to continue receiving their addiction-related medications and other treatments without interruption.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Early indicators suggest the changes have helped more patients stick with their substance-use treatments at the hospital’s 50-year-old Opiate Treatment Outpatient Program (OTOP).\u003c/p>\n\u003cp>“More people are coming, and more people are staying” with their treatment plan, said Dr. Lisa Fortuna, chief of psychiatry at SF General.\u003c/p>\n\u003cp>But as local and federal pandemic emergency orders — and many of the programs that came with them — come to an end, the future of the mobile clinic is uncertain.\u003c/p>\n\u003cp>Tamra Lombardo, a former heroin user who has received treatment from OTOP for nearly 10 years, said the outdoor site is more discreet and much easier to access compared to the hospital ward, which she frequented before the pandemic.\u003c/p>\n\u003cfigure id=\"attachment_11941679\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941679 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light brown skin and black hair pulled into a bun wearing a face mask fills medication.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Registered nurse Sheena Simon prepares medication inside a mobile methadone clinic operated by SF General’s Opiate Treatment Outpatient Program, on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I haven’t missed no days here. It’s more convenient and a lot smoother. It’s way better, I think,” said Lombardo, 52, after picking up the cherry-flavored dose of methadone from one of the clinic’s vans on a recent Friday, with her dog Eddy at her side. Finding a program that works, she added, has allowed her to focus on her work as a caregiver.\u003c/p>\n\u003cp>Lombardo is one of about 600 OTOP patients, roughly 75% of whom now use the program’s mobile clinic, according to Hasija Sisic, a nurse manager. Participation in the program, which dropped considerably during the first year of the pandemic, has since rebounded and even exceeded pre-pandemic levels, according to data provided by the program.\u003c/p>\n\u003cp>That retention is sorely needed as cities throughout the region, and country, continue to grapple with an overdose epidemic driven by potent opioids like fentanyl. In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>, according to data from the Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>Seven days a week, OTOP nurses work out of the clinic’s large white vans in the hospital parking lot, near Potrero Boulevard. On Monday through Friday, one of the vans also parks in the Bayview neighborhood. [pullquote align=\"right\" size=\"medium\" citation=\"Tamra Lombardo, patient, Opiate Treatment Outpatient Program\"]‘I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that.’[/pullquote]On a recent Friday afternoon, nurses outside the hospital dispensed methadone and buprenorphine — medications used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>After picking up their doses, patients talked with counselors in person or on iPads in heated booths inside the vans. At the start of the pandemic, the program gave out free mobile phones to almost all patients, many of whom lack reliable internet access, so they could be reached for daily check-ins.\u003c/p>\n\u003cp>Sisic said she hopes the mobile sites will continue to operate, even as emergency orders sunset.\u003c/p>\n\u003cp>“We are still talking to the state to at least consider that this might be a good option to keep, because there are a lot of regulations,” she said. “But it’s very needed and we do have the skills.”\u003c/p>\n\u003cp>Opioid withdrawal symptoms can be extremely painful and, in some cases, fatal. So when methadone was approved by the U.S. Food and Drug Administration in 1972, San Francisco became an early adopter in dispensing it. That effort was later incorporated into the city’s strategy to help combat HIV among injection drug users during the start of the AIDS epidemic in the early 1980s.\u003c/p>\n\u003cfigure id=\"attachment_11941681\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941681 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light skin and a purple bandana stands in the doorway of a large white van, with her dog on a leash outside.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tamra Lombardo, a patient, speaks with a nurse at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many health experts now argue that standard treatment for substance-use disorders has failed to keep pace with the ever-expanding landscape of increasingly potent and dangerous street drugs.\u003c/p>\n\u003cp>Treating the withdrawal symptoms of fentanyl, for example, an opioid that’s 50 times more potent than heroin, requires a higher initial dose of methadone than what’s typically allowed by the Substance Abuse and Mental Health Services Administration, the federal agency that regulates how opioid-treatment drugs are administered.\u003c/p>\n\u003cp>Before the pandemic, federal health authorities strictly regulated many aspects of opiate treatment programs in an effort to stem overdoses of methadone, which is itself an opioid. Rules around treatment dictate everything from dosage levels to when and where patients consume their medications.\u003c/p>\n\u003cp>Some of those rules were temporarily relaxed at the start of the pandemic, as drug treatment centers scrambled to prevent overcrowding and continue programs.[aside label=\"related coverage\" tag=\"opioid-crisis\"]Under the updated COVID-era federal regulations, health care providers can prescribe higher doses of methadone depending on a patient’s needs. Stabilized patients also have more access to take-home medications and can attend counseling by video or phone rather than in person.\u003c/p>\n\u003cp>Before the pandemic, “we couldn’t go up as quickly on dosage to get to the appropriate dosage that stops cravings of opioids,” said Dr. Andrew Tompkins, head of UCSF’s Division of Substance Abuse and Addiction Medicine. “And all counseling had to be face-to-face. We weren’t allowed to use telehealth or telephone.”\u003c/p>\n\u003cp>Now about 82% of patients in the program qualify for at least one take-home dose, up from the roughly 25% who qualified before the pandemic, Tompkins said.\u003c/p>\n\u003cp>And so far, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/04/LearningCOVID19PandemicPoliciesMethadoneOpioidTreatment.pdf\">concerns about take-home methadone doses leading to increased overdoses “have not borne out” (PDF)\u003c/a>, according to a recent UCSF report. In observing opiate treatment programs in five different states, the study’s authors found no significant increase in methadone diversion or overdose after take-home regulations were relaxed in 2020, as compared to previous years.\u003c/p>\n\u003cp>The study goes on to suggest that expanding methadone and buprenorphine treatment options can begin to address some of that history of “medical racism and treatment segregation.”\u003c/p>\n\u003cp>A recently proposed federal rule change could make the loosened \u003ca href=\"https://www.hhs.gov/about/news/2022/12/13/samhsa-proposes-update-federal-rules-expand-access-opioid-use-disorder-treatment-help-close-gap-in-care.html\">opiate treatment rules permanent\u003c/a>. Specifically, it would allow providers to continue prescribing take-home doses of methadone and allow treatment programs to be initiated through telehealth consultations.\u003c/p>\n\u003cp>Being able to receive take-home medication has been a welcome change for patients like Debra Allen, a Tenderloin resident, who has attempted opioid treatment for years to combat her cocaine and heroin addiction.\u003c/p>\n\u003cp>The mobile clinic allows her to more easily hop on and off the bus to pick up her medication, and it’s a calmer environment than the buzzing methadone clinic inside the hospital, she said.\u003c/p>\n\u003cfigure id=\"attachment_11941680\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11941680\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A Black woman drinks out of a disposable cup, as a nurse behind a window watches.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Debra Allen takes her methadone dose while speaking with nurse Heather Cruz at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This site is nice. I’ve been here a long time. Other ones are nasty and dirty. Here they keep the bathroom clean,” Allen said.\u003c/p>\n\u003cp>“You can be using so long you get immune and you have to go up [with your dosage],” she said, adding that this treatment approach “makes me not want heroin.”\u003c/p>\n\u003cp>Lombardo, one of the longtime patients, said she’ll keep returning for treatment as long as the vans are around.\u003c/p>\n\u003cp>“I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that,” she said. To other folks who might be considering treatment, she recommended the mobile clinics: “Take the time to try it. The more you put into it, the more you will get out of it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Things at the opiate treatment program at San Francisco General Hospital look a good deal different these days from before the pandemic hit.\u003c/p>\n\u003cp>For starters, there’s now an option to pick up methadone from a mobile clinic stationed in the hospital’s shaded parking lot, rather than in the traditional clinic inside Ward 93. More crucially, patients can now get the dosage level they need, when they need it, and are able to take their medications home with them — allowances that were previously restricted.\u003c/p>\n\u003cp>In the spring of 2020, as many medical facilities limited their indoor services, the mobile clinic’s two vans set up shop, enabling patients to continue receiving their addiction-related medications and other treatments without interruption.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Early indicators suggest the changes have helped more patients stick with their substance-use treatments at the hospital’s 50-year-old Opiate Treatment Outpatient Program (OTOP).\u003c/p>\n\u003cp>“More people are coming, and more people are staying” with their treatment plan, said Dr. Lisa Fortuna, chief of psychiatry at SF General.\u003c/p>\n\u003cp>But as local and federal pandemic emergency orders — and many of the programs that came with them — come to an end, the future of the mobile clinic is uncertain.\u003c/p>\n\u003cp>Tamra Lombardo, a former heroin user who has received treatment from OTOP for nearly 10 years, said the outdoor site is more discreet and much easier to access compared to the hospital ward, which she frequented before the pandemic.\u003c/p>\n\u003cfigure id=\"attachment_11941679\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941679 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light brown skin and black hair pulled into a bun wearing a face mask fills medication.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62988_002_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Registered nurse Sheena Simon prepares medication inside a mobile methadone clinic operated by SF General’s Opiate Treatment Outpatient Program, on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I haven’t missed no days here. It’s more convenient and a lot smoother. It’s way better, I think,” said Lombardo, 52, after picking up the cherry-flavored dose of methadone from one of the clinic’s vans on a recent Friday, with her dog Eddy at her side. Finding a program that works, she added, has allowed her to focus on her work as a caregiver.\u003c/p>\n\u003cp>Lombardo is one of about 600 OTOP patients, roughly 75% of whom now use the program’s mobile clinic, according to Hasija Sisic, a nurse manager. Participation in the program, which dropped considerably during the first year of the pandemic, has since rebounded and even exceeded pre-pandemic levels, according to data provided by the program.\u003c/p>\n\u003cp>That retention is sorely needed as cities throughout the region, and country, continue to grapple with an overdose epidemic driven by potent opioids like fentanyl. In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>, according to data from the Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>Seven days a week, OTOP nurses work out of the clinic’s large white vans in the hospital parking lot, near Potrero Boulevard. On Monday through Friday, one of the vans also parks in the Bayview neighborhood. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>On a recent Friday afternoon, nurses outside the hospital dispensed methadone and buprenorphine — medications used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>After picking up their doses, patients talked with counselors in person or on iPads in heated booths inside the vans. At the start of the pandemic, the program gave out free mobile phones to almost all patients, many of whom lack reliable internet access, so they could be reached for daily check-ins.\u003c/p>\n\u003cp>Sisic said she hopes the mobile sites will continue to operate, even as emergency orders sunset.\u003c/p>\n\u003cp>“We are still talking to the state to at least consider that this might be a good option to keep, because there are a lot of regulations,” she said. “But it’s very needed and we do have the skills.”\u003c/p>\n\u003cp>Opioid withdrawal symptoms can be extremely painful and, in some cases, fatal. So when methadone was approved by the U.S. Food and Drug Administration in 1972, San Francisco became an early adopter in dispensing it. That effort was later incorporated into the city’s strategy to help combat HIV among injection drug users during the start of the AIDS epidemic in the early 1980s.\u003c/p>\n\u003cfigure id=\"attachment_11941681\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11941681 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A woman with light skin and a purple bandana stands in the doorway of a large white van, with her dog on a leash outside.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62998_014_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tamra Lombardo, a patient, speaks with a nurse at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many health experts now argue that standard treatment for substance-use disorders has failed to keep pace with the ever-expanding landscape of increasingly potent and dangerous street drugs.\u003c/p>\n\u003cp>Treating the withdrawal symptoms of fentanyl, for example, an opioid that’s 50 times more potent than heroin, requires a higher initial dose of methadone than what’s typically allowed by the Substance Abuse and Mental Health Services Administration, the federal agency that regulates how opioid-treatment drugs are administered.\u003c/p>\n\u003cp>Before the pandemic, federal health authorities strictly regulated many aspects of opiate treatment programs in an effort to stem overdoses of methadone, which is itself an opioid. Rules around treatment dictate everything from dosage levels to when and where patients consume their medications.\u003c/p>\n\u003cp>Some of those rules were temporarily relaxed at the start of the pandemic, as drug treatment centers scrambled to prevent overcrowding and continue programs.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Under the updated COVID-era federal regulations, health care providers can prescribe higher doses of methadone depending on a patient’s needs. Stabilized patients also have more access to take-home medications and can attend counseling by video or phone rather than in person.\u003c/p>\n\u003cp>Before the pandemic, “we couldn’t go up as quickly on dosage to get to the appropriate dosage that stops cravings of opioids,” said Dr. Andrew Tompkins, head of UCSF’s Division of Substance Abuse and Addiction Medicine. “And all counseling had to be face-to-face. We weren’t allowed to use telehealth or telephone.”\u003c/p>\n\u003cp>Now about 82% of patients in the program qualify for at least one take-home dose, up from the roughly 25% who qualified before the pandemic, Tompkins said.\u003c/p>\n\u003cp>And so far, \u003ca href=\"https://www.chcf.org/wp-content/uploads/2022/04/LearningCOVID19PandemicPoliciesMethadoneOpioidTreatment.pdf\">concerns about take-home methadone doses leading to increased overdoses “have not borne out” (PDF)\u003c/a>, according to a recent UCSF report. In observing opiate treatment programs in five different states, the study’s authors found no significant increase in methadone diversion or overdose after take-home regulations were relaxed in 2020, as compared to previous years.\u003c/p>\n\u003cp>The study goes on to suggest that expanding methadone and buprenorphine treatment options can begin to address some of that history of “medical racism and treatment segregation.”\u003c/p>\n\u003cp>A recently proposed federal rule change could make the loosened \u003ca href=\"https://www.hhs.gov/about/news/2022/12/13/samhsa-proposes-update-federal-rules-expand-access-opioid-use-disorder-treatment-help-close-gap-in-care.html\">opiate treatment rules permanent\u003c/a>. Specifically, it would allow providers to continue prescribing take-home doses of methadone and allow treatment programs to be initiated through telehealth consultations.\u003c/p>\n\u003cp>Being able to receive take-home medication has been a welcome change for patients like Debra Allen, a Tenderloin resident, who has attempted opioid treatment for years to combat her cocaine and heroin addiction.\u003c/p>\n\u003cp>The mobile clinic allows her to more easily hop on and off the bus to pick up her medication, and it’s a calmer environment than the buzzing methadone clinic inside the hospital, she said.\u003c/p>\n\u003cfigure id=\"attachment_11941680\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11941680\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg\" alt=\"A Black woman drinks out of a disposable cup, as a nurse behind a window watches.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/02/RS62991_009_KQED_SFGeneralMethadoneClinic_02102023-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Debra Allen takes her methadone dose while speaking with nurse Heather Cruz at OTOP’s mobile methadone clinic at San Francisco General Hospital on Feb. 10, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This site is nice. I’ve been here a long time. Other ones are nasty and dirty. Here they keep the bathroom clean,” Allen said.\u003c/p>\n\u003cp>“You can be using so long you get immune and you have to go up [with your dosage],” she said, adding that this treatment approach “makes me not want heroin.”\u003c/p>\n\u003cp>Lombardo, one of the longtime patients, said she’ll keep returning for treatment as long as the vans are around.\u003c/p>\n\u003cp>“I don’t have to use the junk out there anymore. I’ve lost a lot of people I know to that,” she said. To other folks who might be considering treatment, she recommended the mobile clinics: “Take the time to try it. The more you put into it, the more you will get out of it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>Saving an Economy Battered by Coronavirus\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">President Donald Trump signed into law today a two trillion dollar economic relief plan — the largest in the nation’s history — for industries, workers and hospitals devastated by the coronavirus, which has affected every state and now claimed more than 1,000 lives. Senate Democrats succeeded in winning concessions from Republicans, like boosting unemployment benefits for workers and placing limits on which companies are eligible for federal loans. Also this week, President Trump said he would like to see the economy reopen by Easter, on April 12. But California Gov. Gavin Newsom thinks that’s too soon for the state. Plus, school districts in the Bay Area announced they would stay closed at least until May 1. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">U.S. Rep. Adam Schiff (D-Burbank)\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Coronavirus Cases Expected to Surge in San Francisco\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, San Francisco Department of Public Health Director Grant Colfax warned that the number of coronavirus cases in the city will surge in the next week or two. The city also recorded its first two deaths from COVID-19, the respiratory disease caused by the novel coronavirus. On Wednesday, Mayor London Breed and health officials said the city may need 5,000 more hospital beds and up to 1,500 ventilators to treat a surge in new infections. Breed had announced earlier that San Francisco hired 82 new nurses and would receive one million face masks, as hospitals in the Bay Area — and around the nation — face severe shortages of critical supplies such as N95 masks, gowns and ventilators. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Ayanna Bennett, San Francisco Department of Public Health\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Christa Duran, emergency room nurse, San Francisco General Hospital\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Grassroots Group Helps Neighbors in Need\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">It’s been nearly two weeks since residents in San Francisco and several other Bay Area counties were ordered not to leave their homes except for essential tasks, like picking up medicine or food. But for some vulnerable residents, that can be tough to do while also limiting their exposure to the coronavirus. So Madeline Su and three other volunteers launched a grassroots organization to help neighbors in need in San Francisco. From delivering groceries to seniors, to just being a friendly voice to talk to, they are helping their communities stay safe — but not isolated. \u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Madeline Su, co-organizer, SF Community Support\u003c/span>\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Saving an Economy Battered by Coronavirus\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">President Donald Trump signed into law today a two trillion dollar economic relief plan — the largest in the nation’s history — for industries, workers and hospitals devastated by the coronavirus, which has affected every state and now claimed more than 1,000 lives. Senate Democrats succeeded in winning concessions from Republicans, like boosting unemployment benefits for workers and placing limits on which companies are eligible for federal loans. Also this week, President Trump said he would like to see the economy reopen by Easter, on April 12. But California Gov. Gavin Newsom thinks that’s too soon for the state. Plus, school districts in the Bay Area announced they would stay closed at least until May 1. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">U.S. Rep. Adam Schiff (D-Burbank)\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Coronavirus Cases Expected to Surge in San Francisco\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, San Francisco Department of Public Health Director Grant Colfax warned that the number of coronavirus cases in the city will surge in the next week or two. The city also recorded its first two deaths from COVID-19, the respiratory disease caused by the novel coronavirus. On Wednesday, Mayor London Breed and health officials said the city may need 5,000 more hospital beds and up to 1,500 ventilators to treat a surge in new infections. Breed had announced earlier that San Francisco hired 82 new nurses and would receive one million face masks, as hospitals in the Bay Area — and around the nation — face severe shortages of critical supplies such as N95 masks, gowns and ventilators. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Ayanna Bennett, San Francisco Department of Public Health\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Christa Duran, emergency room nurse, San Francisco General Hospital\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Grassroots Group Helps Neighbors in Need\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">It’s been nearly two weeks since residents in San Francisco and several other Bay Area counties were ordered not to leave their homes except for essential tasks, like picking up medicine or food. But for some vulnerable residents, that can be tough to do while also limiting their exposure to the coronavirus. So Madeline Su and three other volunteers launched a grassroots organization to help neighbors in need in San Francisco. From delivering groceries to seniors, to just being a friendly voice to talk to, they are helping their communities stay safe — but not isolated. \u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Bay Area Hospitals Gear Up for Potential Surge in Coronavirus Cases",
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"content": "\u003cp>Canceling or postponing non-urgent appointments, seeing patients through remote tools like telehealth and, in some cases, locking up face masks so they don't go missing: These are just some of the ways that local hospitals are preparing for an influx of coronavirus cases in the Bay Area.\u003c/p>\n\u003cp>This comes as the Centers for Disease Control and Prevention (CDC) announced that \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/summary.html\">more cases of COVID-19\u003c/a> are likely to be identified and that widespread transmission could occur, which \"would translate into large numbers of people needing medical care at the same time.\"\u003c/p>\n\u003cp>\"I think what’s a little tricky now is it’s just not at all clear whether it’s going to be medium bad or quite terrible,\" said Dr. Robert Wachter, chair of the UCSF Department of Medicine. \"We don’t want to panic anyone and we don’t want to overreact, but we feel that under-reacting could be the greater sin.\"\u003c/p>\n\u003cp>On Wednesday, the World Health Organization (WHO) said that the COVID-19 viral disease is now officially considered a \u003ca href=\"https://www.kqed.org/science/1958628/coronavirus-covid-19-is-now-officially-a-pandemic-who-says\">pandemic\u003c/a>. [ad fullwidth]\u003c/p>\n\u003ch3>Zuckerberg San Francisco General Hospital\u003c/h3>\n\u003cp>At Zuckerberg San Francisco General Hospital (SFGH), officials said they're working to ensure that patients are routed to the right part of the hospital.\u003c/p>\n\u003cp>\"It's critically important that people aren't in the emergency department unless they absolutely need to be there,\" said SFGH CEO Susan Ehrlich. \"We have other resources for them on campus, including an urgent care clinic and a number of different primary care clinics and specialty clinics.\"\u003c/p>\n\u003cp>They're also canceling non-urgent medical appointments and conducting many appointments and evaluations over the phone.\u003c/p>\n\u003cp>Additionally, because California has declared a state of emergency over the coronavirus outbreak, Ehrlich said that the state Department of Public Health is now allowing the hospital more discretion over how the building can be used to better meet patient needs.\u003c/p>\n\u003cp>\"Each space in the hospital is licensed for a very particular use — for example, labor and delivery, medical surgical floors or critical care floors,\" Ehrlich explained. \"We have to use those spaces in those ways unless we have this special dispensation from the state to use them in different ways.\"\u003c/p>\n\u003cp>[aside tag=\"coronavirus\" label=\"more coverage\"]\u003c/p>\n\u003ch3>Stanford Health Care\u003c/h3>\n\u003cp>At Stanford Health Care systems, which are located in Santa Clara County — where most of the Bay Area's confirmed cases of COVID-19 have been located — staff have confined those patients to particular sections at each hospital.\u003c/p>\n\u003cp>Dr. Yvonne Maldonado, a professor of pediatrics and an infectious disease epidemiologist at Stanford University School of Medicine, said that selecting one particular location in each hospital for these patients has logistical advantages.\u003c/p>\n\u003cp>\"You can have one team that's going to clean those areas. One team is going to take care of those patients,\" she said.\u003c/p>\n\u003cp>Stanford hospitals' staff is currently conducting daily morning meetings, virtually or in-person, and having subcommittee meetings throughout the day to ensure that all their facilities are adequately staffed and have enough equipment.\u003c/p>\n\u003cp>Maldonado said they've also taken to locking away some of their protective gear, including N95 face masks, after some started going missing.\u003c/p>\n\u003cp>Maldonado said that people did not initially understand that N95 masks are not required for every patient, but only for a specific set of patients. \u003c/p>\n\u003cp>\"We're doing a lot of training about what kinds of isolation equipment should be used for what kinds of patients and restricting the use to just those patients,\" Maldonado said.\u003c/p>\n\u003cp>As for seeing patients through remote video connections or over the phone, Maldonado said Stanford had already been using some telemedicine before the outbreak and are working on building out those systems.\u003c/p>\n\u003cp>\"Obviously, you need to make sure that the facilities are sufficient on both ends,\" said Maldonado, referring as well to the ability of providers to work remotely. \"Some people may not need to come in, and can see patients from off-site as well. But, again, that all needs to be set up so it's compliant with all of our hospital and regulatory requirements.\"\u003c/p>\n\u003cfigure id=\"attachment_11806325\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11806325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>UCSF\u003c/h3>\n\u003cp>While there haven't been as many confirmed cases of COVID-19 in San Francisco County as in places like Santa Clara County, officials at UCSF are also working on getting ready for the potential influx.\u003c/p>\n\u003cp>\"We have a hotline that patients are calling in on and we are trying to get the patients in who need to get in, but also giving information, advice to those who don't,\" said UCSF's Dr. Wachter. \"We're also markedly ramping up our telemedicine capabilities.\"\u003c/p>\n\u003cp>UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. Wachter said that under a worst-case scenario, they could limit staff vacation time and delay elective surgeries.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Canceling or postponing non-urgent appointments, seeing patients through remote tools like telehealth and, in some cases, locking up face masks so they don't go missing: These are just some of the ways that local hospitals are preparing for an influx of coronavirus cases in the Bay Area.\u003c/p>\n\u003cp>This comes as the Centers for Disease Control and Prevention (CDC) announced that \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/summary.html\">more cases of COVID-19\u003c/a> are likely to be identified and that widespread transmission could occur, which \"would translate into large numbers of people needing medical care at the same time.\"\u003c/p>\n\u003cp>\"I think what’s a little tricky now is it’s just not at all clear whether it’s going to be medium bad or quite terrible,\" said Dr. Robert Wachter, chair of the UCSF Department of Medicine. \"We don’t want to panic anyone and we don’t want to overreact, but we feel that under-reacting could be the greater sin.\"\u003c/p>\n\u003cp>On Wednesday, the World Health Organization (WHO) said that the COVID-19 viral disease is now officially considered a \u003ca href=\"https://www.kqed.org/science/1958628/coronavirus-covid-19-is-now-officially-a-pandemic-who-says\">pandemic\u003c/a>. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Zuckerberg San Francisco General Hospital\u003c/h3>\n\u003cp>At Zuckerberg San Francisco General Hospital (SFGH), officials said they're working to ensure that patients are routed to the right part of the hospital.\u003c/p>\n\u003cp>\"It's critically important that people aren't in the emergency department unless they absolutely need to be there,\" said SFGH CEO Susan Ehrlich. \"We have other resources for them on campus, including an urgent care clinic and a number of different primary care clinics and specialty clinics.\"\u003c/p>\n\u003cp>They're also canceling non-urgent medical appointments and conducting many appointments and evaluations over the phone.\u003c/p>\n\u003cp>Additionally, because California has declared a state of emergency over the coronavirus outbreak, Ehrlich said that the state Department of Public Health is now allowing the hospital more discretion over how the building can be used to better meet patient needs.\u003c/p>\n\u003cp>\"Each space in the hospital is licensed for a very particular use — for example, labor and delivery, medical surgical floors or critical care floors,\" Ehrlich explained. \"We have to use those spaces in those ways unless we have this special dispensation from the state to use them in different ways.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Stanford Health Care\u003c/h3>\n\u003cp>At Stanford Health Care systems, which are located in Santa Clara County — where most of the Bay Area's confirmed cases of COVID-19 have been located — staff have confined those patients to particular sections at each hospital.\u003c/p>\n\u003cp>Dr. Yvonne Maldonado, a professor of pediatrics and an infectious disease epidemiologist at Stanford University School of Medicine, said that selecting one particular location in each hospital for these patients has logistical advantages.\u003c/p>\n\u003cp>\"You can have one team that's going to clean those areas. One team is going to take care of those patients,\" she said.\u003c/p>\n\u003cp>Stanford hospitals' staff is currently conducting daily morning meetings, virtually or in-person, and having subcommittee meetings throughout the day to ensure that all their facilities are adequately staffed and have enough equipment.\u003c/p>\n\u003cp>Maldonado said they've also taken to locking away some of their protective gear, including N95 face masks, after some started going missing.\u003c/p>\n\u003cp>Maldonado said that people did not initially understand that N95 masks are not required for every patient, but only for a specific set of patients. \u003c/p>\n\u003cp>\"We're doing a lot of training about what kinds of isolation equipment should be used for what kinds of patients and restricting the use to just those patients,\" Maldonado said.\u003c/p>\n\u003cp>As for seeing patients through remote video connections or over the phone, Maldonado said Stanford had already been using some telemedicine before the outbreak and are working on building out those systems.\u003c/p>\n\u003cp>\"Obviously, you need to make sure that the facilities are sufficient on both ends,\" said Maldonado, referring as well to the ability of providers to work remotely. \"Some people may not need to come in, and can see patients from off-site as well. But, again, that all needs to be set up so it's compliant with all of our hospital and regulatory requirements.\"\u003c/p>\n\u003cfigure id=\"attachment_11806325\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11806325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>UCSF\u003c/h3>\n\u003cp>While there haven't been as many confirmed cases of COVID-19 in San Francisco County as in places like Santa Clara County, officials at UCSF are also working on getting ready for the potential influx.\u003c/p>\n\u003cp>\"We have a hotline that patients are calling in on and we are trying to get the patients in who need to get in, but also giving information, advice to those who don't,\" said UCSF's Dr. Wachter. \"We're also markedly ramping up our telemedicine capabilities.\"\u003c/p>\n\u003cp>UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. Wachter said that under a worst-case scenario, they could limit staff vacation time and delay elective surgeries.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"disqusTitle": "Documentary '5B' Introduces The Heroes Of SF General's First Dedicated AIDs Ward",
"title": "Documentary '5B' Introduces The Heroes Of SF General's First Dedicated AIDs Ward",
"headTitle": "KQED Pop | KQED Arts",
"content": "\u003cp>Today, antiretroviral medicines allow people with HIV, the virus that causes AIDS, to live long, productive lives. But at the onset of the AIDS epidemic in the early 1980s, the disease was considered a death sentence. No one was sure \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMp038194\">what caused it\u003c/a> or how it was spread. Some doctors and nurses refused to treat patients with the disease; others protected themselves by wearing full body suits.\u003c/p>\n\u003cp>\u003ca href=\"https://hab.hrsa.gov/livinghistory/voices/morrison.htm\">Cliff Morrison\u003c/a>, a nurse at San Francisco General Hospital at the time, remembers being appalled by what he was seeing: \"I would go in patients' rooms and you could tell that they hadn't had a bath,\" he says. \"They weren't being taken care of.\"\u003c/p>\n\u003cp>In 1983, Morrison organized a team of healthcare providers to open Ward 5B, an in-patient AIDS special care unit at San Francisco General Hospital. The medical team on the unit encouraged patients to make their rooms like home, and allowed families and partners to visit whenever they could. They comforted patients by touching them, and would even sneak in pets.\u003c/p>\n\u003cp>5B was the first unit of its kind in the nation—and it became a model for AIDS treatment, both in the U. S. and overseas. Now, a new documentary, called \u003cem>5B,\u003c/em> tells the story of the doctors and nurses who cared for patients on the ward.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=d3D7IWTohps\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://cfar.ucsf.edu/people/paul-volberding\">Dr. Paul Volberding\u003c/a> was a doctor on Ward 5B and went on to co-create an AIDS clinic at the hospital, which was one of the first in the country. He emphasizes how critically ill the patients on the unit were.\u003c/p>\n\u003cp>\"These were people that were really, sometimes literally, dying when they came into the hospital, so whatever we could do to make them more comfortable was really important,\" he says.\u003c/p>\n\u003cp>The work on 5B was emotionally draining, and death was a constant reality. Still, Volberding describes his time there as a \"blessing.\"\u003c/p>\n\u003cp>\"The care that patients were getting was really special and very different than the rest of the hospital,\" he says. \"It was always a complete privilege to do this work.\"\u003c/p>\n\u003cp>Morrison adds, \"I had some really wonderful experiences with people in their passing, and they taught me a great deal. It really put in perspective the fact that life is on a continuum, and death is just part of that continuum. I saw people have beautiful deaths, and that was wonderful.\"\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how everyone who came into the hospital with the virus in the early 1980s died\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I don't think most people can understand today how devastating a disease AIDS was back in those days. ... It's just impossible to appreciate that HIV, if it's untreated, kills essentially 100 percent of the people. It's much worse than \u003ca href=\"https://www.npr.org/tags/147820238/ebola\">Ebola\u003c/a>, much worse than smallpox. So, everyone died. Every patient that was sick enough to come to us to look for medical care would die from this disease. And people knew that there was a lot of education to be done, but they knew that this was a really bad situation.\u003c/p>\n\u003cp>\u003cstrong>On how they didn't know if what they were seeing was infectious when the first patients came in with the rare cancer, Kaposi's sarcoma, which ended up being one of the symptoms of the as-yet-unknown AIDS virus\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_112568\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-112568\" src=\"https://ww2.kqed.org/pop/wp-content/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-800x892.jpg\" alt='\"It was always a complete privilege to do this work,\" Dr. Paul Volberding says of treating patients on 5B.' width=\"800\" height=\"892\" srcset=\"https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-800x892.jpg 800w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-160x178.jpg 160w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-768x857.jpg 768w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1020x1138.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1076x1200.jpg 1076w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1920x2141.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27.jpg 1836w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">\"It was always a complete privilege to do this work,\" Dr. Paul Volberding says of treating patients on 5B. \u003ccite>(Courtesy of Paul Volberding)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I wasn't worried about catching anything from the patients because that's not what I expected in taking care of cancer patients. I didn't expect to be worried about anything, and wasn't really. But the care that the patients were getting was pretty spotty in the hospital. I think that was one of the things that led Cliff and the others to really put together the nursing unit.\u003c/p>\n\u003cp>\u003cstrong>Morrison:\u003c/strong> In my experience, in already what had been seen and what I was hearing from the specialists around us with the information that was coming out, was that I wasn't at risk providing care to people by touching people. And everybody around us was saying, \"Oh you're just being cavalier. This is really not what you should be doing, and you're giving the wrong message.\" And our response always was, \"We're giving the right message.\" So we were dealing with a lot of hysteria and misinformation and just outright discrimination, I think, very early on.\u003c/p>\n\u003cp>\u003cstrong>On expanding the hospital's family and visitors' policy for Ward 5B\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Morrison:\u003c/strong> We also noticed right away ... that we needed to really look at issues around family and visitation, because healthcare was very rigid and was really stuck on this whole idea [regarding] visiting hours that it could only be immediate family. Most of our patients didn't have family around. ... We almost immediately began talking about, in all of these regular meetings and sessions that we had, that maybe we needed to start letting our patients tell us who their family was, and that we needed to kind of move away from this whole idea of traditional family and biological family.\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I think that the patients were so sick—and they were so in need of support — that the idea of visiting hours and keeping people away didn't make sense.\u003c/p>\n\u003cp>\u003cstrong>Morrison: \u003c/strong>There were times when they were alone in their rooms and they always needed something. They were very anxious. It not only made them more comfortable, it made our lives a lot easier having people that were there in the rooms most of the time.\u003c/p>\n\u003cp>\u003cstrong>On the bond that existed among 5B staff members\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding: \u003c/strong>It was a family. The physicians, the staff and the clinic and in the inpatient unit—we all worked so closely together because those were our patients. As physicians, those were our patients. And we were on the unit every day seeing our patients, and it was, again, a very special group of people.\u003c/p>\n\u003cp>\u003cstrong>On how the homophobia of the time influenced patient care\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_112569\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-112569\" src=\"https://ww2.kqed.org/pop/wp-content/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-800x600.jpe\" alt=\"Appalled by the way patients with AIDS were being treated by hospital personnel, nurse Cliff Morrison decided to create a dedicated unit within SF General that would emphasize compassionate care.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-800x600.jpe 800w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-160x120.jpe 160w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-768x576.jpe 768w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-1020x765.jpe 1020w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-1200x900.jpe 1200w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a.jpe 1511w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Appalled by the way patients with AIDS were being treated by hospital personnel, nurse Cliff Morrison decided to create a dedicated unit within SF General that would emphasize compassionate care. \u003ccite>(Verizon Media)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Morrison: \u003c/strong>That was, I think, probably the most glaring reality of the situation. Even in San Francisco—which, even at that time was considered the gay mecca—gay people had very established careers and homes and families, and yet all of that started coming apart. And it really was centered around homophobia. There were people in the hospital that should have known better. ... There was a group of nurses that basically said that what we were doing was crazy and that we were putting all of them at risk. It went before the labor board—but that was all homophobia.\u003c/p>\n\u003cp>\u003cstrong>On the evolution of AIDS treatment\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> In 1987 we began to have some drugs that were doing something. ... And then, by 1996, the so-called triple therapy was developed and that was really a turning point in the epidemic. We could suddenly start seeing some of our patients actually get better—not just die more slowly, but actually get better.\u003c/p>\n\u003cp>And some of those people are still alive today. The effort since '96 has been to take those potent drugs and make them less toxic and more convenient. Today, we treat this very typically with what we call \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296592/\">single tab regimens\u003c/a>—one pill taken once a day that contains two, three or even four drugs—all in the same pill. Many of my patients don't have any side effects at all from the medicines they're taking. The change from the early days, and seeing the drugs being developed, and now seeing that this is truly a chronic condition is, I think, one of the most amazing stories we'll ever hear from in medicine.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Amy Salit and Mooj Zadie produced and edited the audio of this interview. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=1st+AIDS+Ward+%275B%27+Fought+To+Give+Patients+Compassionate+Care%2C+Dignified+Deaths&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Today, antiretroviral medicines allow people with HIV, the virus that causes AIDS, to live long, productive lives. But at the onset of the AIDS epidemic in the early 1980s, the disease was considered a death sentence. No one was sure \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMp038194\">what caused it\u003c/a> or how it was spread. Some doctors and nurses refused to treat patients with the disease; others protected themselves by wearing full body suits.\u003c/p>\n\u003cp>\u003ca href=\"https://hab.hrsa.gov/livinghistory/voices/morrison.htm\">Cliff Morrison\u003c/a>, a nurse at San Francisco General Hospital at the time, remembers being appalled by what he was seeing: \"I would go in patients' rooms and you could tell that they hadn't had a bath,\" he says. \"They weren't being taken care of.\"\u003c/p>\n\u003cp>In 1983, Morrison organized a team of healthcare providers to open Ward 5B, an in-patient AIDS special care unit at San Francisco General Hospital. The medical team on the unit encouraged patients to make their rooms like home, and allowed families and partners to visit whenever they could. They comforted patients by touching them, and would even sneak in pets.\u003c/p>\n\u003cp>5B was the first unit of its kind in the nation—and it became a model for AIDS treatment, both in the U. S. and overseas. Now, a new documentary, called \u003cem>5B,\u003c/em> tells the story of the doctors and nurses who cared for patients on the ward.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/d3D7IWTohps'\n title='//www.youtube.com/embed/d3D7IWTohps'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://cfar.ucsf.edu/people/paul-volberding\">Dr. Paul Volberding\u003c/a> was a doctor on Ward 5B and went on to co-create an AIDS clinic at the hospital, which was one of the first in the country. He emphasizes how critically ill the patients on the unit were.\u003c/p>\n\u003cp>\"These were people that were really, sometimes literally, dying when they came into the hospital, so whatever we could do to make them more comfortable was really important,\" he says.\u003c/p>\n\u003cp>The work on 5B was emotionally draining, and death was a constant reality. Still, Volberding describes his time there as a \"blessing.\"\u003c/p>\n\u003cp>\"The care that patients were getting was really special and very different than the rest of the hospital,\" he says. \"It was always a complete privilege to do this work.\"\u003c/p>\n\u003cp>Morrison adds, \"I had some really wonderful experiences with people in their passing, and they taught me a great deal. It really put in perspective the fact that life is on a continuum, and death is just part of that continuum. I saw people have beautiful deaths, and that was wonderful.\"\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how everyone who came into the hospital with the virus in the early 1980s died\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I don't think most people can understand today how devastating a disease AIDS was back in those days. ... It's just impossible to appreciate that HIV, if it's untreated, kills essentially 100 percent of the people. It's much worse than \u003ca href=\"https://www.npr.org/tags/147820238/ebola\">Ebola\u003c/a>, much worse than smallpox. So, everyone died. Every patient that was sick enough to come to us to look for medical care would die from this disease. And people knew that there was a lot of education to be done, but they knew that this was a really bad situation.\u003c/p>\n\u003cp>\u003cstrong>On how they didn't know if what they were seeing was infectious when the first patients came in with the rare cancer, Kaposi's sarcoma, which ended up being one of the symptoms of the as-yet-unknown AIDS virus\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_112568\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-112568\" src=\"https://ww2.kqed.org/pop/wp-content/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-800x892.jpg\" alt='\"It was always a complete privilege to do this work,\" Dr. Paul Volberding says of treating patients on 5B.' width=\"800\" height=\"892\" srcset=\"https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-800x892.jpg 800w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-160x178.jpg 160w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-768x857.jpg 768w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1020x1138.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1076x1200.jpg 1076w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27-1920x2141.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/volberding_custom-f293e3227c8627ea60036b96d678fd3887a96f27.jpg 1836w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">\"It was always a complete privilege to do this work,\" Dr. Paul Volberding says of treating patients on 5B. \u003ccite>(Courtesy of Paul Volberding)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I wasn't worried about catching anything from the patients because that's not what I expected in taking care of cancer patients. I didn't expect to be worried about anything, and wasn't really. But the care that the patients were getting was pretty spotty in the hospital. I think that was one of the things that led Cliff and the others to really put together the nursing unit.\u003c/p>\n\u003cp>\u003cstrong>Morrison:\u003c/strong> In my experience, in already what had been seen and what I was hearing from the specialists around us with the information that was coming out, was that I wasn't at risk providing care to people by touching people. And everybody around us was saying, \"Oh you're just being cavalier. This is really not what you should be doing, and you're giving the wrong message.\" And our response always was, \"We're giving the right message.\" So we were dealing with a lot of hysteria and misinformation and just outright discrimination, I think, very early on.\u003c/p>\n\u003cp>\u003cstrong>On expanding the hospital's family and visitors' policy for Ward 5B\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Morrison:\u003c/strong> We also noticed right away ... that we needed to really look at issues around family and visitation, because healthcare was very rigid and was really stuck on this whole idea [regarding] visiting hours that it could only be immediate family. Most of our patients didn't have family around. ... We almost immediately began talking about, in all of these regular meetings and sessions that we had, that maybe we needed to start letting our patients tell us who their family was, and that we needed to kind of move away from this whole idea of traditional family and biological family.\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> I think that the patients were so sick—and they were so in need of support — that the idea of visiting hours and keeping people away didn't make sense.\u003c/p>\n\u003cp>\u003cstrong>Morrison: \u003c/strong>There were times when they were alone in their rooms and they always needed something. They were very anxious. It not only made them more comfortable, it made our lives a lot easier having people that were there in the rooms most of the time.\u003c/p>\n\u003cp>\u003cstrong>On the bond that existed among 5B staff members\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding: \u003c/strong>It was a family. The physicians, the staff and the clinic and in the inpatient unit—we all worked so closely together because those were our patients. As physicians, those were our patients. And we were on the unit every day seeing our patients, and it was, again, a very special group of people.\u003c/p>\n\u003cp>\u003cstrong>On how the homophobia of the time influenced patient care\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_112569\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-112569\" src=\"https://ww2.kqed.org/pop/wp-content/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-800x600.jpe\" alt=\"Appalled by the way patients with AIDS were being treated by hospital personnel, nurse Cliff Morrison decided to create a dedicated unit within SF General that would emphasize compassionate care.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-800x600.jpe 800w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-160x120.jpe 160w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-768x576.jpe 768w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-1020x765.jpe 1020w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a-1200x900.jpe 1200w, https://ww2.kqed.org/app/uploads/sites/12/2019/06/cliff_morrison-31d31b26f723b22c4c3edae6109665e9077ccb9a.jpe 1511w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Appalled by the way patients with AIDS were being treated by hospital personnel, nurse Cliff Morrison decided to create a dedicated unit within SF General that would emphasize compassionate care. \u003ccite>(Verizon Media)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Morrison: \u003c/strong>That was, I think, probably the most glaring reality of the situation. Even in San Francisco—which, even at that time was considered the gay mecca—gay people had very established careers and homes and families, and yet all of that started coming apart. And it really was centered around homophobia. There were people in the hospital that should have known better. ... There was a group of nurses that basically said that what we were doing was crazy and that we were putting all of them at risk. It went before the labor board—but that was all homophobia.\u003c/p>\n\u003cp>\u003cstrong>On the evolution of AIDS treatment\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Volberding:\u003c/strong> In 1987 we began to have some drugs that were doing something. ... And then, by 1996, the so-called triple therapy was developed and that was really a turning point in the epidemic. We could suddenly start seeing some of our patients actually get better—not just die more slowly, but actually get better.\u003c/p>\n\u003cp>And some of those people are still alive today. The effort since '96 has been to take those potent drugs and make them less toxic and more convenient. Today, we treat this very typically with what we call \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296592/\">single tab regimens\u003c/a>—one pill taken once a day that contains two, three or even four drugs—all in the same pill. Many of my patients don't have any side effects at all from the medicines they're taking. The change from the early days, and seeing the drugs being developed, and now seeing that this is truly a chronic condition is, I think, one of the most amazing stories we'll ever hear from in medicine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Assemblyman David Chiu and state Sen. Scott Wiener, both of San Francisco, announced a bill Monday that would prevent public hospitals from charging emergency room patients whose insurance won’t cover their medical bills. This practice is called “balance billing,” and according to Chiu, it’s costing Californians thousands of dollars.\u003c/p>\n\u003cp>Even if a patient has private insurance, an ambulance might transport them to an out-of-network hospital that doesn’t accept it — like Zuckerberg San Francisco General Hospital. Then, a month after getting treatment, they’re hit with a surprise from the hospital.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">Report: Zuckerberg San Francisco General Leaves Privately Insured Patients on the Hook for Thousands\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/wp-content/uploads/sites/43/2018/11/zuckberghospitalcropped-1180x664.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>“I got this atrocious bill for $13,000,” said Nicki Pogue, who was treated at SFGH after experiencing a severe reaction to bronchitis medication. To her shock, UnitedHealthcare would only cover $3,000 of the bill.\u003c/p>\n\u003cp>Pogue said she left the hospital within five hours, but spent the next five months trying to fight the charges.\u003c/p>\n\u003cp>“I went into the underworld of our health care system,” she said. Her weeknights and weekends were consumed by writing appeal letters, researching state legislation and talking to lawyers.\u003c/p>\n\u003cp>Ultimately, UnitedHealthcare covered her bill, but she’s not done campaigning yet. \u003c/p>\n\u003cp>“I will drive to Sacramento, I don’t care how many times, to make sure this bill gets passed,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Pogue has been working with Chiu, Wiener, San Francisco Supervisor Norman Yee and other patients to rally for the bill, Assembly Bill 1611. \u003c/p>\n\u003cp>She warns, “Until this bill passes, I don’t recommend anybody with insurance visit S.F. General.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to.’\u003ccite>Assemblyman David Chiu\u003c/cite>\u003c/aside>\n\u003cp>However, Chiu said choosing hospitals isn’t always easy. \u003c/p>\n\u003cp>“If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to,” Chiu said.\u003c/p>\n\u003cp>He said the problem of balance billing first came to his attention after \u003ca href=\"https://www.vox.com/policy-and-politics/2019/1/7/18137967/er-bills-zuckerberg-san-francisco-general-hospital\" rel=\"noopener\" target=\"_blank\">Vox\u003c/a> and the San Francisco Chronicle reported it last month.\u003c/p>\n\u003cp>“Until these stories surfaced, many of us had thought the practice of balance billing had been addressed by a decades old Supreme Court case and a 2016 California law,” Chiu said. In reaction to these news stories, ZSFGH said \u003ca href=\"https://www.vox.com/2019/2/1/18206893/zuckerberg-hospital-er-surprise-billing-suspension\" rel=\"noopener\" target=\"_blank\">they’ve halted balance billing\u003c/a> to review the policy.\u003c/p>\n\u003cp>Now, Chiu is searching for other public hospitals in California that might be balance billing. He expects it could be impacting millions of Californians. If it passes, AB 1611 will go into effect next year.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The bill would prevent public hospitals from \"balance billing,\" which is costing Californians thousands of dollars, state lawmakers say.",
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"title": "State Lawmakers Push to End Surprise Emergency Room Bills | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Assemblyman David Chiu and state Sen. Scott Wiener, both of San Francisco, announced a bill Monday that would prevent public hospitals from charging emergency room patients whose insurance won’t cover their medical bills. This practice is called “balance billing,” and according to Chiu, it’s costing Californians thousands of dollars.\u003c/p>\n\u003cp>Even if a patient has private insurance, an ambulance might transport them to an out-of-network hospital that doesn’t accept it — like Zuckerberg San Francisco General Hospital. Then, a month after getting treatment, they’re hit with a surprise from the hospital.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">Report: Zuckerberg San Francisco General Leaves Privately Insured Patients on the Hook for Thousands\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/forum/2010101869030/report-zuckerberg-sf-general-leaves-privately-insured-patients-on-the-hook-for-thousands\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/wp-content/uploads/sites/43/2018/11/zuckberghospitalcropped-1180x664.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>“I got this atrocious bill for $13,000,” said Nicki Pogue, who was treated at SFGH after experiencing a severe reaction to bronchitis medication. To her shock, UnitedHealthcare would only cover $3,000 of the bill.\u003c/p>\n\u003cp>Pogue said she left the hospital within five hours, but spent the next five months trying to fight the charges.\u003c/p>\n\u003cp>“I went into the underworld of our health care system,” she said. Her weeknights and weekends were consumed by writing appeal letters, researching state legislation and talking to lawyers.\u003c/p>\n\u003cp>Ultimately, UnitedHealthcare covered her bill, but she’s not done campaigning yet. \u003c/p>\n\u003cp>“I will drive to Sacramento, I don’t care how many times, to make sure this bill gets passed,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pogue has been working with Chiu, Wiener, San Francisco Supervisor Norman Yee and other patients to rally for the bill, Assembly Bill 1611. \u003c/p>\n\u003cp>She warns, “Until this bill passes, I don’t recommend anybody with insurance visit S.F. General.”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to.’\u003ccite>Assemblyman David Chiu\u003c/cite>\u003c/aside>\n\u003cp>However, Chiu said choosing hospitals isn’t always easy. \u003c/p>\n\u003cp>“If you’re incapacitated or undergoing a life-threatening condition, you don’t have the ability or time to decide what hospital to go to,” Chiu said.\u003c/p>\n\u003cp>He said the problem of balance billing first came to his attention after \u003ca href=\"https://www.vox.com/policy-and-politics/2019/1/7/18137967/er-bills-zuckerberg-san-francisco-general-hospital\" rel=\"noopener\" target=\"_blank\">Vox\u003c/a> and the San Francisco Chronicle reported it last month.\u003c/p>\n\u003cp>“Until these stories surfaced, many of us had thought the practice of balance billing had been addressed by a decades old Supreme Court case and a 2016 California law,” Chiu said. In reaction to these news stories, ZSFGH said \u003ca href=\"https://www.vox.com/2019/2/1/18206893/zuckerberg-hospital-er-surprise-billing-suspension\" rel=\"noopener\" target=\"_blank\">they’ve halted balance billing\u003c/a> to review the policy.\u003c/p>\n\u003cp>Now, Chiu is searching for other public hospitals in California that might be balance billing. He expects it could be impacting millions of Californians. If it passes, AB 1611 will go into effect next year.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"disqusTitle": "How an Intervention Program Stops the Revolving Door of Violent Injuries",
"title": "How an Intervention Program Stops the Revolving Door of Violent Injuries",
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"content": "\u003cp>Darius Irvin grew up in violent neighborhoods in Oakland and San Francisco. While Irvin was never in a gang, he was around them a lot. One winter when he was back home in Oakland from his freshman year of college up in Chico, he knocked on the door of his barbershop. He wanted a local haircut to show off when he returned to school. Before he could get inside, though, he heard gunshots and felt a piercing pain in his buttock. He'd been shot.\u003c/p>\n\u003cp>He survived, but the recovery took almost two years. Then he was shot again, this time at a party in Oakland. A stray bullet hit him in the back right shoulder, where it remains today. After more recovery, he planned to move to San Francisco for a fresh start.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/293730059\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>While job searching, he stopped at a convenience store in the city. There again, the gunshots found him. \"I pretty much remember the freezer glasses busting, chip bags popping over the shots ringing out,\" Irvin says. He fell to the ground, sitting in his own blood, thinking \"Is this true? This can’t be happening right now.\"\u003c/p>\n\u003cp>This time he was shot with nine bullets, again by someone he did not know. He was rushed to \u003ca href=\"http://zuckerbergsanfranciscogeneral.org/\" target=\"_blank\">San Francisco General Hospital\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It was there something unexpected happened. \"All I know is I woke up and there was Popeyes,\" Irvin recalls, referring to one of his favorite fast food restaurants. \"I had some Popeyes chicken on my bed, and I love Popeyes.\"\u003c/p>\n\u003cp>That’s because \u003ca href=\"http://violenceprevention.surgery.ucsf.edu/\" target=\"_blank\">the Wraparound Project\u003c/a> had stepped in to help. It's a program based at San Francisco General Hospital. Wraparound's goal is to reduce re-injury for young people who have been violently hurt, through either a shooting or stabbing.\u003c/p>\n\u003cfigure id=\"attachment_11178940\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11178940\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-800x600.jpg\" alt=\"Mike Texada (left) of The Wraparound Project stands with James Caldwell (center) and Joseph Kaulave (right) from the Street Violence Intervention Program. After a violent crime, their teams work together to prevent future injury for individuals and communities.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Mike Texada (left) of The Wraparound Project stands with James Caldwell (center) and Joseph Kaulave (right) from the Street Violence Intervention Program. After a violent crime, their teams work together to prevent future injury for individuals and communities. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Repeat injury for survivors of violent crime is remarkably high. \u003ca href=\"https://books.google.com/books?hl=en&lr=&id=0y4DBQAAQBAJ&oi=fnd&pg=PA231#v=onepage&q&f=false\" target=\"_blank\">Studies\u003c/a> show 44 percent of people who have been shot or stabbed get violently injured again within five years, and that one out of five of those people die.\u003c/p>\n\u003cp>UC San Francisco professor and doctor Rochelle Dicker saw this in her own practice. During her internship years ago at the SFGH Trauma Center, she stitched up a 16-year-old who'd been violently injured, only to see him return some weeks later with even worse injuries.\u003c/p>\n\u003cp>Dr. Dicker started to look at violent injuries as a public health issue. \"Unless you go upstream a little bit to figure out ways to prevent future injury,\" she says, \"you’re really not putting a lasting effect on the idea of improving population health and improving individuals.\"\u003c/p>\n\u003cp>With that, Dicker created the Wrapround Project in 2006. The program literally provides \"wraparound\" services like mentorship, job training and even getting clients their favorite foods. The program serves 10- to 30-year olds who end up at SFGH. And there's no cutoff date for support.\u003c/p>\n\u003cp>Since the program's founding 10 years ago, the return visit rate for violent injuries at the hospital has fallen from 16 to 4.5 percent. Programs based on Dicker's work have started in Indianapolis and Davis.\u003c/p>\n\u003cp>This type of intervention work is expanding nationwide. Wraparound is part of the \u003ca href=\"http://nnhvip.org/\" target=\"_blank\">National Network of Hospital-based Violence Intervention Programs (NNHVIP)\u003c/a>, a growing group of programs across the United States that not only focus on re-injury prevention, but also on reducing retaliation for crimes.\u003c/p>\n\u003cfigure id=\"attachment_11178943\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11178943 size-medium\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/11/21912_transform-2-800x561.jpg\" alt=\"A mural, painted by the father of a former client, marks the entrance to The Wraparound Project at Zuckerberg San Francisco General Hospital and Trauma Center.\" width=\"800\" height=\"561\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-800x561.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-160x112.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1020x715.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1920x1346.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1180x827.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-960x673.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-240x168.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-375x263.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-520x365.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A mural, painted by the father of a former client, marks the entrance to the Wraparound Project at San Francisco General Hospital and Trauma Center. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Wraparound's case managers come from the same communities as the clients, which gets at the program's goal of providing culturally competent services, and staff like case manager Mike Texada intervene right as patients wake up and realize they’re alive.\u003c/p>\n\u003cp>\"We call it the teachable moment,\" he says. \"That’s when you have time to offer services, you got time to have a conversation, you got time to have dialogue with that individual who’s injured.\"\u003c/p>\n\u003cp>When Texada met Darius Irvin, the case manager immediately saw Irvin light up when they talked about college. Irvin had lost hope about ever attending a four-year university after all his health setbacks.\u003c/p>\n\u003cp>\"When I visited Darius at bedside and I told him about college he was like, 'Man, quit trying to gas me up,' \" Texada says about Irvin's incredulity. \"And I was like, 'Dude, I’m serious.' \"\u003c/p>\n\u003cp>He was. Texada connected Irvin to a program that helped him get into \u003ca href=\"http://www.sfsu.edu/\" target=\"_blank\">San Francisco State University\u003c/a>, a college Irvin had dreamed of attending since high school.\u003c/p>\n\u003cp>Now at 26, Irvin's a sophomore at SFSU. He studies juvenile justice and sociology, and he’s on the honor roll.\u003c/p>\n\u003cp>\"It’s crazy,\" he says walking through the green, bustling campus. \"It’s kind of too good to be true.\" He points out his favorite spots on campus. \"Everything I’ve been wanting and looking for is coming to me on behalf of the university.\"\u003c/p>\n\u003cp>Looking at Irvin, you’d never know what he’s been through, or that he questioned if he'd ever be able to walk regularly again. But now he walks seamlessly, smoothly. When asked about it, he laughs and says, \"Chin up with a positive stride. It's called a 'thankful walk.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Music in the audio version of this story is \u003ca href=\"http://freemusicarchive.org/music/Black_Ant/Free_Beats_Sel_3\" target=\"_blank\">\"Father Lee\" by Black Ant from \"Free Beats Sel. 3,\"\u003c/a> and \u003ca href=\"http://freemusicarchive.org/music/Broke_For_Free/Layers/\" target=\"_blank\">\"Only Knows,\" \"The Collector,\" and \"Note Drop\" by Broke For Free from \"Layers.\"\u003c/a>\u003c/em>\u003c/p>\n\n",
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"excerpt": "Darius Irvin was shot on three separate occasions as an innocent bystander. The Wraparound Project helped break that cycle, and now he’s in college.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Darius Irvin grew up in violent neighborhoods in Oakland and San Francisco. While Irvin was never in a gang, he was around them a lot. One winter when he was back home in Oakland from his freshman year of college up in Chico, he knocked on the door of his barbershop. He wanted a local haircut to show off when he returned to school. Before he could get inside, though, he heard gunshots and felt a piercing pain in his buttock. He'd been shot.\u003c/p>\n\u003cp>He survived, but the recovery took almost two years. Then he was shot again, this time at a party in Oakland. A stray bullet hit him in the back right shoulder, where it remains today. After more recovery, he planned to move to San Francisco for a fresh start.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/293730059&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/293730059'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>While job searching, he stopped at a convenience store in the city. There again, the gunshots found him. \"I pretty much remember the freezer glasses busting, chip bags popping over the shots ringing out,\" Irvin says. He fell to the ground, sitting in his own blood, thinking \"Is this true? This can’t be happening right now.\"\u003c/p>\n\u003cp>This time he was shot with nine bullets, again by someone he did not know. He was rushed to \u003ca href=\"http://zuckerbergsanfranciscogeneral.org/\" target=\"_blank\">San Francisco General Hospital\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It was there something unexpected happened. \"All I know is I woke up and there was Popeyes,\" Irvin recalls, referring to one of his favorite fast food restaurants. \"I had some Popeyes chicken on my bed, and I love Popeyes.\"\u003c/p>\n\u003cp>That’s because \u003ca href=\"http://violenceprevention.surgery.ucsf.edu/\" target=\"_blank\">the Wraparound Project\u003c/a> had stepped in to help. It's a program based at San Francisco General Hospital. Wraparound's goal is to reduce re-injury for young people who have been violently hurt, through either a shooting or stabbing.\u003c/p>\n\u003cfigure id=\"attachment_11178940\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11178940\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-800x600.jpg\" alt=\"Mike Texada (left) of The Wraparound Project stands with James Caldwell (center) and Joseph Kaulave (right) from the Street Violence Intervention Program. After a violent crime, their teams work together to prevent future injury for individuals and communities.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/RS21904_IMG_6081-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Mike Texada (left) of The Wraparound Project stands with James Caldwell (center) and Joseph Kaulave (right) from the Street Violence Intervention Program. After a violent crime, their teams work together to prevent future injury for individuals and communities. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Repeat injury for survivors of violent crime is remarkably high. \u003ca href=\"https://books.google.com/books?hl=en&lr=&id=0y4DBQAAQBAJ&oi=fnd&pg=PA231#v=onepage&q&f=false\" target=\"_blank\">Studies\u003c/a> show 44 percent of people who have been shot or stabbed get violently injured again within five years, and that one out of five of those people die.\u003c/p>\n\u003cp>UC San Francisco professor and doctor Rochelle Dicker saw this in her own practice. During her internship years ago at the SFGH Trauma Center, she stitched up a 16-year-old who'd been violently injured, only to see him return some weeks later with even worse injuries.\u003c/p>\n\u003cp>Dr. Dicker started to look at violent injuries as a public health issue. \"Unless you go upstream a little bit to figure out ways to prevent future injury,\" she says, \"you’re really not putting a lasting effect on the idea of improving population health and improving individuals.\"\u003c/p>\n\u003cp>With that, Dicker created the Wrapround Project in 2006. The program literally provides \"wraparound\" services like mentorship, job training and even getting clients their favorite foods. The program serves 10- to 30-year olds who end up at SFGH. And there's no cutoff date for support.\u003c/p>\n\u003cp>Since the program's founding 10 years ago, the return visit rate for violent injuries at the hospital has fallen from 16 to 4.5 percent. Programs based on Dicker's work have started in Indianapolis and Davis.\u003c/p>\n\u003cp>This type of intervention work is expanding nationwide. Wraparound is part of the \u003ca href=\"http://nnhvip.org/\" target=\"_blank\">National Network of Hospital-based Violence Intervention Programs (NNHVIP)\u003c/a>, a growing group of programs across the United States that not only focus on re-injury prevention, but also on reducing retaliation for crimes.\u003c/p>\n\u003cfigure id=\"attachment_11178943\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-11178943 size-medium\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/11/21912_transform-2-800x561.jpg\" alt=\"A mural, painted by the father of a former client, marks the entrance to The Wraparound Project at Zuckerberg San Francisco General Hospital and Trauma Center.\" width=\"800\" height=\"561\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-800x561.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-160x112.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1020x715.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1920x1346.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-1180x827.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-960x673.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-240x168.jpg 240w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-375x263.jpg 375w, https://ww2.kqed.org/app/uploads/sites/10/2016/11/21912_transform-2-520x365.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A mural, painted by the father of a former client, marks the entrance to the Wraparound Project at San Francisco General Hospital and Trauma Center. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Wraparound's case managers come from the same communities as the clients, which gets at the program's goal of providing culturally competent services, and staff like case manager Mike Texada intervene right as patients wake up and realize they’re alive.\u003c/p>\n\u003cp>\"We call it the teachable moment,\" he says. \"That’s when you have time to offer services, you got time to have a conversation, you got time to have dialogue with that individual who’s injured.\"\u003c/p>\n\u003cp>When Texada met Darius Irvin, the case manager immediately saw Irvin light up when they talked about college. Irvin had lost hope about ever attending a four-year university after all his health setbacks.\u003c/p>\n\u003cp>\"When I visited Darius at bedside and I told him about college he was like, 'Man, quit trying to gas me up,' \" Texada says about Irvin's incredulity. \"And I was like, 'Dude, I’m serious.' \"\u003c/p>\n\u003cp>He was. Texada connected Irvin to a program that helped him get into \u003ca href=\"http://www.sfsu.edu/\" target=\"_blank\">San Francisco State University\u003c/a>, a college Irvin had dreamed of attending since high school.\u003c/p>\n\u003cp>Now at 26, Irvin's a sophomore at SFSU. He studies juvenile justice and sociology, and he’s on the honor roll.\u003c/p>\n\u003cp>\"It’s crazy,\" he says walking through the green, bustling campus. \"It’s kind of too good to be true.\" He points out his favorite spots on campus. \"Everything I’ve been wanting and looking for is coming to me on behalf of the university.\"\u003c/p>\n\u003cp>Looking at Irvin, you’d never know what he’s been through, or that he questioned if he'd ever be able to walk regularly again. But now he walks seamlessly, smoothly. When asked about it, he laughs and says, \"Chin up with a positive stride. It's called a 'thankful walk.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Music in the audio version of this story is \u003ca href=\"http://freemusicarchive.org/music/Black_Ant/Free_Beats_Sel_3\" target=\"_blank\">\"Father Lee\" by Black Ant from \"Free Beats Sel. 3,\"\u003c/a> and \u003ca href=\"http://freemusicarchive.org/music/Broke_For_Free/Layers/\" target=\"_blank\">\"Only Knows,\" \"The Collector,\" and \"Note Drop\" by Broke For Free from \"Layers.\"\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"title": "Selected Shorts",
"info": "Spellbinding short stories by established and emerging writers take on a new life when they are performed by stars of the stage and screen.",
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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