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"content": "\u003cp>When it comes to school breakfasts, two is better than none, says a new report released Thursday in the journal \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/ijpo.v11.2/issuetoc\" target=\"_blank\">Pediatric Obesity\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Researchers tracked nearly 600 middle-school students from fifth to seventh grade, looking to see if students ate no breakfast; ate breakfast at home or school; or ate both — and whether that affected obesity rates. The result: Weight gain among students who ate \"double-breakfast\" was no different than that seen among all other students. Meanwhile, the risk of obesity doubled among students who skipped breakfast or ate it inconsistently.\u003c/p>\n\u003cp>\"It seems it's a bigger problem to have kids skipping breakfast than to have these kids eating two breakfasts,\" says Marlene Schwartz of the \u003ca href=\"http://chip.uconn.edu/person/marlene-schwartz/\" target=\"_blank\">Rudd Center for Food Policy and Obesity\u003c/a> and one of the study's authors.\u003c/p>\n\u003cp>\"This study ... debunks an important misconception that school breakfast contributes to childhood obesity,\" says Duke Storen from \u003ca href=\"http://https/www.nokidhungry.org/about-us\" target=\"_blank\">Share Our Strength\u003c/a>, a national group that runs anti-hunger and nutrition programs for children.\u003c/p>\n\u003cp>While direct opposition to free school breakfast is unusual, says Storen, officials sometimes balk at implementing \"alternative breakfast models\" designed to encourage use of the program — such as offering breakfast in grab-and-go bags or in classrooms, rather than traditional sit-down meals in a cafeteria. That's a concern, say hunger advocates, because while eligibility rules for free and reduced-price breakfast are the same as for lunch, only about \u003ca href=\"http://frac.org/pdf/School_Breakfast_Scorecard_SY_2014_2015.pdf\" target=\"_blank\">half as many children get subsidized breakfast as receive lunch\u003c/a>, according to the Food Research and Action Center, an advocacy group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Indeed, the study was inspired in part by real-world concerns that school breakfast programs might promote obesity, says Schwartz.\u003c/p>\n\u003cp>In 2012, the administration of New York City's then-Mayor Michael Bloomberg \u003ca href=\"http://www.nytimes.com/2012/04/20/nyregion/with-classroom-breakfasts-some-children-may-eat-twice.html\" target=\"_blank\">opposed\u003c/a> offering breakfast in classrooms instead of school cafeterias, arguing that the change would exacerbate childhood obesity. A year later, an \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23947326\" target=\"_blank\">American Journal of Public Health study\u003c/a> showed that, on average, kids eating two breakfasts in New York City schools consumed 95 more calories daily than did those eating one breakfast.\u003c/p>\n\u003cp>Researchers of the new study didn't examine why eating double breakfasts did not affect obesity, but skipping the meal did. But Schwartz has a few hypotheses. First, school breakfast is fairly healthful; \"they weren't eating doughnuts or Denny's Grand Slam,\" she says.\u003c/p>\n\u003cp>Second, kids who skip breakfast — a habit that doubled in frequency between grades 5 and 7, according to the study — are likely to overeat later in the day. And, of course, just the fact that growing adolescents often need a lot of food to grow means that they can eat more without necessarily gaining weight.\u003c/p>\n\u003cp>The study also draws a direct line between school breakfast and fighting childhood hunger, underscoring the idea that malnourishment and obesity in the U.S. are not so much opposites as two sides of the same coin.\u003c/p>\n\u003cp>\"The latest figures show that 15 million children live in food insecure households,\" says Heather Hardline-Grafton, a senior researcher at FRAC. \"While obesity is a serious problem for many children in the United States, so, too, is food insecurity.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tracie McMillan is the author of \u003c/em>\u003ca href=\"http://www.americanwayofeating.com/\">The American Way of Eating\u003c/a>,\u003cem> a \u003c/em>New York Times \u003cem>best-seller, and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. You can follow her on Twitter @tmmcmillan.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=2+Breakfasts+May+Be+Better+Than+None+For+School+Kids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When it comes to school breakfasts, two is better than none, says a new report released Thursday in the journal \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/ijpo.v11.2/issuetoc\" target=\"_blank\">Pediatric Obesity\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Researchers tracked nearly 600 middle-school students from fifth to seventh grade, looking to see if students ate no breakfast; ate breakfast at home or school; or ate both — and whether that affected obesity rates. The result: Weight gain among students who ate \"double-breakfast\" was no different than that seen among all other students. Meanwhile, the risk of obesity doubled among students who skipped breakfast or ate it inconsistently.\u003c/p>\n\u003cp>\"It seems it's a bigger problem to have kids skipping breakfast than to have these kids eating two breakfasts,\" says Marlene Schwartz of the \u003ca href=\"http://chip.uconn.edu/person/marlene-schwartz/\" target=\"_blank\">Rudd Center for Food Policy and Obesity\u003c/a> and one of the study's authors.\u003c/p>\n\u003cp>\"This study ... debunks an important misconception that school breakfast contributes to childhood obesity,\" says Duke Storen from \u003ca href=\"http://https/www.nokidhungry.org/about-us\" target=\"_blank\">Share Our Strength\u003c/a>, a national group that runs anti-hunger and nutrition programs for children.\u003c/p>\n\u003cp>While direct opposition to free school breakfast is unusual, says Storen, officials sometimes balk at implementing \"alternative breakfast models\" designed to encourage use of the program — such as offering breakfast in grab-and-go bags or in classrooms, rather than traditional sit-down meals in a cafeteria. That's a concern, say hunger advocates, because while eligibility rules for free and reduced-price breakfast are the same as for lunch, only about \u003ca href=\"http://frac.org/pdf/School_Breakfast_Scorecard_SY_2014_2015.pdf\" target=\"_blank\">half as many children get subsidized breakfast as receive lunch\u003c/a>, according to the Food Research and Action Center, an advocacy group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Indeed, the study was inspired in part by real-world concerns that school breakfast programs might promote obesity, says Schwartz.\u003c/p>\n\u003cp>In 2012, the administration of New York City's then-Mayor Michael Bloomberg \u003ca href=\"http://www.nytimes.com/2012/04/20/nyregion/with-classroom-breakfasts-some-children-may-eat-twice.html\" target=\"_blank\">opposed\u003c/a> offering breakfast in classrooms instead of school cafeterias, arguing that the change would exacerbate childhood obesity. A year later, an \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23947326\" target=\"_blank\">American Journal of Public Health study\u003c/a> showed that, on average, kids eating two breakfasts in New York City schools consumed 95 more calories daily than did those eating one breakfast.\u003c/p>\n\u003cp>Researchers of the new study didn't examine why eating double breakfasts did not affect obesity, but skipping the meal did. But Schwartz has a few hypotheses. First, school breakfast is fairly healthful; \"they weren't eating doughnuts or Denny's Grand Slam,\" she says.\u003c/p>\n\u003cp>Second, kids who skip breakfast — a habit that doubled in frequency between grades 5 and 7, according to the study — are likely to overeat later in the day. And, of course, just the fact that growing adolescents often need a lot of food to grow means that they can eat more without necessarily gaining weight.\u003c/p>\n\u003cp>The study also draws a direct line between school breakfast and fighting childhood hunger, underscoring the idea that malnourishment and obesity in the U.S. are not so much opposites as two sides of the same coin.\u003c/p>\n\u003cp>\"The latest figures show that 15 million children live in food insecure households,\" says Heather Hardline-Grafton, a senior researcher at FRAC. \"While obesity is a serious problem for many children in the United States, so, too, is food insecurity.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tracie McMillan is the author of \u003c/em>\u003ca href=\"http://www.americanwayofeating.com/\">The American Way of Eating\u003c/a>,\u003cem> a \u003c/em>New York Times \u003cem>best-seller, and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. You can follow her on Twitter @tmmcmillan.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=2+Breakfasts+May+Be+Better+Than+None+For+School+Kids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>SACRAMENTO, Calif. (AP) — A leader of the movement to exempt tampons from California's sales tax is now proposing to reinstate the tax on candy and snack foods.\u003c/p>\n\u003cp>Assemblywoman Cristina Garcia said Friday she will seek a constitutional amendment to undo \u003ca href=\"https://ballotpedia.org/California_Proposition_163,_No_Sales_Tax_on_Food_Products_Sold_for_Home_Use_(1992)\" target=\"_blank\">California voters' 1992 decision \u003c/a>to classify candy and snacks as tax-exempt essential food items.\u003c/p>\n\u003cp>The Bell Gardens Democrat says consumption of fatty, ultra-processed foods has exploded since the sales taxes were repealed.\u003c/p>\n\u003cp>Grocers and bottled water producers supported the tax repeal 24 years ago. It faced no organized opposition.\u003c/p>\n\u003cp>The California Grocers Association says it's reviewing Garcia's proposal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The announcement comes one day after the release of a UCLA study that estimated 46 percent of Californians are prediabetic. On Wednesday, Democratic Assemblyman Richard Bloom of Santa Monica \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">proposed a fee on sugary beverages\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SACRAMENTO, Calif. (AP) — A leader of the movement to exempt tampons from California's sales tax is now proposing to reinstate the tax on candy and snack foods.\u003c/p>\n\u003cp>Assemblywoman Cristina Garcia said Friday she will seek a constitutional amendment to undo \u003ca href=\"https://ballotpedia.org/California_Proposition_163,_No_Sales_Tax_on_Food_Products_Sold_for_Home_Use_(1992)\" target=\"_blank\">California voters' 1992 decision \u003c/a>to classify candy and snacks as tax-exempt essential food items.\u003c/p>\n\u003cp>The Bell Gardens Democrat says consumption of fatty, ultra-processed foods has exploded since the sales taxes were repealed.\u003c/p>\n\u003cp>Grocers and bottled water producers supported the tax repeal 24 years ago. It faced no organized opposition.\u003c/p>\n\u003cp>The California Grocers Association says it's reviewing Garcia's proposal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The announcement comes one day after the release of a UCLA study that estimated 46 percent of Californians are prediabetic. On Wednesday, Democratic Assemblyman Richard Bloom of Santa Monica \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">proposed a fee on sugary beverages\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Will California End Daylight Saving Time?",
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"content": "\u003cp>Get ready to set your clock forward this Sunday for the start of daylight saving time. If the thought of losing an hour of sleep makes you roll your eyes and grumble, you are not alone. Recent \u003ca href=\"http://www.rasmussenreports.com/public_content/lifestyle/general_lifestyle/march_2014/just_33_see_the_purpose_of_daylight_saving_time\" target=\"_blank\">national polls\u003c/a> show that nearly half of adults think daylight saving time is not worth the hassle.\u003c/p>\n\u003cp>One local critic of turning his clock forward in the spring and back in the fall is Richard Chavez. He frequents the daily lunch for seniors at the Berryessa Community Center in San Jose.\u003c/p>\n\u003cp>\"A lot of us seniors, we forget. It's confusing,\" says Chavez, after finishing the last of a fish sandwich. \"You get used to the time, and then they are changing it again. Just leave it alone one way or the other!\"\u003c/p>\n\u003cp>Chavez remembers when California voters first approved the statewide observance of daylight saving time in 1949 through a ballot proposition.\u003c/p>\n\u003cfigure id=\"attachment_158456\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-158456 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-400x267.jpg\" alt=\"Richard Chavez, at the Berryesa Community Center in San Jose, supports Assemblymember Chu's proposal to let California voters decide whether the state should keep one standard time year round.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Richard Chavez, at Berryessa Community Center's dining room in San Jose. He supports Assemblymember Chu's proposal to let California voters weigh on whether the state should keep moving clocks one hour forward in the spring and one hour back in the fall. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Those\u003ca href=\"http://repository.uchastings.edu/cgi/viewcontent.cgi?article=1501&context=ca_ballot_props\" target=\"_blank\"> 1949 supporters said the practice\u003c/a> \"gives people an extra hour of daylight after they get home, and thus increases public health and industrial efficiency,\" among other advantages. But Chavez contends he has never personally felt much benefit from it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After feedback from constituents like Chavez, Assemblymember Kansen Chu, D-San Jose, introduced a bill that would allow voters to weigh in on whether the state should keep the practice of switching to daylight saving time. Potential alternatives, according to Chu, would be for the state to observe either standard time or daylight saving time permanently.\u003c/p>\n\u003cp>\"A lot of my constituents would love to stay on daylight saving time year round,\" said Chu. \"The older you get, giving up an hour of sleep has more impact on your physical condition.\"\u003c/p>\n\u003cp>Chu cites recent studies linking the jetlag effect some people feel right after changing to daylight saving time with an uptick of \u003ca href=\"https://www.sciencedaily.com/releases/2014/03/140329175108.htm\" target=\"_blank\">heart attacks\u003c/a>, and traffic and workplace\u003ca href=\"http://www.sleep-journal.com/article/S1389-9457%2800%2900032-0/abstract?nl=nytnow&em_pos=large&emc=edit_nn_20150309\" target=\"_blank\"> injuries\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_158687\" class=\"wp-caption aligncenter\" style=\"max-width: 943px\">\u003ca href=\"http://repository.uchastings.edu/cgi/viewcontent.cgi?article=1501&context=ca_ballot_props\" rel=\"attachment wp-att-158687\">\u003cimg class=\"size-full wp-image-158687\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM.png\" alt=\"Proposition 12, passed by California voters in 1949, established daylight saving time in California. \" width=\"943\" height=\"606\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM.png 943w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-400x257.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-800x514.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-768x494.png 768w\" sizes=\"(max-width: 943px) 100vw, 943px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposition 12, passed by California voters in 1949, established daylight saving time in California. \u003ccite>(UC Hastings Scholarship Repository)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Why Do We Have Daylight Saving Time Anyway?\u003c/strong>\u003c/p>\n\u003cp>Benjamin Franklin proposed making more efficient use of daylight to save candles in a 1784 \u003ca href=\"http://www.webexhibits.org/daylightsaving/franklin3.html\" target=\"_blank\">letter\u003c/a>. But British businessman William Willett is credited with spreading the idea of tinkering with clocks to make better use of daylight in Britain and other parts of Europe.\u003c/p>\n\u003cp>Willett persistently lobbied the British parliament to adopt this change in the early 1900s. However, he died before Britons began observing it in 1916, a few months after Germany became the first country to implement the practice.\u003c/p>\n\u003cp>The U.S. as a whole first tried daylight saving time during World War I to save energy, and then again during World War II. But afterward, the decision to adopt daylight saving was up to cities and towns. Chaos ensued.\u003c/p>\n\u003cp>\"You could have one town that doesn't have daylight saving time, the neighboring town does, and then the third neighboring town has daylight saving time but starts and ends in different dates. So it got to be very confusing,\" says David Prerau, author of \u003ca href=\"http://www.amazon.com/Seize-Daylight-Curious-Contentious-Saving/dp/1560257962\" target=\"_blank\">\u003cem>Seize the Daylight: The Curious and Contentious Story of Daylight Saving Time\u003c/em>.\u003c/a>\u003c/p>\n\u003cp>Iowa alone had 23 different sets of starting and ending dates for daylight saving time, says Prerau, causing a major headache for businessmen and others traveling from one town to another.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/251396920\" 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>Congress intervened in 1966 with the \u003ca href=\"https://www.transportation.gov/regulations/time-act\" target=\"_blank\">Uniform Time Act \u003c/a>that gave states two options: keep daylight saving time during federally mandated dates or stay on standard time year round. Most states opted for a coordinated daylight saving time. (Hawaii never observed it; Arizona opted out in 1968.) Initially, daylight saving time lasted only six months.\u003c/p>\n\u003cp>The U.S. Department of Transportation, which oversees the uniform \u003ca href=\"https://www.transportation.gov/regulations/daylight-saving-time\" target=\"_blank\">observance\u003c/a> of daylight saving time, says having most people go about their business while the sun is shining saves electricity, prevents traffic deaths and injuries, and even reduces crime.\u003c/p>\n\u003cp>Prerau researched for years the benefits of daylight saving time for the federal government, when the country was looking for ways to reduce energy consumption during the 1970s oil crisis. After the results were out, Congress issued months-long extensions of the practice in 1974 and 1975.\u003c/p>\n\u003cp>Today, daylight saving time \u003ca href=\"http://www.webexhibits.org/daylightsaving/b.html\" target=\"_blank\">begins\u003c/a> at 2 a.m. on the second Sunday in March, and ends at 2 a.m. the first Sunday of November.\u003c/p>\n\u003cp>Still, not everyone agrees with those energy saving claims, including one\u003ca href=\"http://www.nber.org/papers/w14429\" target=\"_blank\"> widely cited study\u003c/a> conducted after Indiana adopted daylight saving time in 2006 questions its effects.\u003c/p>\n\u003cp>\"Energy consumption is much more complex than back in the 40s,\" says Assemblymember Chu, an electrical engineer who used to work for IBM.\u003cb> \"\u003c/b>It's about time for us to revisit this practice that we have been doing for the last 70 years.\"\u003c/p>\n\u003cp>Prerau counters that adjusting our clocks to maximize activity during daylight continues to be worth it.\u003c/p>\n\u003cp>\"\u003cspan style=\"font-weight: 400\">The negatives of switching the clock a\u003c/span>ffect some people the first few days of a daylight saving time period, at most\u003cb>,\u003c/b>\" says Prerau. \"But the benefits go on for eight months.\"\u003c/p>\n\u003cfigure id=\"attachment_158455\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-158455 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut.jpg\" alt=\"Betty Smith, 81, and Bill Painter, 75, at the Berryesa Community Center in San Jose. Unlike other seniors who frequent the center's lunch program, they agree Daylight Saving Time is a "good thing."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Betty Smith, 81, and Bill Painter, 75, frequent the Berryessa Community Center in San Jose. Unlike other seniors there, Smith says switching to daylight saving time is a \"good thing,\" and Painter agrees. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For California or other states to opt daylight saving time year round (instead of standard time), Congress would have to amend federal law. Chu is working on a resolution that -- if approved by the Legislature -- would make that request to Congress.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Quitting the current switch to daylight saving time would leave California out of sync with most of the country. Prerau says that could hurt businesses and cause headaches in airline and other transportation schedules.\u003c/p>\n\n",
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"excerpt": "A California legislator wants to let voters decide whether the state should have one standard time year round.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Get ready to set your clock forward this Sunday for the start of daylight saving time. If the thought of losing an hour of sleep makes you roll your eyes and grumble, you are not alone. Recent \u003ca href=\"http://www.rasmussenreports.com/public_content/lifestyle/general_lifestyle/march_2014/just_33_see_the_purpose_of_daylight_saving_time\" target=\"_blank\">national polls\u003c/a> show that nearly half of adults think daylight saving time is not worth the hassle.\u003c/p>\n\u003cp>One local critic of turning his clock forward in the spring and back in the fall is Richard Chavez. He frequents the daily lunch for seniors at the Berryessa Community Center in San Jose.\u003c/p>\n\u003cp>\"A lot of us seniors, we forget. It's confusing,\" says Chavez, after finishing the last of a fish sandwich. \"You get used to the time, and then they are changing it again. Just leave it alone one way or the other!\"\u003c/p>\n\u003cp>Chavez remembers when California voters first approved the statewide observance of daylight saving time in 1949 through a ballot proposition.\u003c/p>\n\u003cfigure id=\"attachment_158456\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-158456 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-400x267.jpg\" alt=\"Richard Chavez, at the Berryesa Community Center in San Jose, supports Assemblymember Chu's proposal to let California voters decide whether the state should keep one standard time year round.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18783_IMG_9612.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Richard Chavez, at Berryessa Community Center's dining room in San Jose. He supports Assemblymember Chu's proposal to let California voters weigh on whether the state should keep moving clocks one hour forward in the spring and one hour back in the fall. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Those\u003ca href=\"http://repository.uchastings.edu/cgi/viewcontent.cgi?article=1501&context=ca_ballot_props\" target=\"_blank\"> 1949 supporters said the practice\u003c/a> \"gives people an extra hour of daylight after they get home, and thus increases public health and industrial efficiency,\" among other advantages. But Chavez contends he has never personally felt much benefit from it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After feedback from constituents like Chavez, Assemblymember Kansen Chu, D-San Jose, introduced a bill that would allow voters to weigh in on whether the state should keep the practice of switching to daylight saving time. Potential alternatives, according to Chu, would be for the state to observe either standard time or daylight saving time permanently.\u003c/p>\n\u003cp>\"A lot of my constituents would love to stay on daylight saving time year round,\" said Chu. \"The older you get, giving up an hour of sleep has more impact on your physical condition.\"\u003c/p>\n\u003cp>Chu cites recent studies linking the jetlag effect some people feel right after changing to daylight saving time with an uptick of \u003ca href=\"https://www.sciencedaily.com/releases/2014/03/140329175108.htm\" target=\"_blank\">heart attacks\u003c/a>, and traffic and workplace\u003ca href=\"http://www.sleep-journal.com/article/S1389-9457%2800%2900032-0/abstract?nl=nytnow&em_pos=large&emc=edit_nn_20150309\" target=\"_blank\"> injuries\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_158687\" class=\"wp-caption aligncenter\" style=\"max-width: 943px\">\u003ca href=\"http://repository.uchastings.edu/cgi/viewcontent.cgi?article=1501&context=ca_ballot_props\" rel=\"attachment wp-att-158687\">\u003cimg class=\"size-full wp-image-158687\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM.png\" alt=\"Proposition 12, passed by California voters in 1949, established daylight saving time in California. \" width=\"943\" height=\"606\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM.png 943w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-400x257.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-800x514.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/Screen-Shot-2016-03-11-at-11.43.42-AM-768x494.png 768w\" sizes=\"(max-width: 943px) 100vw, 943px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposition 12, passed by California voters in 1949, established daylight saving time in California. \u003ccite>(UC Hastings Scholarship Repository)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Why Do We Have Daylight Saving Time Anyway?\u003c/strong>\u003c/p>\n\u003cp>Benjamin Franklin proposed making more efficient use of daylight to save candles in a 1784 \u003ca href=\"http://www.webexhibits.org/daylightsaving/franklin3.html\" target=\"_blank\">letter\u003c/a>. But British businessman William Willett is credited with spreading the idea of tinkering with clocks to make better use of daylight in Britain and other parts of Europe.\u003c/p>\n\u003cp>Willett persistently lobbied the British parliament to adopt this change in the early 1900s. However, he died before Britons began observing it in 1916, a few months after Germany became the first country to implement the practice.\u003c/p>\n\u003cp>The U.S. as a whole first tried daylight saving time during World War I to save energy, and then again during World War II. But afterward, the decision to adopt daylight saving was up to cities and towns. Chaos ensued.\u003c/p>\n\u003cp>\"You could have one town that doesn't have daylight saving time, the neighboring town does, and then the third neighboring town has daylight saving time but starts and ends in different dates. So it got to be very confusing,\" says David Prerau, author of \u003ca href=\"http://www.amazon.com/Seize-Daylight-Curious-Contentious-Saving/dp/1560257962\" target=\"_blank\">\u003cem>Seize the Daylight: The Curious and Contentious Story of Daylight Saving Time\u003c/em>.\u003c/a>\u003c/p>\n\u003cp>Iowa alone had 23 different sets of starting and ending dates for daylight saving time, says Prerau, causing a major headache for businessmen and others traveling from one town to another.\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/251396920&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/251396920'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Congress intervened in 1966 with the \u003ca href=\"https://www.transportation.gov/regulations/time-act\" target=\"_blank\">Uniform Time Act \u003c/a>that gave states two options: keep daylight saving time during federally mandated dates or stay on standard time year round. Most states opted for a coordinated daylight saving time. (Hawaii never observed it; Arizona opted out in 1968.) Initially, daylight saving time lasted only six months.\u003c/p>\n\u003cp>The U.S. Department of Transportation, which oversees the uniform \u003ca href=\"https://www.transportation.gov/regulations/daylight-saving-time\" target=\"_blank\">observance\u003c/a> of daylight saving time, says having most people go about their business while the sun is shining saves electricity, prevents traffic deaths and injuries, and even reduces crime.\u003c/p>\n\u003cp>Prerau researched for years the benefits of daylight saving time for the federal government, when the country was looking for ways to reduce energy consumption during the 1970s oil crisis. After the results were out, Congress issued months-long extensions of the practice in 1974 and 1975.\u003c/p>\n\u003cp>Today, daylight saving time \u003ca href=\"http://www.webexhibits.org/daylightsaving/b.html\" target=\"_blank\">begins\u003c/a> at 2 a.m. on the second Sunday in March, and ends at 2 a.m. the first Sunday of November.\u003c/p>\n\u003cp>Still, not everyone agrees with those energy saving claims, including one\u003ca href=\"http://www.nber.org/papers/w14429\" target=\"_blank\"> widely cited study\u003c/a> conducted after Indiana adopted daylight saving time in 2006 questions its effects.\u003c/p>\n\u003cp>\"Energy consumption is much more complex than back in the 40s,\" says Assemblymember Chu, an electrical engineer who used to work for IBM.\u003cb> \"\u003c/b>It's about time for us to revisit this practice that we have been doing for the last 70 years.\"\u003c/p>\n\u003cp>Prerau counters that adjusting our clocks to maximize activity during daylight continues to be worth it.\u003c/p>\n\u003cp>\"\u003cspan style=\"font-weight: 400\">The negatives of switching the clock a\u003c/span>ffect some people the first few days of a daylight saving time period, at most\u003cb>,\u003c/b>\" says Prerau. \"But the benefits go on for eight months.\"\u003c/p>\n\u003cfigure id=\"attachment_158455\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-158455 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut.jpg\" alt=\"Betty Smith, 81, and Bill Painter, 75, at the Berryesa Community Center in San Jose. Unlike other seniors who frequent the center's lunch program, they agree Daylight Saving Time is a "good thing."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18781_IMG_9624.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Betty Smith, 81, and Bill Painter, 75, frequent the Berryessa Community Center in San Jose. Unlike other seniors there, Smith says switching to daylight saving time is a \"good thing,\" and Painter agrees. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For California or other states to opt daylight saving time year round (instead of standard time), Congress would have to amend federal law. Chu is working on a resolution that -- if approved by the Legislature -- would make that request to Congress.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Quitting the current switch to daylight saving time would leave California out of sync with most of the country. Prerau says that could hurt businesses and cause headaches in airline and other transportation schedules.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California's 'Physician-Assisted Suicide' Law To Take Effect in June",
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"content": "\u003cp>California Gov. Jerry Brown \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">signed landmark legislation\u003c/a> last October that would allow terminally ill people to request life-ending medication from their physicians.\u003c/p>\n\u003cp>But no one knew when the law would take effect, because of the unusual way in which the law was passed -- in a legislative \"extraordinary session\" called by Gov. Brown. The bill could not go into effect until 90 days after the session adjourned.\u003c/p>\n\u003cp>That was this morning, after the Senate sent\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/10/california-legislature-raises-tobacco-age-to-21-on-to-gov-brown/\" target=\"_blank\"> new tobacco regulations \u003c/a>to the governor's desk and means the \"\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>\" will go into effect June 9.\u003c/p>\n\u003cp>\"We're glad to finally have arrived at this day where we have a date certain,\" said Sen. Bill Monning, D-Carmel, in an interview.\u003c/p>\n\u003cp>[contextly_sidebar id=\"QprUvNgADZTCik5lQFnDPC4zn6m3MBQ0\"]\"It's a historic achievement for California, and for a limited universe of people dealing with a terminal illness, it could indeed be a transformative way of giving them the option of a compassionate end-of-life process.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Disability-rights advocates fought hard last year against passage of the act and continue to voice concern.\u003c/p>\n\u003cp>Golden said it's impossible to know if a depressed patient went to many doctors who all denied the request for lethal medication before finding one who agreed to write the prescription.\u003c/p>\n\u003cp>\"We are looking ahead at measures to protect people from abuse,\" said Marilyn Golden, senior policy analyst with the Disability Rights Education & Defense Fund, \"and to explore and inform doctors, nurses and pharmacists that they don't have to participate.\"\u003c/p>\n\u003cp>As written, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">the law \u003c/a>requires two doctors to agree that a patient has six months or less to live before prescribing the drugs. Patients must be able to swallow the medication themselves and must affirm in writing 48 hours before taking the medication that they will do so.\u003c/p>\n\u003cp>California is the \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">fifth state\u003c/a> to permit this end of life option. It joins Vermont, Oregon, Washington and Montana.\u003c/p>\n\u003cp>Across the state, some patients with advanced cancer welcomed the news.\u003c/p>\n\u003cp>\"It gives me a great peace of mind to know that I will not be forced to die slowly and painfully,\" said Elizabeth Wallner, in a release from Compassion & Choices, an advocacy group. Wallner, 52, of Sacramento, is a single mother\u003cstrong> \u003c/strong>with stage IV colon cancer that has spread to her liver and lungs.\u003c/p>\n\u003cp>\"It gives great comfort to know that the agonizingly traumatic image of me suffering will not be my family's last memory of me,\" she said.\u003c/p>\n\u003cp>Sen. Monning expressed his gratitude to people who worked for passage of the law, some in their final days:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Brittany Maynard\u003c/strong>, an Orange County woman with brain cancer who moved to Oregon to take advantage of aid-in-dying there. Before she died, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">she recorded a video\u003c/a> that was shown during hearings on the \"End of Life Option Act\" in Sacramento\u003c/li>\n\u003cli>\u003cstrong>Jennifer Glass\u003c/strong>, of San Mateo, who helped to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">launch the campaign in 2014\u003c/a>, then died of lung cancer last year\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"http://www.latimes.com/local/politics/la-me-0212-christy-odonnell-20160212-story.html\" target=\"_blank\">Christy O'Donnell\u003c/a>\u003c/strong>, 47, of Los Angeles, who died of lung cancer last month\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"I really believe we use today to mark and dedicate the memory .. of some true champions,\" Monning said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Gov. Jerry Brown \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">signed landmark legislation\u003c/a> last October that would allow terminally ill people to request life-ending medication from their physicians.\u003c/p>\n\u003cp>But no one knew when the law would take effect, because of the unusual way in which the law was passed -- in a legislative \"extraordinary session\" called by Gov. Brown. The bill could not go into effect until 90 days after the session adjourned.\u003c/p>\n\u003cp>That was this morning, after the Senate sent\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/10/california-legislature-raises-tobacco-age-to-21-on-to-gov-brown/\" target=\"_blank\"> new tobacco regulations \u003c/a>to the governor's desk and means the \"\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>\" will go into effect June 9.\u003c/p>\n\u003cp>\"We're glad to finally have arrived at this day where we have a date certain,\" said Sen. Bill Monning, D-Carmel, in an interview.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"It's a historic achievement for California, and for a limited universe of people dealing with a terminal illness, it could indeed be a transformative way of giving them the option of a compassionate end-of-life process.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Disability-rights advocates fought hard last year against passage of the act and continue to voice concern.\u003c/p>\n\u003cp>Golden said it's impossible to know if a depressed patient went to many doctors who all denied the request for lethal medication before finding one who agreed to write the prescription.\u003c/p>\n\u003cp>\"We are looking ahead at measures to protect people from abuse,\" said Marilyn Golden, senior policy analyst with the Disability Rights Education & Defense Fund, \"and to explore and inform doctors, nurses and pharmacists that they don't have to participate.\"\u003c/p>\n\u003cp>As written, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">the law \u003c/a>requires two doctors to agree that a patient has six months or less to live before prescribing the drugs. Patients must be able to swallow the medication themselves and must affirm in writing 48 hours before taking the medication that they will do so.\u003c/p>\n\u003cp>California is the \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">fifth state\u003c/a> to permit this end of life option. It joins Vermont, Oregon, Washington and Montana.\u003c/p>\n\u003cp>Across the state, some patients with advanced cancer welcomed the news.\u003c/p>\n\u003cp>\"It gives me a great peace of mind to know that I will not be forced to die slowly and painfully,\" said Elizabeth Wallner, in a release from Compassion & Choices, an advocacy group. Wallner, 52, of Sacramento, is a single mother\u003cstrong> \u003c/strong>with stage IV colon cancer that has spread to her liver and lungs.\u003c/p>\n\u003cp>\"It gives great comfort to know that the agonizingly traumatic image of me suffering will not be my family's last memory of me,\" she said.\u003c/p>\n\u003cp>Sen. Monning expressed his gratitude to people who worked for passage of the law, some in their final days:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Brittany Maynard\u003c/strong>, an Orange County woman with brain cancer who moved to Oregon to take advantage of aid-in-dying there. Before she died, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">she recorded a video\u003c/a> that was shown during hearings on the \"End of Life Option Act\" in Sacramento\u003c/li>\n\u003cli>\u003cstrong>Jennifer Glass\u003c/strong>, of San Mateo, who helped to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">launch the campaign in 2014\u003c/a>, then died of lung cancer last year\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"http://www.latimes.com/local/politics/la-me-0212-christy-odonnell-20160212-story.html\" target=\"_blank\">Christy O'Donnell\u003c/a>\u003c/strong>, 47, of Los Angeles, who died of lung cancer last month\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"I really believe we use today to mark and dedicate the memory .. of some true champions,\" Monning said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California lawmakers voted Thursday to raise the smoking age from 18 to 21, approving a measure that would make the nation's most populous state only the second to put legal tobacco products out of the reach of most teenagers.\u003c/p>\n\u003cp>Before it can become law, Democratic Gov. Jerry Brown must sign the legislation, which has already passed the state Assembly. His spokesman said last week that the governor generally does not comment on pending legislation.\u003c/p>\n\u003cp>Only Hawaii has adopted the higher age limit statewide\u003ca href=\"http://tobacco21.org/state-by-state/\" target=\"_blank\">, although dozens of cities\u003c/a>, including New York and San Francisco, have passed their own laws.\u003c/p>\n\u003cp>\u003cstrong>New Regulations on E-Cigarettes\u003c/strong>\u003c/p>\n\u003cp>The package of anti-tobacco bills would also restrict electronic cigarettes, which are increasingly popular and not regulated by the federal government.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The higher age limit won approval despite intense lobbying from tobacco interests and fierce opposition from many Republicans, who said the state should butt out of people's personal health decisions, even if they are harmful.\u003c/p>\n\u003cp>The six bills, which passed both houses, represented California's most substantial anti-tobacco effort in nearly two decades, according to the American Cancer Society.\u003c/p>\n\u003cp>\"With California having such a huge population, it's going to be very impactful nationwide,\" said Cathy Callaway, associate director of state and local campaigns for the society.\u003c/p>\n\u003cp>Advocates noted that the vast majority of smokers start before they are 18, according to data from the \u003ca href=\"http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/\" target=\"_blank\">U.S. surgeon general\u003c/a>. Making it illegal for 18-year-old high school students to buy tobacco for their underage friends will make it more difficult for teens to get the products, they said.\u003c/p>\n\u003cp>Opponents said 18-year-olds are trusted to make important decisions such as how to vote or whether to join the military. In response, Democrats changed the bill to allow members of the military to continue buying cigarettes at 18.\u003c/p>\n\u003cp>\"You can commit a felony when you're 18 years old and for the rest of your life, be in prison,\" Assembly Republican Leader Chad Mayes said. \"And yet you can't buy a pack of cigarettes.\"\u003c/p>\n\u003cp>Another bill would classify e-cigarettes, or \"vaping\" devices, as tobacco products subject to the same restrictions on who can purchase them and where they can be used.\u003c/p>\n\u003cp>The Food and Drug Administration has proposed regulations for e-cigarettes, but none has taken effect.\u003c/p>\n\u003cp>Anti-tobacco groups fear that vaporizers are enticing to young people and may encourage them to eventually take up smoking. Others say the devices are a less harmful, tar-free alternative to cigarettes. They have not been extensively studied, and there is no scientific consensus on their risks.\u003c/p>\n\u003cp>\u003cstrong>Expansion of Smoke-Free Areas\u003c/strong>\u003c/p>\n\u003cp>The bills would also expand smoke-free areas to include bars, workplace break rooms, small businesses, warehouses and hotel lobbies and meeting rooms. Smoking bans would apply at more schools, including charter schools, and counties would be able to raise their own cigarette taxes beyond the state's levy of $0.87 per pack.\u003c/p>\n\u003cp>The Senate vote came just over a week after \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/01/san-francisco-supervisors-raise-tobacco-age-to-21/\" target=\"_blank\">San Francisco officials \u003c/a>opted to raise the tobacco buying age to 21, making it the largest city to do so after New York. Nationwide, \u003ca href=\"http://tobacco21.org/state-by-state/\" target=\"_blank\">more than 120 municipalities\u003c/a> have raised the smoking age, according to Tobacco 21, a group that advocates the policy shift nationally.\u003c/p>\n\u003cp>Hawaii was first to adopt the higher age limit statewide. New Jersey's Legislature voted to raise the smoking age from 19 to 21, but the bill died when Republican Gov. Chris Christie decided not to act on it before a January deadline.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Anti-smoking groups are collecting signatures for a November ballot initiative that would raise the cigarette tax to $2 a pack and direct the money to health care, tobacco-use prevention, research and law enforcement.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California lawmakers voted Thursday to raise the smoking age from 18 to 21, approving a measure that would make the nation's most populous state only the second to put legal tobacco products out of the reach of most teenagers.\u003c/p>\n\u003cp>Before it can become law, Democratic Gov. Jerry Brown must sign the legislation, which has already passed the state Assembly. His spokesman said last week that the governor generally does not comment on pending legislation.\u003c/p>\n\u003cp>Only Hawaii has adopted the higher age limit statewide\u003ca href=\"http://tobacco21.org/state-by-state/\" target=\"_blank\">, although dozens of cities\u003c/a>, including New York and San Francisco, have passed their own laws.\u003c/p>\n\u003cp>\u003cstrong>New Regulations on E-Cigarettes\u003c/strong>\u003c/p>\n\u003cp>The package of anti-tobacco bills would also restrict electronic cigarettes, which are increasingly popular and not regulated by the federal government.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The higher age limit won approval despite intense lobbying from tobacco interests and fierce opposition from many Republicans, who said the state should butt out of people's personal health decisions, even if they are harmful.\u003c/p>\n\u003cp>The six bills, which passed both houses, represented California's most substantial anti-tobacco effort in nearly two decades, according to the American Cancer Society.\u003c/p>\n\u003cp>\"With California having such a huge population, it's going to be very impactful nationwide,\" said Cathy Callaway, associate director of state and local campaigns for the society.\u003c/p>\n\u003cp>Advocates noted that the vast majority of smokers start before they are 18, according to data from the \u003ca href=\"http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/\" target=\"_blank\">U.S. surgeon general\u003c/a>. Making it illegal for 18-year-old high school students to buy tobacco for their underage friends will make it more difficult for teens to get the products, they said.\u003c/p>\n\u003cp>Opponents said 18-year-olds are trusted to make important decisions such as how to vote or whether to join the military. In response, Democrats changed the bill to allow members of the military to continue buying cigarettes at 18.\u003c/p>\n\u003cp>\"You can commit a felony when you're 18 years old and for the rest of your life, be in prison,\" Assembly Republican Leader Chad Mayes said. \"And yet you can't buy a pack of cigarettes.\"\u003c/p>\n\u003cp>Another bill would classify e-cigarettes, or \"vaping\" devices, as tobacco products subject to the same restrictions on who can purchase them and where they can be used.\u003c/p>\n\u003cp>The Food and Drug Administration has proposed regulations for e-cigarettes, but none has taken effect.\u003c/p>\n\u003cp>Anti-tobacco groups fear that vaporizers are enticing to young people and may encourage them to eventually take up smoking. Others say the devices are a less harmful, tar-free alternative to cigarettes. They have not been extensively studied, and there is no scientific consensus on their risks.\u003c/p>\n\u003cp>\u003cstrong>Expansion of Smoke-Free Areas\u003c/strong>\u003c/p>\n\u003cp>The bills would also expand smoke-free areas to include bars, workplace break rooms, small businesses, warehouses and hotel lobbies and meeting rooms. Smoking bans would apply at more schools, including charter schools, and counties would be able to raise their own cigarette taxes beyond the state's levy of $0.87 per pack.\u003c/p>\n\u003cp>The Senate vote came just over a week after \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/01/san-francisco-supervisors-raise-tobacco-age-to-21/\" target=\"_blank\">San Francisco officials \u003c/a>opted to raise the tobacco buying age to 21, making it the largest city to do so after New York. Nationwide, \u003ca href=\"http://tobacco21.org/state-by-state/\" target=\"_blank\">more than 120 municipalities\u003c/a> have raised the smoking age, according to Tobacco 21, a group that advocates the policy shift nationally.\u003c/p>\n\u003cp>Hawaii was first to adopt the higher age limit statewide. New Jersey's Legislature voted to raise the smoking age from 19 to 21, but the bill died when Republican Gov. Chris Christie decided not to act on it before a January deadline.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Anti-smoking groups are collecting signatures for a November ballot initiative that would raise the cigarette tax to $2 a pack and direct the money to health care, tobacco-use prevention, research and law enforcement.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California lawmakers have again \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2782\" target=\"_blank\">introduced legislation\u003c/a> to impose a fee on sodas and other sugary beverages -- not a true tax, but a \"health impact fee\" to be paid by beverage distributors.\u003c/p>\n\u003cp>Still, the presumption is that the two-cents-an-ounce fee -- 24 cents on a 12-ounce can of soda -- would be passed along to consumers, and, if passed, would raise $2 billion annually.\u003c/p>\n\u003cp>\"That's real money,\" said the legislation's author, Assemblymember Richard Bloom, D-Santa Monica.\u003c/p>\n\u003cp>The revenue would go into a \"Healthy California Fund,\" to be created by the bill. From there it would be spent on public health programs across the state, to fight obesity, diabetes and dental disease.\u003c/p>\n\u003cp>\"It's not going to fix things overnight,\" Bloom said, \"but as this money starts to flow ... that's going to have the effect, long term, of leading Californians to healthier lifestyles and also lower health costs.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bloom said that medical research is pointing to sugar-sweetened beverages as a driver of diabetes and other health problems.\u003c/p>\n\u003cp>Bob Achermann, the executive director of \u003ca href=\"http://calbev.org/#!/home\" target=\"_blank\">CalBev\u003c/a>, a statewide industry group, said the organization is opposed to the bill. He said that obesity and diabetes are \"complicated problems\" and a broader approach is needed.\u003c/p>\n\u003cp>\"Calories from any source\" can increase the risk of obesity and diabetes, Achermann said, \"so we think focusing on sugar-sweetened beverages isn't appropriate, and it isn't fair.\"\u003c/p>\n\u003cp>The Associated Press reports that California lawmakers have attempted either a so-called soda tax or a warning label\u003ca href=\"http://www.sacbee.com/news/state/california/article65000127.html\" target=\"_blank\"> seven times\u003c/a> between 2010 and 2015. None has passed.\u003c/p>\n\u003cp>Bloom introduced the soda tax legislation last year as well. It did not make it out of the \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article20776941.html\" target=\"_blank\">Assembly Health committee\u003c/a>. Bloom says he has \"kept up the discussion\" with fellow legislators and that new studies \"point in the same direction and tell us that sugary beverages are an anathema to public health.\"\u003c/p>\n\u003cp>He expects the Assembly Health committee to hear this new legislation in a month or so.\u003c/p>\n\u003cp>Berkeley is the only city in California to have a fee on sugar-sweetened beverages. The penny-per-ounce fee was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">overwhelmingly approved by voters in 2014\u003c/a> and is levied on distributors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new \u003ca href=\"http://health.gov/dietaryguidelines/2015/guidelines/\" target=\"_blank\">U.S. dietary guidelines\u003c/a> urge all Americans to limit sugar consumption to no more than 10 percent of daily calories, or about 12 teaspoons. By comparison, a can of Coke or other (non-diet) soda has about 10 teaspoons of sugar.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California lawmakers have again \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2782\" target=\"_blank\">introduced legislation\u003c/a> to impose a fee on sodas and other sugary beverages -- not a true tax, but a \"health impact fee\" to be paid by beverage distributors.\u003c/p>\n\u003cp>Still, the presumption is that the two-cents-an-ounce fee -- 24 cents on a 12-ounce can of soda -- would be passed along to consumers, and, if passed, would raise $2 billion annually.\u003c/p>\n\u003cp>\"That's real money,\" said the legislation's author, Assemblymember Richard Bloom, D-Santa Monica.\u003c/p>\n\u003cp>The revenue would go into a \"Healthy California Fund,\" to be created by the bill. From there it would be spent on public health programs across the state, to fight obesity, diabetes and dental disease.\u003c/p>\n\u003cp>\"It's not going to fix things overnight,\" Bloom said, \"but as this money starts to flow ... that's going to have the effect, long term, of leading Californians to healthier lifestyles and also lower health costs.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bloom said that medical research is pointing to sugar-sweetened beverages as a driver of diabetes and other health problems.\u003c/p>\n\u003cp>Bob Achermann, the executive director of \u003ca href=\"http://calbev.org/#!/home\" target=\"_blank\">CalBev\u003c/a>, a statewide industry group, said the organization is opposed to the bill. He said that obesity and diabetes are \"complicated problems\" and a broader approach is needed.\u003c/p>\n\u003cp>\"Calories from any source\" can increase the risk of obesity and diabetes, Achermann said, \"so we think focusing on sugar-sweetened beverages isn't appropriate, and it isn't fair.\"\u003c/p>\n\u003cp>The Associated Press reports that California lawmakers have attempted either a so-called soda tax or a warning label\u003ca href=\"http://www.sacbee.com/news/state/california/article65000127.html\" target=\"_blank\"> seven times\u003c/a> between 2010 and 2015. None has passed.\u003c/p>\n\u003cp>Bloom introduced the soda tax legislation last year as well. It did not make it out of the \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article20776941.html\" target=\"_blank\">Assembly Health committee\u003c/a>. Bloom says he has \"kept up the discussion\" with fellow legislators and that new studies \"point in the same direction and tell us that sugary beverages are an anathema to public health.\"\u003c/p>\n\u003cp>He expects the Assembly Health committee to hear this new legislation in a month or so.\u003c/p>\n\u003cp>Berkeley is the only city in California to have a fee on sugar-sweetened beverages. The penny-per-ounce fee was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">overwhelmingly approved by voters in 2014\u003c/a> and is levied on distributors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new \u003ca href=\"http://health.gov/dietaryguidelines/2015/guidelines/\" target=\"_blank\">U.S. dietary guidelines\u003c/a> urge all Americans to limit sugar consumption to no more than 10 percent of daily calories, or about 12 teaspoons. By comparison, a can of Coke or other (non-diet) soda has about 10 teaspoons of sugar.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California's Last Institutions for Developmentally Disabled to be Closed",
"title": "California's Last Institutions for Developmentally Disabled to be Closed",
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"content": "\u003cp>The final countdown has begun for the last of three large state-run institutions that care for the severely disabled: In less than six years, almost all of their residents are likely to be transferred to other settings.\u003c/p>\n\u003caside class=\"pullquote alignright\">It's the end of a long era in providing care to people in large institutional settings\u003c/aside>\n\u003cp>The public comment period ended last week on a plan to move 776 patients currently housed at the three development centers into smaller community-based homes. The state expects the move to save it roughly $250 million a year.\u003c/p>\n\u003cp>The average cost of caring for those patients — who have conditions such as cerebral palsy, epilepsy, brain injuries and severe autism — is $500,000 a year per person, according to the Legislative Analyst’s Office in Sacramento. Following previous closures of sister institutions and the transfer of their residents to smaller local facilities, the average cost fell to about $180,000 per patient.\u003c/p>\n\u003cp>\u003cstrong>Last 3 Centers are in Sonoma, Costa Mesa and Porterville\u003c/strong>\u003c/p>\n\u003cp>Shutting down facilities in Sonoma and Costa Mesa, and partially closing a third site in Porterville, will not only save money on patient care, it also will open up some prime real estate opportunities for the state-owned sites. What the state will do with the land and the many large buildings that sit on it is still being publicly debated.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Porterville site will move roughly half of its patients. The rest, 211 developmentally disabled felons in the center’s secure treatment area, can’t be moved into the community and will remain where they are.\u003c/p>\n\u003cp>A much smaller state-run residential facility, Canyon Springs in Cathedral City — near Palm Springs — will continue to house its 55 residents.\u003c/p>\n\u003cp>Also up for debate in the Capitol next week will be the amount of money earmarked by the state to finance the closures and patient transitions. A legislative budget hearing on March 16 will examine the cost of doing so.\u003c/p>\n\u003cp>\u003cstrong>Concerns of Insufficient Staffing \u003c/strong>\u003c/p>\n\u003cp>A \u003ca href=\"http://lao.ca.gov/Publications/Report/3382?utm_source=subscription&utm_medium=email&utm_campaign=traditional\" target=\"_blank\">\u003cu>report released Friday \u003c/u>\u003c/a>by the Legislative Analyst’s Office raised concern about the potential loss of federal money during the roughly six years it will take to nearly empty the facilities.\u003c/p>\n\u003cp>According to the LAO, federal officials have been worried about insufficient staffing and inadequate care at the centers, as well as their failure to follow up on cases of abuse and neglect.\u003c/p>\n\u003cp>The feds will be carefully monitoring the state to make sure it complies with all requirements for the health and safety of residents in the new, smaller community settings.\u003c/p>\n\u003cp>The state’s final proposal will be presented to the legislature Apr. 1.\u003c/p>\n\u003cp>The plan is the latest — and last — move in California’s shift away from providing care in large residential centers.\u003c/p>\n\u003cp>Over the past two decades, the state has been slowly shuttering them and moving its developmentally disabled residents into smaller facilities. At the system’s peak in 1968, 10 large developmental centers housed more than 13,000 patients.\u003c/p>\n\u003cp>The switch to community-based care in smaller group homes, along with the creation of 21 non-residential regional centers to coordinate that transition and provide other services across the state, has siphoned away most of the population at the larger centers.\u003c/p>\n\u003cp>Over the past decade, the state shut down three other developmental centers — Agnews in Santa Clara, Lanterman in Pomona and Sierra Vista in Yuba City.\u003c/p>\n\u003cp>Of the three big centers currently operating, Sonoma is expected to be closed by the end of 2018; the one in Costa Mesa and the non-secure area of Porterville, by the end of 2021.\u003c/p>\n\u003cp>\u003cstrong>\"Shift in Philosophy\" -- With Some Criticism\u003c/strong>\u003c/p>\n\u003cp>The high cost of care is not the only reason for shutting down the centers, said John Doyle, chief deputy director of the state’s Department of Developmental Services, which operates them and is coordinating the closures.\u003c/p>\n\u003cp>“Every decision in government at some level is a monetary decision,” Doyle said. “But this is more of a shift in philosophy.”\u003c/p>\n\u003cp>In the newer model of care, he said, “people can make their own decisions about their own life,” rather than having their daily schedule dictated by an institution.\u003c/p>\n\u003cp>That thought is cold comfort for Christina Nielsen, whose son Tom has lived off and on for the past eight years at the Costa Mesa facility, known as the Fairview Developmental Center. He has severe autism and is called a “runner.”\u003c/p>\n\u003cp>“Tom has a long history of wandering away and running,” Nielsen said. A court order placed him in the Fairview center and he needs to stay there, she added.\u003c/p>\n\u003cp>The closure of the centers, Nielsen said, “is a death sentence for my son, and others like him.”\u003c/p>\n\u003cp>Nielsen said Tom has been moved three times already from Fairview’s institutional setting to smaller “crisis centers” — and it hasn’t gone well.\u003c/p>\n\u003cp>“He ran away from a caregiver and onto the 101 freeway and was hit by a car,” she recounted. “He has been in three other crisis homes and failed [at] each of them.”\u003c/p>\n\u003cp>As part of the closure plan, the state is creating half a dozen community crisis homes across the state, which have many clinical services built in for patients with complex physical issues. It is also creating homes that offer what officials call “enhanced behavioral supports,” such as medical staff members with special training.\u003c/p>\n\u003cp>“People will see it can work,” Doyle said. “There are people we serve already who have challenging behaviors who have never been institutionalized. So it definitely can work.”\u003c/p>\n\u003cp>Disability Rights California, a Sacramento-based advocacy group, has endorsed the decision to close the developmental centers.\u003c/p>\n\u003cp>“This plan ensures that residents may safely and successfully transition into the community,” said Jennifer Alfaro, a spokeswoman for the group. “California has successfully closed other [developmental] centers, which demonstrates we know how to do this right.”\u003c/p>\n\u003cp>That sentiment was echoed by Carolyn Davis of Huntington Beach, an 89-year-old mother of a longtime Fairview center patient.\u003c/p>\n\u003cp>“My daughter moved out last May, and I was one of the ones who definitely did not want that to happen,” Davis said. “I’m not one to rant and rave about it, but they certainly knew how I felt about it.”\u003c/p>\n\u003cp>Davis said she’s thrilled now, because her daughter is much happier and more engaged since she made the move to a smaller residential care facility in Long Beach.\u003c/p>\n\u003cp>“I spent sleepless nights worrying about whether or not she would be OK,” Davis said. “I really was not believing it could go as well as it did.”\u003c/p>\n\u003cp>But, Davis added, she knows that won’t be the case for all of the residents at Fairview.\u003c/p>\n\u003cp>“For some people it almost is impossible,” she said. “Others have not had it go so well.”\u003c/p>\n\u003cp>Maggie Flavia has big worries about the transfer of her 43-year-old son, Pete, who had viral encephalopathy as a youngster and now has the mental status of a 3-year-old, she said.\u003c/p>\n\u003cp>“Pete’s totally helpless, he’s totally dependent, he cannot communicate,” Flavia said. “And I fear he’s going to be in big trouble.”\u003c/p>\n\u003cp>Doyle said he understands that fear.\u003c/p>\n\u003cp>“Family members are rightfully scared about their loved ones’ well-being,” he said.\u003c/p>\n\u003cp>The new community-based homes are “like a mini-clinic,” with ready access to physicians, well-trained staff members, and generators to run patients’ life-sustaining machines for three days in case of a power outage, Doyle said. “We’re hoping some of these new models of homes will be an answer.”\u003c/p>\n\u003cp>Flavia remains unconvinced, but at the same time she knows hope is fading for the prospect of keeping Fairview open.\u003c/p>\n\u003cp>“We have a big battle in front of us. So we have to fight,” she said. “But I don’t know how to do it. I’m just a parent.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The final countdown has begun for the last of three large state-run institutions that care for the severely disabled: In less than six years, almost all of their residents are likely to be transferred to other settings.\u003c/p>\n\u003caside class=\"pullquote alignright\">It's the end of a long era in providing care to people in large institutional settings\u003c/aside>\n\u003cp>The public comment period ended last week on a plan to move 776 patients currently housed at the three development centers into smaller community-based homes. The state expects the move to save it roughly $250 million a year.\u003c/p>\n\u003cp>The average cost of caring for those patients — who have conditions such as cerebral palsy, epilepsy, brain injuries and severe autism — is $500,000 a year per person, according to the Legislative Analyst’s Office in Sacramento. Following previous closures of sister institutions and the transfer of their residents to smaller local facilities, the average cost fell to about $180,000 per patient.\u003c/p>\n\u003cp>\u003cstrong>Last 3 Centers are in Sonoma, Costa Mesa and Porterville\u003c/strong>\u003c/p>\n\u003cp>Shutting down facilities in Sonoma and Costa Mesa, and partially closing a third site in Porterville, will not only save money on patient care, it also will open up some prime real estate opportunities for the state-owned sites. What the state will do with the land and the many large buildings that sit on it is still being publicly debated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Porterville site will move roughly half of its patients. The rest, 211 developmentally disabled felons in the center’s secure treatment area, can’t be moved into the community and will remain where they are.\u003c/p>\n\u003cp>A much smaller state-run residential facility, Canyon Springs in Cathedral City — near Palm Springs — will continue to house its 55 residents.\u003c/p>\n\u003cp>Also up for debate in the Capitol next week will be the amount of money earmarked by the state to finance the closures and patient transitions. A legislative budget hearing on March 16 will examine the cost of doing so.\u003c/p>\n\u003cp>\u003cstrong>Concerns of Insufficient Staffing \u003c/strong>\u003c/p>\n\u003cp>A \u003ca href=\"http://lao.ca.gov/Publications/Report/3382?utm_source=subscription&utm_medium=email&utm_campaign=traditional\" target=\"_blank\">\u003cu>report released Friday \u003c/u>\u003c/a>by the Legislative Analyst’s Office raised concern about the potential loss of federal money during the roughly six years it will take to nearly empty the facilities.\u003c/p>\n\u003cp>According to the LAO, federal officials have been worried about insufficient staffing and inadequate care at the centers, as well as their failure to follow up on cases of abuse and neglect.\u003c/p>\n\u003cp>The feds will be carefully monitoring the state to make sure it complies with all requirements for the health and safety of residents in the new, smaller community settings.\u003c/p>\n\u003cp>The state’s final proposal will be presented to the legislature Apr. 1.\u003c/p>\n\u003cp>The plan is the latest — and last — move in California’s shift away from providing care in large residential centers.\u003c/p>\n\u003cp>Over the past two decades, the state has been slowly shuttering them and moving its developmentally disabled residents into smaller facilities. At the system’s peak in 1968, 10 large developmental centers housed more than 13,000 patients.\u003c/p>\n\u003cp>The switch to community-based care in smaller group homes, along with the creation of 21 non-residential regional centers to coordinate that transition and provide other services across the state, has siphoned away most of the population at the larger centers.\u003c/p>\n\u003cp>Over the past decade, the state shut down three other developmental centers — Agnews in Santa Clara, Lanterman in Pomona and Sierra Vista in Yuba City.\u003c/p>\n\u003cp>Of the three big centers currently operating, Sonoma is expected to be closed by the end of 2018; the one in Costa Mesa and the non-secure area of Porterville, by the end of 2021.\u003c/p>\n\u003cp>\u003cstrong>\"Shift in Philosophy\" -- With Some Criticism\u003c/strong>\u003c/p>\n\u003cp>The high cost of care is not the only reason for shutting down the centers, said John Doyle, chief deputy director of the state’s Department of Developmental Services, which operates them and is coordinating the closures.\u003c/p>\n\u003cp>“Every decision in government at some level is a monetary decision,” Doyle said. “But this is more of a shift in philosophy.”\u003c/p>\n\u003cp>In the newer model of care, he said, “people can make their own decisions about their own life,” rather than having their daily schedule dictated by an institution.\u003c/p>\n\u003cp>That thought is cold comfort for Christina Nielsen, whose son Tom has lived off and on for the past eight years at the Costa Mesa facility, known as the Fairview Developmental Center. He has severe autism and is called a “runner.”\u003c/p>\n\u003cp>“Tom has a long history of wandering away and running,” Nielsen said. A court order placed him in the Fairview center and he needs to stay there, she added.\u003c/p>\n\u003cp>The closure of the centers, Nielsen said, “is a death sentence for my son, and others like him.”\u003c/p>\n\u003cp>Nielsen said Tom has been moved three times already from Fairview’s institutional setting to smaller “crisis centers” — and it hasn’t gone well.\u003c/p>\n\u003cp>“He ran away from a caregiver and onto the 101 freeway and was hit by a car,” she recounted. “He has been in three other crisis homes and failed [at] each of them.”\u003c/p>\n\u003cp>As part of the closure plan, the state is creating half a dozen community crisis homes across the state, which have many clinical services built in for patients with complex physical issues. It is also creating homes that offer what officials call “enhanced behavioral supports,” such as medical staff members with special training.\u003c/p>\n\u003cp>“People will see it can work,” Doyle said. “There are people we serve already who have challenging behaviors who have never been institutionalized. So it definitely can work.”\u003c/p>\n\u003cp>Disability Rights California, a Sacramento-based advocacy group, has endorsed the decision to close the developmental centers.\u003c/p>\n\u003cp>“This plan ensures that residents may safely and successfully transition into the community,” said Jennifer Alfaro, a spokeswoman for the group. “California has successfully closed other [developmental] centers, which demonstrates we know how to do this right.”\u003c/p>\n\u003cp>That sentiment was echoed by Carolyn Davis of Huntington Beach, an 89-year-old mother of a longtime Fairview center patient.\u003c/p>\n\u003cp>“My daughter moved out last May, and I was one of the ones who definitely did not want that to happen,” Davis said. “I’m not one to rant and rave about it, but they certainly knew how I felt about it.”\u003c/p>\n\u003cp>Davis said she’s thrilled now, because her daughter is much happier and more engaged since she made the move to a smaller residential care facility in Long Beach.\u003c/p>\n\u003cp>“I spent sleepless nights worrying about whether or not she would be OK,” Davis said. “I really was not believing it could go as well as it did.”\u003c/p>\n\u003cp>But, Davis added, she knows that won’t be the case for all of the residents at Fairview.\u003c/p>\n\u003cp>“For some people it almost is impossible,” she said. “Others have not had it go so well.”\u003c/p>\n\u003cp>Maggie Flavia has big worries about the transfer of her 43-year-old son, Pete, who had viral encephalopathy as a youngster and now has the mental status of a 3-year-old, she said.\u003c/p>\n\u003cp>“Pete’s totally helpless, he’s totally dependent, he cannot communicate,” Flavia said. “And I fear he’s going to be in big trouble.”\u003c/p>\n\u003cp>Doyle said he understands that fear.\u003c/p>\n\u003cp>“Family members are rightfully scared about their loved ones’ well-being,” he said.\u003c/p>\n\u003cp>The new community-based homes are “like a mini-clinic,” with ready access to physicians, well-trained staff members, and generators to run patients’ life-sustaining machines for three days in case of a power outage, Doyle said. “We’re hoping some of these new models of homes will be an answer.”\u003c/p>\n\u003cp>Flavia remains unconvinced, but at the same time she knows hope is fading for the prospect of keeping Fairview open.\u003c/p>\n\u003cp>“We have a big battle in front of us. So we have to fight,” she said. “But I don’t know how to do it. I’m just a parent.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Rise of Latino Political Power in Sacramento Could Give New Momentum to Health Care",
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"content": "\u003cp>When Anthony Rendon, D-Paramount, is sworn in as Assembly Speaker Monday, it will mark a historic moment in California politics: For the first time, the two top posts in the state legislature will be held by Latinos.\u003c/p>\n\u003cp>Rendon will join Senate President Pro Tem Kevin de León, D-Los Angeles, at the top of the Capitol’s political pyramid, a development that could signal much brighter prospects for health care legislation — especially the effort to provide adult immigrants who are living here illegally with coverage under Medi-Cal, the government program for people with low incomes.\u003c/p>\n\u003cp>“What we’re witnessing is a dramatic surge in power. I think it will be a new and dramatic change in California,” said Jaime Regalado, a political science professor emeritus at California State University Los Angeles.\u003c/p>\n\u003cp>The power of the Latino caucus in the state, he said, has reached a point where the top items on its agenda are becoming the top items on the legislature’s agenda.\u003c/p>\n\u003cp>That agenda is weighted toward health care and education, he noted — from Medi-Cal expansion to paid sick leave to health coverage for children of those in the United States illegally.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Aside from Rendon and de León, other Latino leaders in Sacramento also play a big role in Capitol health care politics, including Ed Hernandez, D-West Covina, who heads the Senate Committee on Health and has authored dozens of health-related bills; Lorena Gonzalez, D-San Diego, in Assembly Health, who spearheaded the mandate for paid sick leave; and Ricardo Lara, D-Bell Gardens, who wrote the bill to provide Medi-Cal coverage to children of people living in the United States.\u003c/p>\n\u003cp>“Everybody has been calling [the Latino community] the sleeping giant for so many years. But it has been awake for some time now,” Regalado said. “Latinos have always been concerned about their communities, and they have had the highest proportion of those without health care, so Latino leaders are going to rank those issues high on their list.”\u003c/p>\n\u003cp>Three years after the advent of Covered California and the expansion of Medi-Cal, nearly three-quarters of the roughly 3 million remaining uninsured in the state are Latino, according to a January 2015 \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2015/uninsuredbrief-jan2015.pdf\" target=\"_blank\">\u003cu>study by UCLA and UC Berkeley\u003c/u>\u003c/a> researchers.\u003c/p>\n\u003cfigure class=\"related\">\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>This year the wish list of Latino leaders includes a bill sponsored by de León to provide housing and mental health treatment for the chronically homeless — many of whom suffer from mental illness. And following last year’s successful move to offer full Medi-Cal coverage to undocumented children in California, the next step is to extend it to their adult counterparts, according to Rendon.\u003c/p>\n\u003cp>“It’s important, and it’s important now,” said incoming Assembly Speaker Rendon in an interview at last Saturday’s state Democratic convention in San Jose. “Covering undocumented immigrants is certainly something that resonates with me from a personal point of view, and from the caucus point of view it’s really high on our list.”\u003c/p>\n\u003cp>Rendon noted that de León’s background also makes the Senate leader sympathetic to the goal of providing coverage for immigrants without legal documents. Because it requires heavy political lifting, he said, “it certainly needs to be near the top of the agenda to succeed.”\u003c/p>\n\u003cp>Before he joined the Assembly in 2012, Rendon was executive director of the nonprofit Plaza de la Raza Child Development Services, which provides social and medical services to children in Pico Rivera, east of Los Angeles. De León spent time as a community organizer for immigrant rights before becoming a member of the legislature in 2006.\u003c/p>\n\u003cp>Though Medi-Cal for immigrant children without papers was approved and will take effect in May, providing that coverage for adults with the same immigration status is highly controversial and promises to be a tough political slog.\u003c/p>\n\u003cp>“In general, the direction the legislature has taken over the past decade or two has been to serve people who are in California illegally, and that takes benefits from other people,” said Ira Mehlman, spokesman for the Washington, D.C.-based Federation for American Immigration Reform, which lobbied in Sacramento against “Medi-Cal for all” when it was first put before the legislature last year.\u003c/p>\n\u003cp>“We think that just encourages people who violate laws, and deprives other people in the state of needed resources,” Mehlman said.\u003c/p>\n\u003cp>Regalado said that despite strong opposition, Medi-Cal coverage for the adults could succeed with the expected political push from Rendon and de León.\u003c/p>\n\u003cp>“They will be emboldened,” Regalado said. “They have enormous political power right now.”\u003c/p>\n\u003cp>Rendon said access to health care, especially in rural areas, will also be a top legislative priority.\u003c/p>\n\u003cp>The amount spent on Medi-Cal could change too, said Gerald Kominski, director of the UCLA Center for Health Policy Research.\u003c/p>\n\u003cp>Since the expansion of Medi-Cal began under the Affordable Care Act, enrollment in the program has expanded significantly. Medi-Cal now covers 13.3 million Californians — one-third of the state’s population.\u003c/p>\n\u003cp>“California is now serving a huge percentage of Latinos in Medi-Cal,\" Kominski said, \"and that continues to be seen as underfunded. I think you’ll see increased attention on that.”\u003c/p>\n\u003cp>The Latino caucus, the largest political caucus in the state, flexed its political muscles last weekend at the state Democratic convention in San Jose.\u003c/p>\n\u003cp>In contrast to typically sedate, run-of-the-mill convention caucus meetings, the Latino caucus meeting last week was a high-energy event, more akin to a family reunion.\u003c/p>\n\u003cp>To one side of the front stage, a corner set aside for visiting dignitaries was packed with dozens of political heavyweights — a who’s who of legislators all waiting for their one minute at the microphone to address the crowded room.\u003c/p>\n\u003cp>“We are a blue state because of this community!” shouted former Los Angeles mayor Antonio Villaraigosa to the cheering crowd. “We are the future!”\u003c/p>\n\u003cp>While Latinos tend to share an interest in some issues, they are represented across the political spectrum.\u003c/p>\n\u003cp>A 2014 report by the Public Policy Institute of California showed likely Latino voters register in far higher numbers as Democrats (59 percent) than as Republicans (18 percent) or independents (17 percent). But it also noted that many Latino Democrats are politically conservative. And it found Latino voters are as likely to identify themselves as liberal (34 percent) as they are to call themselves middle of the road (33 percent) or conservative (33 percent).\u003c/p>\n\u003cp>U.S. Congressman Xavier Becerra, D-Los Angeles, chairman of the House Democratic Caucus and the fourth highest ranking Democrat in the House, said he’s been heartened by the growing political power of Latinos and what he characterized as their enormous legislative accomplishments.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“That wave you see on the horizon, it hasn’t hit the beach yet, but it’s coming,” Becerra said at the state Democratic convention. “You now have Latinos as the top two leaders in the state, behind the governor. There are moments that crystallize in the minds of people, and this is one of them. It’s coming.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Anthony Rendon, D-Paramount, is sworn in as Assembly Speaker Monday, it will mark a historic moment in California politics: For the first time, the two top posts in the state legislature will be held by Latinos.\u003c/p>\n\u003cp>Rendon will join Senate President Pro Tem Kevin de León, D-Los Angeles, at the top of the Capitol’s political pyramid, a development that could signal much brighter prospects for health care legislation — especially the effort to provide adult immigrants who are living here illegally with coverage under Medi-Cal, the government program for people with low incomes.\u003c/p>\n\u003cp>“What we’re witnessing is a dramatic surge in power. I think it will be a new and dramatic change in California,” said Jaime Regalado, a political science professor emeritus at California State University Los Angeles.\u003c/p>\n\u003cp>The power of the Latino caucus in the state, he said, has reached a point where the top items on its agenda are becoming the top items on the legislature’s agenda.\u003c/p>\n\u003cp>That agenda is weighted toward health care and education, he noted — from Medi-Cal expansion to paid sick leave to health coverage for children of those in the United States illegally.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Aside from Rendon and de León, other Latino leaders in Sacramento also play a big role in Capitol health care politics, including Ed Hernandez, D-West Covina, who heads the Senate Committee on Health and has authored dozens of health-related bills; Lorena Gonzalez, D-San Diego, in Assembly Health, who spearheaded the mandate for paid sick leave; and Ricardo Lara, D-Bell Gardens, who wrote the bill to provide Medi-Cal coverage to children of people living in the United States.\u003c/p>\n\u003cp>“Everybody has been calling [the Latino community] the sleeping giant for so many years. But it has been awake for some time now,” Regalado said. “Latinos have always been concerned about their communities, and they have had the highest proportion of those without health care, so Latino leaders are going to rank those issues high on their list.”\u003c/p>\n\u003cp>Three years after the advent of Covered California and the expansion of Medi-Cal, nearly three-quarters of the roughly 3 million remaining uninsured in the state are Latino, according to a January 2015 \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2015/uninsuredbrief-jan2015.pdf\" target=\"_blank\">\u003cu>study by UCLA and UC Berkeley\u003c/u>\u003c/a> researchers.\u003c/p>\n\u003cfigure class=\"related\">\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>This year the wish list of Latino leaders includes a bill sponsored by de León to provide housing and mental health treatment for the chronically homeless — many of whom suffer from mental illness. And following last year’s successful move to offer full Medi-Cal coverage to undocumented children in California, the next step is to extend it to their adult counterparts, according to Rendon.\u003c/p>\n\u003cp>“It’s important, and it’s important now,” said incoming Assembly Speaker Rendon in an interview at last Saturday’s state Democratic convention in San Jose. “Covering undocumented immigrants is certainly something that resonates with me from a personal point of view, and from the caucus point of view it’s really high on our list.”\u003c/p>\n\u003cp>Rendon noted that de León’s background also makes the Senate leader sympathetic to the goal of providing coverage for immigrants without legal documents. Because it requires heavy political lifting, he said, “it certainly needs to be near the top of the agenda to succeed.”\u003c/p>\n\u003cp>Before he joined the Assembly in 2012, Rendon was executive director of the nonprofit Plaza de la Raza Child Development Services, which provides social and medical services to children in Pico Rivera, east of Los Angeles. De León spent time as a community organizer for immigrant rights before becoming a member of the legislature in 2006.\u003c/p>\n\u003cp>Though Medi-Cal for immigrant children without papers was approved and will take effect in May, providing that coverage for adults with the same immigration status is highly controversial and promises to be a tough political slog.\u003c/p>\n\u003cp>“In general, the direction the legislature has taken over the past decade or two has been to serve people who are in California illegally, and that takes benefits from other people,” said Ira Mehlman, spokesman for the Washington, D.C.-based Federation for American Immigration Reform, which lobbied in Sacramento against “Medi-Cal for all” when it was first put before the legislature last year.\u003c/p>\n\u003cp>“We think that just encourages people who violate laws, and deprives other people in the state of needed resources,” Mehlman said.\u003c/p>\n\u003cp>Regalado said that despite strong opposition, Medi-Cal coverage for the adults could succeed with the expected political push from Rendon and de León.\u003c/p>\n\u003cp>“They will be emboldened,” Regalado said. “They have enormous political power right now.”\u003c/p>\n\u003cp>Rendon said access to health care, especially in rural areas, will also be a top legislative priority.\u003c/p>\n\u003cp>The amount spent on Medi-Cal could change too, said Gerald Kominski, director of the UCLA Center for Health Policy Research.\u003c/p>\n\u003cp>Since the expansion of Medi-Cal began under the Affordable Care Act, enrollment in the program has expanded significantly. Medi-Cal now covers 13.3 million Californians — one-third of the state’s population.\u003c/p>\n\u003cp>“California is now serving a huge percentage of Latinos in Medi-Cal,\" Kominski said, \"and that continues to be seen as underfunded. I think you’ll see increased attention on that.”\u003c/p>\n\u003cp>The Latino caucus, the largest political caucus in the state, flexed its political muscles last weekend at the state Democratic convention in San Jose.\u003c/p>\n\u003cp>In contrast to typically sedate, run-of-the-mill convention caucus meetings, the Latino caucus meeting last week was a high-energy event, more akin to a family reunion.\u003c/p>\n\u003cp>To one side of the front stage, a corner set aside for visiting dignitaries was packed with dozens of political heavyweights — a who’s who of legislators all waiting for their one minute at the microphone to address the crowded room.\u003c/p>\n\u003cp>“We are a blue state because of this community!” shouted former Los Angeles mayor Antonio Villaraigosa to the cheering crowd. “We are the future!”\u003c/p>\n\u003cp>While Latinos tend to share an interest in some issues, they are represented across the political spectrum.\u003c/p>\n\u003cp>A 2014 report by the Public Policy Institute of California showed likely Latino voters register in far higher numbers as Democrats (59 percent) than as Republicans (18 percent) or independents (17 percent). But it also noted that many Latino Democrats are politically conservative. And it found Latino voters are as likely to identify themselves as liberal (34 percent) as they are to call themselves middle of the road (33 percent) or conservative (33 percent).\u003c/p>\n\u003cp>U.S. Congressman Xavier Becerra, D-Los Angeles, chairman of the House Democratic Caucus and the fourth highest ranking Democrat in the House, said he’s been heartened by the growing political power of Latinos and what he characterized as their enormous legislative accomplishments.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That wave you see on the horizon, it hasn’t hit the beach yet, but it’s coming,” Becerra said at the state Democratic convention. “You now have Latinos as the top two leaders in the state, behind the governor. There are moments that crystallize in the minds of people, and this is one of them. It’s coming.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Assembly Votes to Raise Smoking Age, Regulate E-Cigarettes",
"title": "California Assembly Votes to Raise Smoking Age, Regulate E-Cigarettes",
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"content": "\u003cp>In major victories for anti-tobacco advocates, the California Assembly voted Thursday to raise the smoking age to 21, regulate electronic cigarettes as tobacco products and take a variety of other steps aiming to restrict access to tobacco.\u003c/p>\n\u003cp>California would become just the second state to raise the smoking age from 18, joining the state of Hawaii and dozens of cities around the country that have already moved to the higher limit. The move comes days after the San Francisco Board of Supervisors \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/01/san-francisco-supervisors-raise-tobacco-age-to-21/\" target=\"_blank\">increased the legal age \u003c/a>to buy tobacco products to 21.\u003c/p>\n\u003cp>Ending months of stalling on legislation approved last year in the Senate, Assembly Democrats said the measure will prevent young people from taking up smoking. Proponents say it would make it much harder for teens to get access to tobacco because 18-year-old high school students would not be able to buy it for their underage friends.\u003c/p>\n\u003cp>\"This will save the medical system in the outgoing years millions of dollars,\" said Assemblyman Jim Wood, D-Healdsburg. \"It will save thousands of lives.\"\u003c/p>\n\u003cp>A landmark study from the prestigious Institute of Medicine reached a similar conclusion in \u003ca href=\"https://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/TobaccoMinAge/tobacco_minimum_age_report_brief.pdf\" target=\"_blank\">an analysis published last year\u003c/a>. The panel found that if the minimum legal age to buy tobacco were raised to 21 nationwide, tobacco use would drop by 12 percent by the time today’s teens reached adulthood. In addition, there would be 223,000 fewer premature deaths and 50,000 fewer deaths from lung cancer,\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Republicans said the government should not restrict people's freedom to make their own decisions.\u003c/p>\n\u003cp>\"I don't smoke. I don't encourage my children to,\" said Assemblyman Donald Wagner, R-Irvine. \"But they're adults, and it's our job to treat our citizens as adults, not to nanny them.\"\u003c/p>\n\u003cp>The legal age to purchase alcohol is 21 across the U.S., and most casinos set 21 as the age for gambling. In the four states that have legalized marijuana, 21 is the legal age to purchase.\u003c/p>\n\u003cp>The age to purchase tobacco would remain 18 for members of the military.\u003c/p>\n\u003cp>The bills also would require that e-cigarettes be regulated like tobacco products, impose new restrictions on workplace smoking and expand tobacco bans to more schools. Counties would be able to raise their own cigarette taxes beyond the state's levy of $0.87 per pack.\u003c/p>\n\u003cp>The bills now return to the Senate, which must approve changes made in the Assembly before the legislation can reach Democratic Gov. Jerry Brown.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers approved the tobacco legislation in a special session called last year by Brown to restructure taxes on health plans.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In major victories for anti-tobacco advocates, the California Assembly voted Thursday to raise the smoking age to 21, regulate electronic cigarettes as tobacco products and take a variety of other steps aiming to restrict access to tobacco.\u003c/p>\n\u003cp>California would become just the second state to raise the smoking age from 18, joining the state of Hawaii and dozens of cities around the country that have already moved to the higher limit. The move comes days after the San Francisco Board of Supervisors \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/01/san-francisco-supervisors-raise-tobacco-age-to-21/\" target=\"_blank\">increased the legal age \u003c/a>to buy tobacco products to 21.\u003c/p>\n\u003cp>Ending months of stalling on legislation approved last year in the Senate, Assembly Democrats said the measure will prevent young people from taking up smoking. Proponents say it would make it much harder for teens to get access to tobacco because 18-year-old high school students would not be able to buy it for their underage friends.\u003c/p>\n\u003cp>\"This will save the medical system in the outgoing years millions of dollars,\" said Assemblyman Jim Wood, D-Healdsburg. \"It will save thousands of lives.\"\u003c/p>\n\u003cp>A landmark study from the prestigious Institute of Medicine reached a similar conclusion in \u003ca href=\"https://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/TobaccoMinAge/tobacco_minimum_age_report_brief.pdf\" target=\"_blank\">an analysis published last year\u003c/a>. The panel found that if the minimum legal age to buy tobacco were raised to 21 nationwide, tobacco use would drop by 12 percent by the time today’s teens reached adulthood. In addition, there would be 223,000 fewer premature deaths and 50,000 fewer deaths from lung cancer,\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Republicans said the government should not restrict people's freedom to make their own decisions.\u003c/p>\n\u003cp>\"I don't smoke. I don't encourage my children to,\" said Assemblyman Donald Wagner, R-Irvine. \"But they're adults, and it's our job to treat our citizens as adults, not to nanny them.\"\u003c/p>\n\u003cp>The legal age to purchase alcohol is 21 across the U.S., and most casinos set 21 as the age for gambling. In the four states that have legalized marijuana, 21 is the legal age to purchase.\u003c/p>\n\u003cp>The age to purchase tobacco would remain 18 for members of the military.\u003c/p>\n\u003cp>The bills also would require that e-cigarettes be regulated like tobacco products, impose new restrictions on workplace smoking and expand tobacco bans to more schools. Counties would be able to raise their own cigarette taxes beyond the state's levy of $0.87 per pack.\u003c/p>\n\u003cp>The bills now return to the Senate, which must approve changes made in the Assembly before the legislation can reach Democratic Gov. Jerry Brown.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers approved the tobacco legislation in a special session called last year by Brown to restructure taxes on health plans.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Trump Health Plan Recycles GOP Staples And Adds A Populist Wrinkle",
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"headTitle": "State of Health | KQED News",
"content": "\u003cp>Republican front-runner Donald Trump released a seven-point plan to change the country's health care system that includes several familiar GOP proposals and one that puts him in agreement with, believe it or not, Democratic hopeful Bernie Sanders.\u003c/p>\n\u003cp>Right off the bat, Trump calls for the elimination of the Affordable Care Act, ringing the repeal bell that has been popular among a wide swath of Republicans and that has fueled dozens of votes to overturn Obamacare in Congress, including another \u003ca href=\"http://www.npr.org/2016/01/06/462114338/lawmakers-in-the-house-will-try-again-in-2016-to-repeal-obamacare\" target=\"_blank\">failed attempt when lawmakers reconvened first thing in January\u003c/a>.\u003c/p>\n\u003cp>The prime target is the individual mandate, the requirement that almost every American have or buy health insurance — or pay a penalty. \"No person should be required to buy insurance unless he or she wants to,\" the Trump proposal declares.\u003c/p>\n\u003cp>Obamacare relies on the mandate to make sure it isn't just the sick and people at high risk of getting sick who buy coverage, driving up insurance costs.\u003c/p>\n\u003cp>While Trump decries the mandate, the \u003ca href=\"http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html\" target=\"_blank\">idea has Republican roots\u003c/a>. The mandate was seen as a market-friendly alternative to a national health system or a strict requirement on employers to provide coverage.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still, the mandate and its associated tax penalties for people who don't comply has become a lightning rod for people dissatisfied with the Affordable Care Act. In 2014, the first year that the fine for lack of coverage was in place, about 7.5 million Americans \u003ca href=\"http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html\" target=\"_blank\">paid an average penalty of $200\u003c/a> for not having insurance according to the IRS. In 2015, \u003ca href=\"http://kff.org/health-reform/issue-brief/the-cost-of-the-individual-mandate-penalty-for-the-remaining-uninsured/\">the potential penalties rose\u003c/a> to greater of 2 percent of annual income or $325 per adult. And this year they rise again to the greater of 2.5 percent of income or $695 per adult.\u003c/p>\n\u003cp>In a second plank, Trump calls for the sale of health insurance plans across state lines to bolster competition by increasing the number of policies being sold. Health insurance is regulated largely at the state level. And critics of the multistate approach, a \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=120276553\" target=\"_blank\">favorite of the GOP\u003c/a> for years, say it would erode consumer protections.\u003c/p>\n\u003cp>Trump hedges his call for multistate plans by saying they would have to comply with regulations in each state where they are offered. It's hard to see how, if states continue to regulate insurance differently, the theoretical benefits he touts could be achieved in practice. In fact, over the years six states, including \u003ca href=\"http://www.npr.org/sections/health-shots/2012/06/25/155702326/dropping-legal-barriers-doesnt-guarantee-interstate-insurance-sales\" target=\"_blank\">Georgia\u003c/a>, enacted laws to encourage insurance sales across their borders and a Georgetown University analysis found that they \u003ca href=\"http://chirblog.org/the-return-of-proposals-for-the-across-state-lines-sale-of-insurance/\" target=\"_blank\">failed to attract new plans\u003c/a> into their markets.\u003c/p>\n\u003cp>Some Trump proposals would change the tax treatment of health coverage.\u003c/p>\n\u003cp>One would let individuals who buy insurance deduct its cost, as employers do for coverage they make available to workers. Many health economists argue that the opposite tack — \u003ca href=\"https://www.aei.org/publication/kill-the-tax-exclusion-for-health-insurance/\" target=\"_blank\">eliminating the employer deduction\u003c/a> — would be more beneficial. The employer tax break obscures the cost of health coverage and thereby contributes to health cost inflation. The benefits from the break also tends to accrue to more highly paid people. Under Obamacare, people with low-to-moderate incomes can get a tax credit to help defray the cost of insurance purchased on marketplaces.\u003c/p>\n\u003cp>The second proposal argues in favor of letting individuals take advantage of Health Savings Accounts, or HSAs. But that's something that is already possible, and the accounts are quite popular. Right now, those accounts are tied to high-deductible health plans.\u003c/p>\n\u003cp>\"Is Trump calling for every American to have access to an HSA, not just those in high-deductible health plans (HDHPs)?\" \u003ca href=\"http://www.forbes.com/sites/ryanellis/2016/03/02/donald-trumps-healthcare-plan-and-taxes/#70c0ee2a404f\" target=\"_blank\">asks a post\u003c/a> on Forbes.com by Ryan Ellis, an adviser on tax policy for the Conservative Reform Network. \"That would seem to be undermined by his statement about how young people should want to enroll in high-deductible plans–why mention them at all?\"\u003c/p>\n\u003cp>Then there's the chicken-in-every-pot plank that would require providers of health care to disclose prices. \"Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure,\" the Trump proposal says. Not many people disagree with the intent. But it's difficult to pull off in a way that helps the average person shop. Health care prices are negotiated between insurers and providers, and people's coverage and copays vary depending on their networks and insurance particulars.\u003c/p>\n\u003cp>Trump also argues for a change in financing Medicaid, the joint federal and state health insurance program for the poor and disabled. His plan calls for block grants, or lump-sum payments, to the states that they could spend as they wish. The idea has been popular with Republicans going back to President Reagan, has been \u003ca href=\"http://www.npr.org/2011/03/08/134363543/gop-governors-revive-historic-call-for-medicaid-block-grants\" target=\"_blank\">revived more recently by GOP governors\u003c/a> as a way to cut costs and has been part of Republican proposals to repeal and replace Obamacare. Critics say block grants would \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15787953?dopt=Abstract\" target=\"_blank\">reduce the number of people covered by Medicaid\u003c/a> and by shifting responsibilities to the states would ultimately saddle them with \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1503455\" target=\"_blank\">greater financial burdens\u003c/a>.\u003c/p>\n\u003cp>Finally, Trump throws his support behind the importation of drugs to cut costs. \"Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers,\" the proposal says. This is the one where Trump and Sanders have common ground. Sanders supports the importation of drugs from Canada and \u003ca href=\"https://berniesanders.com/issues/fighting-to-lower-prescription-drug-prices/\" target=\"_blank\">his website boasts\u003c/a> about a 1999 bus trip that took a bunch of Americans up north to get better deals.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Food and Drug Administration, under both Republican and Democratic presidents, has opposed drug importation on safety grounds. And drugmakers restricted supplies of medicines \u003ca href=\"http://www.wsj.com/articles/SB1042245470898700224\" target=\"_blank\">going to drug distributors in Canada\u003c/a> to combat a rise in online pharmacy sales to Americans more than a decade ago.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Health+Plan+Recycles+GOP+Staples+And+Adds+A+Populist+Wrinkle&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Republican front-runner Donald Trump released a seven-point plan to change the country's health care system that includes several familiar GOP proposals and one that puts him in agreement with, believe it or not, Democratic hopeful Bernie Sanders.\u003c/p>\n\u003cp>Right off the bat, Trump calls for the elimination of the Affordable Care Act, ringing the repeal bell that has been popular among a wide swath of Republicans and that has fueled dozens of votes to overturn Obamacare in Congress, including another \u003ca href=\"http://www.npr.org/2016/01/06/462114338/lawmakers-in-the-house-will-try-again-in-2016-to-repeal-obamacare\" target=\"_blank\">failed attempt when lawmakers reconvened first thing in January\u003c/a>.\u003c/p>\n\u003cp>The prime target is the individual mandate, the requirement that almost every American have or buy health insurance — or pay a penalty. \"No person should be required to buy insurance unless he or she wants to,\" the Trump proposal declares.\u003c/p>\n\u003cp>Obamacare relies on the mandate to make sure it isn't just the sick and people at high risk of getting sick who buy coverage, driving up insurance costs.\u003c/p>\n\u003cp>While Trump decries the mandate, the \u003ca href=\"http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html\" target=\"_blank\">idea has Republican roots\u003c/a>. The mandate was seen as a market-friendly alternative to a national health system or a strict requirement on employers to provide coverage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, the mandate and its associated tax penalties for people who don't comply has become a lightning rod for people dissatisfied with the Affordable Care Act. In 2014, the first year that the fine for lack of coverage was in place, about 7.5 million Americans \u003ca href=\"http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html\" target=\"_blank\">paid an average penalty of $200\u003c/a> for not having insurance according to the IRS. In 2015, \u003ca href=\"http://kff.org/health-reform/issue-brief/the-cost-of-the-individual-mandate-penalty-for-the-remaining-uninsured/\">the potential penalties rose\u003c/a> to greater of 2 percent of annual income or $325 per adult. And this year they rise again to the greater of 2.5 percent of income or $695 per adult.\u003c/p>\n\u003cp>In a second plank, Trump calls for the sale of health insurance plans across state lines to bolster competition by increasing the number of policies being sold. Health insurance is regulated largely at the state level. And critics of the multistate approach, a \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=120276553\" target=\"_blank\">favorite of the GOP\u003c/a> for years, say it would erode consumer protections.\u003c/p>\n\u003cp>Trump hedges his call for multistate plans by saying they would have to comply with regulations in each state where they are offered. It's hard to see how, if states continue to regulate insurance differently, the theoretical benefits he touts could be achieved in practice. In fact, over the years six states, including \u003ca href=\"http://www.npr.org/sections/health-shots/2012/06/25/155702326/dropping-legal-barriers-doesnt-guarantee-interstate-insurance-sales\" target=\"_blank\">Georgia\u003c/a>, enacted laws to encourage insurance sales across their borders and a Georgetown University analysis found that they \u003ca href=\"http://chirblog.org/the-return-of-proposals-for-the-across-state-lines-sale-of-insurance/\" target=\"_blank\">failed to attract new plans\u003c/a> into their markets.\u003c/p>\n\u003cp>Some Trump proposals would change the tax treatment of health coverage.\u003c/p>\n\u003cp>One would let individuals who buy insurance deduct its cost, as employers do for coverage they make available to workers. Many health economists argue that the opposite tack — \u003ca href=\"https://www.aei.org/publication/kill-the-tax-exclusion-for-health-insurance/\" target=\"_blank\">eliminating the employer deduction\u003c/a> — would be more beneficial. The employer tax break obscures the cost of health coverage and thereby contributes to health cost inflation. The benefits from the break also tends to accrue to more highly paid people. Under Obamacare, people with low-to-moderate incomes can get a tax credit to help defray the cost of insurance purchased on marketplaces.\u003c/p>\n\u003cp>The second proposal argues in favor of letting individuals take advantage of Health Savings Accounts, or HSAs. But that's something that is already possible, and the accounts are quite popular. Right now, those accounts are tied to high-deductible health plans.\u003c/p>\n\u003cp>\"Is Trump calling for every American to have access to an HSA, not just those in high-deductible health plans (HDHPs)?\" \u003ca href=\"http://www.forbes.com/sites/ryanellis/2016/03/02/donald-trumps-healthcare-plan-and-taxes/#70c0ee2a404f\" target=\"_blank\">asks a post\u003c/a> on Forbes.com by Ryan Ellis, an adviser on tax policy for the Conservative Reform Network. \"That would seem to be undermined by his statement about how young people should want to enroll in high-deductible plans–why mention them at all?\"\u003c/p>\n\u003cp>Then there's the chicken-in-every-pot plank that would require providers of health care to disclose prices. \"Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure,\" the Trump proposal says. Not many people disagree with the intent. But it's difficult to pull off in a way that helps the average person shop. Health care prices are negotiated between insurers and providers, and people's coverage and copays vary depending on their networks and insurance particulars.\u003c/p>\n\u003cp>Trump also argues for a change in financing Medicaid, the joint federal and state health insurance program for the poor and disabled. His plan calls for block grants, or lump-sum payments, to the states that they could spend as they wish. The idea has been popular with Republicans going back to President Reagan, has been \u003ca href=\"http://www.npr.org/2011/03/08/134363543/gop-governors-revive-historic-call-for-medicaid-block-grants\" target=\"_blank\">revived more recently by GOP governors\u003c/a> as a way to cut costs and has been part of Republican proposals to repeal and replace Obamacare. Critics say block grants would \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15787953?dopt=Abstract\" target=\"_blank\">reduce the number of people covered by Medicaid\u003c/a> and by shifting responsibilities to the states would ultimately saddle them with \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1503455\" target=\"_blank\">greater financial burdens\u003c/a>.\u003c/p>\n\u003cp>Finally, Trump throws his support behind the importation of drugs to cut costs. \"Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers,\" the proposal says. This is the one where Trump and Sanders have common ground. Sanders supports the importation of drugs from Canada and \u003ca href=\"https://berniesanders.com/issues/fighting-to-lower-prescription-drug-prices/\" target=\"_blank\">his website boasts\u003c/a> about a 1999 bus trip that took a bunch of Americans up north to get better deals.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Food and Drug Administration, under both Republican and Democratic presidents, has opposed drug importation on safety grounds. And drugmakers restricted supplies of medicines \u003ca href=\"http://www.wsj.com/articles/SB1042245470898700224\" target=\"_blank\">going to drug distributors in Canada\u003c/a> to combat a rise in online pharmacy sales to Americans more than a decade ago.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trump+Health+Plan+Recycles+GOP+Staples+And+Adds+A+Populist+Wrinkle&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Supreme Court Strikes At States' Efforts On Health Care Transparency",
"title": "Supreme Court Strikes At States' Efforts On Health Care Transparency",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>The U.S. Supreme Court dealt a \u003ca href=\"http://www.supremecourt.gov/opinions/15pdf/14-181_5426.pdf\" target=\"_blank\">blow Tuesday\u003c/a> to nascent efforts to track the quality and cost of health care, ruling that a 1974 law precludes states from requiring that every health care claim involving their residents be submitted to a massive database.\u003c/p>\n\u003cp>The arguments were arcane, but the effect is clear: We're a long way off from having a true picture of the country's health care spending, especially differences in the way hospitals treat patients and doctors practice medicine.\u003c/p>\n\u003cp>It also means that, for the time being at least, we'll remain heavily reliant on data being released by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care. ProPublica has used Medicare data to study differences in \u003ca href=\"https://projects.propublica.org/checkup\" target=\"_blank\">medication prescribing\u003c/a>, \u003ca href=\"https://projects.propublica.org/surgeons/\" target=\"_blank\">surgeons' complication rates\u003c/a> and \u003ca href=\"https://projects.propublica.org/treatment/\" target=\"_blank\">use of services by doctors\u003c/a>, but it's still not clear that Medicare is representative of all health care in the country.\u003c/p>\n\u003cp>The court's decision involves a case from Vermont, one of 18 states that created so-called all-payer claims databases. Vermont's law called for health insurers, health providers, medical facilities and government agencies to report data on health care costs, prices, quality and use of services to the state. That included employers who pay the costs of their workers' treatments themselves, and not through an insurance contract. (Self-insurance is common for large companies.)\u003c/p>\n\u003cp>But Liberty Mutual Insurance Co. objected, saying the Employee Retirement Income Security Act of 1974, or ERISA, prevents states from imposing such a requirement on self-funded plans. The idea is that companies that have operations across the country shouldn't be subjected to 50 different state laws, but instead should only have to abide by rules from one agency, namely the U.S. Department of Labor.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The court sided with Liberty Mutual, in a 6-2 decision, ruling it didn't have to submit the data demanded by Vermont.\u003c/p>\n\u003cp>In a friend-of-the-court \u003ca href=\"http://www.scotusblog.com/wp-content/uploads/2015/09/150904-amicus-gobeille-liberty.pdf\" target=\"_blank\">brief filed last September\u003c/a>, the American Hospital Association and the Association of American Medical Colleges said that without the data from self-funded plans, all-payer claims databases will be incomplete and not as valuable as they could be.\u003c/p>\n\u003cp>\"Hospitals only have data for the patients they treat,\" the groups wrote. \"Information from across the spectrum of an individual's health care experience is needed to inform clinical, payment, and public health policy...Complete data across all payers (including self-insurers like Respondent) is required so that both health care providers and policymakers can understand the variations in the health care system, and address those that need to change.\"\u003c/p>\n\u003cp>They also noted that self-insured plans cover a \"large majority of the working population: in 2013, nearly 60 percent of workers with health insurance were enrolled in such plans, and that figure is growing.\"\u003c/p>\n\u003cp>So what now? One option is for self-insured plans like Liberty Mutual to voluntarily provide their data to state-run databases. But given the lawsuit, that appears unlikely.\u003c/p>\n\u003cp>Another possibility, raised by Justice Stephen Breyer, is for the federal government to require self-insured plans to disclose their data. \"I see no reason why the Secretary of Labor could not develop reporting requirements that satisfy the states' needs, including some state-specific requirements, as appropriate,\" he wrote.\u003c/p>\n\u003cp>For now, though, we may have to do what we have done for years: Settle for an incomplete picture of health care spending and utilization.\u003c/p>\n\u003cp>Our team at ProPublica has already found fascinating patterns in Medicare data. In \u003ca href=\"https://www.propublica.org/article/billing-to-the-max-docs-charge-medicare-top-rate-for-office-visits\">one example\u003c/a>, 1,800 doctors billed Medicare for the most expensive type of office visits at least 90 percent of the time, compared to just 4 percent of office visits for all doctors.\u003c/p>\n\u003cp>Another group, the \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, has greenlighted research using data from three of the nation's largest private insurance companies. It has found some \u003ca href=\"http://www.healthcostinstitute.org/news-and-events/hcci-releases-new-research-assessing-national-and-state-health-policies\" target=\"_blank\">interesting trends\u003c/a> too, but hasn't released data on individual doctors and hospitals.\u003c/p>\n\u003cp>Medicare could release more data, as could the Health Care Cost Institute.\u003c/p>\n\u003cp>The Supreme Court decision means transparency has a long way to go.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.propublica.org/about/pixelping\" target=\"_blank\">Charles Ornstein\u003c/a>\u003cem> is a senior reporter at \u003c/em>\u003ca href=\"https://www.propublica.org/\" target=\"_blank\">ProPublica\u003c/a>,\u003cem> an independent investigative newsroom based in New York.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 ProPublica. To see more, visit \u003ca>ProPublica\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Supreme+Court+Strikes+At+States%27+Efforts+On+Health+Care+Transparency&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"excerpt": "The U.S. Supreme Court ruled that states can't require many large employers to submit health care claims to a massive database. The decision means Medicare data will remain the go-to source for now.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The U.S. Supreme Court dealt a \u003ca href=\"http://www.supremecourt.gov/opinions/15pdf/14-181_5426.pdf\" target=\"_blank\">blow Tuesday\u003c/a> to nascent efforts to track the quality and cost of health care, ruling that a 1974 law precludes states from requiring that every health care claim involving their residents be submitted to a massive database.\u003c/p>\n\u003cp>The arguments were arcane, but the effect is clear: We're a long way off from having a true picture of the country's health care spending, especially differences in the way hospitals treat patients and doctors practice medicine.\u003c/p>\n\u003cp>It also means that, for the time being at least, we'll remain heavily reliant on data being released by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care. ProPublica has used Medicare data to study differences in \u003ca href=\"https://projects.propublica.org/checkup\" target=\"_blank\">medication prescribing\u003c/a>, \u003ca href=\"https://projects.propublica.org/surgeons/\" target=\"_blank\">surgeons' complication rates\u003c/a> and \u003ca href=\"https://projects.propublica.org/treatment/\" target=\"_blank\">use of services by doctors\u003c/a>, but it's still not clear that Medicare is representative of all health care in the country.\u003c/p>\n\u003cp>The court's decision involves a case from Vermont, one of 18 states that created so-called all-payer claims databases. Vermont's law called for health insurers, health providers, medical facilities and government agencies to report data on health care costs, prices, quality and use of services to the state. That included employers who pay the costs of their workers' treatments themselves, and not through an insurance contract. (Self-insurance is common for large companies.)\u003c/p>\n\u003cp>But Liberty Mutual Insurance Co. objected, saying the Employee Retirement Income Security Act of 1974, or ERISA, prevents states from imposing such a requirement on self-funded plans. The idea is that companies that have operations across the country shouldn't be subjected to 50 different state laws, but instead should only have to abide by rules from one agency, namely the U.S. Department of Labor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The court sided with Liberty Mutual, in a 6-2 decision, ruling it didn't have to submit the data demanded by Vermont.\u003c/p>\n\u003cp>In a friend-of-the-court \u003ca href=\"http://www.scotusblog.com/wp-content/uploads/2015/09/150904-amicus-gobeille-liberty.pdf\" target=\"_blank\">brief filed last September\u003c/a>, the American Hospital Association and the Association of American Medical Colleges said that without the data from self-funded plans, all-payer claims databases will be incomplete and not as valuable as they could be.\u003c/p>\n\u003cp>\"Hospitals only have data for the patients they treat,\" the groups wrote. \"Information from across the spectrum of an individual's health care experience is needed to inform clinical, payment, and public health policy...Complete data across all payers (including self-insurers like Respondent) is required so that both health care providers and policymakers can understand the variations in the health care system, and address those that need to change.\"\u003c/p>\n\u003cp>They also noted that self-insured plans cover a \"large majority of the working population: in 2013, nearly 60 percent of workers with health insurance were enrolled in such plans, and that figure is growing.\"\u003c/p>\n\u003cp>So what now? One option is for self-insured plans like Liberty Mutual to voluntarily provide their data to state-run databases. But given the lawsuit, that appears unlikely.\u003c/p>\n\u003cp>Another possibility, raised by Justice Stephen Breyer, is for the federal government to require self-insured plans to disclose their data. \"I see no reason why the Secretary of Labor could not develop reporting requirements that satisfy the states' needs, including some state-specific requirements, as appropriate,\" he wrote.\u003c/p>\n\u003cp>For now, though, we may have to do what we have done for years: Settle for an incomplete picture of health care spending and utilization.\u003c/p>\n\u003cp>Our team at ProPublica has already found fascinating patterns in Medicare data. In \u003ca href=\"https://www.propublica.org/article/billing-to-the-max-docs-charge-medicare-top-rate-for-office-visits\">one example\u003c/a>, 1,800 doctors billed Medicare for the most expensive type of office visits at least 90 percent of the time, compared to just 4 percent of office visits for all doctors.\u003c/p>\n\u003cp>Another group, the \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, has greenlighted research using data from three of the nation's largest private insurance companies. It has found some \u003ca href=\"http://www.healthcostinstitute.org/news-and-events/hcci-releases-new-research-assessing-national-and-state-health-policies\" target=\"_blank\">interesting trends\u003c/a> too, but hasn't released data on individual doctors and hospitals.\u003c/p>\n\u003cp>Medicare could release more data, as could the Health Care Cost Institute.\u003c/p>\n\u003cp>The Supreme Court decision means transparency has a long way to go.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.propublica.org/about/pixelping\" target=\"_blank\">Charles Ornstein\u003c/a>\u003cem> is a senior reporter at \u003c/em>\u003ca href=\"https://www.propublica.org/\" target=\"_blank\">ProPublica\u003c/a>,\u003cem> an independent investigative newsroom based in New York.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 ProPublica. To see more, visit \u003ca>ProPublica\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Supreme+Court+Strikes+At+States%27+Efforts+On+Health+Care+Transparency&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The San Francisco Board of Supervisors voted unanimously Monday to raise the age to buy tobacco products from 18 to 21, joining more than \u003ca href=\"http://tobacco21.org/wp-content/uploads/2014/02/Tobacco-21-Cities-new24.pdf\" target=\"_blank\">120 cities across the country\u003c/a>, including New York and Boston, in the latest tactic to reduce smoking rates.\u003c/p>\n\u003cp>In California, Berkeley and parts of Santa Clara County have already moved to put tobacco out of the hands of teenagers. San Francisco Supervisor Scott Wiener, one of the authors of the measure, pointed to a \u003ca href=\"http://iom.nationalacademies.org/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">major analysis \u003c/a>from the Institute of Medicine last year that showed people who start smoking as teens are more likely to become hooked.\u003c/p>\n\u003cp>\"By increasing the legal age to buy tobacco products from the age of 18 to the age of 21, we will save lives,\" he said just before the vote. The measure applies to many tobacco products, including smokeless tobacco and e-cigarettes.\u003c/p>\n\u003cp>But there's a potential glitch. Tom Briant, executive director of the National Association of Tobacco Outlets says California law pre-empts cities from raising the age.\u003c/p>\n\u003cp>\"There needs to be some resolution on these questions, and the best person to do that is the California attorney general,\" Briant said in an interview.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Briant stopped short of saying his organization would challenge San Francisco in court, but did say the board of his organization would meet in April and discuss both Santa Clara County and San Francisco's moves.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/pubsforms/Documents/California%20Penal%20Codes%20308-308b.pdf\" target=\"_blank\">California law\u003c/a> states that 18 is the legal age to buy or possess tobacco products. In this passage, the Legislature seems to claim for itself the\u003ca href=\"https://www.cdph.ca.gov/pubsforms/Documents/California%20Penal%20Codes%20308-308b.pdf\" target=\"_blank\"> right to regulate tobacco\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It is the Legislature's intent to regulate the subject matter of this section. As a result, no city, county, or city and county shall adopt any ordinance or regulation inconsistent with this section.\u003c/p>\u003c/blockquote>\n\u003cp>Supervisor Wiener was unfazed. He said the San Francisco law did not interfere with state law and was unconcerned about challenges from the tobacco industry.\u003c/p>\n\u003cp>\"Our city has a history of taking on major industries in the name of public health, in the name of consumers, and winning. And we will do so here,\" he said.\u003c/p>\n\u003cp>The wine country city of Healdsburg was first in California to raise the tobacco age last fall, but declined to implement the higher age, apparently under pressure from the tobacco industry. Wiener said that with San Francisco's greater resources, the city would prevail in any court case.\u003c/p>\n\u003cp>Larry Cohen, executive director of the Oakland-based advocacy group Prevention Institute, said he \"couldn't be more pleased\" with the supervisors' vote. The move to raise the tobacco age to 21 is \"gathering momentum nationally,\" he said.\u003c/p>\n\u003cp>\"Ninety-five percent of daily smokers pick up the habit before age 21,\" he said. \"So the 21 age is really a critical number\" to reduce the numbers of smokers.\u003c/p>\n\u003cp>Certainly San Franciscans who are 18, 19 and 20 would be able to travel to a nearby city to legally purchase tobacco, but the higher age \"would still have its impact,\" Cohen said.\u003c/p>\n\u003cp>Most would not be thinking, \"Can I get on a BART train and go to South San Francisco\" to buy cigarettes, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measure goes to the mayor later this month. A spokeswoman said he supports the move and will sign.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The San Francisco Board of Supervisors voted unanimously Monday to raise the age to buy tobacco products from 18 to 21, joining more than \u003ca href=\"http://tobacco21.org/wp-content/uploads/2014/02/Tobacco-21-Cities-new24.pdf\" target=\"_blank\">120 cities across the country\u003c/a>, including New York and Boston, in the latest tactic to reduce smoking rates.\u003c/p>\n\u003cp>In California, Berkeley and parts of Santa Clara County have already moved to put tobacco out of the hands of teenagers. San Francisco Supervisor Scott Wiener, one of the authors of the measure, pointed to a \u003ca href=\"http://iom.nationalacademies.org/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">major analysis \u003c/a>from the Institute of Medicine last year that showed people who start smoking as teens are more likely to become hooked.\u003c/p>\n\u003cp>\"By increasing the legal age to buy tobacco products from the age of 18 to the age of 21, we will save lives,\" he said just before the vote. The measure applies to many tobacco products, including smokeless tobacco and e-cigarettes.\u003c/p>\n\u003cp>But there's a potential glitch. Tom Briant, executive director of the National Association of Tobacco Outlets says California law pre-empts cities from raising the age.\u003c/p>\n\u003cp>\"There needs to be some resolution on these questions, and the best person to do that is the California attorney general,\" Briant said in an interview.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Briant stopped short of saying his organization would challenge San Francisco in court, but did say the board of his organization would meet in April and discuss both Santa Clara County and San Francisco's moves.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/pubsforms/Documents/California%20Penal%20Codes%20308-308b.pdf\" target=\"_blank\">California law\u003c/a> states that 18 is the legal age to buy or possess tobacco products. In this passage, the Legislature seems to claim for itself the\u003ca href=\"https://www.cdph.ca.gov/pubsforms/Documents/California%20Penal%20Codes%20308-308b.pdf\" target=\"_blank\"> right to regulate tobacco\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It is the Legislature's intent to regulate the subject matter of this section. As a result, no city, county, or city and county shall adopt any ordinance or regulation inconsistent with this section.\u003c/p>\u003c/blockquote>\n\u003cp>Supervisor Wiener was unfazed. He said the San Francisco law did not interfere with state law and was unconcerned about challenges from the tobacco industry.\u003c/p>\n\u003cp>\"Our city has a history of taking on major industries in the name of public health, in the name of consumers, and winning. And we will do so here,\" he said.\u003c/p>\n\u003cp>The wine country city of Healdsburg was first in California to raise the tobacco age last fall, but declined to implement the higher age, apparently under pressure from the tobacco industry. Wiener said that with San Francisco's greater resources, the city would prevail in any court case.\u003c/p>\n\u003cp>Larry Cohen, executive director of the Oakland-based advocacy group Prevention Institute, said he \"couldn't be more pleased\" with the supervisors' vote. The move to raise the tobacco age to 21 is \"gathering momentum nationally,\" he said.\u003c/p>\n\u003cp>\"Ninety-five percent of daily smokers pick up the habit before age 21,\" he said. \"So the 21 age is really a critical number\" to reduce the numbers of smokers.\u003c/p>\n\u003cp>Certainly San Franciscans who are 18, 19 and 20 would be able to travel to a nearby city to legally purchase tobacco, but the higher age \"would still have its impact,\" Cohen said.\u003c/p>\n\u003cp>Most would not be thinking, \"Can I get on a BART train and go to South San Francisco\" to buy cigarettes, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measure goes to the mayor later this month. A spokeswoman said he supports the move and will sign.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"order": 8
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},
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"order": 9
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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"id": "latino-usa",
"title": "Latino USA",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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