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"content": "\u003cp>If you’re struck by an orca, sucked into a jet engine, or having relationship problems with your in-laws, fear not: Your doctor now has a medical diagnosis code for that.\u003c/p>\n\u003cp>Today U.S. doctors, hospitals and health insurers must start using the ICD-10, a vast new set of alphanumeric codes for describing diseases and injuries in unprecedented detail.\u003c/p>\n\u003cp>The transition, mandated by the federal government, has been called American health care’s Y2K moment, because the codes haven’t been updated in 36 years. Doctors and hospitals are on high alert since the arcane letters and digits are key to how health care providers get paid. If they don’t use the right codes, down to the decimal, they may not be paid sufficiently – or at all.\u003c/p>\n\u003cp>For months, healthcare insiders have been venting their frustrations with the changeover, posting Halloween-themed ICD-10 office decor on social media and mocking some of the wackier codes. Among the targets: W61.33 (pecked by a chicken), Y08.01 (assault by hockey stick) and R46.1 (bizarre personal appearance).\u003c/p>\n\u003cp>Not to mention W56.22xA – “struck by orca” – which became the title of an illustrated book of infamous ICD-10 codes that’s sold nearly 10,000 copies, said its editor, Niko Skievaski of Madison, Wis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Basically everyone who works in health care interacts with this code system – it’s really the language that’s used to communicate from the clinical side to insurers,” said Skievaski, whose experience at a health information technology company helped him and colleagues come up with the book idea. “These codes, they affect everybody.”\u003c/p>\n\u003cp>Behind the gallows humor lies a major change in how health providers do business, albeit one that’s nearly invisible to patients.\u003c/p>\n\u003cp>The codes doctors now must use to diagnose patients have multiplied from about 14,000 to nearly 70,000. Hospitals use a related set of medical procedure codes, which has grown even more — from 4,000 to about 72,000.\u003c/p>\n\u003cp>The reason for the change? The previous set of codes, ICD-9, which were in use since 1979, didn’t reflect the complexity of modern medicine. And some of the information was wrong or obsolete.\u003c/p>\n\u003cp>The ICD-10 codes set a new bar for comprehensiveness. Did you break your shinbone? Your physician will need to figure out which among dozens of codes for a fractured tibia correctly identify your injury. And if you’ve eaten toxic mushrooms, there are 18 potential codes to cover you.\u003c/p>\n\u003cp>Government and private insurers can reject claims that aren’t specific enough, use the wrong codes, or have a mismatch between a diagnosis and procedure code.\u003c/p>\n\u003cp>The ICD-10 changeover will be even more complicated in four states – California, Louisiana, Maryland, and Montana — because of their antiquated billing systems. They have permission from the federal government to temporarily use the old codes, at least for their Medicaid billing, until their systems can be upgraded. California’s upgrade is expected to be completed by 2017.\u003c/p>\n\u003cp>In Kaiser Permanente’s 4-million member health care region in Southern California, the transition involved revamping up to 30 computer systems and training about 10,000 employees, at an estimated cost of $15 million to $25 million.\u003c/p>\n\u003cp>“We’re about as prepared as any region can be,” senior manager Larry Sharfstein, who has been leading the process.\u003c/p>\n\u003cp>A Pasadena “command center” – a term generally applied in crisis situations — has been up and running since Monday.\u003c/p>\n\u003cp>So how does he feel now that the big day is here?\u003c/p>\n\u003cp>Sharfstein laughed. “I feel older,” he said.\u003c/p>\n\u003cp>The ICD-10 codes used by doctors are based on the International Classification of Diseases, 10th edition, a list of medical classifications maintained by the World Health Organization. It contains codes for injuries and diseases and their causes and symptoms, along with patient complaints and socioeconomic circumstances. While health organizations have long been preparing for the transition from ICD-9, the actual changeover date was delayed several times after some physicians and provider lobbying groups said they weren’t ready.\u003c/p>\n\u003cp>Even with the additional time, some recent tests of the codes among early adopters nationwide resulted in about a fifth of the claims being denied because they weren’t accurate or weren’t correctly submitted, said Dr. Richard Thorp, the immediate past president of the California Medical Association.\u003c/p>\n\u003cp>In the small town of Paradise, Calif., 85 miles north of Sacramento, Thorp said his 18-person medical group is hoping for the best. It invested late last year in a new electronic health records system that should help with the transition. Even so, he remains skeptical that things will go smoothly.\u003c/p>\n\u003cp>“It’s not going to be clear for three to six weeks whether there are going to be payment issues,” he said.\u003c/p>\n\u003cp>If everything goes well, he said, “we’ll just breathe a sigh of relief and go on doing what we really want to do — which is take care of patients.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003c/em>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you’re struck by an orca, sucked into a jet engine, or having relationship problems with your in-laws, fear not: Your doctor now has a medical diagnosis code for that.\u003c/p>\n\u003cp>Today U.S. doctors, hospitals and health insurers must start using the ICD-10, a vast new set of alphanumeric codes for describing diseases and injuries in unprecedented detail.\u003c/p>\n\u003cp>The transition, mandated by the federal government, has been called American health care’s Y2K moment, because the codes haven’t been updated in 36 years. Doctors and hospitals are on high alert since the arcane letters and digits are key to how health care providers get paid. If they don’t use the right codes, down to the decimal, they may not be paid sufficiently – or at all.\u003c/p>\n\u003cp>For months, healthcare insiders have been venting their frustrations with the changeover, posting Halloween-themed ICD-10 office decor on social media and mocking some of the wackier codes. Among the targets: W61.33 (pecked by a chicken), Y08.01 (assault by hockey stick) and R46.1 (bizarre personal appearance).\u003c/p>\n\u003cp>Not to mention W56.22xA – “struck by orca” – which became the title of an illustrated book of infamous ICD-10 codes that’s sold nearly 10,000 copies, said its editor, Niko Skievaski of Madison, Wis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Basically everyone who works in health care interacts with this code system – it’s really the language that’s used to communicate from the clinical side to insurers,” said Skievaski, whose experience at a health information technology company helped him and colleagues come up with the book idea. “These codes, they affect everybody.”\u003c/p>\n\u003cp>Behind the gallows humor lies a major change in how health providers do business, albeit one that’s nearly invisible to patients.\u003c/p>\n\u003cp>The codes doctors now must use to diagnose patients have multiplied from about 14,000 to nearly 70,000. Hospitals use a related set of medical procedure codes, which has grown even more — from 4,000 to about 72,000.\u003c/p>\n\u003cp>The reason for the change? The previous set of codes, ICD-9, which were in use since 1979, didn’t reflect the complexity of modern medicine. And some of the information was wrong or obsolete.\u003c/p>\n\u003cp>The ICD-10 codes set a new bar for comprehensiveness. Did you break your shinbone? Your physician will need to figure out which among dozens of codes for a fractured tibia correctly identify your injury. And if you’ve eaten toxic mushrooms, there are 18 potential codes to cover you.\u003c/p>\n\u003cp>Government and private insurers can reject claims that aren’t specific enough, use the wrong codes, or have a mismatch between a diagnosis and procedure code.\u003c/p>\n\u003cp>The ICD-10 changeover will be even more complicated in four states – California, Louisiana, Maryland, and Montana — because of their antiquated billing systems. They have permission from the federal government to temporarily use the old codes, at least for their Medicaid billing, until their systems can be upgraded. California’s upgrade is expected to be completed by 2017.\u003c/p>\n\u003cp>In Kaiser Permanente’s 4-million member health care region in Southern California, the transition involved revamping up to 30 computer systems and training about 10,000 employees, at an estimated cost of $15 million to $25 million.\u003c/p>\n\u003cp>“We’re about as prepared as any region can be,” senior manager Larry Sharfstein, who has been leading the process.\u003c/p>\n\u003cp>A Pasadena “command center” – a term generally applied in crisis situations — has been up and running since Monday.\u003c/p>\n\u003cp>So how does he feel now that the big day is here?\u003c/p>\n\u003cp>Sharfstein laughed. “I feel older,” he said.\u003c/p>\n\u003cp>The ICD-10 codes used by doctors are based on the International Classification of Diseases, 10th edition, a list of medical classifications maintained by the World Health Organization. It contains codes for injuries and diseases and their causes and symptoms, along with patient complaints and socioeconomic circumstances. While health organizations have long been preparing for the transition from ICD-9, the actual changeover date was delayed several times after some physicians and provider lobbying groups said they weren’t ready.\u003c/p>\n\u003cp>Even with the additional time, some recent tests of the codes among early adopters nationwide resulted in about a fifth of the claims being denied because they weren’t accurate or weren’t correctly submitted, said Dr. Richard Thorp, the immediate past president of the California Medical Association.\u003c/p>\n\u003cp>In the small town of Paradise, Calif., 85 miles north of Sacramento, Thorp said his 18-person medical group is hoping for the best. It invested late last year in a new electronic health records system that should help with the transition. Even so, he remains skeptical that things will go smoothly.\u003c/p>\n\u003cp>“It’s not going to be clear for three to six weeks whether there are going to be payment issues,” he said.\u003c/p>\n\u003cp>If everything goes well, he said, “we’ll just breathe a sigh of relief and go on doing what we really want to do — which is take care of patients.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003c/em>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Orange County Says Special-Ed Students Must Also Comply with Vaccine Law",
"title": "Orange County Says Special-Ed Students Must Also Comply with Vaccine Law",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>In Orange County, home to the \u003ca class=\"external\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">Disneyland measles outbreak\u003c/a> that spread to seven other states and fueled a strict California vaccination law this year, attorneys for the Orange County Department of Education have stated that the new vaccination requirements apply equally to special education students, a group that some thought would be exempt because of their federally protected right to educational services.\u003c/p>\n\u003cp>In \u003ca class=\"external\" href=\"https://www.documentcloud.org/documents/2429711-8-19-15-sb277-q-and-a.html\" target=\"_blank\">a memo\u003c/a> issued last month, the Orange County Department of Education has advised its 28 school districts that students in special education must comply with the law.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The law doesn’t say they are exempt.”\u003ccite>Ronald Wenkart, general counsel, Orange County Department of Education \u003c/cite>\u003c/aside>\n\u003cp>Under the law, which goes into effect on July 1, students must be vaccinated before attending school, unless they obtain a medical exemption to the required vaccinations, or enroll in homeschooling or independent study. The law abolished the \"personal belief exemption\" which allowed parents to refuse to vaccinate their children -- but still send them to public or private school.\u003c/p>\n\u003cp>“The law doesn’t say (special education students) are exempt,” said Ronald Wenkart, general counsel for the Orange County Department of Education and the author of the memo. If the lawmakers who drafted the legislation had wanted to exempt these students, “they could have put an exemption in there,” he said.\u003c/p>\n\u003cp>Yet, many parents who opposed the new vaccination law, known as \u003ca class=\"external\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">Senate Bill 277\u003c/a>, believed that special education students would be exempt. That's because of language in the bill, inserted late in the legislative process, that they felt guaranteed federally-protected educational services no matter what. The law states that it “does not prohibit” a student who qualifies for a special education from “accessing any special education and related services.” No details are provided.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the meaning of the phrase “accessing any special education and related services” has not yet been clarified by the California Department of Public Health, which is charged with issuing regulations and guidance to schools about the vaccination law. The Orange County Office of Education appears to be one of the first education agencies to offer an interpretation.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There’s a lot of anxiety, a lot of frustration and the feeling that we were lied to.” \u003ccite>Kristie Sepulveda-Burchit, executive director, Educate Advocate\u003c/cite>\u003c/aside>\n\u003cp>Its memo has surprised and upset some parents of unvaccinated students in special education, said Kristie Sepulveda-Burchit, executive director of Educate Advocate, a Southern California-based nonprofit organization of parents of children with special needs.\u003c/p>\n\u003cp>“There’s a lot of anxiety, a lot of frustration and the feeling that we were lied to,” Sepulveda-Burchit said. “Pretty much anyone you talk to was under the impression that students with an IEP (Individualized Education Program) were exempt from the bill.”\u003c/p>\n\u003cp>But that is not how the Orange County Department of Education sees it.\u003c/p>\n\u003cp>“I don’t think there is any difference between general education and special education in terms of vaccinations,” Wenkart said. “It’s the same rules.”\u003c/p>\n\u003cp>He said the federal guarantee of a “free and appropriate education” for students with disabilities does not conflict with the state law requiring that students be vaccinated.\u003c/p>\n\u003cp>“A child is entitled to a free and appropriate education and you also have a legal obligation to vaccinate your child,” he said. Wenkart did not provide further explanation about how schools would provide special education services to unvaccinated students.\u003c/p>\n\u003cp>He added, “If a parent chooses to violate the law, consequences could follow.” After notifying parents in writing about the requirements of Senate Bill 277, school districts could contact the Orange County Health Care Agency for assistance, he said.\u003c/p>\n\u003cp>And parents could end up in court, he said. “They’d have to present what would be their reason for not vaccinating their child,” Wenkart said. “If they believe vaccinations are harmful, the burden of proof is on them and they’d have to provide medical backup.” A school district could seek a court order to force parents to comply with the law, he said.\u003c/p>\n\u003cp>The legal opinion of the Orange County Department of Education is not the final word. The California Department of Public Health said that with regard to special education students, it “is reviewing the new law and meeting with partners to determine what guidance might be needed.”\u003c/p>\n\u003cp>Jennifer Nix, an attorney with School and College Legal Services of California, noted that the federal law is clear in requiring that students who qualify for special education receive those services.\u003c/p>\n\u003cp>“Federal law always trumps state law, if they can’t be implemented at the same time,” Nix said.\u003c/p>\n\u003cp>Paul Lavigne, executive director of the Greater Anaheim Special Education Local Plan Area, said his organization is waiting for further guidance. \"It’s one of these situations where the interpretation of the law is going to be the issue,” he said.\u003c/p>\n\u003cp>At the board meeting scheduled for Monday at the Orange County Department of Education in Costa Mesa, Sepulveda-Burchit and other members of Educate Advocate are “hoping to get some more answers,” she said.\u003c/p>\n\u003cp>“This brings fear to a whole other level for parents of kids with special needs,” she said of the memo.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://edsource.org/author/jadams\" target=\"_blank\">Jane Meredith Adams\u003c/a> covers student health and well-being for EdSource. Follow her on \u003ca href=\"https://twitter.com/JaneAdams\" target=\"_blank\">Twitter\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In Orange County, home to the \u003ca class=\"external\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">Disneyland measles outbreak\u003c/a> that spread to seven other states and fueled a strict California vaccination law this year, attorneys for the Orange County Department of Education have stated that the new vaccination requirements apply equally to special education students, a group that some thought would be exempt because of their federally protected right to educational services.\u003c/p>\n\u003cp>In \u003ca class=\"external\" href=\"https://www.documentcloud.org/documents/2429711-8-19-15-sb277-q-and-a.html\" target=\"_blank\">a memo\u003c/a> issued last month, the Orange County Department of Education has advised its 28 school districts that students in special education must comply with the law.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The law doesn’t say they are exempt.”\u003ccite>Ronald Wenkart, general counsel, Orange County Department of Education \u003c/cite>\u003c/aside>\n\u003cp>Under the law, which goes into effect on July 1, students must be vaccinated before attending school, unless they obtain a medical exemption to the required vaccinations, or enroll in homeschooling or independent study. The law abolished the \"personal belief exemption\" which allowed parents to refuse to vaccinate their children -- but still send them to public or private school.\u003c/p>\n\u003cp>“The law doesn’t say (special education students) are exempt,” said Ronald Wenkart, general counsel for the Orange County Department of Education and the author of the memo. If the lawmakers who drafted the legislation had wanted to exempt these students, “they could have put an exemption in there,” he said.\u003c/p>\n\u003cp>Yet, many parents who opposed the new vaccination law, known as \u003ca class=\"external\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">Senate Bill 277\u003c/a>, believed that special education students would be exempt. That's because of language in the bill, inserted late in the legislative process, that they felt guaranteed federally-protected educational services no matter what. The law states that it “does not prohibit” a student who qualifies for a special education from “accessing any special education and related services.” No details are provided.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the meaning of the phrase “accessing any special education and related services” has not yet been clarified by the California Department of Public Health, which is charged with issuing regulations and guidance to schools about the vaccination law. The Orange County Office of Education appears to be one of the first education agencies to offer an interpretation.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There’s a lot of anxiety, a lot of frustration and the feeling that we were lied to.” \u003ccite>Kristie Sepulveda-Burchit, executive director, Educate Advocate\u003c/cite>\u003c/aside>\n\u003cp>Its memo has surprised and upset some parents of unvaccinated students in special education, said Kristie Sepulveda-Burchit, executive director of Educate Advocate, a Southern California-based nonprofit organization of parents of children with special needs.\u003c/p>\n\u003cp>“There’s a lot of anxiety, a lot of frustration and the feeling that we were lied to,” Sepulveda-Burchit said. “Pretty much anyone you talk to was under the impression that students with an IEP (Individualized Education Program) were exempt from the bill.”\u003c/p>\n\u003cp>But that is not how the Orange County Department of Education sees it.\u003c/p>\n\u003cp>“I don’t think there is any difference between general education and special education in terms of vaccinations,” Wenkart said. “It’s the same rules.”\u003c/p>\n\u003cp>He said the federal guarantee of a “free and appropriate education” for students with disabilities does not conflict with the state law requiring that students be vaccinated.\u003c/p>\n\u003cp>“A child is entitled to a free and appropriate education and you also have a legal obligation to vaccinate your child,” he said. Wenkart did not provide further explanation about how schools would provide special education services to unvaccinated students.\u003c/p>\n\u003cp>He added, “If a parent chooses to violate the law, consequences could follow.” After notifying parents in writing about the requirements of Senate Bill 277, school districts could contact the Orange County Health Care Agency for assistance, he said.\u003c/p>\n\u003cp>And parents could end up in court, he said. “They’d have to present what would be their reason for not vaccinating their child,” Wenkart said. “If they believe vaccinations are harmful, the burden of proof is on them and they’d have to provide medical backup.” A school district could seek a court order to force parents to comply with the law, he said.\u003c/p>\n\u003cp>The legal opinion of the Orange County Department of Education is not the final word. The California Department of Public Health said that with regard to special education students, it “is reviewing the new law and meeting with partners to determine what guidance might be needed.”\u003c/p>\n\u003cp>Jennifer Nix, an attorney with School and College Legal Services of California, noted that the federal law is clear in requiring that students who qualify for special education receive those services.\u003c/p>\n\u003cp>“Federal law always trumps state law, if they can’t be implemented at the same time,” Nix said.\u003c/p>\n\u003cp>Paul Lavigne, executive director of the Greater Anaheim Special Education Local Plan Area, said his organization is waiting for further guidance. \"It’s one of these situations where the interpretation of the law is going to be the issue,” he said.\u003c/p>\n\u003cp>At the board meeting scheduled for Monday at the Orange County Department of Education in Costa Mesa, Sepulveda-Burchit and other members of Educate Advocate are “hoping to get some more answers,” she said.\u003c/p>\n\u003cp>“This brings fear to a whole other level for parents of kids with special needs,” she said of the memo.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://edsource.org/author/jadams\" target=\"_blank\">Jane Meredith Adams\u003c/a> covers student health and well-being for EdSource. Follow her on \u003ca href=\"https://twitter.com/JaneAdams\" target=\"_blank\">Twitter\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bill Making California Toughest in U.S. on Livestock Antibiotics Now Up to Governor",
"title": "Bill Making California Toughest in U.S. on Livestock Antibiotics Now Up to Governor",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>A bill that would require the most stringent regulations in the country on the use of antibiotics in livestock is on Gov. Jerry Brown's desk.\u003c/p>\n\u003cp>If signed into law, California would ban the common practice of using drugs to fatten animals and would require a prescription from a veterinarian for other uses, such as fighting disease or infection.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB27\" target=\"_blank\">SB27\u003c/a>, would effectively end over-the-counter sales of antibiotics for livestock. It also calls for monitoring by California's Department of Food and Agriculture and development of best practices for antibiotic use in livestock.\u003c/p>\n\u003cp>\"It will make California the first state in the nation to put constraints on the regular ongoing uses of antibiotics,\" said Avinash Kar, a senior attorney with the Natural Resources Defense Council, which supports the bill. \"These are all important advances, and we are hopeful that this will mean that other states will follow California's lead and, hopefully, even the federal government.”\u003c/p>\n\u003cp>More than 70 percent of the antibiotics sold in the U.S. are for animal use. Widespread use -- in people, too -- contributes to the rise of drug-resistant bacteria. (As an aside, the \"70 percent\" number is the subject of some debate, but \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/\" target=\"_blank\">appears to be quite accurate\u003c/a>.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that 2 million people get sick every year with a drug-resistant infection and \u003ca href=\"http://www.cdc.gov/drugresistance/\" target=\"_blank\">23,000 die \u003c/a>as a result of those illnesses.\u003c/p>\n\u003cp>\"Massive amounts of antibiotics are used on farms in the creation of meat,\" said Elisa Odabashian, director of Consumers Union's West Coast office, which also backs the bill.\u003c/p>\n\u003cp>\"If they're used to treat a disease, like antibiotics are used to treat a disease in humans, for a limited time, we're fine with that,” she said. “It's using it for growth promotion or disease prevention that creates these adaptive superbugs that makes medicines ineffective.”\u003c/p>\n\u003cp>Both the NRDC and Consumers Union had originally opposed the bill, labeling it too weak. It was first introduced last December.\u003c/p>\n\u003cp>But in the final two weeks of the session, which ended last Friday, Odabashian and Kar say that the governor’s office got involved and pushed for a tougher bill. It was only after the bill was amended to be more stringent did the NRDC and Consumers Union drop their opposition.\u003c/p>\n\u003cp>Brown had been pushing for a tougher livestock antibiotics bill since last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/02/why-advocates-say-browns-veto-of-livestock-antibiotics-bill-is-a-good-thing/\" target=\"_blank\">when he vetoed SB835\u003c/a>, a bill many advocates opposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">saying it was too lax\u003c/a>. In his veto statement, Brown said he wanted state regulators to work with legislators to find “new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.”\u003c/p>\n\u003cp>Sen. Jerry Hill, D-San Mateo, is the author of both last year’s bill and this one. “I worked very closely with Gov. Brown’s administration on SB27 and I’m confident the governor will sign it,” Hill said in an email. “There is no other state that has regulations as strong as those proposed by the bill. What we are able to accomplish here in California will hopefully set the trend for the rest of the country.”\u003c/p>\n\u003cp>The governor’s office did not return a call seeking comment in time for publication.\u003c/p>\n\u003cp>Industry groups have not mounted strong opposition. California’s Farm Bureau, for example, is neutral on the bill. Noelle Cremers, its director of natural resources and commodities, said that antibiotic resistance is an issue in livestock. “We have members who are not able to use antibiotics that they used to,” she said. “So we recognize the importance of being engaged in the discussion of having antibiotics available and effective into the future.”\u003c/p>\n\u003cp>The Farm Bureau remains neutral on the bill because of its requirement of a veterinarian’s prescription for antibiotics. California will be the first state in the country to require these prescriptions. Cremers said it will be a challenge for some livestock producers in rural areas to find a veterinarian.\u003c/p>\n\u003cp>“That requirement is significant and is going to be a burden to some of our members, and that’s why we couldn’t support the bill,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The governor has until early October to sign or veto the bill.\u003c/p>\n\n",
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"excerpt": "If signed into law, California would become the first state to ban use of antibiotics to fatten animals.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill that would require the most stringent regulations in the country on the use of antibiotics in livestock is on Gov. Jerry Brown's desk.\u003c/p>\n\u003cp>If signed into law, California would ban the common practice of using drugs to fatten animals and would require a prescription from a veterinarian for other uses, such as fighting disease or infection.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB27\" target=\"_blank\">SB27\u003c/a>, would effectively end over-the-counter sales of antibiotics for livestock. It also calls for monitoring by California's Department of Food and Agriculture and development of best practices for antibiotic use in livestock.\u003c/p>\n\u003cp>\"It will make California the first state in the nation to put constraints on the regular ongoing uses of antibiotics,\" said Avinash Kar, a senior attorney with the Natural Resources Defense Council, which supports the bill. \"These are all important advances, and we are hopeful that this will mean that other states will follow California's lead and, hopefully, even the federal government.”\u003c/p>\n\u003cp>More than 70 percent of the antibiotics sold in the U.S. are for animal use. Widespread use -- in people, too -- contributes to the rise of drug-resistant bacteria. (As an aside, the \"70 percent\" number is the subject of some debate, but \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/\" target=\"_blank\">appears to be quite accurate\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention estimates that 2 million people get sick every year with a drug-resistant infection and \u003ca href=\"http://www.cdc.gov/drugresistance/\" target=\"_blank\">23,000 die \u003c/a>as a result of those illnesses.\u003c/p>\n\u003cp>\"Massive amounts of antibiotics are used on farms in the creation of meat,\" said Elisa Odabashian, director of Consumers Union's West Coast office, which also backs the bill.\u003c/p>\n\u003cp>\"If they're used to treat a disease, like antibiotics are used to treat a disease in humans, for a limited time, we're fine with that,” she said. “It's using it for growth promotion or disease prevention that creates these adaptive superbugs that makes medicines ineffective.”\u003c/p>\n\u003cp>Both the NRDC and Consumers Union had originally opposed the bill, labeling it too weak. It was first introduced last December.\u003c/p>\n\u003cp>But in the final two weeks of the session, which ended last Friday, Odabashian and Kar say that the governor’s office got involved and pushed for a tougher bill. It was only after the bill was amended to be more stringent did the NRDC and Consumers Union drop their opposition.\u003c/p>\n\u003cp>Brown had been pushing for a tougher livestock antibiotics bill since last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/02/why-advocates-say-browns-veto-of-livestock-antibiotics-bill-is-a-good-thing/\" target=\"_blank\">when he vetoed SB835\u003c/a>, a bill many advocates opposed \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">saying it was too lax\u003c/a>. In his veto statement, Brown said he wanted state regulators to work with legislators to find “new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.”\u003c/p>\n\u003cp>Sen. Jerry Hill, D-San Mateo, is the author of both last year’s bill and this one. “I worked very closely with Gov. Brown’s administration on SB27 and I’m confident the governor will sign it,” Hill said in an email. “There is no other state that has regulations as strong as those proposed by the bill. What we are able to accomplish here in California will hopefully set the trend for the rest of the country.”\u003c/p>\n\u003cp>The governor’s office did not return a call seeking comment in time for publication.\u003c/p>\n\u003cp>Industry groups have not mounted strong opposition. California’s Farm Bureau, for example, is neutral on the bill. Noelle Cremers, its director of natural resources and commodities, said that antibiotic resistance is an issue in livestock. “We have members who are not able to use antibiotics that they used to,” she said. “So we recognize the importance of being engaged in the discussion of having antibiotics available and effective into the future.”\u003c/p>\n\u003cp>The Farm Bureau remains neutral on the bill because of its requirement of a veterinarian’s prescription for antibiotics. California will be the first state in the country to require these prescriptions. Cremers said it will be a challenge for some livestock producers in rural areas to find a veterinarian.\u003c/p>\n\u003cp>“That requirement is significant and is going to be a burden to some of our members, and that’s why we couldn’t support the bill,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The governor has until early October to sign or veto the bill.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A controversial bill to legalize physician-assisted suicide in California is headed to the governor for consideration, after almost nine months of intense, often personal debate in the Legislature.\u003c/p>\n\u003cp>If Gov. Jerry Brown signs the bill, California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana.\u003c/p>\n\u003cp>“Our hope, our fervent hope, is that Gov. Jerry Brown will sign this bill and bring relief to hundreds of dying Californians,” said Toni Broaddus, California campaign director for advocacy group Compassion & Choices.\u003c/p>\n\u003cp>The California bill was modeled after the Oregon law. It requires two different doctors to determine that a patient has six months or less to live before prescribing the drugs. Patients must be physically able to swallow the medication themselves, and must have the mental capacity to make medical decisions.\u003c/p>\n\u003cp>[contextly_sidebar id=\"WwaMXY3KhsB3D0AneaZItuHsUvPEDxTV\"]Numerous additional safeguards were added to the bill in recent months to sway opponents, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/09/physician-assisted-suicide-bill-one-step-from-governors-desk/\" target=\"_blank\">a sunset clause\u003c/a> that ends the law in 10 years. Patients must request the drugs three times to receive them, once in writing before two witnesses, and they must sign a form two days before ingesting the medication.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I can assure you that the joint and co-authors on this bill ... have endeavored to build in protections in this law that are stronger than the protections in any of the states where this has been practiced,” said Sen. Bill Monning, D-Carmel.\u003c/p>\n\u003cp>The bill continued to face fierce opposition, however, from religious groups and disability rights advocates. They are concerned that elderly and disabled people, especially those who are low income, could be pressured into taking the drugs in order to end or avoid expensive, life-sustaining care. They fear the protections are not enough, and that family members or other heirs could slip the drugs to the patient without their knowledge or consent.\u003c/p>\n\u003cp>“The legislation effectively paints a target on the back of each and every elderly and disabled person in our state,” said Sen. Joel Anderson, R-San Diego, paraphrasing an elder abuse advocate. “The promises and assurances of the safeguards and protections from the representatives of those in favor are based in innocent ignorance.”\u003c/p>\n\u003cp>Opponents also criticized the procedure for getting the bill through the Legislature. During the normal legislative session, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\">the bill stalled \u003c/a>in the Assembly Health Committee when authors couldn’t get enough votes. Several Democrats from Southern California would not support it.\u003c/p>\n\u003cp>But proponents managed to navigate through that roadblock by re-introducing the bill during a special session on health care financing, where committee memberships were different. The bill passed the Assembly on Wednesday 44-35, and it passed the Senate on Friday 23-14.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">Gov. Jerry Brown’s office also criticized \u003c/a>the political pathway, saying the special session was not the appropriate venue for the physician-assisted suicide bill. But Brown has not indicated where he stands on the issue itself, nor whether he will sign or veto the bill. If he does nothing, after 30 days the bill will become law.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A controversial bill to legalize physician-assisted suicide in California is headed to the governor for consideration, after almost nine months of intense, often personal debate in the Legislature.\u003c/p>\n\u003cp>If Gov. Jerry Brown signs the bill, California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana.\u003c/p>\n\u003cp>“Our hope, our fervent hope, is that Gov. Jerry Brown will sign this bill and bring relief to hundreds of dying Californians,” said Toni Broaddus, California campaign director for advocacy group Compassion & Choices.\u003c/p>\n\u003cp>The California bill was modeled after the Oregon law. It requires two different doctors to determine that a patient has six months or less to live before prescribing the drugs. Patients must be physically able to swallow the medication themselves, and must have the mental capacity to make medical decisions.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Numerous additional safeguards were added to the bill in recent months to sway opponents, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/09/physician-assisted-suicide-bill-one-step-from-governors-desk/\" target=\"_blank\">a sunset clause\u003c/a> that ends the law in 10 years. Patients must request the drugs three times to receive them, once in writing before two witnesses, and they must sign a form two days before ingesting the medication.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I can assure you that the joint and co-authors on this bill ... have endeavored to build in protections in this law that are stronger than the protections in any of the states where this has been practiced,” said Sen. Bill Monning, D-Carmel.\u003c/p>\n\u003cp>The bill continued to face fierce opposition, however, from religious groups and disability rights advocates. They are concerned that elderly and disabled people, especially those who are low income, could be pressured into taking the drugs in order to end or avoid expensive, life-sustaining care. They fear the protections are not enough, and that family members or other heirs could slip the drugs to the patient without their knowledge or consent.\u003c/p>\n\u003cp>“The legislation effectively paints a target on the back of each and every elderly and disabled person in our state,” said Sen. Joel Anderson, R-San Diego, paraphrasing an elder abuse advocate. “The promises and assurances of the safeguards and protections from the representatives of those in favor are based in innocent ignorance.”\u003c/p>\n\u003cp>Opponents also criticized the procedure for getting the bill through the Legislature. During the normal legislative session, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\">the bill stalled \u003c/a>in the Assembly Health Committee when authors couldn’t get enough votes. Several Democrats from Southern California would not support it.\u003c/p>\n\u003cp>But proponents managed to navigate through that roadblock by re-introducing the bill during a special session on health care financing, where committee memberships were different. The bill passed the Assembly on Wednesday 44-35, and it passed the Senate on Friday 23-14.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">Gov. Jerry Brown’s office also criticized \u003c/a>the political pathway, saying the special session was not the appropriate venue for the physician-assisted suicide bill. But Brown has not indicated where he stands on the issue itself, nor whether he will sign or veto the bill. If he does nothing, after 30 days the bill will become law.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Calif. Legislature Approves Bill Requiring Prescription Labels In 5 Foreign Languages",
"title": "Calif. Legislature Approves Bill Requiring Prescription Labels In 5 Foreign Languages",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>California’s pharmacists would be required to provide prescription drug labels or medication instructions in five languages besides English under a bill passed unanimously Thursday by California lawmakers.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB1073\" target=\"_blank\">AB 1073\u003c/a>, will be sent to Gov. Jerry Brown for his signature and would take effect Jan. 1 if signed into law. Upon request from patients or their caregivers, pharmacists would need to provide medication instructions in Spanish, Tagalog, Chinese, Vietnamese or Korean, the most common languages in California after English. The instructions could be on prescription labels or in patient handouts.\u003c/p>\n\u003cp>The measure would make California the second state in the nation, after New York, to require pharmacists to provide non-English materials for patients to take home. New York’s law only applies to pharmacy chains with eight or more stores, while California’s applies to all pharmacies regardless of size.\u003c/p>\n\u003cp>“We’re hoping this improves medical adherence and saves lives,” said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, which supported the bill. The legislation will make it easier for non-English and limited-English speakers to take their medications correctly, she said.\u003c/p>\n\u003cp>An estimated \u003ca href=\"http://www.migrationpolicy.org/article/limited-english-proficient-population-united-states\" target=\"_blank\">6.8 million\u003c/a> Californians –- nearly 20 percent of the state’s residents –- are considered to have limited English skills, according to the U.S. Census.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The California Board of Pharmacy, which supported the bill, already requires pharmacists to offer free interpreting services for non-English speakers, upon request at the pharmacy counter.\u003c/p>\n\u003cp>Some California pharmacies already provide translated prescription labels and medication instructions, but they aren’t required to by law.\u003c/p>\n\u003cp>Other pharmacies, from “mom-and-pop” stores serving ethnic communities to large drugstore chains, go further to serve the state’s diverse population. CVS, which operates 865 pharmacies in California, provides medication instructions in 15 languages in addition to English when customers request them. The company also provides telephone translation in more than 150 languages, said company spokesman Mike DeAngelis.\u003c/p>\n\u003cp>A California Pharmacists Association spokeswoman declined to comment on the bill Thursday.\u003c/p>\n\u003cp>The current prescription translation bill faced no opposition, but similar bills in previous years had stalled over pharmacists’ fears of liability if prescription labels or medication instruction handouts weren’t correctly translated. This time, pharmacists will have more flexibility and oversight in developing the translated information for their customers, said Virginia Herold, executive officer of the California Board of Pharmacy.\u003c/p>\n\u003cp>“Pharmacy services are an integral part of health care and language skills should never be an impediment to equal access,” said California Assemblyman Phil Ting, D-San Francisco, who sponsored the bill. “California is the most linguistically diverse state in the nation. By ensuring that all patients understand their medications, we will save lives and improve health care for millions of people.”\u003c/p>\n\u003cp>A state law passed in 2007 required the California Board of Pharmacy to develop more patient-friendly prescription labels. The board subsequently provided \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\">translations in five languages\u003c/a> for common medication instructions, such as “take one pill at night.” But pharmacists didn’t have to use them, and many didn’t.\u003c/p>\n\u003cp>There’s little current data on how many California pharmacies offer prescription labels or medication instructions in languages other than English. A California Board of Pharmacy survey found that about 70 percent of pharmacies offered some translations, but their accuracy could not be determined.\u003c/p>\n\u003cp>A 2009 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/19433992\" target=\"_blank\">study\u003c/a> of pharmacies in four states (not including California) found that 43 percent of pharmacies reported medication translations were available in at least one language other than English, but 21 percent reported limited availability and 35 percent cited no availability.\u003c/p>\n\u003cp>Herold said the Board of Pharmacy will urge pharmacists to place the medication instructions directly on the prescription bottle label, where they can’t be lost, although that’s not mandated by the current bill.\u003c/p>\n\u003cp>“Nobody got everything they wanted (in the bill), but we think we're moving in the right direction, compared to where we were five years ago,” Herold said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003ca href=\"http://khn.org\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the Kaiser Family Foundation. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s pharmacists would be required to provide prescription drug labels or medication instructions in five languages besides English under a bill passed unanimously Thursday by California lawmakers.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB1073\" target=\"_blank\">AB 1073\u003c/a>, will be sent to Gov. Jerry Brown for his signature and would take effect Jan. 1 if signed into law. Upon request from patients or their caregivers, pharmacists would need to provide medication instructions in Spanish, Tagalog, Chinese, Vietnamese or Korean, the most common languages in California after English. The instructions could be on prescription labels or in patient handouts.\u003c/p>\n\u003cp>The measure would make California the second state in the nation, after New York, to require pharmacists to provide non-English materials for patients to take home. New York’s law only applies to pharmacy chains with eight or more stores, while California’s applies to all pharmacies regardless of size.\u003c/p>\n\u003cp>“We’re hoping this improves medical adherence and saves lives,” said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, which supported the bill. The legislation will make it easier for non-English and limited-English speakers to take their medications correctly, she said.\u003c/p>\n\u003cp>An estimated \u003ca href=\"http://www.migrationpolicy.org/article/limited-english-proficient-population-united-states\" target=\"_blank\">6.8 million\u003c/a> Californians –- nearly 20 percent of the state’s residents –- are considered to have limited English skills, according to the U.S. Census.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The California Board of Pharmacy, which supported the bill, already requires pharmacists to offer free interpreting services for non-English speakers, upon request at the pharmacy counter.\u003c/p>\n\u003cp>Some California pharmacies already provide translated prescription labels and medication instructions, but they aren’t required to by law.\u003c/p>\n\u003cp>Other pharmacies, from “mom-and-pop” stores serving ethnic communities to large drugstore chains, go further to serve the state’s diverse population. CVS, which operates 865 pharmacies in California, provides medication instructions in 15 languages in addition to English when customers request them. The company also provides telephone translation in more than 150 languages, said company spokesman Mike DeAngelis.\u003c/p>\n\u003cp>A California Pharmacists Association spokeswoman declined to comment on the bill Thursday.\u003c/p>\n\u003cp>The current prescription translation bill faced no opposition, but similar bills in previous years had stalled over pharmacists’ fears of liability if prescription labels or medication instruction handouts weren’t correctly translated. This time, pharmacists will have more flexibility and oversight in developing the translated information for their customers, said Virginia Herold, executive officer of the California Board of Pharmacy.\u003c/p>\n\u003cp>“Pharmacy services are an integral part of health care and language skills should never be an impediment to equal access,” said California Assemblyman Phil Ting, D-San Francisco, who sponsored the bill. “California is the most linguistically diverse state in the nation. By ensuring that all patients understand their medications, we will save lives and improve health care for millions of people.”\u003c/p>\n\u003cp>A state law passed in 2007 required the California Board of Pharmacy to develop more patient-friendly prescription labels. The board subsequently provided \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\">translations in five languages\u003c/a> for common medication instructions, such as “take one pill at night.” But pharmacists didn’t have to use them, and many didn’t.\u003c/p>\n\u003cp>There’s little current data on how many California pharmacies offer prescription labels or medication instructions in languages other than English. A California Board of Pharmacy survey found that about 70 percent of pharmacies offered some translations, but their accuracy could not be determined.\u003c/p>\n\u003cp>A 2009 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/19433992\" target=\"_blank\">study\u003c/a> of pharmacies in four states (not including California) found that 43 percent of pharmacies reported medication translations were available in at least one language other than English, but 21 percent reported limited availability and 35 percent cited no availability.\u003c/p>\n\u003cp>Herold said the Board of Pharmacy will urge pharmacists to place the medication instructions directly on the prescription bottle label, where they can’t be lost, although that’s not mandated by the current bill.\u003c/p>\n\u003cp>“Nobody got everything they wanted (in the bill), but we think we're moving in the right direction, compared to where we were five years ago,” Herold said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder Ostrov reported this story for \u003ca href=\"http://khn.org\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the Kaiser Family Foundation. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Physician-Assisted Suicide Bill One Step from Governor's Desk",
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"content": "\u003cp>Supporters of a controversial bill to legalize physician-assisted suicide in California have two more days to get their legislation to the governor's desk.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">The bill \u003c/a>cleared one of its last major hurdles in the Assembly on Wednesday, with members voting 44 to 35 to allow doctors to prescribe lethal medication to terminally ill patients who request it. It is expected to be heard by the full Senate on Friday.\u003c/p>\n\u003cp>Authors were able to convert several opponents in recent weeks by adding more patient protections to the legislation, including\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/04/physician-assisted-suicide-bill-advances-with-new-sunset-clause/\" target=\"_blank\"> a sunset clause\u003c/a> that would end the law after 10 years, and a requirement for patients who have been prescribed the fatal drugs to sign a form two days before taking them.\u003c/p>\n\u003cp>“I didn’t originally support this bill. To me it did not have enough protections,” said Catharine Baker, R-San Ramon. “I believe now it does.”\u003c/p>\n\u003cp>She says she was also influenced by numerous faith leaders in her community who attend deaths and told her that assisted suicide is already happening.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“People are slipped medications to kill them all the time,\" she says they told her. \"And it is completely unregulated with no safeguards. We have an opportunity to provide a choice for someone who is in their final, painful hours, that is safer and well regulated and has a protection for human life and dignity.”\u003c/p>\n\u003cp>The bill requires patients to request the medication three times before they can receive it, once in writing. They must be mentally competent, and physically able to swallow the drugs themselves. Two different doctors must confirm a prognosis of six months or less to live.\u003c/p>\n\u003cp>Opponents in the Assembly argued that it wasn’t the role of the state to ratify peoples' decision to end their lives, especially because doctors are often wrong about terminal prognoses. Cheryl Brown, D-San Bernardino, said one of her relatives was given six months to live after being diagnosed with pancreatic cancer.\u003c/p>\n\u003cp>“Six months later, he didn’t die,” she said. “Eight years later, after he had become a minister of the gospel, the Lord saw fit to take him home.”\u003c/p>\n\u003cp>Other opponents argued that low-income people would suffer under the bill, by being pressured to take life-ending drugs to save their families from the financial burden of pursuing more expensive life-sustaining treatments.\u003c/p>\n\u003cp>“Everything in the health care system is driven by cost. Everything,” said Lorena Gonzalez, D-San Diego. “I just can’t believe that this will actually provide choices for my community.”\u003c/p>\n\u003cp>This is the second attempt to push the aid-in-dying bill through this legislative session. A Senate version of the bill (SB 128) \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\">stalled\u003c/a> in the Assembly this summer. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/18/physician-assisted-suicide-bill-revived-in-special-session/\" target=\"_blank\">Proponents introduced\u003c/a> the current Assembly bill (AB X2-15) during Gov. Jerry Brown’s special session on health care financing.\u003c/p>\n\u003cp>Opponents tried twice to block the bill on procedural grounds Wednesday, but failed both times.\u003c/p>\n\u003cp>The bill goes next to the full Senate, which is expected to endorse the bill, after voting \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/04/california-senate-approves-assisted-suicide-bill/\" target=\"_blank\">to approve the earlier version\u003c/a> 23 to 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>From there it goes to the governor's desk. Though Brown’s office argued that the special session was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">not the appropriate venue \u003c/a>to advance the bill, it has not indicated where Brown stands on the issue, nor whether he will sign or veto the bill.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Supporters of a controversial bill to legalize physician-assisted suicide in California have two more days to get their legislation to the governor's desk.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">The bill \u003c/a>cleared one of its last major hurdles in the Assembly on Wednesday, with members voting 44 to 35 to allow doctors to prescribe lethal medication to terminally ill patients who request it. It is expected to be heard by the full Senate on Friday.\u003c/p>\n\u003cp>Authors were able to convert several opponents in recent weeks by adding more patient protections to the legislation, including\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/04/physician-assisted-suicide-bill-advances-with-new-sunset-clause/\" target=\"_blank\"> a sunset clause\u003c/a> that would end the law after 10 years, and a requirement for patients who have been prescribed the fatal drugs to sign a form two days before taking them.\u003c/p>\n\u003cp>“I didn’t originally support this bill. To me it did not have enough protections,” said Catharine Baker, R-San Ramon. “I believe now it does.”\u003c/p>\n\u003cp>She says she was also influenced by numerous faith leaders in her community who attend deaths and told her that assisted suicide is already happening.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“People are slipped medications to kill them all the time,\" she says they told her. \"And it is completely unregulated with no safeguards. We have an opportunity to provide a choice for someone who is in their final, painful hours, that is safer and well regulated and has a protection for human life and dignity.”\u003c/p>\n\u003cp>The bill requires patients to request the medication three times before they can receive it, once in writing. They must be mentally competent, and physically able to swallow the drugs themselves. Two different doctors must confirm a prognosis of six months or less to live.\u003c/p>\n\u003cp>Opponents in the Assembly argued that it wasn’t the role of the state to ratify peoples' decision to end their lives, especially because doctors are often wrong about terminal prognoses. Cheryl Brown, D-San Bernardino, said one of her relatives was given six months to live after being diagnosed with pancreatic cancer.\u003c/p>\n\u003cp>“Six months later, he didn’t die,” she said. “Eight years later, after he had become a minister of the gospel, the Lord saw fit to take him home.”\u003c/p>\n\u003cp>Other opponents argued that low-income people would suffer under the bill, by being pressured to take life-ending drugs to save their families from the financial burden of pursuing more expensive life-sustaining treatments.\u003c/p>\n\u003cp>“Everything in the health care system is driven by cost. Everything,” said Lorena Gonzalez, D-San Diego. “I just can’t believe that this will actually provide choices for my community.”\u003c/p>\n\u003cp>This is the second attempt to push the aid-in-dying bill through this legislative session. A Senate version of the bill (SB 128) \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\">stalled\u003c/a> in the Assembly this summer. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/18/physician-assisted-suicide-bill-revived-in-special-session/\" target=\"_blank\">Proponents introduced\u003c/a> the current Assembly bill (AB X2-15) during Gov. Jerry Brown’s special session on health care financing.\u003c/p>\n\u003cp>Opponents tried twice to block the bill on procedural grounds Wednesday, but failed both times.\u003c/p>\n\u003cp>The bill goes next to the full Senate, which is expected to endorse the bill, after voting \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/04/california-senate-approves-assisted-suicide-bill/\" target=\"_blank\">to approve the earlier version\u003c/a> 23 to 15.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>From there it goes to the governor's desk. Though Brown’s office argued that the special session was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">not the appropriate venue \u003c/a>to advance the bill, it has not indicated where Brown stands on the issue, nor whether he will sign or veto the bill.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Physician-Assisted Suicide Bill Advances as Backers Add Sunset Clause",
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"content": "\u003cp>With just one week to go in the legislative session, a bill that would legalize physician-assisted suicide in California was approved by the Assembly's finance committee and will move to the Assembly floor next.\u003c/p>\n\u003cp>The committee approved the bill with a new amendment: a sunset clause. If the bill is signed into law, it will remain in effect only until Jan. 1, 2026, unless another law extends or ends that date.\u003c/p>\n\u003cp>Sen. Bill Monning, D-Carmel, a co-author of the bill, said a sunset clause can be used in \"landmark legislation as one way to address concerns of people who may have hesitations.\"\u003c/p>\n\u003cp>\"We think it's an effective tool to assuage concerns of some members and build confidence,\" Monning said. \"If some of their concerns about patient protections are valid, there's a way to revisit the whole issue.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"XB2SO2JCJKRr48MpGuNqzbTfWpEEjHEV\"]Under the \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>, physicians could prescribe lethal medication to terminally ill patients who request it. The patients must be mentally competent and able to swallow the drugs themselves.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After an earlier bill\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\"> stalled in July\u003c/a>, backers introduced this new one weeks later during a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/18/physician-assisted-suicide-bill-revived-in-special-session/\" target=\"_blank\">special session of the Legislature \u003c/a>called by Gov. Brown.\u003c/p>\n\u003cp>Marilyn Golden, senior policy analyst with the Disability Rights Education and Defense Fund, which opposes the bill, said the new amendment \"does not make the law more acceptable.\"\u003c/p>\n\u003cp>She said the policy is \"a recipe for abuse\" and that an \"heir who stands to inherit, or an abusive caregiver, can steer a person -- legally witness their request, pick up the lethal dose and even administer it, because no objective witness is required at the death, so who would know what would happen?\"\u003c/p>\n\u003cp>Monning said that the bill requires two independent physicians to agree on the patient's health status and, if there's any doubt about the patient's decision-making capability, to refer the patient to a psychiatrist or psychologist for evaluation.\u003c/p>\n\u003cp>Another new amendment requires the patient to fill out and sign a form 48 hours before taking the lethal drugs.\u003c/p>\n\u003cp>With these new amendments, Monning said he is \"cautiously optimistic\" for the bill's passage. \"We are as well postured as any other time in the history of this state to pass this historic legislation,\" he said.\u003c/p>\n\u003cp>Backers anticipate the bill will be heard on the Assembly floor on Tuesday. Then it moves back to the Senate, where two committees must pass it before it can move to the Senate floor. Golden said her group would continue to lobby legislators to vote against it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even if the Legislature approves the bill, it's unclear if Brown will sign it into law. He has indicated that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">he does not approve\u003c/a> of this bill being heard in a special session that was called to consider funding for Medi-Cal and that this session is not the appropriate venue for this legislation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With just one week to go in the legislative session, a bill that would legalize physician-assisted suicide in California was approved by the Assembly's finance committee and will move to the Assembly floor next.\u003c/p>\n\u003cp>The committee approved the bill with a new amendment: a sunset clause. If the bill is signed into law, it will remain in effect only until Jan. 1, 2026, unless another law extends or ends that date.\u003c/p>\n\u003cp>Sen. Bill Monning, D-Carmel, a co-author of the bill, said a sunset clause can be used in \"landmark legislation as one way to address concerns of people who may have hesitations.\"\u003c/p>\n\u003cp>\"We think it's an effective tool to assuage concerns of some members and build confidence,\" Monning said. \"If some of their concerns about patient protections are valid, there's a way to revisit the whole issue.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Under the \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>, physicians could prescribe lethal medication to terminally ill patients who request it. The patients must be mentally competent and able to swallow the drugs themselves.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After an earlier bill\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/07/07/californias-physician-assisted-suicide-bill-shelved-for-the-year/\" target=\"_blank\"> stalled in July\u003c/a>, backers introduced this new one weeks later during a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/18/physician-assisted-suicide-bill-revived-in-special-session/\" target=\"_blank\">special session of the Legislature \u003c/a>called by Gov. Brown.\u003c/p>\n\u003cp>Marilyn Golden, senior policy analyst with the Disability Rights Education and Defense Fund, which opposes the bill, said the new amendment \"does not make the law more acceptable.\"\u003c/p>\n\u003cp>She said the policy is \"a recipe for abuse\" and that an \"heir who stands to inherit, or an abusive caregiver, can steer a person -- legally witness their request, pick up the lethal dose and even administer it, because no objective witness is required at the death, so who would know what would happen?\"\u003c/p>\n\u003cp>Monning said that the bill requires two independent physicians to agree on the patient's health status and, if there's any doubt about the patient's decision-making capability, to refer the patient to a psychiatrist or psychologist for evaluation.\u003c/p>\n\u003cp>Another new amendment requires the patient to fill out and sign a form 48 hours before taking the lethal drugs.\u003c/p>\n\u003cp>With these new amendments, Monning said he is \"cautiously optimistic\" for the bill's passage. \"We are as well postured as any other time in the history of this state to pass this historic legislation,\" he said.\u003c/p>\n\u003cp>Backers anticipate the bill will be heard on the Assembly floor on Tuesday. Then it moves back to the Senate, where two committees must pass it before it can move to the Senate floor. Golden said her group would continue to lobby legislators to vote against it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even if the Legislature approves the bill, it's unclear if Brown will sign it into law. He has indicated that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/19/gov-brown-says-not-so-fast-on-new-physician-assisted-suicide-push/\" target=\"_blank\">he does not approve\u003c/a> of this bill being heard in a special session that was called to consider funding for Medi-Cal and that this session is not the appropriate venue for this legislation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Moves To Stop Misuse Of Psychiatric Meds In Foster Care",
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"content": "\u003cp>By the time DeAngelo Cortijo was 14, he had been in more than a dozen foster homes. He had run away and lived on the streets for months, and he had been diagnosed with bipolar and anxiety disorders, attachment disorder, intermittent explosive disorder or post-traumatic stress disorder. He had been in and out of mental hospitals and heavily medicated.\u003c/p>\n\u003cp>Cortijo, who was born in San Francisco, was taken from his mother after she attempted suicide when he was 3.\u003c/p>\n\u003cp>After his later diagnoses, he was prescribed a combination of antipsychotics, antidepressants and stimulants, and was told that taking them was his only hope of being normal. Instead, he said, medication made him feel \"doped up and completely lost.\"\u003c/p>\n\u003cp>It was not until he spent several months developing a relationship with a horse — \"and it was huge,\" said Cortijo with a smile — that he began to really acknowledge his own feelings. \"Animals sense you, your fears, anxieties and insecurities,\" he said.\u003c/p>\n\u003cp>Finding help through equine-assisted therapy — riding a horse, feeding, grooming and communicating with it — helped Cortijo to gain a better perspective on himself. \"It allowed me to understand what a bond was, to realize I am an individual who is capable of caring, capable of being normal,\" said Cortijo.\u003c/p>\n\u003cfigure id=\"attachment_71797\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/sam-1_enl-22bcb13ff05089c6d5a2490ebf0f3a08ab1b43c0-e1441217324828.jpg\">\u003cimg class=\"size-full wp-image-71797\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/sam-1_enl-22bcb13ff05089c6d5a2490ebf0f3a08ab1b43c0-e1441217324828.jpg\" alt=\"DeAngelo Cortijo, 22, says he benefited more from therapy than from psychotropic medications during his years in foster care.\" width=\"1920\" height=\"1439\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">DeAngelo Cortijo, 22, says he benefited more from therapy than from psychotropic medications during his years in foster care. \u003ccite>(Elaine Korry)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He's now 22, off all medication, and is helping troubled youth as a juvenile justice intern at the National Center for Youth Law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Children in foster care are prescribed antipsychotic drugs at double to quadruple the rate of those not in foster care, according to a \u003ca href=\"http://www.gao.gov/products/GAO-12-201\">Government Accountability Office \u003c/a> report. Hundreds of children were found to be taking five or more psychotropic medications at a time, although there is no medical evidence to support such a drug regimen. Thousands of children were prescribed doses that exceeded FDA-approved guidelines. The report found monitoring programs for psychotropic drugs provided to foster children fell short of guidelines established by the American Academy of Child and Adolescent Psychiatry.\u003c/p>\n\u003cp>In March, a \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-12-00320.pdf\">report\u003c/a> by the inspector general at Health and Human Services found quality-of-care concerns in more than two-thirds of claims for psychotropic drugs paid for by Medicaid, the health insurer for most children in foster care. Those included too many drugs (37 percent); wrong dose (23 percent); poor monitoring (53 percent); or wrong treatment (41 percent). The OIG recommended that the Centers for Medicare & Medicaid Services (CMS) work with the states to enhance oversight, medical reviews and utilization reviews of psychotropics prescribed to children.\u003c/p>\n\u003cp>In California, a sweeping package of laws to regulate the prescribing of powerful psychiatric medications to children and teens in the child-welfare system has passed the Senate and is heading to the state Assembly, where it faces no formal opposition. The reforms also are being eyed as a template for federal legislation. Anna Johnson, a social analyst at the Oakland-based \u003ca href=\"http://youthlaw.org/\">National Center for Youth Law\u003c/a>, which helped write the legislation, said an enforcement mechanism is needed to change prescribing practices.\u003c/p>\n\u003cp>\"The legislation describes in detail the oversight function — what everyone's role is, from the juvenile court judge and the social workers, to the care providers, the lawyers, the doctors,\" said Johnson. \"And it names specifically the prescribing practices we want to see reduced: the use of multiple drugs on children, dosages that exceed maximums and the use of antipsychotics where not medically necessary because of physical health risk factors.\"\u003c/p>\n\u003cp>The push for tougher laws follows last year's publication of a \u003ca href=\"http://webspecial.mercurynews.com/druggedkids/\">series of investigative articles \u003c/a>in the San Jose Mercury News, which alleged widespread use of antipsychotics and other psychiatric drugs without proper evaluation and monitoring among the estimated 63,000 California children in foster care.\u003c/p>\n\u003cp>\"It is well beyond time for us to be having this discussion and intervening,\" said Ken Berrick, president and CEO of the \u003ca href=\"http://www.senecafoa.org/\">Seneca Family of Agencies\u003c/a>, which provides mental health and other services for children in California. According to Berrick, overuse of medication has been a problem for decades, often because better alternatives simply weren't available. \"Medication is available right now on demand, and other services are not,\" he said. \"When you don't have a choice, you rely on what you have.\"\u003c/p>\n\u003cp>Under the reforms, there would be better monitoring of children on medication and closer scrutiny of physicians to identify doctors who rely most heavily on medication. The bill also calls for stricter oversight of group homes to determine if psychotropic medications are used to control children's behavior. \"Drugging and sedating children should never be considered the primary option in lieu of counseling, therapy and appropriate treatment,\" said the bill's author, Sen. Jim Beall, D-San Jose.\u003c/p>\n\u003cp>In addition, social workers and caregivers in California would receive training in the risks, benefits and side effects of psychiatric medications. A mix of state and federal dollars would establish a structure to provide second medical opinions.\u003c/p>\n\u003cp>Beyond reining in prescribing outliers, the legislation also places a new emphasis on defining what comprises appropriate care for vulnerable youth. \"It's no longer a drugs-only approach,\" explained Johnson, who said the legislation would require that children who are being given powerful medications also receive other services.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/taking-pills_wide-781ec7995da58abafd14751200dad6284914990a-e1441217370456.jpg\">\u003cimg class=\"aligncenter size-full wp-image-71798\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/taking-pills_wide-781ec7995da58abafd14751200dad6284914990a-e1441217370456.jpg\" alt=\"Andy Baker/Ikon Images/Getty Images\" width=\"1920\" height=\"1080\">\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\"We're saying, you have to do something else — either first or at the same time — to really help a troubled child,\" said Johnson. \"Swallowing a pill doesn't help with grief or trauma. It may contain symptoms, but it doesn't help you move forward and be functional in life.\"\u003c/p>\n\u003cp>In legislative hearings, former foster youth testified about negative side effects from taking psychotropic medications, sometimes unwillingly. And they described how alternatives to drug therapy often led to better outcomes.\u003c/p>\n\u003cp>For Tisha Ortiz, 22, help finally came in the form of a therapeutic behavioral services worker who took a genuine interest in her. \"I felt loved by her, that she actually cared,\" said Ortiz.\u003c/p>\n\u003cp>Ortiz had a chaotic childhood filled with emotional and sexual abuse. While she lived in various group homes, she often lashed out at adults and resorted to self-harm when her emotions got the better of her. For years she lived with flashbacks to traumatic events, which her caregivers and social workers misinterpreted. \"They considered the flashbacks as hearing voices, so I got put on psychotropic meds for that, when I wasn't hearing voices at all.\"\u003c/p>\n\u003cp>On medication, Ortiz gained weight and found it hard to stay awake, yet she continued to feel abandoned and depressed. \"I just felt sedated, and I wasn't really dealing with the problems,\" she said.\u003c/p>\n\u003cp>According to Ortiz, she did not begin to get better until she was connected with a behavioral services worker who encouraged her to talk about her past. \"She helped me understand that what I was feeling was because of the situations I went through and not because there's all these things wrong with me.\"\u003c/p>\n\u003cp>Since then, Ortiz has had other therapists who she felt really listened to her, whom she still occasionally calls if she's had a bad day. But the self-harm has stopped, and she's tapering off the one medication that she still takes. Ortiz says it was human interaction, not drugs, that helped her. \"Having that love was one of the first steps that put me on the road to getting better.\"\u003c/p>\n\u003cp>There are a lot of good evidence-based treatments that work, said Shadi Houshyar, vice president for child welfare policy at \u003ca href=\"http://firstfocus.org/\">First Focus\u003c/a>, a national children's advocacy organization. \"States are just struggling with finding the providers, the resources and the dollars to pay for these interventions,\" she said.\u003c/p>\n\u003cp>Some states resort to Medicaid waivers or use their child welfare general funds to match Medicaid dollars, but that's not enough, Houshyar said. That's why First Focus and other advocacy groups have been big proponents of a White House program aimed at curbing the misuse of psychiatric medication in foster care.\u003c/p>\n\u003cp>The Obama administration has called on states to advance alternative treatments in their child welfare systems. In his 2015 and 2016 budget proposals, President Obama unveiled a two-pronged plan allocating $750 million in grant dollars and incentive payments to address the overprescribing of psychotropics.\u003c/p>\n\u003cp>The demonstration project would bring child welfare and Medicaid agencies together to provide more coordinated services, including behavioral therapies, to foster kids with a history of trauma or mental health problems. \"If we really want to solve this problem, we have to make the alternative interventions available at the same level at which medication is available,\" said Berrick. \"It's really a question of access. When that happens, people will make the right decision.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Elaine Korry writes about health care and social policy from the San Francisco Bay Area. This story was produced by \u003ca href=\"http://www.youthtoday.org/\" target=\"_blank\">Youth Today\u003c/a>, the national news source for youth-service professionals, including child welfare and juvenile justice, youth development and out-of-school-time programming. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=California+Moves+To+Stop+Misuse+Of+Psychiatric+Meds+In+Foster+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By the time DeAngelo Cortijo was 14, he had been in more than a dozen foster homes. He had run away and lived on the streets for months, and he had been diagnosed with bipolar and anxiety disorders, attachment disorder, intermittent explosive disorder or post-traumatic stress disorder. He had been in and out of mental hospitals and heavily medicated.\u003c/p>\n\u003cp>Cortijo, who was born in San Francisco, was taken from his mother after she attempted suicide when he was 3.\u003c/p>\n\u003cp>After his later diagnoses, he was prescribed a combination of antipsychotics, antidepressants and stimulants, and was told that taking them was his only hope of being normal. Instead, he said, medication made him feel \"doped up and completely lost.\"\u003c/p>\n\u003cp>It was not until he spent several months developing a relationship with a horse — \"and it was huge,\" said Cortijo with a smile — that he began to really acknowledge his own feelings. \"Animals sense you, your fears, anxieties and insecurities,\" he said.\u003c/p>\n\u003cp>Finding help through equine-assisted therapy — riding a horse, feeding, grooming and communicating with it — helped Cortijo to gain a better perspective on himself. \"It allowed me to understand what a bond was, to realize I am an individual who is capable of caring, capable of being normal,\" said Cortijo.\u003c/p>\n\u003cfigure id=\"attachment_71797\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/sam-1_enl-22bcb13ff05089c6d5a2490ebf0f3a08ab1b43c0-e1441217324828.jpg\">\u003cimg class=\"size-full wp-image-71797\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/sam-1_enl-22bcb13ff05089c6d5a2490ebf0f3a08ab1b43c0-e1441217324828.jpg\" alt=\"DeAngelo Cortijo, 22, says he benefited more from therapy than from psychotropic medications during his years in foster care.\" width=\"1920\" height=\"1439\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">DeAngelo Cortijo, 22, says he benefited more from therapy than from psychotropic medications during his years in foster care. \u003ccite>(Elaine Korry)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He's now 22, off all medication, and is helping troubled youth as a juvenile justice intern at the National Center for Youth Law.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Children in foster care are prescribed antipsychotic drugs at double to quadruple the rate of those not in foster care, according to a \u003ca href=\"http://www.gao.gov/products/GAO-12-201\">Government Accountability Office \u003c/a> report. Hundreds of children were found to be taking five or more psychotropic medications at a time, although there is no medical evidence to support such a drug regimen. Thousands of children were prescribed doses that exceeded FDA-approved guidelines. The report found monitoring programs for psychotropic drugs provided to foster children fell short of guidelines established by the American Academy of Child and Adolescent Psychiatry.\u003c/p>\n\u003cp>In March, a \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-12-00320.pdf\">report\u003c/a> by the inspector general at Health and Human Services found quality-of-care concerns in more than two-thirds of claims for psychotropic drugs paid for by Medicaid, the health insurer for most children in foster care. Those included too many drugs (37 percent); wrong dose (23 percent); poor monitoring (53 percent); or wrong treatment (41 percent). The OIG recommended that the Centers for Medicare & Medicaid Services (CMS) work with the states to enhance oversight, medical reviews and utilization reviews of psychotropics prescribed to children.\u003c/p>\n\u003cp>In California, a sweeping package of laws to regulate the prescribing of powerful psychiatric medications to children and teens in the child-welfare system has passed the Senate and is heading to the state Assembly, where it faces no formal opposition. The reforms also are being eyed as a template for federal legislation. Anna Johnson, a social analyst at the Oakland-based \u003ca href=\"http://youthlaw.org/\">National Center for Youth Law\u003c/a>, which helped write the legislation, said an enforcement mechanism is needed to change prescribing practices.\u003c/p>\n\u003cp>\"The legislation describes in detail the oversight function — what everyone's role is, from the juvenile court judge and the social workers, to the care providers, the lawyers, the doctors,\" said Johnson. \"And it names specifically the prescribing practices we want to see reduced: the use of multiple drugs on children, dosages that exceed maximums and the use of antipsychotics where not medically necessary because of physical health risk factors.\"\u003c/p>\n\u003cp>The push for tougher laws follows last year's publication of a \u003ca href=\"http://webspecial.mercurynews.com/druggedkids/\">series of investigative articles \u003c/a>in the San Jose Mercury News, which alleged widespread use of antipsychotics and other psychiatric drugs without proper evaluation and monitoring among the estimated 63,000 California children in foster care.\u003c/p>\n\u003cp>\"It is well beyond time for us to be having this discussion and intervening,\" said Ken Berrick, president and CEO of the \u003ca href=\"http://www.senecafoa.org/\">Seneca Family of Agencies\u003c/a>, which provides mental health and other services for children in California. According to Berrick, overuse of medication has been a problem for decades, often because better alternatives simply weren't available. \"Medication is available right now on demand, and other services are not,\" he said. \"When you don't have a choice, you rely on what you have.\"\u003c/p>\n\u003cp>Under the reforms, there would be better monitoring of children on medication and closer scrutiny of physicians to identify doctors who rely most heavily on medication. The bill also calls for stricter oversight of group homes to determine if psychotropic medications are used to control children's behavior. \"Drugging and sedating children should never be considered the primary option in lieu of counseling, therapy and appropriate treatment,\" said the bill's author, Sen. Jim Beall, D-San Jose.\u003c/p>\n\u003cp>In addition, social workers and caregivers in California would receive training in the risks, benefits and side effects of psychiatric medications. A mix of state and federal dollars would establish a structure to provide second medical opinions.\u003c/p>\n\u003cp>Beyond reining in prescribing outliers, the legislation also places a new emphasis on defining what comprises appropriate care for vulnerable youth. \"It's no longer a drugs-only approach,\" explained Johnson, who said the legislation would require that children who are being given powerful medications also receive other services.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/taking-pills_wide-781ec7995da58abafd14751200dad6284914990a-e1441217370456.jpg\">\u003cimg class=\"aligncenter size-full wp-image-71798\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/taking-pills_wide-781ec7995da58abafd14751200dad6284914990a-e1441217370456.jpg\" alt=\"Andy Baker/Ikon Images/Getty Images\" width=\"1920\" height=\"1080\">\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\"We're saying, you have to do something else — either first or at the same time — to really help a troubled child,\" said Johnson. \"Swallowing a pill doesn't help with grief or trauma. It may contain symptoms, but it doesn't help you move forward and be functional in life.\"\u003c/p>\n\u003cp>In legislative hearings, former foster youth testified about negative side effects from taking psychotropic medications, sometimes unwillingly. And they described how alternatives to drug therapy often led to better outcomes.\u003c/p>\n\u003cp>For Tisha Ortiz, 22, help finally came in the form of a therapeutic behavioral services worker who took a genuine interest in her. \"I felt loved by her, that she actually cared,\" said Ortiz.\u003c/p>\n\u003cp>Ortiz had a chaotic childhood filled with emotional and sexual abuse. While she lived in various group homes, she often lashed out at adults and resorted to self-harm when her emotions got the better of her. For years she lived with flashbacks to traumatic events, which her caregivers and social workers misinterpreted. \"They considered the flashbacks as hearing voices, so I got put on psychotropic meds for that, when I wasn't hearing voices at all.\"\u003c/p>\n\u003cp>On medication, Ortiz gained weight and found it hard to stay awake, yet she continued to feel abandoned and depressed. \"I just felt sedated, and I wasn't really dealing with the problems,\" she said.\u003c/p>\n\u003cp>According to Ortiz, she did not begin to get better until she was connected with a behavioral services worker who encouraged her to talk about her past. \"She helped me understand that what I was feeling was because of the situations I went through and not because there's all these things wrong with me.\"\u003c/p>\n\u003cp>Since then, Ortiz has had other therapists who she felt really listened to her, whom she still occasionally calls if she's had a bad day. But the self-harm has stopped, and she's tapering off the one medication that she still takes. Ortiz says it was human interaction, not drugs, that helped her. \"Having that love was one of the first steps that put me on the road to getting better.\"\u003c/p>\n\u003cp>There are a lot of good evidence-based treatments that work, said Shadi Houshyar, vice president for child welfare policy at \u003ca href=\"http://firstfocus.org/\">First Focus\u003c/a>, a national children's advocacy organization. \"States are just struggling with finding the providers, the resources and the dollars to pay for these interventions,\" she said.\u003c/p>\n\u003cp>Some states resort to Medicaid waivers or use their child welfare general funds to match Medicaid dollars, but that's not enough, Houshyar said. That's why First Focus and other advocacy groups have been big proponents of a White House program aimed at curbing the misuse of psychiatric medication in foster care.\u003c/p>\n\u003cp>The Obama administration has called on states to advance alternative treatments in their child welfare systems. In his 2015 and 2016 budget proposals, President Obama unveiled a two-pronged plan allocating $750 million in grant dollars and incentive payments to address the overprescribing of psychotropics.\u003c/p>\n\u003cp>The demonstration project would bring child welfare and Medicaid agencies together to provide more coordinated services, including behavioral therapies, to foster kids with a history of trauma or mental health problems. \"If we really want to solve this problem, we have to make the alternative interventions available at the same level at which medication is available,\" said Berrick. \"It's really a question of access. When that happens, people will make the right decision.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Elaine Korry writes about health care and social policy from the San Francisco Bay Area. This story was produced by \u003ca href=\"http://www.youthtoday.org/\" target=\"_blank\">Youth Today\u003c/a>, the national news source for youth-service professionals, including child welfare and juvenile justice, youth development and out-of-school-time programming. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=California+Moves+To+Stop+Misuse+Of+Psychiatric+Meds+In+Foster+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Many parents likely fear the word “autism” but journalist Steven Silberman advocates a completely different approach in his sweeping book, \"\u003ca href=\"http://stevesilberman.com\" target=\"_blank\">Neurotribes: The Legacy of Autism and the Future of Neurodiversity.\u003c/a>\"\u003c/p>\n\u003caside class=\"pullquote alignright\">A very quick definition of 'neurodiversity' is ‘Great minds don’t think alike, necessarily.' We have to stop pathologizing different styles of cognition.\u003cbr>\n\u003ccite>Steve Silberman\u003c/cite>\u003c/aside>\n\u003cp>Silberman dove into autism in 2001 when his article \"\u003ca href=\"http://archive.wired.com/wired/archive/9.12/aspergers_pr.html\" target=\"_blank\">The Geek Syndrome\u003c/a>\" appeared in \u003ca href=\"http://www.wired.com/category/magazine/\" target=\"_blank\">Wired\u003c/a>. Back then, he was focused on autism's cause.\u003c/p>\n\u003cp>The popularity of that article introduced him to many parents of autistic children. But as Silberman began to spend more time alongside those on the autistic spectrum, he realized that much of the national conversation about autism (and Silberman argues, \u003ca href=\"http://www.latimes.com/opinion/op-ed/la-oe-0824-silberman-autism-speaks-20150824-story.html\" target=\"_blank\">the resources\u003c/a> available to help people live their lives) is focused on the wrong thing.\u003c/p>\n\u003cp>\"Years passed,\" he writes in his book, \"and I still got email about 'The Geek Syndrome' nearly every week.\"\u003c/p>\n\u003cp>He began to worry that he'd missed \"a larger and more important story.\" He continues in the book:\u003c/p>\n\u003cblockquote>\u003cp>\"A seemingly simple question began to formulate in my mind: After seventy years of research on autism, why do we still seem to know so little about it?\u003c/p>\n\u003cp>\"To find the answer to that question for this book, I decided to start my reporting at the very beginning, even before Kanner's and Asperger's allegedly independent discoveries of autism in the 1940s. By taking nothing for granted, I learned that the standard time line of autism history -- its creation myth so to speak -- is fundamentally flawed in ways that render autistic people in previous generations harder to see. Until these inaccuracies in the time line are corrected, they will continue to hamper our ability to make wise choices about the kinds of research and societal accommodations that would be most beneficial to autistic people and their families.\"\u003c/p>\u003c/blockquote>\n\u003cp>In a wide-ranging conversation recently on \u003ca href=\"http://www.kqed.org/a/forum/R201508251000\" target=\"_blank\">KQED's Forum\u003c/a>, Silberman addressed questions about the history of autism and Asperger's, misperceptions about the disorders, how different genders are affected by autism and the need for more services and resources for adults and families coping with autism.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220862510\" 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>Here are some highlights of Silberman's discussion with host Michael Krasny:\u003c/p>\n\u003cp>\u003cstrong>Autism is Not New\u003c/strong>\u003cbr>\n“I think it’s a mistake to see autism as a modern phenomenon and some kind of historical aberration,\" Silberman said. \"I actually think that’s one of the biggest traps in the world of autism.”\u003c/p>\n\u003cp>\u003cstrong>The Quest for the Austism Gene\u003c/strong>\u003cbr>\n“Every couple of years a scientist announces that they have found what could be a biomarker for autism -- 'too much white matter.' Then two years later you read, 'too little white matter.' Actually, we still haven't zeroed in on exactly what the biomarkers for autism are. There is still no brain scan or blood test that can diagnose somebody. People are diagnosed on the basis of subjective clinical observations and a set of standardized clinical instruments. But it's still about observing people and about behavior and social context. ...\u003c/p>\n\u003cp>“Back when I wrote 'Geek Syndrome' a lot of parents were telling me ‘Oh yes, they're going to discover the autism gene.' Well they did -- except it turned out that there were more than a thousand candidate genes that contribute to autism. Not only that, each autistic person is genetically quite unique. As one of the big autism geneticists said and there's a saying in the autistic community ‘If you've met one autistic person, you've met one autistic person.’”\u003c/p>\n\u003cp>\u003cstrong>Great Minds Often Think Differently\u003c/strong>\u003cbr>\n“That is the message of neurodiversity: the styles of human cognition should be celebrated rather than pathologized. A very quick definition of 'neurodiversity' is ‘Great minds don’t think alike, necessarily.' There are lots of different styles of cognition, and we have to stop pathologizing different ones, deal with the real, serious challenges that certain forms of neurodiversity present to people and their families and embrace that diversity as one of the strengths of our society.”\u003c/p>\n\u003cp>\u003cstrong>There Are Autistic Adults, Too\u003c/strong>\u003cbr>\n\"A truly shocking report came out in June from the Government Accountability Office that reported that the research into improving the lives of autistic adults has actually gone down in recent years.\u003c/p>\n\u003cp>“We have to stop talking about ‘autistic children, autistic children, autistic children.’ We should talk about autistic people. If you think about it, there are more autistic adults than there are autistic children, and they are still virtually invisible to our society. There are very few services and resources available to them. It is one of the main things I want to change with my book. ... If you're an academic researcher who wants a promising area of study, please start looking at the lives -- and the life courses -- of autistic adults to figure out ways that we can support them as they go through these changes.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Parents are Heroes\u003c/strong>\u003cbr>\n\"There are so few resources for families. People often end up quitting their jobs to become sort of case managers for their children. People have had to prevail in the face of medical models of autism that blamed them. ... The parents of autistic kids and autistic people themselves are all heroes.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many parents likely fear the word “autism” but journalist Steven Silberman advocates a completely different approach in his sweeping book, \"\u003ca href=\"http://stevesilberman.com\" target=\"_blank\">Neurotribes: The Legacy of Autism and the Future of Neurodiversity.\u003c/a>\"\u003c/p>\n\u003caside class=\"pullquote alignright\">A very quick definition of 'neurodiversity' is ‘Great minds don’t think alike, necessarily.' We have to stop pathologizing different styles of cognition.\u003cbr>\n\u003ccite>Steve Silberman\u003c/cite>\u003c/aside>\n\u003cp>Silberman dove into autism in 2001 when his article \"\u003ca href=\"http://archive.wired.com/wired/archive/9.12/aspergers_pr.html\" target=\"_blank\">The Geek Syndrome\u003c/a>\" appeared in \u003ca href=\"http://www.wired.com/category/magazine/\" target=\"_blank\">Wired\u003c/a>. Back then, he was focused on autism's cause.\u003c/p>\n\u003cp>The popularity of that article introduced him to many parents of autistic children. But as Silberman began to spend more time alongside those on the autistic spectrum, he realized that much of the national conversation about autism (and Silberman argues, \u003ca href=\"http://www.latimes.com/opinion/op-ed/la-oe-0824-silberman-autism-speaks-20150824-story.html\" target=\"_blank\">the resources\u003c/a> available to help people live their lives) is focused on the wrong thing.\u003c/p>\n\u003cp>\"Years passed,\" he writes in his book, \"and I still got email about 'The Geek Syndrome' nearly every week.\"\u003c/p>\n\u003cp>He began to worry that he'd missed \"a larger and more important story.\" He continues in the book:\u003c/p>\n\u003cblockquote>\u003cp>\"A seemingly simple question began to formulate in my mind: After seventy years of research on autism, why do we still seem to know so little about it?\u003c/p>\n\u003cp>\"To find the answer to that question for this book, I decided to start my reporting at the very beginning, even before Kanner's and Asperger's allegedly independent discoveries of autism in the 1940s. By taking nothing for granted, I learned that the standard time line of autism history -- its creation myth so to speak -- is fundamentally flawed in ways that render autistic people in previous generations harder to see. Until these inaccuracies in the time line are corrected, they will continue to hamper our ability to make wise choices about the kinds of research and societal accommodations that would be most beneficial to autistic people and their families.\"\u003c/p>\u003c/blockquote>\n\u003cp>In a wide-ranging conversation recently on \u003ca href=\"http://www.kqed.org/a/forum/R201508251000\" target=\"_blank\">KQED's Forum\u003c/a>, Silberman addressed questions about the history of autism and Asperger's, misperceptions about the disorders, how different genders are affected by autism and the need for more services and resources for adults and families coping with autism.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\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/220862510&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/220862510'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Here are some highlights of Silberman's discussion with host Michael Krasny:\u003c/p>\n\u003cp>\u003cstrong>Autism is Not New\u003c/strong>\u003cbr>\n“I think it’s a mistake to see autism as a modern phenomenon and some kind of historical aberration,\" Silberman said. \"I actually think that’s one of the biggest traps in the world of autism.”\u003c/p>\n\u003cp>\u003cstrong>The Quest for the Austism Gene\u003c/strong>\u003cbr>\n“Every couple of years a scientist announces that they have found what could be a biomarker for autism -- 'too much white matter.' Then two years later you read, 'too little white matter.' Actually, we still haven't zeroed in on exactly what the biomarkers for autism are. There is still no brain scan or blood test that can diagnose somebody. People are diagnosed on the basis of subjective clinical observations and a set of standardized clinical instruments. But it's still about observing people and about behavior and social context. ...\u003c/p>\n\u003cp>“Back when I wrote 'Geek Syndrome' a lot of parents were telling me ‘Oh yes, they're going to discover the autism gene.' Well they did -- except it turned out that there were more than a thousand candidate genes that contribute to autism. Not only that, each autistic person is genetically quite unique. As one of the big autism geneticists said and there's a saying in the autistic community ‘If you've met one autistic person, you've met one autistic person.’”\u003c/p>\n\u003cp>\u003cstrong>Great Minds Often Think Differently\u003c/strong>\u003cbr>\n“That is the message of neurodiversity: the styles of human cognition should be celebrated rather than pathologized. A very quick definition of 'neurodiversity' is ‘Great minds don’t think alike, necessarily.' There are lots of different styles of cognition, and we have to stop pathologizing different ones, deal with the real, serious challenges that certain forms of neurodiversity present to people and their families and embrace that diversity as one of the strengths of our society.”\u003c/p>\n\u003cp>\u003cstrong>There Are Autistic Adults, Too\u003c/strong>\u003cbr>\n\"A truly shocking report came out in June from the Government Accountability Office that reported that the research into improving the lives of autistic adults has actually gone down in recent years.\u003c/p>\n\u003cp>“We have to stop talking about ‘autistic children, autistic children, autistic children.’ We should talk about autistic people. If you think about it, there are more autistic adults than there are autistic children, and they are still virtually invisible to our society. There are very few services and resources available to them. It is one of the main things I want to change with my book. ... If you're an academic researcher who wants a promising area of study, please start looking at the lives -- and the life courses -- of autistic adults to figure out ways that we can support them as they go through these changes.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Parents are Heroes\u003c/strong>\u003cbr>\n\"There are so few resources for families. People often end up quitting their jobs to become sort of case managers for their children. People have had to prevail in the face of medical models of autism that blamed them. ... The parents of autistic kids and autistic people themselves are all heroes.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A bill that would require day care workers to be immunized against three major diseases that could harm children passed out of the Assembly Committee on Appropriations Wednesday.\u003c/p>\n\u003cp>It was the last committee stop for the bill, which passed the Senate and now will be up for an Assembly floor vote.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB792\" target=\"_blank\">SB 792\u003c/a>, by Sen. Tony Mendoza, D-Artesia, would require vaccination for whooping cough, measles and influenza for all day care workers.\u003c/p>\n\u003cp>The only exemption for a whooping cough or measles immunization would be a physician's note that exempts individuals for whom the vaccination would not be safe.\u003c/p>\n\u003cp>Day care workers who do not want to get the influenza vaccine, though, just need to fill out a form to become exempt from the requirement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The bill also reiterated the need for evidence of being free of tuberculosis -- known as \"clearance\" -- among day care workers, which already is required by law.\u003c/p>\n\u003cp>\"[This bill] protects young vulnerable children by making sure that those who care for them in child care settings are vaccinated against serious contagious illnesses,\" Mendoza said at Wednesday's committee hearing.\u003c/p>\n\u003cp>\"One child's death is one too many, especially when it may be preventable,\" Mendoza said in an email. \"With the recent deadly outbreaks of measles and influenza, we must do everything in our power to protect California’s children who spend time in day care. This is not just a common sense solution, but makes scientific sense.\"\u003c/p>\n\u003cp>The state's Department of Finance representative at the hearing, Jacqueline Wong Hernandez, said the bill \"could decrease the health risk to children at no cost to the state.\"\u003c/p>\n\u003cp>If the bill is passed by the Legislature and signed by the governor, it would go into effect Sept. 1, 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline. \u003c/em>\u003c/a>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A bill that would require day care workers to be immunized against three major diseases that could harm children passed out of the Assembly Committee on Appropriations Wednesday.\u003c/p>\n\u003cp>It was the last committee stop for the bill, which passed the Senate and now will be up for an Assembly floor vote.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB792\" target=\"_blank\">SB 792\u003c/a>, by Sen. Tony Mendoza, D-Artesia, would require vaccination for whooping cough, measles and influenza for all day care workers.\u003c/p>\n\u003cp>The only exemption for a whooping cough or measles immunization would be a physician's note that exempts individuals for whom the vaccination would not be safe.\u003c/p>\n\u003cp>Day care workers who do not want to get the influenza vaccine, though, just need to fill out a form to become exempt from the requirement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The bill also reiterated the need for evidence of being free of tuberculosis -- known as \"clearance\" -- among day care workers, which already is required by law.\u003c/p>\n\u003cp>\"[This bill] protects young vulnerable children by making sure that those who care for them in child care settings are vaccinated against serious contagious illnesses,\" Mendoza said at Wednesday's committee hearing.\u003c/p>\n\u003cp>\"One child's death is one too many, especially when it may be preventable,\" Mendoza said in an email. \"With the recent deadly outbreaks of measles and influenza, we must do everything in our power to protect California’s children who spend time in day care. This is not just a common sense solution, but makes scientific sense.\"\u003c/p>\n\u003cp>The state's Department of Finance representative at the hearing, Jacqueline Wong Hernandez, said the bill \"could decrease the health risk to children at no cost to the state.\"\u003c/p>\n\u003cp>If the bill is passed by the Legislature and signed by the governor, it would go into effect Sept. 1, 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003c/em>\u003ca href=\"http://www.californiahealthline.org/\">\u003cem>California Healthline. \u003c/em>\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Voters Back Tobacco Tax Hike, Poll Shows",
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"content": "\u003cp>Fully two-thirds of California voters support a significant increase in tobacco taxes -- $2 a pack -- according to a \u003ca href=\"http://www.field.com/fieldpollonline/subscribers/Rls2511.pdf\" target=\"_blank\">statewide Field Poll\u003c/a> released Wednesday.\u003c/p>\n\u003cp>California currently \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\" target=\"_blank\">ranks 35th in the country \u003c/a>with 87 cents per pack in state taxes. (New York is first at $4.35.) There is an additional $1.01 in federal taxes.\u003c/p>\n\u003cp>Efforts to raise the tax had stalled legislatively earlier this year in Sacramento, but were revived Wednesday when a new bill was introduced at the special session on health care.\u003c/p>\n\u003cp>Advocates say they are committed to passage of the tax. \"The poll suggests there is strong support for (the tax) among the public,\" said Anthony Wright, executive director of Health Access, \"and we hope that it helps spur legislative action.\"\u003c/p>\n\u003cp>Wright says that if the legislature does not act, there will be a strong push for a ballot measure.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Mark DiCamillo, director of the Field Poll, noted that the 2 to 1 support for the tax was very strong, but cautioned that \"this poll was done before any campaign begins.\"\u003c/p>\n\u003cp>In 2006, he said, there was a similar tobacco tax on the ballot, a bit more than $2 per pack, and it, too, started out ahead two to one in a Field Poll, but \"after the campaign kicked in, with tobacco industry ads\" the measure was ultimately defeated 52 to 48, he said.\u003c/p>\n\u003cp>\"So you can't always say with certainty that initiatives that start out with a two to one lead pass,\" DiCamillo said, \"but certainly its chances are a lot better than if it were closer than what we're seeing in this poll.\"\u003c/p>\n\u003cp>Fifty percent of those responding the poll said they \"favor strongly\" increasing the tax while 17 percent said they \"favor somewhat.\" The question posed in the poll included that the money would be used for \"smoking cessation programs, research into smoking-related disease and tobacco law enforcement efforts.\"\u003c/p>\n\u003cp>In the poll, 68 percent of respondents said they favor raising the minimum wage by $1 an hour each year for five years, which would boost it from $10 per hour next year to $15 per hour by 2021.\u003c/p>\n\u003cp>Last July, the minimum wage was lifted from $8 to $9 an hour, and it is scheduled to rise again next year to $10 an hour.\u003c/p>\n\u003cp>The results were part of the ninth annual Field Poll on health policy. It is sponsored by the California Wellness Foundation. The poll found \u003ca href=\"http://www.field.com/fieldpollonline/subscribers/Rls2510.pdf\" target=\"_blank\">increasing support \u003c/a>for the Affordable Care Act (ACA). More than six in 10 voters (62 percent) now support the law, up from 56 percent last year.\u003c/p>\n\u003cp>More significantly, for the first time, more than half of voters in all major regions of the state, all races and ethnicities, and all age groups support the law. DiCamillo said in the years after the 2010 passage of the ACA, support hovered in the 52 to 54 percent range. It was \"supportive but fairly stable.\"\u003c/p>\n\u003cp>He drew a distinction between strong support for the law in California and the 44 percent favorable, 41 percent unfavorable views nationally.\u003c/p>\n\u003cp>Drew Altman is president and CEO of the non-partisan Kaiser Family Foundation, which focuses on national health issues. In an interview, he said that given how California has \"embraced the law and implemented it successfully,\" the poll results were not surprising to him.\u003c/p>\n\u003cp>\"California shows that the ACA can work if there's political will and support,\" he said, \"and it's such harder to make it work in states where there isn't, which is the picture that we're seeing across the country.\"\u003c/p>\n\u003cp>Voters also support expanding Medi-Cal, the state's insurance program for people who are low income, to undocumented immigrants, and this support is growing. Last year, the first year the question was posed in the poll, support was narrow -- 51 to 45 percent. This year, 58 percent of respondents were supportive.\u003c/p>\n\u003cp>\"In California, undocumented people are not an ideological football as they are to some degree in the national debate,\" Altman said. \"They're part of the fabric of life in our state, so people may tend to approach the program from a more pragmatic perspective and believe that it just makes sense to provide health care to people who need it.\"\u003c/p>\n\u003cp>Other questions about the health system showed strong support:\u003c/p>\n\u003cul>\n\u003cli>58 percent say they are satisfied with how the health care system is working since the passage of the ACA\u003c/li>\n\u003cli>86 percent are satisfied with their own individual health plan\u003c/li>\n\u003cli>68 percent believe California has been successful in implementing the ACA in the state. That's up from 60 percent last year.\u003c/li>\n\u003c/ul>\n\u003cp>But the one area presenting a challenge in the poll was cost. Nearly four in 10 respondents said what they pay for health care has increased in the last year. Even at the highest income level -- $100,00 per year or more -- more than one in four respondents said they or a family member had trouble with costs.\u003c/p>\n\u003cp>Still, as the chart shows, the rate of those reporting difficulty with costs are lower than they were last year across all income levels.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png\">\u003cimg class=\"aligncenter wp-image-68174 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png\" alt=\"Screen Shot 2015-08-26 at 10.48.54 AM\" width=\"1010\" height=\"725\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png 1010w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-400x287.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-800x574.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-960x689.png 960w\" sizes=\"(max-width: 1010px) 100vw, 1010px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The poll was conducted June 25-July 16, 2015, among 1,555 registered voters in California in eight languages and dialects. It has an error rate of plus/minus 2.6 percent.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fully two-thirds of California voters support a significant increase in tobacco taxes -- $2 a pack -- according to a \u003ca href=\"http://www.field.com/fieldpollonline/subscribers/Rls2511.pdf\" target=\"_blank\">statewide Field Poll\u003c/a> released Wednesday.\u003c/p>\n\u003cp>California currently \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\" target=\"_blank\">ranks 35th in the country \u003c/a>with 87 cents per pack in state taxes. (New York is first at $4.35.) There is an additional $1.01 in federal taxes.\u003c/p>\n\u003cp>Efforts to raise the tax had stalled legislatively earlier this year in Sacramento, but were revived Wednesday when a new bill was introduced at the special session on health care.\u003c/p>\n\u003cp>Advocates say they are committed to passage of the tax. \"The poll suggests there is strong support for (the tax) among the public,\" said Anthony Wright, executive director of Health Access, \"and we hope that it helps spur legislative action.\"\u003c/p>\n\u003cp>Wright says that if the legislature does not act, there will be a strong push for a ballot measure.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Mark DiCamillo, director of the Field Poll, noted that the 2 to 1 support for the tax was very strong, but cautioned that \"this poll was done before any campaign begins.\"\u003c/p>\n\u003cp>In 2006, he said, there was a similar tobacco tax on the ballot, a bit more than $2 per pack, and it, too, started out ahead two to one in a Field Poll, but \"after the campaign kicked in, with tobacco industry ads\" the measure was ultimately defeated 52 to 48, he said.\u003c/p>\n\u003cp>\"So you can't always say with certainty that initiatives that start out with a two to one lead pass,\" DiCamillo said, \"but certainly its chances are a lot better than if it were closer than what we're seeing in this poll.\"\u003c/p>\n\u003cp>Fifty percent of those responding the poll said they \"favor strongly\" increasing the tax while 17 percent said they \"favor somewhat.\" The question posed in the poll included that the money would be used for \"smoking cessation programs, research into smoking-related disease and tobacco law enforcement efforts.\"\u003c/p>\n\u003cp>In the poll, 68 percent of respondents said they favor raising the minimum wage by $1 an hour each year for five years, which would boost it from $10 per hour next year to $15 per hour by 2021.\u003c/p>\n\u003cp>Last July, the minimum wage was lifted from $8 to $9 an hour, and it is scheduled to rise again next year to $10 an hour.\u003c/p>\n\u003cp>The results were part of the ninth annual Field Poll on health policy. It is sponsored by the California Wellness Foundation. The poll found \u003ca href=\"http://www.field.com/fieldpollonline/subscribers/Rls2510.pdf\" target=\"_blank\">increasing support \u003c/a>for the Affordable Care Act (ACA). More than six in 10 voters (62 percent) now support the law, up from 56 percent last year.\u003c/p>\n\u003cp>More significantly, for the first time, more than half of voters in all major regions of the state, all races and ethnicities, and all age groups support the law. DiCamillo said in the years after the 2010 passage of the ACA, support hovered in the 52 to 54 percent range. It was \"supportive but fairly stable.\"\u003c/p>\n\u003cp>He drew a distinction between strong support for the law in California and the 44 percent favorable, 41 percent unfavorable views nationally.\u003c/p>\n\u003cp>Drew Altman is president and CEO of the non-partisan Kaiser Family Foundation, which focuses on national health issues. In an interview, he said that given how California has \"embraced the law and implemented it successfully,\" the poll results were not surprising to him.\u003c/p>\n\u003cp>\"California shows that the ACA can work if there's political will and support,\" he said, \"and it's such harder to make it work in states where there isn't, which is the picture that we're seeing across the country.\"\u003c/p>\n\u003cp>Voters also support expanding Medi-Cal, the state's insurance program for people who are low income, to undocumented immigrants, and this support is growing. Last year, the first year the question was posed in the poll, support was narrow -- 51 to 45 percent. This year, 58 percent of respondents were supportive.\u003c/p>\n\u003cp>\"In California, undocumented people are not an ideological football as they are to some degree in the national debate,\" Altman said. \"They're part of the fabric of life in our state, so people may tend to approach the program from a more pragmatic perspective and believe that it just makes sense to provide health care to people who need it.\"\u003c/p>\n\u003cp>Other questions about the health system showed strong support:\u003c/p>\n\u003cul>\n\u003cli>58 percent say they are satisfied with how the health care system is working since the passage of the ACA\u003c/li>\n\u003cli>86 percent are satisfied with their own individual health plan\u003c/li>\n\u003cli>68 percent believe California has been successful in implementing the ACA in the state. That's up from 60 percent last year.\u003c/li>\n\u003c/ul>\n\u003cp>But the one area presenting a challenge in the poll was cost. Nearly four in 10 respondents said what they pay for health care has increased in the last year. Even at the highest income level -- $100,00 per year or more -- more than one in four respondents said they or a family member had trouble with costs.\u003c/p>\n\u003cp>Still, as the chart shows, the rate of those reporting difficulty with costs are lower than they were last year across all income levels.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png\">\u003cimg class=\"aligncenter wp-image-68174 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png\" alt=\"Screen Shot 2015-08-26 at 10.48.54 AM\" width=\"1010\" height=\"725\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM.png 1010w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-400x287.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-800x574.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-26-at-10.48.54-AM-960x689.png 960w\" sizes=\"(max-width: 1010px) 100vw, 1010px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The poll was conducted June 25-July 16, 2015, among 1,555 registered voters in California in eight languages and dialects. It has an error rate of plus/minus 2.6 percent.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drought Health Hazard: Not Enough Water to Keep Down Central Valley Dust",
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"content": "\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220309181\" 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>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s almond season in the Central Valley, when loud mechanical harvesters with long arms grip and shake the trees, knocking down the nuts.\u003c/p>\n\u003cp>But the process also sends up huge dust clouds. Farm machines and trucks make multiple trips on dirt roads between fields, and that creates dust, too.\u003c/p>\n\u003cp>The drought has been contributing to a dust bowl in Central Valley farm country. The dust, in turn, exacerbates the region's high rates of asthma. To keep dust down, farmers usually use a watering truck, spraying the roads to knock down the dust and comply with air pollution rules.\u003c/p>\n\u003cp>But now, in the fourth year of a crippling drought, the approach is changing.\u003c/p>\n\u003cp>It’s the job of the San Joaquin Valley Air Pollution Control District to oversee dust rules, and the district’s Ryan Hyashi says farmers have been very responsive. Now the district is trying to balance competing tensions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s potable water that they’re usually putting on these roads,\" Hyashi says. \"People don’t have water to drink, and we’re putting it on roadways. It sends a poor message\u003cstrong>.\"\u003c/strong>\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/220309181&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/220309181'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Instead, the air district is encouraging farmers to limit access to dirt roads, or cover them with things like gravel. If those options won’t work, farmers can now \u003ca href=\"http://www.valleyair.org/busind/comply/AssistanceDocuments/Dust_Control_Agricultural_Advisory.pdf\" target=\"_blank\">sign up for a program\u003c/a> to avoid enforcement penalties as long as they meet certain requirements, such as not being within 1,000 feet of a school or hospital.\u003c/p>\n\u003cp>\"[Farmers] want to do their part and be good stewards,” says Hayashi. But if there's no water for dust control, they may “just have no alternative.\"\u003c/p>\n\u003cp>But air quality advocates say the air district is essentially giving farmers a free pass to pollute.\u003c/p>\n\u003cp>\"When we see any relaxation in the rules, we get very nervous,\" says Kevin Hamilton, with the Central California Asthma Collaborative.\u003c/p>\n\u003cp>As we're talking, Hamilton watches a cloud of dust billow up on a farm road west of Fresno.\u003c/p>\n\u003cfigure id=\"attachment_65299\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-e1440192126284.jpg\">\u003cimg class=\"size-thumbnail wp-image-65299\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/IMG_6792-400x300.jpg\" alt=\"Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno.\" width=\"400\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Kevin Hamilton stands near an unplanted field on a dusty farm road west of Fresno. \u003ccite>(Sasha Khokha)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"So here goes another truck with more dust coming up,\" he says. \"This is dangerous stuff. This is actually a health hazard.\"\u003c/p>\n\u003cp>Hamilton treats patients for asthma and says this kind of dust can travel for miles, ending up in people’s lungs. He criticized air regulators not only for the new dust guidelines, but also that they’re allowing \u003ca href=\"http://www.arb.ca.gov/msprog/ordiesel/faq/waterwelldrillingfaq.pdf\" target=\"_blank\">well-drilling rigs\u003c/a> from out of state that may have dirtier engines than California trucks.\u003c/p>\n\u003cp>\"I understand that we’re in an emergency,\" he says, \"but we’ve all fought so long to begin making progress here -- and I feel we are making progress. At this moment, it feels like we’re going to go backward again.\"\u003c/p>\n\u003cp>Just a few miles away, farmer Paul Betancourt says he doesn’t want his family breathing dusty air either. But he also doesn’t want the dust on his almond trees because it can cause mites. Watering down the roads on his farm, he says, means he uses fewer pesticides.\u003c/p>\n\u003cp>\"We want to use less chemicals on the farm,\" Betancourt says. \"You want us to use less chemicals on the farm. But in a year like this, when we’re really short of water, it’s balancing out how to keep the dust down.\"\u003c/p>\n\u003cp>Betancourt’s almond farm near the Fresno County town of Kerman has very fine, silty soil. For now, Betancourt says as long as he has water in his well, he’ll still periodically spray down the roads. Gravel is too expensive, and road oil just doesn’t work, he says.\u003c/p>\n\u003cp>“We need to use the water carefully and keep the dust down,” Betancourt said. “At this point, it’s still the most cost-effective way.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He doesn’t plan to apply for the air district’s emergency drought relief programs. Farmers who do can avoid using water to control dust through Nov. 1. After that, the valley’s particulate matter season starts, and the air district says it will require farmers to use water to spray down roads again.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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