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"content": "\u003cp>You may remember that San Francisco voters \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">rejected\u003c/a> a soda tax last fall. The tax failed to get the two-thirds vote it needed, but did get a solid majority -- 55 percent.\u003c/p>\n\u003cp>Three San Francisco supervisors are taking that voter sentiment and moving ahead with proposed ordinances that -- while short of a tax -- would still regulate soda and other sugary beverages in other ways.\u003c/p>\n\u003cp>Yesterday, the San Francisco Board of Supervisors Land Use Committee passed three ordinances with a \"positive recommendation,\" meaning they recommend the full board pass all three.\u003c/p>\n\u003cp>The ordinances would require \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240431&GUID=B8DF3155-7848-437C-BBDC-84DE56DEB16D\" target=\"_blank\">warning labels\u003c/a> on advertising for soda and other sugary drinks, \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240423&GUID=5220A723-8443-476C-A36D-A986D9A4AAF3\" target=\"_blank\">ban ads \u003c/a>on city property and \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240429&GUID=86A6B072-6A84-4F5E-88A1-0B133662EF12\" target=\"_blank\">bar city departments\u003c/a> from buying or selling the drinks.\u003c/p>\n\u003cp>Supervisor Scott Wiener, one of the authors of the soda tax proposal, cited research showing negative health effects of the beverages.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"These drinks are making our community less healthy and helping to accelerate disease in our community, Type 2 diabetes first and foremost,\" Wiener said.\u003c/p>\n\u003cp>Speakers lined up to testify in favor of the proposals, including doctors and advocates. But the American Beverage Association was represented as well, and dietitian Liz Katic, a consultant with the group, testified against the ordinances.\u003c/p>\n\u003cp>She said she agreed that obesity and related health problems are serious issues, \"but I want to say it’s overly simplistic, not to mention potentially misleading, to single out sugar-sweetened beverages as the driving cause of Type 2 diabetes and obesity.\"\u003c/p>\n\u003cp>Local moves like these ordinances in San Francisco are having some success where statewide efforts are stalling.\u003c/p>\n\u003cp>Berkeley \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">passed the first soda tax \u003c/a>in the country last fall. Last week, the Davis City Council \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/27/davis-requires-all-restaurants-to-offer-milk-water-as-first-choice-in-kids-meals/\" target=\"_blank\">approved an ordinance \u003c/a>requiring that all restaurants serving children's meals make milk or water the first choice offered -- although parents can still request soda.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, in Sacramento last month, both a statewide \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/30/health-advocates-frustrated-as-soda-warning-bill-dies/\" target=\"_blank\">soda warning label \u003c/a>and a 2-cents-an -ounce \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2015/5/assembly-committee-squashes-soda-tax\" target=\"_blank\">soda tax failed\u003c/a> to get out of committee\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>You may remember that San Francisco voters \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">rejected\u003c/a> a soda tax last fall. The tax failed to get the two-thirds vote it needed, but did get a solid majority -- 55 percent.\u003c/p>\n\u003cp>Three San Francisco supervisors are taking that voter sentiment and moving ahead with proposed ordinances that -- while short of a tax -- would still regulate soda and other sugary beverages in other ways.\u003c/p>\n\u003cp>Yesterday, the San Francisco Board of Supervisors Land Use Committee passed three ordinances with a \"positive recommendation,\" meaning they recommend the full board pass all three.\u003c/p>\n\u003cp>The ordinances would require \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240431&GUID=B8DF3155-7848-437C-BBDC-84DE56DEB16D\" target=\"_blank\">warning labels\u003c/a> on advertising for soda and other sugary drinks, \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240423&GUID=5220A723-8443-476C-A36D-A986D9A4AAF3\" target=\"_blank\">ban ads \u003c/a>on city property and \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=2240429&GUID=86A6B072-6A84-4F5E-88A1-0B133662EF12\" target=\"_blank\">bar city departments\u003c/a> from buying or selling the drinks.\u003c/p>\n\u003cp>Supervisor Scott Wiener, one of the authors of the soda tax proposal, cited research showing negative health effects of the beverages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These drinks are making our community less healthy and helping to accelerate disease in our community, Type 2 diabetes first and foremost,\" Wiener said.\u003c/p>\n\u003cp>Speakers lined up to testify in favor of the proposals, including doctors and advocates. But the American Beverage Association was represented as well, and dietitian Liz Katic, a consultant with the group, testified against the ordinances.\u003c/p>\n\u003cp>She said she agreed that obesity and related health problems are serious issues, \"but I want to say it’s overly simplistic, not to mention potentially misleading, to single out sugar-sweetened beverages as the driving cause of Type 2 diabetes and obesity.\"\u003c/p>\n\u003cp>Local moves like these ordinances in San Francisco are having some success where statewide efforts are stalling.\u003c/p>\n\u003cp>Berkeley \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">passed the first soda tax \u003c/a>in the country last fall. Last week, the Davis City Council \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/27/davis-requires-all-restaurants-to-offer-milk-water-as-first-choice-in-kids-meals/\" target=\"_blank\">approved an ordinance \u003c/a>requiring that all restaurants serving children's meals make milk or water the first choice offered -- although parents can still request soda.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, in Sacramento last month, both a statewide \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/30/health-advocates-frustrated-as-soda-warning-bill-dies/\" target=\"_blank\">soda warning label \u003c/a>and a 2-cents-an -ounce \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2015/5/assembly-committee-squashes-soda-tax\" target=\"_blank\">soda tax failed\u003c/a> to get out of committee\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When a Murietta Valley Unified School District elementary student bit into a cupcake made with peanut butter in April, she quickly struggled to breathe. A school health aide grabbed a pre-loaded syringe of adrenaline from the supply cabinet, injected the girl and contained the girls' allergic reaction to peanuts until she got to the emergency room. This is exactly as a \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1266\" target=\"_blank\">new California law\u003c/a> intended –- but not, in fact, how the law is playing out in many districts.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The law indemnified everybody except the doctor.\"\u003cbr>\n\u003ccite> Dr. Brett Curtis, consultant with Oakland Unified School District\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Six months after the Jan. 1 law required schools to stock these pre-loaded syringes – known as \u003ca class=\"\" href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603002.html\" target=\"_blank\">epinephrine automatic injectors\u003c/a> and considered the \u003ca class=\"\" href=\"https://escholarship.org/uc/item/64f526r6#page-1\" target=\"_blank\">first line treatment\u003c/a> for potentially life-threatening allergic reactions – many districts have been unable to obtain what Riverside County's Murietta Unified has: a doctor’s prescription for the devices.\u003c/p>\n\u003cp>Up and down the state, doctors have declined to write prescriptions for epinephrine auto-injectors for districts, citing liability concerns and derailing the promise of the law. A February survey of 408 school nurses by the California School Nurses Organization found that 57 percent had been unable to obtain epinephrine auto-injectors for their district, calling the inability to find a doctor to write a prescription a major obstacle.\u003c/p>\n\u003cp>Many districts have turned to city and county public health doctors as the logical prescription writers, only to be rebuffed. “They are being asked to sign these orders, but are being told by their county counsel and their risk managers that the liability risks are real,” said Kat DeBurgh, executive director of the Health Officers Association of California, a Sacramento-based membership group for city and county public health doctors.\u003c/p>\n\u003cp>The impasse has prompted the author of the law, state Sen. Robert Huff, R-Diamond Bar, to introduce follow-up legislation designed to protect physicians from prosecution if they write these prescriptions. The bill, \u003ca class=\"\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB738\" target=\"_blank\">Senate Bill 738\u003c/a>, passed the Senate this month and is in the Assembly.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brett Curtis, a consulting physician for the Oakland Unified School District, is all for it. “The standard is to prescribe on the basis of a good faith exam,” he said. But the law asks doctors to write a prescription naming the school district as the patient, with the injectors to be used to treat a student or adult as needed – which means “a patient I’ve never seen,” Curtis said.\u003c/p>\n\u003cp>“The law indemnified everybody except the doctor,” he said.\u003c/p>\n\u003cp>His medical liability insurance company agreed. In order to write a prescription to bring Oakland Unified into compliance with the new law, Curtis took out additional liability insurance. Now he writes prescriptions for stock epinephrine auto-injectors for all 86 schools in Oakland.\u003c/p>\n\u003cp>About\u003ca href=\"http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2011-0204.abstract\" target=\"_blank\"> 8 percent of children nationwide \u003c/a>have food allergies, and of those, nearly 40 percent have had a severe reaction known as \u003ca href=\"http://edsource.org/wp-admin/post.php?post=80214&action=edit\" target=\"_blank\">anaphylaxis\u003c/a>, where blood pressure drops and airways constrict. Other symptoms include hives, a swollen tongue and vomiting.\u003c/p>\n\u003cp>Severe food allergies have become an issue in schools across the state and the nation as the percentage of children who are allergic to nuts, milk, wheat and other substances has \u003ca class=\"\" href=\"http://www.cdc.gov/media/pressrel/2008/r081022.htm\" target=\"_blank\">increased\u003c/a>, according to the Centers for Disease Control, for reasons researchers \u003ca class=\"\" href=\"https://ncchildrenshospital.org/enews/foodallergyqa\" target=\"_blank\">can’t definitively explain.\u003c/a>\u003c/p>\n\u003cp>Some schools have introduced nut-free zones in school cafeterias and ingredient inspections for classroom birthday treats. But enforcement can be difficult.\u003c/p>\n\u003cp>For instance, just days before the Murietta Valley student took a bite of the peanut butter-filled cupcake, Cathy Owens, a school nurse, sent a memo to teachers stating that parents must give advance permission for their child to eat food brought in for school events. But at the classroom cupcake party, that notification never happened, Owens said.\u003c/p>\n\u003cp>The result is a lot of anxiety for parents and for school nurses like Martha Wallis, who said she has given at least four emergency epinephrine injections in the past five years in the unified districts of Moreno Valley and Lake Elsinore. A local physician was willing to write a prescription for stock epinephrine even before the law required schools to have it, she said.\u003c/p>\n\u003cp>While many students with severe allergies carry their own epinephrine auto-injectors or keep one at the school office, others don’t. And 20 percent of severe allergic reactions at school happen to children who have never been diagnosed with a severe allergy, said Dr. Marc Lerner, medical officer for the Orange County Department of Education.\u003c/p>\n\u003cp>As a school district employee, Lerner says he is covered by the district’s risk insurance. So he’s written prescriptions for epinephrine auto-injectors for 600 schools in 28 districts in Orange County, using the website \u003ca class=\"\" href=\"https://www.epipen4schools.com/\" target=\"_blank\">EpiPen4Schools.com\u003c/a>, which offers free and reduced price epinephrine auto-injectors to schools across the country.\u003c/p>\n\u003cp>Lerner is one of a group of doctors who have stepped up to write prescriptions for districts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a hearing of the state Senate Judiciary Committee earlier this month, school nurse Melissa Locketz urged passage of the new legislation to dispatch physicians’ liability worries. She read five statements from fellow school nurses, including this one: “It does not seem fair that some schools are lucky to have relationships with physicians, while others can’t comply because no one will sign.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When a Murietta Valley Unified School District elementary student bit into a cupcake made with peanut butter in April, she quickly struggled to breathe. A school health aide grabbed a pre-loaded syringe of adrenaline from the supply cabinet, injected the girl and contained the girls' allergic reaction to peanuts until she got to the emergency room. This is exactly as a \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1266\" target=\"_blank\">new California law\u003c/a> intended –- but not, in fact, how the law is playing out in many districts.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The law indemnified everybody except the doctor.\"\u003cbr>\n\u003ccite> Dr. Brett Curtis, consultant with Oakland Unified School District\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Six months after the Jan. 1 law required schools to stock these pre-loaded syringes – known as \u003ca class=\"\" href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603002.html\" target=\"_blank\">epinephrine automatic injectors\u003c/a> and considered the \u003ca class=\"\" href=\"https://escholarship.org/uc/item/64f526r6#page-1\" target=\"_blank\">first line treatment\u003c/a> for potentially life-threatening allergic reactions – many districts have been unable to obtain what Riverside County's Murietta Unified has: a doctor’s prescription for the devices.\u003c/p>\n\u003cp>Up and down the state, doctors have declined to write prescriptions for epinephrine auto-injectors for districts, citing liability concerns and derailing the promise of the law. A February survey of 408 school nurses by the California School Nurses Organization found that 57 percent had been unable to obtain epinephrine auto-injectors for their district, calling the inability to find a doctor to write a prescription a major obstacle.\u003c/p>\n\u003cp>Many districts have turned to city and county public health doctors as the logical prescription writers, only to be rebuffed. “They are being asked to sign these orders, but are being told by their county counsel and their risk managers that the liability risks are real,” said Kat DeBurgh, executive director of the Health Officers Association of California, a Sacramento-based membership group for city and county public health doctors.\u003c/p>\n\u003cp>The impasse has prompted the author of the law, state Sen. Robert Huff, R-Diamond Bar, to introduce follow-up legislation designed to protect physicians from prosecution if they write these prescriptions. The bill, \u003ca class=\"\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB738\" target=\"_blank\">Senate Bill 738\u003c/a>, passed the Senate this month and is in the Assembly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brett Curtis, a consulting physician for the Oakland Unified School District, is all for it. “The standard is to prescribe on the basis of a good faith exam,” he said. But the law asks doctors to write a prescription naming the school district as the patient, with the injectors to be used to treat a student or adult as needed – which means “a patient I’ve never seen,” Curtis said.\u003c/p>\n\u003cp>“The law indemnified everybody except the doctor,” he said.\u003c/p>\n\u003cp>His medical liability insurance company agreed. In order to write a prescription to bring Oakland Unified into compliance with the new law, Curtis took out additional liability insurance. Now he writes prescriptions for stock epinephrine auto-injectors for all 86 schools in Oakland.\u003c/p>\n\u003cp>About\u003ca href=\"http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2011-0204.abstract\" target=\"_blank\"> 8 percent of children nationwide \u003c/a>have food allergies, and of those, nearly 40 percent have had a severe reaction known as \u003ca href=\"http://edsource.org/wp-admin/post.php?post=80214&action=edit\" target=\"_blank\">anaphylaxis\u003c/a>, where blood pressure drops and airways constrict. Other symptoms include hives, a swollen tongue and vomiting.\u003c/p>\n\u003cp>Severe food allergies have become an issue in schools across the state and the nation as the percentage of children who are allergic to nuts, milk, wheat and other substances has \u003ca class=\"\" href=\"http://www.cdc.gov/media/pressrel/2008/r081022.htm\" target=\"_blank\">increased\u003c/a>, according to the Centers for Disease Control, for reasons researchers \u003ca class=\"\" href=\"https://ncchildrenshospital.org/enews/foodallergyqa\" target=\"_blank\">can’t definitively explain.\u003c/a>\u003c/p>\n\u003cp>Some schools have introduced nut-free zones in school cafeterias and ingredient inspections for classroom birthday treats. But enforcement can be difficult.\u003c/p>\n\u003cp>For instance, just days before the Murietta Valley student took a bite of the peanut butter-filled cupcake, Cathy Owens, a school nurse, sent a memo to teachers stating that parents must give advance permission for their child to eat food brought in for school events. But at the classroom cupcake party, that notification never happened, Owens said.\u003c/p>\n\u003cp>The result is a lot of anxiety for parents and for school nurses like Martha Wallis, who said she has given at least four emergency epinephrine injections in the past five years in the unified districts of Moreno Valley and Lake Elsinore. A local physician was willing to write a prescription for stock epinephrine even before the law required schools to have it, she said.\u003c/p>\n\u003cp>While many students with severe allergies carry their own epinephrine auto-injectors or keep one at the school office, others don’t. And 20 percent of severe allergic reactions at school happen to children who have never been diagnosed with a severe allergy, said Dr. Marc Lerner, medical officer for the Orange County Department of Education.\u003c/p>\n\u003cp>As a school district employee, Lerner says he is covered by the district’s risk insurance. So he’s written prescriptions for epinephrine auto-injectors for 600 schools in 28 districts in Orange County, using the website \u003ca class=\"\" href=\"https://www.epipen4schools.com/\" target=\"_blank\">EpiPen4Schools.com\u003c/a>, which offers free and reduced price epinephrine auto-injectors to schools across the country.\u003c/p>\n\u003cp>Lerner is one of a group of doctors who have stepped up to write prescriptions for districts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a hearing of the state Senate Judiciary Committee earlier this month, school nurse Melissa Locketz urged passage of the new legislation to dispatch physicians’ liability worries. She read five statements from fellow school nurses, including this one: “It does not seem fair that some schools are lucky to have relationships with physicians, while others can’t comply because no one will sign.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In what it's calling an effort to \u003ca href=\"http://city-managers-office.cityofdavis.org/housing-and-human-services/kids-meals-beverage-choice-ordinance-information\" target=\"_blank\">encourage healthier options\u003c/a> for children, Davis will require all restaurants in the city to offer milk or water as the first choice for all children's meals.\u003c/p>\n\u003cp>\u003ca href=\"http://city-council.cityofdavis.org/Media/Default/Documents/PDF/CityCouncil/CouncilMeetings/Agendas/20150526/07-Kids-Meal-Beverages.pdf\" target=\"_blank\">An ordinance was passed by the City Council unanimously\u003c/a> on Tuesday night, the Sacramento Bee reports. Parents can still order soda for their children, but they must specifically request it.\u003c/p>\n\u003cp>More from the \u003ca href=\"http://www.sacbee.com/food-drink/article22438713.html\" target=\"_blank\">Bee\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The rule will go into effect on September 1, giving restaurants enough time to notify staff and implement healthy beverage options if they don’t already do so, said Julie Gallelo, executive director of First 5 Yolo, a non-profit organization that pushed for the ordinance starting last fall.\u003c/p>\n\u003cp>The ordinance will affect about 18 restaurants in the city, including both fast food establishments – Taco Bell, Carl’s Jr. and Round Table Pizza – and some local bistros and pubs.\u003c/p>\u003c/blockquote>\n\u003cp>The new ordinance applies to \"a restaurant that sells a children's meal that includes a beverage.\" The default beverage must now be milk or water.\u003c/p>\n\u003cp>Harold Goldstein, executive director of the California Center for Public Health Advocacy -- a longtime foe of sugary drinks -- called the City Council's action \"a bold move.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Parents will now have to ask for soda specifically if they want to serve their children liquid candy instead of a healthy beverage,\" he said in a statement. \"Studies have shown that parents will stick with the healthier option.\"\u003c/p>\n\u003cp>A spokeswoman for CalBev, the trade association for soda and other non-alcoholic beverages companies in California, said the group had no comment on the new ordinance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Center for Science in the Public Interest, a national advocacy group, \u003ca href=\"http://cspinet.org/new/201505271.html\" target=\"_blank\">also praised the move\u003c/a> and said that many large restaurant chains have already taken soda off kids' menus. These companies include: McDonald's, Burger King, Wendy's, Dairy Queen, Panera, Subway and Chipotle.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In what it's calling an effort to \u003ca href=\"http://city-managers-office.cityofdavis.org/housing-and-human-services/kids-meals-beverage-choice-ordinance-information\" target=\"_blank\">encourage healthier options\u003c/a> for children, Davis will require all restaurants in the city to offer milk or water as the first choice for all children's meals.\u003c/p>\n\u003cp>\u003ca href=\"http://city-council.cityofdavis.org/Media/Default/Documents/PDF/CityCouncil/CouncilMeetings/Agendas/20150526/07-Kids-Meal-Beverages.pdf\" target=\"_blank\">An ordinance was passed by the City Council unanimously\u003c/a> on Tuesday night, the Sacramento Bee reports. Parents can still order soda for their children, but they must specifically request it.\u003c/p>\n\u003cp>More from the \u003ca href=\"http://www.sacbee.com/food-drink/article22438713.html\" target=\"_blank\">Bee\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The rule will go into effect on September 1, giving restaurants enough time to notify staff and implement healthy beverage options if they don’t already do so, said Julie Gallelo, executive director of First 5 Yolo, a non-profit organization that pushed for the ordinance starting last fall.\u003c/p>\n\u003cp>The ordinance will affect about 18 restaurants in the city, including both fast food establishments – Taco Bell, Carl’s Jr. and Round Table Pizza – and some local bistros and pubs.\u003c/p>\u003c/blockquote>\n\u003cp>The new ordinance applies to \"a restaurant that sells a children's meal that includes a beverage.\" The default beverage must now be milk or water.\u003c/p>\n\u003cp>Harold Goldstein, executive director of the California Center for Public Health Advocacy -- a longtime foe of sugary drinks -- called the City Council's action \"a bold move.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Parents will now have to ask for soda specifically if they want to serve their children liquid candy instead of a healthy beverage,\" he said in a statement. \"Studies have shown that parents will stick with the healthier option.\"\u003c/p>\n\u003cp>A spokeswoman for CalBev, the trade association for soda and other non-alcoholic beverages companies in California, said the group had no comment on the new ordinance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Center for Science in the Public Interest, a national advocacy group, \u003ca href=\"http://cspinet.org/new/201505271.html\" target=\"_blank\">also praised the move\u003c/a> and said that many large restaurant chains have already taken soda off kids' menus. These companies include: McDonald's, Burger King, Wendy's, Dairy Queen, Panera, Subway and Chipotle.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Supreme Court Will Not Review Alameda's Drug Disposal Law",
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"content": "\u003cp>Many of us have old prescription drugs sitting around in medicine cabinets -- so what's the best way to get rid of them?\u003c/p>\n\u003cp>Some folks simply toss old pills in the garbage, or down the toilet.\u003c/p>\n\u003cp>Both of those options can lead to medications in the ocean, bays or rivers. Three years ago Alameda \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/07/16/alameda-county-says-drug-companies-should-pay-for-medication-disposal/\" target=\"_blank\">became the first county in the nation\u003c/a> to require pharmaceutical companies to pay for safe disposal of prescription drugs. Pharmaceutical manufacturers sued and lost in lower courts. Tuesday the U.S. Supreme Court refused to hear the case, meaning that drug makers will now need to pay for collection and disposal of unused drugs.\u003c/p>\n\u003cp>\"I think that this is an important step forward for protecting our marine resources as well as our drinking water,\" said Miriam Gordon with Clean Water Action, an advocacy group.\u003c/p>\n\u003cp>Actually, the FDA says it's \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm\" target=\"_blank\">OK to flush \u003c/a>many kinds of old pills down the toilet. Regulators say the risk of kids or pets getting into them around the house is much worse than any impact on our water.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still, Art Shartsis, attorney for Alameda County, says the drug disposal law costs pharmaceutical companies very little to implement.\u003c/p>\n\u003cp>\"Drugs are dangerous in a home where you have elderly people who lose track of what they're doing and where you have others, children in the house,\" he said. \"There are health, safety and environmental problems.\"\u003c/p>\n\u003cp>Attorney Richard Semp with the Washington Legal Foundation is a strong opponent of the drug disposal law. He calls it \"selfish\" because it forces others to pay for something that should be paid for locally, and says it also interferes with interstate commerce.\u003c/p>\n\u003cp>\"The whole point of the Commerce Clause is that we have one national economy,\" he said. \"If you had every jurisdiction around the country trying to impose its waste disposal costs on other jurisdictions, it would lead to chaos.\"\u003c/p>\n\u003cp>Semp says Tuesday's Supreme Court decision could ultimately be the law's undoing, as other counties around the nation pass similar laws and are sued.\u003c/p>\n\u003cp>\"If, at the end of the day, you have conflicting lower court decisions, then almost surely the U.S. Supreme Court will have to jump in,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>San Francisco and San Mateo counties now have similar drug disposal laws, with dozens of locations to drop off old pills. Other counties, including Los Angeles and Santa Barbara, are looking into it.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many of us have old prescription drugs sitting around in medicine cabinets -- so what's the best way to get rid of them?\u003c/p>\n\u003cp>Some folks simply toss old pills in the garbage, or down the toilet.\u003c/p>\n\u003cp>Both of those options can lead to medications in the ocean, bays or rivers. Three years ago Alameda \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/07/16/alameda-county-says-drug-companies-should-pay-for-medication-disposal/\" target=\"_blank\">became the first county in the nation\u003c/a> to require pharmaceutical companies to pay for safe disposal of prescription drugs. Pharmaceutical manufacturers sued and lost in lower courts. Tuesday the U.S. Supreme Court refused to hear the case, meaning that drug makers will now need to pay for collection and disposal of unused drugs.\u003c/p>\n\u003cp>\"I think that this is an important step forward for protecting our marine resources as well as our drinking water,\" said Miriam Gordon with Clean Water Action, an advocacy group.\u003c/p>\n\u003cp>Actually, the FDA says it's \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm\" target=\"_blank\">OK to flush \u003c/a>many kinds of old pills down the toilet. Regulators say the risk of kids or pets getting into them around the house is much worse than any impact on our water.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, Art Shartsis, attorney for Alameda County, says the drug disposal law costs pharmaceutical companies very little to implement.\u003c/p>\n\u003cp>\"Drugs are dangerous in a home where you have elderly people who lose track of what they're doing and where you have others, children in the house,\" he said. \"There are health, safety and environmental problems.\"\u003c/p>\n\u003cp>Attorney Richard Semp with the Washington Legal Foundation is a strong opponent of the drug disposal law. He calls it \"selfish\" because it forces others to pay for something that should be paid for locally, and says it also interferes with interstate commerce.\u003c/p>\n\u003cp>\"The whole point of the Commerce Clause is that we have one national economy,\" he said. \"If you had every jurisdiction around the country trying to impose its waste disposal costs on other jurisdictions, it would lead to chaos.\"\u003c/p>\n\u003cp>Semp says Tuesday's Supreme Court decision could ultimately be the law's undoing, as other counties around the nation pass similar laws and are sued.\u003c/p>\n\u003cp>\"If, at the end of the day, you have conflicting lower court decisions, then almost surely the U.S. Supreme Court will have to jump in,\" he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>San Francisco and San Mateo counties now have similar drug disposal laws, with dozens of locations to drop off old pills. Other counties, including Los Angeles and Santa Barbara, are looking into it.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Adios, Trans Fats: FDA Poised To Phase Out Artery-Clogging Fat",
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"content": "\u003cp>The case against trans fats is not new. For years, health experts have been telling us to avoid them.\u003c/p>\n\u003cp>And as retailing behemoths such as Wal-Mart have \u003ca href=\"http://news.walmart.com/news-archive/2011/01/20/walmart-launches-major-initiative-to-make-food-healthier-healthier-food-more-affordable\">committed\u003c/a> to the removal of all remaining, industrially produced trans fats in the products they sell, the food industry has stepped up its pace to reformulate its offerings.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.gmaonline.org/\">Grocery Manufacturers Association\u003c/a> says the food industry has already reduced its use of trans fats by more than 85 percent. Even Crisco is now made without partially hydrogenated oils.\u003c/p>\n\u003cp>Now, the Food and Drug Administration is expected to take action soon to \u003ca href=\"http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/ucm274590.htm\">phase out\u003c/a> much of the remaining trans fats in the food supply. The agency first \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm372915.htm\">announced\u003c/a> its plan back in 2013. And, any day now, the FDA is expected to announce a final rule that could amount to a near ban of trans fats.\u003c/p>\n\u003cp>\"The time is long overdue to get trans fats out of the food supply,\" says Michael Jacobson of the Center for Science in the Public Interest. He nudged for a mandatory labeling of trans fats on food packages, which has been in place since 2006.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So, where do we still find trans fats in the food supply? The labels of ready-to-bake pie crusts, baked goods and microwave popcorn are a good place to look.\u003c/p>\n\u003cp>Also, there are low-levels of trans fats in lots of foods — levels that fall below the threshold for labeling. As my colleague Eliza Barclay has reported, \u003ca href=\"http://www.npr.org/sections/thesalt/2014/08/28/343971652/trans-fats-linger-stubbornly-in-the-food-supply\">zero trans fats doesn't necessarily mean zero\u003c/a>.\u003c/p>\n\u003cp>The FDA allows companies to list 0 grams on the label even if the food contains up to half a gram of trans fats. In other words, If a packaged food has less than .5 grams per serving, it can be labeled as trans-fat free.\u003c/p>\n\u003cp>So, if you want to avoid these trace levels, you've got to scan the ingredient list. If you see partially hydrogenated oils listed, you know there's a small amount of trans fats in the food.\u003c/p>\n\u003cp>And here's a little history lesson in how trans fats came to be: As my colleague Dan Charles has \u003ca href=\"http://www.npr.org/sections/thesalt/2013/11/07/243730263/fda-moves-to-phase-out-remaining-trans-fats-in-food-supply\">reported\u003c/a>, in the early 1900s scientists worked out a way to add hydrogen atoms to a molecule of oil. In essence, that process converted liquid vegetable oils into solid fats.\u003c/p>\n\u003cp>After this discovery, the era of baking with Crisco and margarine began.\u003c/p>\n\u003cp>But, decades later, scientists began to document the damaging health effects of partially hydrogenated oils. Turns out, the ubiquitous use of trans fats was wreaking havoc on our cardiovascular systems.\u003c/p>\n\u003cp>Trans fats \"raise bad cholesterol and lower good cholesterol,\" explains \u003ca href=\"http://provost.tufts.edu/about/academic-leadership-team/mozaffarian-friedman-school-of-nutrition-science-and-policy/\">Dariush Mozaffarian\u003c/a>, a cardiologist, epidemiologist and dean of the nutrition policy and science school at Tufts University. And that's not all, he says.\u003c/p>\n\u003cp>As Mozaffarian explains, trans fats also raise inflammation and worsen the health of blood vessels. \"There's really not any other fat that has this constellation of harmful effects,\" he says.\u003c/p>\n\u003cp>The food industry has moved to reformulate many foods. Manufacturers have turned to alternative fats, such as palm oil and blends of vegetable oils. From a health perspective, that's an improvement, Mozaffarian says.\u003c/p>\n\u003cp>\"Any natural replacement is superior to partially hydrogenated vegetable oil — whether it's butter, palm oil or blends of oils,\" Mozaffarian says.\u003c/p>\n\u003cp>(However, as we've reported, when it comes to environmental and worker's rights issues, palm oil has historically been \u003ca href=\"http://www.npr.org/sections/thesalt/2014/06/06/319231081/doughnut-day-downer-palm-oil-in-pastries-drives-deforestation\">problematic\u003c/a>, though the industry is \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2015/04/21/396815303/palm-oil-plantations-are-blamed-for-many-evils-but-change-is-coming\">changing\u003c/a> as a result of consumer pressure.)\u003c/p>\n\u003cp>When the FDA issues its final rule, it will likely move to revoke the \u003ca href=\"http://www.npr.org/sections/thesalt/2015/04/14/399591292/why-the-fda-is-clueless-about-some-of-the-additives-in-our-food\">GRAS \u003c/a>(Generally Recognized As Safe) status of trans fats. And this could pose a problem for manufacturers that still have small amounts of partially hydrogenated oils in the products they sell. For instance, it could open them up to lawsuits.\u003c/p>\n\u003cp>The Grocery Manufacturers Association told us in a statement that \"we share FDA's goal of reducing trans fatty acids in the diet.\" But the group is preparing to file a petition. \"The food additive petition currently in development will help us to achieve this shared objective,\" the GMA statement says.\u003c/p>\n\u003cp>It's possible that the Grocery Manufacturers Association may ask for more flexibility in meeting the goal.\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=Adios%2C+Trans+Fats%3A+FDA+Poised+To+Phase+Out+Artery-Clogging+Fat&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003cstrong>Transcript :\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The case against trans fats is not new. For years, health experts have been telling us to avoid them.\u003c/p>\n\u003cp>And as retailing behemoths such as Wal-Mart have \u003ca href=\"http://news.walmart.com/news-archive/2011/01/20/walmart-launches-major-initiative-to-make-food-healthier-healthier-food-more-affordable\">committed\u003c/a> to the removal of all remaining, industrially produced trans fats in the products they sell, the food industry has stepped up its pace to reformulate its offerings.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.gmaonline.org/\">Grocery Manufacturers Association\u003c/a> says the food industry has already reduced its use of trans fats by more than 85 percent. Even Crisco is now made without partially hydrogenated oils.\u003c/p>\n\u003cp>Now, the Food and Drug Administration is expected to take action soon to \u003ca href=\"http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/ucm274590.htm\">phase out\u003c/a> much of the remaining trans fats in the food supply. The agency first \u003ca href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm372915.htm\">announced\u003c/a> its plan back in 2013. And, any day now, the FDA is expected to announce a final rule that could amount to a near ban of trans fats.\u003c/p>\n\u003cp>\"The time is long overdue to get trans fats out of the food supply,\" says Michael Jacobson of the Center for Science in the Public Interest. He nudged for a mandatory labeling of trans fats on food packages, which has been in place since 2006.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, where do we still find trans fats in the food supply? The labels of ready-to-bake pie crusts, baked goods and microwave popcorn are a good place to look.\u003c/p>\n\u003cp>Also, there are low-levels of trans fats in lots of foods — levels that fall below the threshold for labeling. As my colleague Eliza Barclay has reported, \u003ca href=\"http://www.npr.org/sections/thesalt/2014/08/28/343971652/trans-fats-linger-stubbornly-in-the-food-supply\">zero trans fats doesn't necessarily mean zero\u003c/a>.\u003c/p>\n\u003cp>The FDA allows companies to list 0 grams on the label even if the food contains up to half a gram of trans fats. In other words, If a packaged food has less than .5 grams per serving, it can be labeled as trans-fat free.\u003c/p>\n\u003cp>So, if you want to avoid these trace levels, you've got to scan the ingredient list. If you see partially hydrogenated oils listed, you know there's a small amount of trans fats in the food.\u003c/p>\n\u003cp>And here's a little history lesson in how trans fats came to be: As my colleague Dan Charles has \u003ca href=\"http://www.npr.org/sections/thesalt/2013/11/07/243730263/fda-moves-to-phase-out-remaining-trans-fats-in-food-supply\">reported\u003c/a>, in the early 1900s scientists worked out a way to add hydrogen atoms to a molecule of oil. In essence, that process converted liquid vegetable oils into solid fats.\u003c/p>\n\u003cp>After this discovery, the era of baking with Crisco and margarine began.\u003c/p>\n\u003cp>But, decades later, scientists began to document the damaging health effects of partially hydrogenated oils. Turns out, the ubiquitous use of trans fats was wreaking havoc on our cardiovascular systems.\u003c/p>\n\u003cp>Trans fats \"raise bad cholesterol and lower good cholesterol,\" explains \u003ca href=\"http://provost.tufts.edu/about/academic-leadership-team/mozaffarian-friedman-school-of-nutrition-science-and-policy/\">Dariush Mozaffarian\u003c/a>, a cardiologist, epidemiologist and dean of the nutrition policy and science school at Tufts University. And that's not all, he says.\u003c/p>\n\u003cp>As Mozaffarian explains, trans fats also raise inflammation and worsen the health of blood vessels. \"There's really not any other fat that has this constellation of harmful effects,\" he says.\u003c/p>\n\u003cp>The food industry has moved to reformulate many foods. Manufacturers have turned to alternative fats, such as palm oil and blends of vegetable oils. From a health perspective, that's an improvement, Mozaffarian says.\u003c/p>\n\u003cp>\"Any natural replacement is superior to partially hydrogenated vegetable oil — whether it's butter, palm oil or blends of oils,\" Mozaffarian says.\u003c/p>\n\u003cp>(However, as we've reported, when it comes to environmental and worker's rights issues, palm oil has historically been \u003ca href=\"http://www.npr.org/sections/thesalt/2014/06/06/319231081/doughnut-day-downer-palm-oil-in-pastries-drives-deforestation\">problematic\u003c/a>, though the industry is \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2015/04/21/396815303/palm-oil-plantations-are-blamed-for-many-evils-but-change-is-coming\">changing\u003c/a> as a result of consumer pressure.)\u003c/p>\n\u003cp>When the FDA issues its final rule, it will likely move to revoke the \u003ca href=\"http://www.npr.org/sections/thesalt/2015/04/14/399591292/why-the-fda-is-clueless-about-some-of-the-additives-in-our-food\">GRAS \u003c/a>(Generally Recognized As Safe) status of trans fats. And this could pose a problem for manufacturers that still have small amounts of partially hydrogenated oils in the products they sell. For instance, it could open them up to lawsuits.\u003c/p>\n\u003cp>The Grocery Manufacturers Association told us in a statement that \"we share FDA's goal of reducing trans fatty acids in the diet.\" But the group is preparing to file a petition. \"The food additive petition currently in development will help us to achieve this shared objective,\" the GMA statement says.\u003c/p>\n\u003cp>It's possible that the Grocery Manufacturers Association may ask for more flexibility in meeting the goal.\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=Adios%2C+Trans+Fats%3A+FDA+Poised+To+Phase+Out+Artery-Clogging+Fat&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003cstrong>Transcript :\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Considers Capping Patients' Drug Costs",
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"content": "\u003cp>Sometimes Mikkel Lawrence gets up in the morning, eats breakfast, and then heads straight back to bed for a nap.\u003c/p>\n\u003cp>“I get really bad tired spells. It’s like you \u003cem>have\u003c/em> to go to sleep,” he says.\u003c/p>\n\u003cp>This is one of the symptoms of Hepatitis C, a virus that damages the liver. Most people who have it don’t have any symptoms, sometimes for decades. But for some people like Lawrence, waves of intense fatigue hit several times a day.\u003c/p>\n\u003cp>“It takes away probably three or four hours of my waking day,” he says.\u003c/p>\n\u003cp>There’s also an increased risk of liver cancer or liver failure. So when Lawrence heard last year that there was a new drug regimen that could cure his disease, he went straight to his insurance company.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The first thing they did, of course, was deny it,” he says.\u003c/p>\n\u003cp>But the real problem, once he did get approval, was the price tag. Each pill costs $1,000.\u003c/p>\n\u003cp>“The first quote I got was $140,000, and I would be responsible for $14,000 of it,” he remembers.\u003c/p>\n\u003cp>Lawrence is a retired middle school teacher. He lives on Social Security. There was just no way he could come up with $14,000 on his own.\u003c/p>\n\u003cp>“I went to everybody I knew of,” he says, “and fussed and fumed and all that stuff.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/206549879\" 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>Eventually, Lawrence got financial aid from a nonprofit to help him cover his out-of-pocket costs. Every morning at 10 a.m., he stood over his bathroom sink and swallowed two capsules.\u003c/p>\n\u003cp>“I’d go to take my pills and I’d go, there’s one thousand,” he says. “And there’s another thousand.”\u003c/p>\n\u003cp>Health advocates hear scenarios like this all the time from patients with a range of chronic conditions, including Hepatitis C, HIV, multiple sclerosis and rheumatoid arthritis.\u003c/p>\n\u003cp>“We’ve heard stories of people who’ve emptied their retirement savings to cover their drug needs,” said Betsy Imholz, special projects director at Consumers Union, an advocacy group. “It’s a really frightening, Wild West situation for people who need these specialty drugs.”\u003c/p>\n\u003cp>She and other advocates took their concerns to Covered California, the agency that implements the Affordable Care Act in the state. Advocates argued there should be a limit on how much consumers have to pay for these drugs.\u003c/p>\n\u003cp>The agency agreed, and today the board will vote on a proposal that would cap the monthly out-of-pocket costs for specialty drugs. Under most plans, people would have to pay only $250 per prescription, per month. Some silver plans would have $150-caps, while bronze plans would have caps of $500.\u003c/p>\n\u003cp>\u003cem>UPDATE: Covered California's board approved these caps at Thursday's meeting. Health plans must now incorporate them into their benefits for 2016. \u003c/em>\u003c/p>\n\u003cp>\u003cem>\"We are putting California consumers first,\" said Peter Lee, Covered California's executive director. \"These new policies strike a balance between ensuring Covered California consumers can afford the medication they need to treat chronic and life-threatening conditions while keeping premiums affordable for all.”\u003c/em>\u003c/p>\n\u003cp>This policy will apply only to the 2.2 million people who buy coverage on the individual market. \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0501-0550/ab_533_bill_20150223_introduced.pdf\" target=\"_blank\">A bill\u003c/a> currently being considered in the state's Legislature would extend that protection to many people with employer-based plans as well.\u003c/p>\n\u003cp>Several other states are also considering similar caps, some as low as $100.\u003c/p>\n\u003cp>“We’re better than most,\" Imholz says, \"but not the absolute top of the heap as we usually are.\"\u003c/p>\n\u003cp>Health insurance companies involved in Covered California meetings tried to negotiate for higher caps, closer to $500 for all plans, Imholz says. Still, she added, insurers did support the overall idea of caps.\u003c/p>\n\u003cp>Nicole Kasabian Evans of the California Association of Health Plans says insurers see a correlation between the cost of a drug and adherence - patients who can't afford what they're prescribed will sometimes split pills, or not take them at all.\u003c/p>\n\u003cp>“If you ultimately have to go back and take a second round, because you didn't take it right the first time, or you never took it and you develop a more serious health condition, it's not good for the consumer, and it costs the health care system more money,” she says.\u003c/p>\n\u003cp>Kasabian Evans says the real root of the problem lies with the pharmaceutical companies that set the drug prices. Last year, more than half a million patients in the U.S. had medication costs that exceeded $50,000, according to a recent \u003ca href=\"http://lab.express-scripts.com/insights/drug-options/super-spending-US-trends-in-high-cost-medication-use\" target=\"_blank\">report\u003c/a> from Express Scripts, a company that manages prescription benefits\u003c/p>\n\u003cp>“This is unsustainable,” she says, “and it’s going to have a major impact on the price of health care.”\u003c/p>\n\u003cp>Even if insurers lower the co-pays for patients who take specialty drugs, the price the insurers pay stays the same. Eventually, they say the only way to balance the books will be to raise monthly premiums for everyone else.\u003c/p>\n\u003cp>“So if we really want to make sure consumers can afford prescription drug coverage, then we need to deal with the root price of the drug,” Kasabian Evans says.\u003c/p>\n\u003cp>Drug companies routinely defend their drug prices, citing the lengthy and expensive process of developing new drugs, and the many failed attempts that often precede successes.\u003c/p>\n\u003cp>The debates aren’t helping Mikkel Lawrence right now. His battle over Hepatitis C drugs continues. Turns out that $140,000 regimen he took last year didn’t work. He fell into the 5 percent of patients who don’t respond. But now he’s caught wind of a new drug that’s coming down the pipeline. And he’s already drafting a series of emails and letters to get it approved and to find the money to pay for it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“As soon as they’re out, I’m taking them,” he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sometimes Mikkel Lawrence gets up in the morning, eats breakfast, and then heads straight back to bed for a nap.\u003c/p>\n\u003cp>“I get really bad tired spells. It’s like you \u003cem>have\u003c/em> to go to sleep,” he says.\u003c/p>\n\u003cp>This is one of the symptoms of Hepatitis C, a virus that damages the liver. Most people who have it don’t have any symptoms, sometimes for decades. But for some people like Lawrence, waves of intense fatigue hit several times a day.\u003c/p>\n\u003cp>“It takes away probably three or four hours of my waking day,” he says.\u003c/p>\n\u003cp>There’s also an increased risk of liver cancer or liver failure. So when Lawrence heard last year that there was a new drug regimen that could cure his disease, he went straight to his insurance company.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The first thing they did, of course, was deny it,” he says.\u003c/p>\n\u003cp>But the real problem, once he did get approval, was the price tag. Each pill costs $1,000.\u003c/p>\n\u003cp>“The first quote I got was $140,000, and I would be responsible for $14,000 of it,” he remembers.\u003c/p>\n\u003cp>Lawrence is a retired middle school teacher. He lives on Social Security. There was just no way he could come up with $14,000 on his own.\u003c/p>\n\u003cp>“I went to everybody I knew of,” he says, “and fussed and fumed and all that stuff.”\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/206549879&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/206549879'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Eventually, Lawrence got financial aid from a nonprofit to help him cover his out-of-pocket costs. Every morning at 10 a.m., he stood over his bathroom sink and swallowed two capsules.\u003c/p>\n\u003cp>“I’d go to take my pills and I’d go, there’s one thousand,” he says. “And there’s another thousand.”\u003c/p>\n\u003cp>Health advocates hear scenarios like this all the time from patients with a range of chronic conditions, including Hepatitis C, HIV, multiple sclerosis and rheumatoid arthritis.\u003c/p>\n\u003cp>“We’ve heard stories of people who’ve emptied their retirement savings to cover their drug needs,” said Betsy Imholz, special projects director at Consumers Union, an advocacy group. “It’s a really frightening, Wild West situation for people who need these specialty drugs.”\u003c/p>\n\u003cp>She and other advocates took their concerns to Covered California, the agency that implements the Affordable Care Act in the state. Advocates argued there should be a limit on how much consumers have to pay for these drugs.\u003c/p>\n\u003cp>The agency agreed, and today the board will vote on a proposal that would cap the monthly out-of-pocket costs for specialty drugs. Under most plans, people would have to pay only $250 per prescription, per month. Some silver plans would have $150-caps, while bronze plans would have caps of $500.\u003c/p>\n\u003cp>\u003cem>UPDATE: Covered California's board approved these caps at Thursday's meeting. Health plans must now incorporate them into their benefits for 2016. \u003c/em>\u003c/p>\n\u003cp>\u003cem>\"We are putting California consumers first,\" said Peter Lee, Covered California's executive director. \"These new policies strike a balance between ensuring Covered California consumers can afford the medication they need to treat chronic and life-threatening conditions while keeping premiums affordable for all.”\u003c/em>\u003c/p>\n\u003cp>This policy will apply only to the 2.2 million people who buy coverage on the individual market. \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0501-0550/ab_533_bill_20150223_introduced.pdf\" target=\"_blank\">A bill\u003c/a> currently being considered in the state's Legislature would extend that protection to many people with employer-based plans as well.\u003c/p>\n\u003cp>Several other states are also considering similar caps, some as low as $100.\u003c/p>\n\u003cp>“We’re better than most,\" Imholz says, \"but not the absolute top of the heap as we usually are.\"\u003c/p>\n\u003cp>Health insurance companies involved in Covered California meetings tried to negotiate for higher caps, closer to $500 for all plans, Imholz says. Still, she added, insurers did support the overall idea of caps.\u003c/p>\n\u003cp>Nicole Kasabian Evans of the California Association of Health Plans says insurers see a correlation between the cost of a drug and adherence - patients who can't afford what they're prescribed will sometimes split pills, or not take them at all.\u003c/p>\n\u003cp>“If you ultimately have to go back and take a second round, because you didn't take it right the first time, or you never took it and you develop a more serious health condition, it's not good for the consumer, and it costs the health care system more money,” she says.\u003c/p>\n\u003cp>Kasabian Evans says the real root of the problem lies with the pharmaceutical companies that set the drug prices. Last year, more than half a million patients in the U.S. had medication costs that exceeded $50,000, according to a recent \u003ca href=\"http://lab.express-scripts.com/insights/drug-options/super-spending-US-trends-in-high-cost-medication-use\" target=\"_blank\">report\u003c/a> from Express Scripts, a company that manages prescription benefits\u003c/p>\n\u003cp>“This is unsustainable,” she says, “and it’s going to have a major impact on the price of health care.”\u003c/p>\n\u003cp>Even if insurers lower the co-pays for patients who take specialty drugs, the price the insurers pay stays the same. Eventually, they say the only way to balance the books will be to raise monthly premiums for everyone else.\u003c/p>\n\u003cp>“So if we really want to make sure consumers can afford prescription drug coverage, then we need to deal with the root price of the drug,” Kasabian Evans says.\u003c/p>\n\u003cp>Drug companies routinely defend their drug prices, citing the lengthy and expensive process of developing new drugs, and the many failed attempts that often precede successes.\u003c/p>\n\u003cp>The debates aren’t helping Mikkel Lawrence right now. His battle over Hepatitis C drugs continues. Turns out that $140,000 regimen he took last year didn’t work. He fell into the 5 percent of patients who don’t respond. But now he’s caught wind of a new drug that’s coming down the pipeline. And he’s already drafting a series of emails and letters to get it approved and to find the money to pay for it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“As soon as they’re out, I’m taking them,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Calming Dementia Patients -- Without Powerful Drugs",
"title": "Calming Dementia Patients -- Without Powerful Drugs",
"headTitle": "State of Health | KQED News",
"content": "\u003cp class=\"\">Diane Schoenfeld is a weekly visitor at the Chaparral House nursing home in Berkeley.\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She comes every Friday to spend time with her aunt, Lillie Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, an homage to the dancer she used to be.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s me?” asks Manger\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s you,” her niece confirms.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Am I supposed to remember?” says Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld smiles at her encouragingly. \u003c/span>\u003cspan class=\"\">“I don’t know if you’re supposed to. It’s OK either way.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger has dementia. Schoenfeld is her \"surrogate decision maker\" meaning that, legally, she is the person who makes decisions about Manger's health care. Schoenfeld has filled me in on her story. This is the second nursing home where Manger has lived. The first was 45 minutes away, and Schoenfeld wasn’t able to visit as often. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At that first nursing home, staff had recommended antipsychotic sedatives for Manger’s behaviors, like crying out and outbursts. Schoenfeld shared staff notes with me about the recommendations. She says she wasn’t thrilled but agreed. She thought her aunt might get better care, \u003c/span>\u003cspan class=\"\">“rather than (staff) being unhappy with her behavior.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>\u003cspan class=\"\">Coming Out of a Fog\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Two years later Schoenfeld had moved her aunt to Chaparral House, to have her closer. By this time, Manger appeared to be in a fog. Eventually, Schoenfeld broached the idea of weaning her aunt from the medication with Chaparral House. As soon as they did, she says things turned around. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“I could see her personality again, I was so happy,\" Schoenfeld said. \"My sister came to visit and (Lillie) used my sister’s name and clearly recognized her, which we had not seen in the years that she was on the medication. I only wish I had done that sooner.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld says it just didn’t feel right to have her aunt sedated.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If a baby is crying, I mean most people will go to a baby and comfort them. They won’t try to ignore them and drug them,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">[soundcloud url=\"https://api.soundcloud.com/tracks/206401562\" 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/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">KJ Page, administrator of Chaparral House, shares that philosophy. Page says in many cases dementia patients came to their facility with a prescription to be given antipsychotics half an hour before bathtime. Then, a number of years ago she read a book called \u003ca href=\"http://bathingwithoutabattle.unc.edu/\" target=\"_blank\">Bathing Without a Battle\u003c/a> about bathing dementia patients and why it can be such a challenge.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She asks people to imagine putting yourself in the place of the nursing home resident. “A person they didn’t know, couldn’t recognize, comes to take off their clothes,\" she says. \"Ah! No wonder they’re screaming and fighting and kicking!”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says after that “Aha!” moment, the staff came to a new agreement. The residents were not out running marathons, for instance, or other sweat-inducing activities, so regular showers weren't necessary. Instead, residents would have a regular caregiver do simple sponge baths. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says the results inspired further changes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“It just rolled into what else are they fighting for, and why do we need to have a fight?\" Page says, \"What can we do to make it easier for people and the staff? And that’s how we approached it from there on.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It worked. While Page says antipsychotics do have a place for some people, not one of Chaparral House’s dementia patients is currently taking the medications. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Grading Nursing Homes on Avoiding Antipsychotic Drugs\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Federal Changes Chaparral House's experience is unusual. In California nursing homes, just over 15 percent of dementia patients are on these drugs. That’s far more than advocates say is necessary. But that number is actually down from almost 22 percent just three years ago. That’s when the \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-08-00151.pdf\" target=\"_blank\">federal government \u003c/a>began regulating \u003c/span>\u003cspan class=\"\">their use for dementia in nursing homes. This came in response to several studies warning the medicines had \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm\" target=\"_blank\">serious risks\u003c/a> including, strokes, falls and even death.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The new guidelines stipulate that nursing homes are graded on the percent of their dementia patients receiving antipsychotic medications. That figure becomes part of their rating on \u003ca href=\"http://www.medicare.gov/NursingHomeCompare/About/HowWeCalculate.html\" target=\"_blank\">Nursing Home Compare\u003c/a>, a tool from Medicare that helps consumers compare information about nursing homes. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The drugs are traditionally deployed to control what is seen as problem behaviors. Reducing the medication requires new approaches and retraining staff to deal with people with dementia. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Enter Caroline Stephens, a\u003c/span>\u003cspan class=\"\">ssistant professor at the UCSF school of nursing, who specializes in psychiatric care for the elderly and long term care policy.\u003c/span>\u003c/p>\n\u003cp class=\"\">She says that the new regulations have had a positive impact on staff. \"\u003cspan class=\"\">They’re now realizing we don’t have to reach for the medication and they’re getting to think creatively about what we can do for this resident.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Clinicians Become 'Good Detectives'\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">I meet Stephens at the Hayward Healthcare & Wellness Center nursing home, where she consults. She helps train nurses and staff on person-centered care, being attentive to the cues that people give and trying to understand what is bothering them, even if they can’t communicate it directly.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens tells me the new regulations have given more credence to this medical approach. She describes one of her success stories helping a dementia patient who was always fighting to leave the facility at the end of the day.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“They felt they needed to catch the bus, they had to get home because they need to take care of their daughter,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Instead of physically restraining the person or prescribing medication, Stephens says they put a sign on the door that said, simply, \"It’s a holiday; buses aren’t running today.\" The sign worked. The person stopped fighting to leave and there was no need for antipsychotic medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At another nursing home, Stephens consulted with staff about a resident who was disruptive and constantly wandered at night -- including into other patients’ rooms. He had been given an antipsychotic to control his behavior. But in a deeper look at his background, staff learned that he’d worked as a night security guard for most of his adult life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The staff came up with a new plan. They gave the resident a badge and clipboard and walked with him on an abbreviated set of “evening rounds.” Sure enough, after that he’d willingly go to bed, and they were able to take him off medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens says when the patients themselves can’t communicate it’s vital to talk to family, to find out what the person did for a living, what they enjoyed in life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\"It is our job as clinicians to be good detectives,” she explains.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">This is especially important as nursing homes serve an increasingly diverse clientele. Stephens says the nursing home model was built around an older, white, female patient. Today, the demographics have changed.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At Hayward Healthcare and Wellness, she says, \"There are probably 15 different racial groups and a minimum of five languages spoken.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cb>Risk of Cherry-Picking Patients\u003c/b>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">One of the big advocates for the federal regulations was Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. He welcomes the guidelines, but says he has noticed a concerning unintended consequence. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">While across the state the overall rate has dropped, he says he has noticed that several hundred nursing homes have rates that have either stayed the same or increased, in some cases almost doubled.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says that in an effort to decrease their patients on antipsychotics to get better ratings, some facilities may be cherry-picking patients, essentially warehousing the hardest to wean from anti-psychotics in the bleakest facilities.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says for families and caregivers can look up a nursing home’s antipsychotic drug use rates as well as other drug usage on websites including \u003ca href=\"https://www.medicare.gov/nursinghomecompare/?AspxAutoDetectCookieSupport=1\" target=\"_blank\">Nursing Home Compare\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Still, these guidelines and ratings only cover nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says increasingly he is fielding calls from families worried about the use of antipsychotics in assisted living and home care settings, which don’t fall under the regulations.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“We need to be more proactive about trying to get data for assisted living facilities and reconfiguring our message so it’s more applicable to assisted-living facilities,” Chicotel says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It seems likely, though that that is coming. Earlier this year, the GAO released \u003ca href=\"http://www.gao.gov/products/GAO-15-211\" target=\"_blank\">a report\u003c/a> urging HHS to expand their regulation of antipsychotics in dementia patients to settings other than just nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">UCSF professor Stephens says this points to retraining ever more medical professionals in patient-centered care, eliminating the need for patients to be medicated as a form of restraint.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If we can train generalists I think we can make some headway,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cem>\u003cspan class=\"\">Rachel Dornhelm wrote this piece with support from the \u003ca href=\"https://www.geron.org/press-room/journalists-in-aging-fellows-program\" target=\"_blank\">Journalists in Aging Fellows Program\u003c/a> of the Gerontological Society of America and New America Media, sponsored by the AARP.\u003c/span>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "\"I could see her personality again, I was so happy,\" a niece says of her 97-year-old aunt. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"\">Diane Schoenfeld is a weekly visitor at the Chaparral House nursing home in Berkeley.\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She comes every Friday to spend time with her aunt, Lillie Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, an homage to the dancer she used to be.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s me?” asks Manger\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s you,” her niece confirms.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Am I supposed to remember?” says Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld smiles at her encouragingly. \u003c/span>\u003cspan class=\"\">“I don’t know if you’re supposed to. It’s OK either way.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger has dementia. Schoenfeld is her \"surrogate decision maker\" meaning that, legally, she is the person who makes decisions about Manger's health care. Schoenfeld has filled me in on her story. This is the second nursing home where Manger has lived. The first was 45 minutes away, and Schoenfeld wasn’t able to visit as often. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At that first nursing home, staff had recommended antipsychotic sedatives for Manger’s behaviors, like crying out and outbursts. Schoenfeld shared staff notes with me about the recommendations. She says she wasn’t thrilled but agreed. She thought her aunt might get better care, \u003c/span>\u003cspan class=\"\">“rather than (staff) being unhappy with her behavior.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>\u003cspan class=\"\">Coming Out of a Fog\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Two years later Schoenfeld had moved her aunt to Chaparral House, to have her closer. By this time, Manger appeared to be in a fog. Eventually, Schoenfeld broached the idea of weaning her aunt from the medication with Chaparral House. As soon as they did, she says things turned around. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“I could see her personality again, I was so happy,\" Schoenfeld said. \"My sister came to visit and (Lillie) used my sister’s name and clearly recognized her, which we had not seen in the years that she was on the medication. I only wish I had done that sooner.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld says it just didn’t feel right to have her aunt sedated.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If a baby is crying, I mean most people will go to a baby and comfort them. They won’t try to ignore them and drug them,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\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/206401562&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/206401562'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">KJ Page, administrator of Chaparral House, shares that philosophy. Page says in many cases dementia patients came to their facility with a prescription to be given antipsychotics half an hour before bathtime. Then, a number of years ago she read a book called \u003ca href=\"http://bathingwithoutabattle.unc.edu/\" target=\"_blank\">Bathing Without a Battle\u003c/a> about bathing dementia patients and why it can be such a challenge.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She asks people to imagine putting yourself in the place of the nursing home resident. “A person they didn’t know, couldn’t recognize, comes to take off their clothes,\" she says. \"Ah! No wonder they’re screaming and fighting and kicking!”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says after that “Aha!” moment, the staff came to a new agreement. The residents were not out running marathons, for instance, or other sweat-inducing activities, so regular showers weren't necessary. Instead, residents would have a regular caregiver do simple sponge baths. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says the results inspired further changes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“It just rolled into what else are they fighting for, and why do we need to have a fight?\" Page says, \"What can we do to make it easier for people and the staff? And that’s how we approached it from there on.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It worked. While Page says antipsychotics do have a place for some people, not one of Chaparral House’s dementia patients is currently taking the medications. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Grading Nursing Homes on Avoiding Antipsychotic Drugs\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Federal Changes Chaparral House's experience is unusual. In California nursing homes, just over 15 percent of dementia patients are on these drugs. That’s far more than advocates say is necessary. But that number is actually down from almost 22 percent just three years ago. That’s when the \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-08-00151.pdf\" target=\"_blank\">federal government \u003c/a>began regulating \u003c/span>\u003cspan class=\"\">their use for dementia in nursing homes. This came in response to several studies warning the medicines had \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm\" target=\"_blank\">serious risks\u003c/a> including, strokes, falls and even death.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The new guidelines stipulate that nursing homes are graded on the percent of their dementia patients receiving antipsychotic medications. That figure becomes part of their rating on \u003ca href=\"http://www.medicare.gov/NursingHomeCompare/About/HowWeCalculate.html\" target=\"_blank\">Nursing Home Compare\u003c/a>, a tool from Medicare that helps consumers compare information about nursing homes. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The drugs are traditionally deployed to control what is seen as problem behaviors. Reducing the medication requires new approaches and retraining staff to deal with people with dementia. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Enter Caroline Stephens, a\u003c/span>\u003cspan class=\"\">ssistant professor at the UCSF school of nursing, who specializes in psychiatric care for the elderly and long term care policy.\u003c/span>\u003c/p>\n\u003cp class=\"\">She says that the new regulations have had a positive impact on staff. \"\u003cspan class=\"\">They’re now realizing we don’t have to reach for the medication and they’re getting to think creatively about what we can do for this resident.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Clinicians Become 'Good Detectives'\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">I meet Stephens at the Hayward Healthcare & Wellness Center nursing home, where she consults. She helps train nurses and staff on person-centered care, being attentive to the cues that people give and trying to understand what is bothering them, even if they can’t communicate it directly.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens tells me the new regulations have given more credence to this medical approach. She describes one of her success stories helping a dementia patient who was always fighting to leave the facility at the end of the day.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“They felt they needed to catch the bus, they had to get home because they need to take care of their daughter,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Instead of physically restraining the person or prescribing medication, Stephens says they put a sign on the door that said, simply, \"It’s a holiday; buses aren’t running today.\" The sign worked. The person stopped fighting to leave and there was no need for antipsychotic medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At another nursing home, Stephens consulted with staff about a resident who was disruptive and constantly wandered at night -- including into other patients’ rooms. He had been given an antipsychotic to control his behavior. But in a deeper look at his background, staff learned that he’d worked as a night security guard for most of his adult life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The staff came up with a new plan. They gave the resident a badge and clipboard and walked with him on an abbreviated set of “evening rounds.” Sure enough, after that he’d willingly go to bed, and they were able to take him off medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens says when the patients themselves can’t communicate it’s vital to talk to family, to find out what the person did for a living, what they enjoyed in life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\"It is our job as clinicians to be good detectives,” she explains.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">This is especially important as nursing homes serve an increasingly diverse clientele. Stephens says the nursing home model was built around an older, white, female patient. Today, the demographics have changed.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At Hayward Healthcare and Wellness, she says, \"There are probably 15 different racial groups and a minimum of five languages spoken.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cb>Risk of Cherry-Picking Patients\u003c/b>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">One of the big advocates for the federal regulations was Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. He welcomes the guidelines, but says he has noticed a concerning unintended consequence. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">While across the state the overall rate has dropped, he says he has noticed that several hundred nursing homes have rates that have either stayed the same or increased, in some cases almost doubled.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says that in an effort to decrease their patients on antipsychotics to get better ratings, some facilities may be cherry-picking patients, essentially warehousing the hardest to wean from anti-psychotics in the bleakest facilities.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says for families and caregivers can look up a nursing home’s antipsychotic drug use rates as well as other drug usage on websites including \u003ca href=\"https://www.medicare.gov/nursinghomecompare/?AspxAutoDetectCookieSupport=1\" target=\"_blank\">Nursing Home Compare\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Still, these guidelines and ratings only cover nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says increasingly he is fielding calls from families worried about the use of antipsychotics in assisted living and home care settings, which don’t fall under the regulations.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“We need to be more proactive about trying to get data for assisted living facilities and reconfiguring our message so it’s more applicable to assisted-living facilities,” Chicotel says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It seems likely, though that that is coming. Earlier this year, the GAO released \u003ca href=\"http://www.gao.gov/products/GAO-15-211\" target=\"_blank\">a report\u003c/a> urging HHS to expand their regulation of antipsychotics in dementia patients to settings other than just nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">UCSF professor Stephens says this points to retraining ever more medical professionals in patient-centered care, eliminating the need for patients to be medicated as a form of restraint.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If we can train generalists I think we can make some headway,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cem>\u003cspan class=\"\">Rachel Dornhelm wrote this piece with support from the \u003ca href=\"https://www.geron.org/press-room/journalists-in-aging-fellows-program\" target=\"_blank\">Journalists in Aging Fellows Program\u003c/a> of the Gerontological Society of America and New America Media, sponsored by the AARP.\u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Berkeley Soda Tax Brings in $116,000 in First Month",
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"content": "\u003cp>Berkeley’s tax on sugary drinks brought in $116,000 in its first month, in line with projections made before \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">voters overwhelmingly approved Measure D\u003c/a> last November.\u003c/p>\n\u003cp>“We have delivered for the city of Berkeley,” said Berkeley City CouncilwomanLinda Maio, one of several council members who gathered on the steps of City Hall on Monday to announce the numbers. She estimated that the tax would bring in at least $1.2 million in its first year.\u003c/p>\n\u003cp>The penny-per-ounce tax, the first of its kind in the nation, took effect March 1. It is levied on the distribution of most sugar-sweetened beverages, including sodas and energy drinks.\u003c/p>\n\u003cp>City Councilman Laurie Capitelli said the funds will be used for programs aimed at reducing obesity, poor dental health and diabetes among children.\u003c/p>\n\u003cp>“What we really want to do in 10 years is collect no tax,” Capitelli said. \"We don’t want soda consumed in this community. We don’t want 50 percent of our African-American and Latino children facing diabetes in our lifetime.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Berkeley City Council has already \u003ca href=\"http://www.ci.berkeley.ca.us/Clerk/City_Council/2015/05_May/Documents/2015-05-12_Item_17_Allocate_%24500,000.aspx\" target=\"_blank\">approved advance funding of $500,000\u003c/a>, and wants half of that to go to the school district's \u003ca href=\"http://www.berkeleyschools.net/gcp/\">nutrition education program\u003c/a>. Tuesday night is \u003ca href=\"http://www.ci.berkeley.ca.us/Clerk/Commissions/Commissions__Sugar-Sweetened_Beverage_Panel_of_Experts.aspx\" target=\"_blank\">the first meeting of an expert panel\u003c/a> -- the Sugar-Sweetened Beverage Product Panel of Experts -- that will advise the City Council on which specific health programs to fund or establish.\u003c/p>\n\u003cp>Panel member Joy Moore, a cooking and gardening instructor at Berkeley Technical Academy, said the rest of the allocated money will be directed to community-based groups and programs, with an emphasis on programs that serve low-income children and people of color.\u003c/p>\n\u003cp>“The place we can make the most difference is in the schools,\" Moore said. “Education is going to be important to everyone because we need all people to implement, to buy into, to understand the dangers that overconsumption of sweetened beverages will do.”\u003c/p>\n\u003cp>The nine-member panel plans to consult with the community and will make recommendations to the City Council by Oct. 1. Local organizations will be able to apply for community-based funds.\u003c/p>\n\u003cp>“We are tired of burying our family members,” said Xavier Morales, executive director of the \u003ca href=\"http://www.lchc.org/\" target=\"_blank\">Latino Coalition for a Healthy California,\u003c/a> and another member of the expert panel. “We have a diabetes crisis in Berkeley.\"\u003c/p>\n\u003cp>He said that having dedicated revenue to fund programs to help people with diabetes or families at high risk \"will really help us in Berkeley.\"\u003c/p>\n\u003cp>\u003ca href=\"http://calbev.org/#!/home\" target=\"_blank\">California Beverage Association\u003c/a> spokesman Roger Salazar, who was standing only a few feet from the jubilant press conference, called the tax measure “very confusing.”\u003c/p>\n\u003cp>“We’ve heard from a lot of grocers, retailers, restaurateurs who want to comply with the measure but can't get real clarity of what it applies to and who it applies to,” Salazar said.\u003c/p>\n\u003cp>During the month of March, 36 entities, mostly larger distributors, paid the tax. Maio said the city is doing person-to-person outreach to inform smaller merchants about how the tax might affect them. Measure D stipulated that the tax take effect on Jan. 1 -- but to give time to businesses to adjust, the council delayed the start date until March 1.\u003c/p>\n\u003cp>“We want to do a truly good job of implementing this, because we know we are being watched very carefully,\" Maio said, \"and that particularly the (soda) industry is watching very carefully. … We want it to work well.”\u003c/p>\n\u003cp>Maio also praised \u003ca href=\"https://aaf1a18515da0e792f78-c27fdabe952dfc357fe25ebf5c8897ee.ssl.cf5.rackcdn.com/1927/dq-response-5-11.pdf?v=1431611387000\" target=\"_blank\">Dairy Queen’s recent decision to remove soda\u003c/a> from its children’s menus — following the lead of Burger King, McDonald's, Wendy’s, Chipotle and Panera.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We think we are at the beginning of a continuum that has to move forward for the health of our kids,” she said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Berkeley’s tax on sugary drinks brought in $116,000 in its first month, in line with projections made before \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">voters overwhelmingly approved Measure D\u003c/a> last November.\u003c/p>\n\u003cp>“We have delivered for the city of Berkeley,” said Berkeley City CouncilwomanLinda Maio, one of several council members who gathered on the steps of City Hall on Monday to announce the numbers. She estimated that the tax would bring in at least $1.2 million in its first year.\u003c/p>\n\u003cp>The penny-per-ounce tax, the first of its kind in the nation, took effect March 1. It is levied on the distribution of most sugar-sweetened beverages, including sodas and energy drinks.\u003c/p>\n\u003cp>City Councilman Laurie Capitelli said the funds will be used for programs aimed at reducing obesity, poor dental health and diabetes among children.\u003c/p>\n\u003cp>“What we really want to do in 10 years is collect no tax,” Capitelli said. \"We don’t want soda consumed in this community. We don’t want 50 percent of our African-American and Latino children facing diabetes in our lifetime.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Berkeley City Council has already \u003ca href=\"http://www.ci.berkeley.ca.us/Clerk/City_Council/2015/05_May/Documents/2015-05-12_Item_17_Allocate_%24500,000.aspx\" target=\"_blank\">approved advance funding of $500,000\u003c/a>, and wants half of that to go to the school district's \u003ca href=\"http://www.berkeleyschools.net/gcp/\">nutrition education program\u003c/a>. Tuesday night is \u003ca href=\"http://www.ci.berkeley.ca.us/Clerk/Commissions/Commissions__Sugar-Sweetened_Beverage_Panel_of_Experts.aspx\" target=\"_blank\">the first meeting of an expert panel\u003c/a> -- the Sugar-Sweetened Beverage Product Panel of Experts -- that will advise the City Council on which specific health programs to fund or establish.\u003c/p>\n\u003cp>Panel member Joy Moore, a cooking and gardening instructor at Berkeley Technical Academy, said the rest of the allocated money will be directed to community-based groups and programs, with an emphasis on programs that serve low-income children and people of color.\u003c/p>\n\u003cp>“The place we can make the most difference is in the schools,\" Moore said. “Education is going to be important to everyone because we need all people to implement, to buy into, to understand the dangers that overconsumption of sweetened beverages will do.”\u003c/p>\n\u003cp>The nine-member panel plans to consult with the community and will make recommendations to the City Council by Oct. 1. Local organizations will be able to apply for community-based funds.\u003c/p>\n\u003cp>“We are tired of burying our family members,” said Xavier Morales, executive director of the \u003ca href=\"http://www.lchc.org/\" target=\"_blank\">Latino Coalition for a Healthy California,\u003c/a> and another member of the expert panel. “We have a diabetes crisis in Berkeley.\"\u003c/p>\n\u003cp>He said that having dedicated revenue to fund programs to help people with diabetes or families at high risk \"will really help us in Berkeley.\"\u003c/p>\n\u003cp>\u003ca href=\"http://calbev.org/#!/home\" target=\"_blank\">California Beverage Association\u003c/a> spokesman Roger Salazar, who was standing only a few feet from the jubilant press conference, called the tax measure “very confusing.”\u003c/p>\n\u003cp>“We’ve heard from a lot of grocers, retailers, restaurateurs who want to comply with the measure but can't get real clarity of what it applies to and who it applies to,” Salazar said.\u003c/p>\n\u003cp>During the month of March, 36 entities, mostly larger distributors, paid the tax. Maio said the city is doing person-to-person outreach to inform smaller merchants about how the tax might affect them. Measure D stipulated that the tax take effect on Jan. 1 -- but to give time to businesses to adjust, the council delayed the start date until March 1.\u003c/p>\n\u003cp>“We want to do a truly good job of implementing this, because we know we are being watched very carefully,\" Maio said, \"and that particularly the (soda) industry is watching very carefully. … We want it to work well.”\u003c/p>\n\u003cp>Maio also praised \u003ca href=\"https://aaf1a18515da0e792f78-c27fdabe952dfc357fe25ebf5c8897ee.ssl.cf5.rackcdn.com/1927/dq-response-5-11.pdf?v=1431611387000\" target=\"_blank\">Dairy Queen’s recent decision to remove soda\u003c/a> from its children’s menus — following the lead of Burger King, McDonald's, Wendy’s, Chipotle and Panera.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We think we are at the beginning of a continuum that has to move forward for the health of our kids,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Gov. Jerry Brown's \u003ca href=\"http://gov.ca.gov/news.php?id=18958\" target=\"_blank\">May budget revision\u003c/a> released on Thursday included about $381 million in health care revenue that wasn't in the previous January budget proposal. Health care advocates wondered which programs might be funded by the new federal money, but the governor has proposed absorbing it into the general fund.\u003c/p>\n\u003cp>The estimated $381 million comes from the federal Children's Health Insurance Program (CHIP).\u003c/p>\n\u003cp>The state budget proposal calls this money \"$381 million in savings.\"\u003c/p>\n\u003cp>\"They're not demonstrating where they're spending that money, especially for children's health care. And that's where it's supposed to be spent,\" said Kathryn Dresslar with The Children's Partnership.\u003c/p>\n\u003cp>\"That's a lot of money. We would like to see the administration make some kind of effort to address the serious questions of access for children, particularly dental access,\" Dresslar said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's being done, state officials said.\u003c/p>\n\u003cp>\"It is in the health budget,\" said Diana Dooley, Secretary of California HHS. \"In broad terms, the Medicaid budget is $95 billion this year, and it's a big expenditure. We have increases and reductions based on a variety of issues, and the funding is not specific to the source. So if we have savings in one place, we have spending in another.\"\u003c/p>\n\u003cp>Dooley said there may still be some shuffling of funding as the Legislature takes up the debate next week.\u003c/p>\n\u003cp>\"We will be having conversations with the Legislature about … modifications, about places we would rather spend money,\" Dooley said. \"But we will live within the means.\"\u003c/p>\n\u003cp>Advocates say the budget picture looks a lot brighter than 2011, when the governor and Legislature came up with a series of cuts to health care programs, including a 10 percent Medi-Cal provider rate reduction.\u003c/p>\n\u003cp>At the least, they say, the federal money for children's health that has been added into the May revision should go to children's health programs.\u003c/p>\n\u003cp>Lobbying efforts for new funding have included:\u003c/p>\n\u003cul>\n\u003cli>Restoration of the 2011 Medi-Cal provider rate reduction\u003c/li>\n\u003cli>A hike in provider rates for the top 10 dental procedures, to bring them in line with the national average\u003c/li>\n\u003cli>Strengthening the early learning and child care system in California\u003c/li>\n\u003cli>Providing health care to undocumented immigrants\u003c/li>\n\u003c/ul>\n\u003cp>The governor indicated he would veto legislation to extend full-scope health benefits to the undocumented, if \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB4\" target=\"_blank\">SB 4\u003c/a> by Sen. Ricardo Lara (D-Bell Gardens) was passed by the Legislature and appeared on his desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This is the governor's May revise, there's still time,\" Dresslar said. \"The Legislature ultimately decides where the money goes. We'll make our pitch.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown's \u003ca href=\"http://gov.ca.gov/news.php?id=18958\" target=\"_blank\">May budget revision\u003c/a> released on Thursday included about $381 million in health care revenue that wasn't in the previous January budget proposal. Health care advocates wondered which programs might be funded by the new federal money, but the governor has proposed absorbing it into the general fund.\u003c/p>\n\u003cp>The estimated $381 million comes from the federal Children's Health Insurance Program (CHIP).\u003c/p>\n\u003cp>The state budget proposal calls this money \"$381 million in savings.\"\u003c/p>\n\u003cp>\"They're not demonstrating where they're spending that money, especially for children's health care. And that's where it's supposed to be spent,\" said Kathryn Dresslar with The Children's Partnership.\u003c/p>\n\u003cp>\"That's a lot of money. We would like to see the administration make some kind of effort to address the serious questions of access for children, particularly dental access,\" Dresslar said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's being done, state officials said.\u003c/p>\n\u003cp>\"It is in the health budget,\" said Diana Dooley, Secretary of California HHS. \"In broad terms, the Medicaid budget is $95 billion this year, and it's a big expenditure. We have increases and reductions based on a variety of issues, and the funding is not specific to the source. So if we have savings in one place, we have spending in another.\"\u003c/p>\n\u003cp>Dooley said there may still be some shuffling of funding as the Legislature takes up the debate next week.\u003c/p>\n\u003cp>\"We will be having conversations with the Legislature about … modifications, about places we would rather spend money,\" Dooley said. \"But we will live within the means.\"\u003c/p>\n\u003cp>Advocates say the budget picture looks a lot brighter than 2011, when the governor and Legislature came up with a series of cuts to health care programs, including a 10 percent Medi-Cal provider rate reduction.\u003c/p>\n\u003cp>At the least, they say, the federal money for children's health that has been added into the May revision should go to children's health programs.\u003c/p>\n\u003cp>Lobbying efforts for new funding have included:\u003c/p>\n\u003cul>\n\u003cli>Restoration of the 2011 Medi-Cal provider rate reduction\u003c/li>\n\u003cli>A hike in provider rates for the top 10 dental procedures, to bring them in line with the national average\u003c/li>\n\u003cli>Strengthening the early learning and child care system in California\u003c/li>\n\u003cli>Providing health care to undocumented immigrants\u003c/li>\n\u003c/ul>\n\u003cp>The governor indicated he would veto legislation to extend full-scope health benefits to the undocumented, if \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB4\" target=\"_blank\">SB 4\u003c/a> by Sen. Ricardo Lara (D-Bell Gardens) was passed by the Legislature and appeared on his desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This is the governor's May revise, there's still time,\" Dresslar said. \"The Legislature ultimately decides where the money goes. We'll make our pitch.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The state Senate has passed a bill that would require virtually all California schoolchildren to be vaccinated.\u003c/p>\n\u003cp>\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\" rel=\"noopener\">SB277\u003c/a> would end the “personal belief exemption” that allows parents to opt out of vaccines on behalf of their children and send their kids to school with some vaccinations or none at all. The Senate voted 25-10, mostly on partisan lines, after a long debate Thursday morning.\u003c/p>\n\u003cp>The bill’s co-author, Sen. Richard Pan (D-Sacramento), introduced the bill in the wake of a measles outbreak earlier this year that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\" rel=\"noopener\">started at Disneyland\u003c/a>.\u003c/p>\n\u003cp>While statewide vaccination rates are high — over 90 percent — some communities have high rates of children with a personal belief exemption on file with their school districts. In some schools, the rate of personal belief exemptions can be \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\" target=\"_blank\" rel=\"noopener\">50 percent or much higher\u003c/a>.\u003c/p>\n\u003cp>“When you have pockets of low vaccination,” Pan said, “we need to do more to protect our communities. … This is a matter of public safety.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Several sets of amendments to the bill — including a religious exemption and a requirement to disclose vaccine ingredients — were introduced and then tabled after votes by the full Senate.\u003c/p>\n\u003cp>“Getting a religious exemption is not unreasonable,” said Sen. Joel Anderson, R-San Diego. “Don’t get caught up with zeal. … You can gain more with honey than you can with vinegar.”\u003c/p>\n\u003cp>But Pan said that he had not received any letters from mainstream religious organizations opposing the bill. He and SB277 co-author Ben Allen (D-Santa Monica) have “had our own conversations with religious leaders, including the Catholic Church, and they do not oppose vaccination or this bill,” he said.\u003c/p>\n\u003cp>A religious exemption could become an issue with Gov. Jerry Brown, who \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/11/how-californias-law-to-encourage-vaccination-could-backfire/\" target=\"_blank\" rel=\"noopener\">added a religious exemption in 2012 \u003c/a>when he signed into law another Pan vaccine bill — AB2109, which required those wanting a personal belief exemption to first meet with a health care provider.\u003c/p>\n\u003cp>Pan said he was open to talking with the governor about a religious exemption, but said he had not heard from Brown’s office.\u003c/p>\n\u003cp>If Pan’s bill becomes law, California would become only the third state without both a religious and personal exemption to vaccines. It would mean that children not fully vaccinated against 10 specified diseases could only be home-schooled. The bill applies to all students in public, private and parochial schools.\u003c/p>\n\u003cp>Children who cannot be vaccinated for medical reasons would be able to obtain an exemption. This includes children being treated for cancer or those with a compromised immune system.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads next to the Assembly.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state Senate has passed a bill that would require virtually all California schoolchildren to be vaccinated.\u003c/p>\n\u003cp>\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\" rel=\"noopener\">SB277\u003c/a> would end the “personal belief exemption” that allows parents to opt out of vaccines on behalf of their children and send their kids to school with some vaccinations or none at all. The Senate voted 25-10, mostly on partisan lines, after a long debate Thursday morning.\u003c/p>\n\u003cp>The bill’s co-author, Sen. Richard Pan (D-Sacramento), introduced the bill in the wake of a measles outbreak earlier this year that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\" rel=\"noopener\">started at Disneyland\u003c/a>.\u003c/p>\n\u003cp>While statewide vaccination rates are high — over 90 percent — some communities have high rates of children with a personal belief exemption on file with their school districts. In some schools, the rate of personal belief exemptions can be \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\" target=\"_blank\" rel=\"noopener\">50 percent or much higher\u003c/a>.\u003c/p>\n\u003cp>“When you have pockets of low vaccination,” Pan said, “we need to do more to protect our communities. … This is a matter of public safety.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Several sets of amendments to the bill — including a religious exemption and a requirement to disclose vaccine ingredients — were introduced and then tabled after votes by the full Senate.\u003c/p>\n\u003cp>“Getting a religious exemption is not unreasonable,” said Sen. Joel Anderson, R-San Diego. “Don’t get caught up with zeal. … You can gain more with honey than you can with vinegar.”\u003c/p>\n\u003cp>But Pan said that he had not received any letters from mainstream religious organizations opposing the bill. He and SB277 co-author Ben Allen (D-Santa Monica) have “had our own conversations with religious leaders, including the Catholic Church, and they do not oppose vaccination or this bill,” he said.\u003c/p>\n\u003cp>A religious exemption could become an issue with Gov. Jerry Brown, who \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/11/how-californias-law-to-encourage-vaccination-could-backfire/\" target=\"_blank\" rel=\"noopener\">added a religious exemption in 2012 \u003c/a>when he signed into law another Pan vaccine bill — AB2109, which required those wanting a personal belief exemption to first meet with a health care provider.\u003c/p>\n\u003cp>Pan said he was open to talking with the governor about a religious exemption, but said he had not heard from Brown’s office.\u003c/p>\n\u003cp>If Pan’s bill becomes law, California would become only the third state without both a religious and personal exemption to vaccines. It would mean that children not fully vaccinated against 10 specified diseases could only be home-schooled. The bill applies to all students in public, private and parochial schools.\u003c/p>\n\u003cp>Children who cannot be vaccinated for medical reasons would be able to obtain an exemption. This includes children being treated for cancer or those with a compromised immune system.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads next to the Assembly.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Here's A Radical Approach to Huge Hospital Bills: Set Your Own Price",
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"content": "\u003cp>In the late 1990s you could have taken what hospitals charged to administer inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges (not even counting the price of the anti-cancer drugs) are enough to pay for a Lexus GX sport-utility vehicle, \u003ca href=\"http://hcupnet.ahrq.gov/HCUPnet.jsp?Id=02579B1BD79C1C3C&Form=SelDXPR&JS=Y&Action=%3E%3ENext%3E%3E&_DXPR=PCCHPR1\">government data show\u003c/a>.\u003c/p>\n\u003cp>Hospital prices have risen nearly \u003ca href=\"http://data.bls.gov/cgi-bin/dsrv?cu\">three times as much\u003c/a> as overall inflation since Ronald Reagan was president. Health payers have tried HMOs, accountable care organizations and other innovations to control them, with little effect.\u003c/p>\n\u003cp>A small benefits consulting firm called ELAP Services is causing commotion by suggesting an alternative: Refuse to pay. When hospitals send invoices with charges that seem to bear no relationship to their costs, the Pennsylvania firm tells its clients (generally medium-sized employers) to just say no.\u003c/p>\n\u003cp>Instead, employers pay hospitals a much lower amount for their services — based on ELAP’s analysis of what is reasonable after analyzing the hospitals’ own financial filings.\u003c/p>\n\u003cp>For facilities on the receiving end of ELAP’s unusual strategy, this is a disruption of business as usual, to say the least. Hospitals are unhappy but have failed to make headway against it in court.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It was a leap of faith,” when \u003ca href=\"http://www.huffines.net/\">Huffines Auto Dealerships\u003c/a>, which provides coverage to 300 employees and their families, signed on to the ELAP plan a few years ago, said Eric Hartter, chief financial officer for the Texas firm.\u003c/p>\n\u003cp>What he says now: “This is the best form of true health care reform that I’ve come across.”\u003c/p>\n\u003cp>Huffines first worked with ELAP on charges for an employee’s back surgery. The worker had spent three days in a Dallas hospital. The bill was $600,000, Hartter said.\u003c/p>\n\u003cp>Like many businesses, the dealership pays worker health costs directly. At the time it was working with a claims administrator that set up a traditional, “preferred provider” network with agreed hospital discounts.\u003c/p>\n\u003cp>The administrator looked at the bill and said, “‘Don’t worry. By the time we apply the discounts and everything else it’ll be down to about $300,000,’” Hartter recalled. “I said, ‘What’s the difference? That doesn’t make me feel any better.’”\u003c/p>\n\u003cp>Instead he had ELAP analyze the bill. The firm estimated costs for the treatment based on the hospital’s financial reports filed with Medicare. Then it added a cushion so the hospital could make a modest profit.\u003c/p>\n\u003cp>“We wrote a check to the hospital for $28,900 and we never heard from them again,” Hartter said.\u003c/p>\n\u003cp>Now Huffines and ELAP, which launched this service in 2007 and has been growing since, treat every big hospital bill the same way. The result has saved so much money that what the dealership and workers contribute for health costs stayed unchanged for six years while benefits remained the same, Hartter said.\u003c/p>\n\u003cp>More than 200 employers providing health coverage to about 115,000 workers and dependents have hired ELAP. Company CEO Steve Kelly said he is aware of only one other, smaller, benefits consultant with the same approach.\u003c/p>\n\u003cp>Normally customers who don’t pay bills get hassled or sued. This sometimes happens to ELAP clients and their workers. Hospitals send patients huge invoices for what the employer refused to pay. They hire collection agents and threaten credit scores.\u003c/p>\n\u003cp>ELAP fights back with lawyers and several arguments: How can hospitals justifiably charge employers and their workers so much more than they accept from Medicare, the government program for seniors? How can hospitals bill $30 for a gauze pad? How can employee-patients consent to prices they will never see until after they’ve been discharged?\u003c/p>\n\u003cp>The American Hospital Association and the Federation of American Hospitals did not respond to requests for comment about ELAP.\u003c/p>\n\u003cp>ELAP is not merely a medical-bill auditor, like many other companies, combing hospital statements for errors. It sets the reimbursement, telling hospitals what clients will pay.\u003c/p>\n\u003cp>Eventually, “overwhelmingly, the providers just accept the payment” and leave patients alone, Kelly said. A federal district judge in Georgia \u003ca href=\"http://www.elapservices.com/sites/default/files/Order%20Granting%20Defendants-msj_0.pdf\">decided a 2012 case\u003c/a> against a hospital and in favor of ELAP and its furniture chain client.\u003c/p>\n\u003cp>Most patients being dunned by hospitals are unlikely to meet with the same success on their own, lacking backup from ELAP and its legal firepower.\u003c/p>\n\u003cp>Under ELAP’s main model, neither employers nor their claims administrators sign contracts with hospitals. Employers detail the reimbursement process in documents establishing how the plan covers workers. That gives it legal weight, ELAP has argued in court. ELAP agrees to handle all hospital bills for an employer and defend workers from collections in return for a percentage fee tied to total hospital charges.\u003c/p>\n\u003cp>There is no hospital network. Employees may use almost any facility. Payments are made later based on ELAP’s analysis.\u003c/p>\n\u003cp>That may change, Kelly said. Often it makes sense even for medium-sized employers to\u003ca href=\"http://www.beckershospitalreview.com/finance/working-together-to-contain-costs-what-hospital-leaders-need-to-know-for-successful-direct-contracting-with-employers.html\">contract directly with hospitals\u003c/a> to treat their workers, he said. That way prices are clear.\u003c/p>\n\u003cp>But for now ELAP clients such as Huffines and \u003ca href=\"http://www.ibtinc.com/About/\">IBT Industrial Solutions\u003c/a> are giving hospitals a different dose of medicine.\u003c/p>\n\u003cp>At IBT, a Kansas distributor of bearings and motors, “runaway health costs were starting to threaten the long-term viability of our company,” said chief financial officer Greg Drown. After reading “Bitter Pill,” a critical Time magazine piece about hospitals, IBT executives decided to try something else.\u003c/p>\n\u003cp>They hired ELAP, which was “not a simple or risk-free move,” cautions Drown.\u003c/p>\n\u003cp>About one IBT worker in five using a hospital gets “balance billed” for amounts the employer won’t pay, he said. That can take months to resolve even with ELAP’s legal support. But ELAP’s program cut health costs by about a fourth, he added.\u003c/p>\n\u003cp>Recently managers at a big medical system in metro Kansas City “finally figured out we were doing something a little bit different,” sent “a nasty letter” and followed up with a call, he said.\u003c/p>\n\u003cp>The hospital executive on the phone “was very condescending and thought I was stupid and had been duped by a predatory consultant and had been sold a — quote — crappy plan,” Drown said.\u003c/p>\n\u003cp>Drown listened. He told the man he would consult with his colleagues and reply.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I called him back a week or two later and left him a rather detailed voicemail that said, ‘We’re not changing anything. We’re staying where we are.’ And the guy never called me back.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the late 1990s you could have taken what hospitals charged to administer inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges (not even counting the price of the anti-cancer drugs) are enough to pay for a Lexus GX sport-utility vehicle, \u003ca href=\"http://hcupnet.ahrq.gov/HCUPnet.jsp?Id=02579B1BD79C1C3C&Form=SelDXPR&JS=Y&Action=%3E%3ENext%3E%3E&_DXPR=PCCHPR1\">government data show\u003c/a>.\u003c/p>\n\u003cp>Hospital prices have risen nearly \u003ca href=\"http://data.bls.gov/cgi-bin/dsrv?cu\">three times as much\u003c/a> as overall inflation since Ronald Reagan was president. Health payers have tried HMOs, accountable care organizations and other innovations to control them, with little effect.\u003c/p>\n\u003cp>A small benefits consulting firm called ELAP Services is causing commotion by suggesting an alternative: Refuse to pay. When hospitals send invoices with charges that seem to bear no relationship to their costs, the Pennsylvania firm tells its clients (generally medium-sized employers) to just say no.\u003c/p>\n\u003cp>Instead, employers pay hospitals a much lower amount for their services — based on ELAP’s analysis of what is reasonable after analyzing the hospitals’ own financial filings.\u003c/p>\n\u003cp>For facilities on the receiving end of ELAP’s unusual strategy, this is a disruption of business as usual, to say the least. Hospitals are unhappy but have failed to make headway against it in court.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It was a leap of faith,” when \u003ca href=\"http://www.huffines.net/\">Huffines Auto Dealerships\u003c/a>, which provides coverage to 300 employees and their families, signed on to the ELAP plan a few years ago, said Eric Hartter, chief financial officer for the Texas firm.\u003c/p>\n\u003cp>What he says now: “This is the best form of true health care reform that I’ve come across.”\u003c/p>\n\u003cp>Huffines first worked with ELAP on charges for an employee’s back surgery. The worker had spent three days in a Dallas hospital. The bill was $600,000, Hartter said.\u003c/p>\n\u003cp>Like many businesses, the dealership pays worker health costs directly. At the time it was working with a claims administrator that set up a traditional, “preferred provider” network with agreed hospital discounts.\u003c/p>\n\u003cp>The administrator looked at the bill and said, “‘Don’t worry. By the time we apply the discounts and everything else it’ll be down to about $300,000,’” Hartter recalled. “I said, ‘What’s the difference? That doesn’t make me feel any better.’”\u003c/p>\n\u003cp>Instead he had ELAP analyze the bill. The firm estimated costs for the treatment based on the hospital’s financial reports filed with Medicare. Then it added a cushion so the hospital could make a modest profit.\u003c/p>\n\u003cp>“We wrote a check to the hospital for $28,900 and we never heard from them again,” Hartter said.\u003c/p>\n\u003cp>Now Huffines and ELAP, which launched this service in 2007 and has been growing since, treat every big hospital bill the same way. The result has saved so much money that what the dealership and workers contribute for health costs stayed unchanged for six years while benefits remained the same, Hartter said.\u003c/p>\n\u003cp>More than 200 employers providing health coverage to about 115,000 workers and dependents have hired ELAP. Company CEO Steve Kelly said he is aware of only one other, smaller, benefits consultant with the same approach.\u003c/p>\n\u003cp>Normally customers who don’t pay bills get hassled or sued. This sometimes happens to ELAP clients and their workers. Hospitals send patients huge invoices for what the employer refused to pay. They hire collection agents and threaten credit scores.\u003c/p>\n\u003cp>ELAP fights back with lawyers and several arguments: How can hospitals justifiably charge employers and their workers so much more than they accept from Medicare, the government program for seniors? How can hospitals bill $30 for a gauze pad? How can employee-patients consent to prices they will never see until after they’ve been discharged?\u003c/p>\n\u003cp>The American Hospital Association and the Federation of American Hospitals did not respond to requests for comment about ELAP.\u003c/p>\n\u003cp>ELAP is not merely a medical-bill auditor, like many other companies, combing hospital statements for errors. It sets the reimbursement, telling hospitals what clients will pay.\u003c/p>\n\u003cp>Eventually, “overwhelmingly, the providers just accept the payment” and leave patients alone, Kelly said. 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Payments are made later based on ELAP’s analysis.\u003c/p>\n\u003cp>That may change, Kelly said. Often it makes sense even for medium-sized employers to\u003ca href=\"http://www.beckershospitalreview.com/finance/working-together-to-contain-costs-what-hospital-leaders-need-to-know-for-successful-direct-contracting-with-employers.html\">contract directly with hospitals\u003c/a> to treat their workers, he said. That way prices are clear.\u003c/p>\n\u003cp>But for now ELAP clients such as Huffines and \u003ca href=\"http://www.ibtinc.com/About/\">IBT Industrial Solutions\u003c/a> are giving hospitals a different dose of medicine.\u003c/p>\n\u003cp>At IBT, a Kansas distributor of bearings and motors, “runaway health costs were starting to threaten the long-term viability of our company,” said chief financial officer Greg Drown. After reading “Bitter Pill,” a critical Time magazine piece about hospitals, IBT executives decided to try something else.\u003c/p>\n\u003cp>They hired ELAP, which was “not a simple or risk-free move,” cautions Drown.\u003c/p>\n\u003cp>About one IBT worker in five using a hospital gets “balance billed” for amounts the employer won’t pay, he said. That can take months to resolve even with ELAP’s legal support. But ELAP’s program cut health costs by about a fourth, he added.\u003c/p>\n\u003cp>Recently managers at a big medical system in metro Kansas City “finally figured out we were doing something a little bit different,” sent “a nasty letter” and followed up with a call, he said.\u003c/p>\n\u003cp>The hospital executive on the phone “was very condescending and thought I was stupid and had been duped by a predatory consultant and had been sold a — quote — crappy plan,” Drown said.\u003c/p>\n\u003cp>Drown listened. 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"disqusTitle": "Berkeley Bans Sale of E-Cigarettes and Flavored Tobacco Near Parks, Schools",
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"content": "\u003cp>Berkeley is moving ahead to ban the sale of e-cigarettes and flavored tobacco products within 1,000 feet of parks or schools.\u003c/p>\n\u003cp>But after hearing from numerous business owners Tuesday night who said they’d fold without tobacco sales, the City Council dialed back a proposal to ban all tobacco sales in those areas.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.ci.berkeley.ca.us/Clerk/City_Council/2015/05_May/Documents/2015-05-12_Item_26a_Amendment_to_BMC.aspx\" target=\"_blank\">original proposal\u003c/a> would have affected 63 stores, out of 84 that sell tobacco in the city. About a dozen store owners told the City Council their families’ livelihoods would be threatened by a ban on tobacco sales.\u003c/p>\n\u003cfigure id=\"attachment_10523928\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/05/storeowners-wait-to-speak.jpg\">\u003cimg class=\"size-thumbnail wp-image-10523928\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2015/05/storeowners-wait-to-speak-400x225.jpg\" alt=\"Shop owners waiting to testify as Berkeley City Council weighed strict limits on tobacco sales in the city. \" width=\"400\" height=\"225\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak-1440x811.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak-960x541.jpg 960w, https://ww2.kqed.org/app/uploads/sites/10/2015/05/storeowners-wait-to-speak.jpg 1920w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shop owners waiting to testify as Berkeley City Council weighed strict limits on tobacco sales in the city. \u003ccite>(Andrew Stelzer/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It will shut me down,” said Zeaad Handoush, who has owned Whelan’s Smoke Shop, on Bancroft Way across the street from UC Berkeley, for the past 15 years.\u003c/p>\n\u003cp>“We came here to Berkeley to do business,\" Handoush said. \"We’ve done business exactly like you’ve told us you’d like it to be run. I’ve never sold to minors ... so I’m up here to defend myself for doing everything right.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“How am I to raise my two kids? Do you want me to become homeless? How can I live?” asked Ziada Araya, who came to the United States in 1979 as a refugee from Eritrea and now owns U.S. Liquor at Ashby Avenue and Sacramento Street.\u003c/p>\n\u003cp>The shop owners were responding to a barrage of public comment in favor of more stringent restrictions on tobacco sales. Numerous people stated that 80 percent of smokers start before they turn 18 years old and that easy access to tobacco products helps lead to addiction.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.berkeleychamber.com/\" target=\"_blank\">Berkeley Chamber of Commerce\u003c/a>’s Kirsten MacDonald said most of the 63 stores that would be affected by a 1,000-foot ban get more than half their business from tobacco products.\u003c/p>\n\u003cp>“This ordinance will not stop smoking,\" said MacDonald. \"It will only cause job loss, tax loss to the city and exacerbate the problem of food deserts in neighborhoods that depend on their existence.\"\u003c/p>\n\u003cp>The Berkeley NAACP’s Carol McGruder, who also serves as co-chair of the \u003ca href=\"http://www.savingblacklives.org/\" target=\"_blank\">African American Tobacco Control Leadership Council\u003c/a>, said she sympathizes with store owners -- up to a point.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We’re weighing the health of our kids against the livelihood of these families.'\u003ccite>Berkeley Councilwoman Linda Maio\u003c/cite>\u003c/aside>\n\u003cp>\"I frankly feel very sorry for them because they are decent people, they are not rich, they are trying to support their families,\" said McGruder. \"But I feel more sorry of the people who become addicted to tobacco, which usually starts under the age of 18.\"\u003c/p>\n\u003cp>“We’re weighing the health of our kids against the livelihood of these families,” said Councilwoman Linda Maio, one of several council members who referenced their own personal and family battles with smoking.\u003c/p>\n\u003cp>Councilman Max Anderson, who says he quit smoking 41 years ago and has worked as a respiratory therapist, reluctantly voted along with seven other council members to send the original proposal to the city manager for more work.\u003c/p>\n\u003cp>“The right to poison people, whether it’s been legal for years or not, is not something you want to sustain, add to, temporize about, and back away from controls on,” Anderson said. “How can it be that the health of this community is less important that somebody making money?”\u003c/p>\n\u003cp>A ban on all tobacco products being sold near parks or schools will likely include a grace period of one to two years.\u003c/p>\n\u003cp>Councilwoman Susan Wengraf said a 600-foot buffer, in line with regulations for the location of medical marijuana businesses, might be more appropriate. City staff said that would affect only 31 of the city's 84 businesses that sell tobacco.\u003c/p>\n\u003cp>“I’m very concerned about affecting 63 businesses in this town, and the hundreds of workers whose lives would be impacted by doing that,\" she said. \"Although there’s no doubt in the mind that tobacco is bad, I just think that’s a little extreme.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>There was unanimous contempt on the council for flavored tobacco and e-cigarettes, which are seen as gateway products for children. Mayor Tom Bates instructed city staff to see if those products can be banned citywide, even beyond the 1,000-foot buffer.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“How am I to raise my two kids? Do you want me to become homeless? How can I live?” asked Ziada Araya, who came to the United States in 1979 as a refugee from Eritrea and now owns U.S. Liquor at Ashby Avenue and Sacramento Street.\u003c/p>\n\u003cp>The shop owners were responding to a barrage of public comment in favor of more stringent restrictions on tobacco sales. Numerous people stated that 80 percent of smokers start before they turn 18 years old and that easy access to tobacco products helps lead to addiction.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.berkeleychamber.com/\" target=\"_blank\">Berkeley Chamber of Commerce\u003c/a>’s Kirsten MacDonald said most of the 63 stores that would be affected by a 1,000-foot ban get more than half their business from tobacco products.\u003c/p>\n\u003cp>“This ordinance will not stop smoking,\" said MacDonald. \"It will only cause job loss, tax loss to the city and exacerbate the problem of food deserts in neighborhoods that depend on their existence.\"\u003c/p>\n\u003cp>The Berkeley NAACP’s Carol McGruder, who also serves as co-chair of the \u003ca href=\"http://www.savingblacklives.org/\" target=\"_blank\">African American Tobacco Control Leadership Council\u003c/a>, said she sympathizes with store owners -- up to a point.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We’re weighing the health of our kids against the livelihood of these families.'\u003ccite>Berkeley Councilwoman Linda Maio\u003c/cite>\u003c/aside>\n\u003cp>\"I frankly feel very sorry for them because they are decent people, they are not rich, they are trying to support their families,\" said McGruder. \"But I feel more sorry of the people who become addicted to tobacco, which usually starts under the age of 18.\"\u003c/p>\n\u003cp>“We’re weighing the health of our kids against the livelihood of these families,” said Councilwoman Linda Maio, one of several council members who referenced their own personal and family battles with smoking.\u003c/p>\n\u003cp>Councilman Max Anderson, who says he quit smoking 41 years ago and has worked as a respiratory therapist, reluctantly voted along with seven other council members to send the original proposal to the city manager for more work.\u003c/p>\n\u003cp>“The right to poison people, whether it’s been legal for years or not, is not something you want to sustain, add to, temporize about, and back away from controls on,” Anderson said. “How can it be that the health of this community is less important that somebody making money?”\u003c/p>\n\u003cp>A ban on all tobacco products being sold near parks or schools will likely include a grace period of one to two years.\u003c/p>\n\u003cp>Councilwoman Susan Wengraf said a 600-foot buffer, in line with regulations for the location of medical marijuana businesses, might be more appropriate. City staff said that would affect only 31 of the city's 84 businesses that sell tobacco.\u003c/p>\n\u003cp>“I’m very concerned about affecting 63 businesses in this town, and the hundreds of workers whose lives would be impacted by doing that,\" she said. \"Although there’s no doubt in the mind that tobacco is bad, I just think that’s a little extreme.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>There was unanimous contempt on the council for flavored tobacco and e-cigarettes, which are seen as gateway products for children. Mayor Tom Bates instructed city staff to see if those products can be banned citywide, even beyond the 1,000-foot buffer.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"order": 1
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"code-switch-life-kit": {
"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"commonwealth-club": {
"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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