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"disqusTitle": "State Revokes Blue Shield of California's Tax-Exempt Status",
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"content": "\u003cfigure id=\"attachment_24598\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/ari/4053409353/in/photolist-7bbMoa-7bbYQk-7bfwqs-7bd3c8-7bgMHE-7bcqci-7bgac3-7bgLko-7bcqtn-7bgfHS-7bcjnz-7bcoWv-7bbKqa-7bgaYm-7bbL6z-7bgMob-7bco7v-7bcrNH-7bckoB-7bcm7D-7bfsR5-7bcYNR-7bbHGz-7bcWSg-7bgaNu-7bfMHu-7bc2e2-7bgKrJ-7bckVk-7bg7sC-ptfyE4-7bfayY-7bbfHp-7bbkzP-7bcXFt-7bfvCY-7bcspp-7bf7RS-7bf56h-7bbikK-7bf29Y-7bbgJx-7bbf5F-7bbfAi-7bf4sG-7bbdZH-7bbe9c-7bf38o-7bbj74-7bf4Jy\">\u003cimg class=\"wp-image-24598 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/4053409353_87d696f4e8_o-640x428.jpg\" alt=\"(Steve Rhodes via Flickr)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Steve Rhodes via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>On the Blue Shield of California Web page called \"\u003ca href=\"https://www.blueshieldca.com/employer/knowledge-center/features/perspectives/not-for-profit.sp\" target=\"_blank\">What Does Being a Not-for-Profit Mean to Us\u003c/a>?\" the health insurer provides an answer:\u003c/p>\n\u003cblockquote>\u003cp>Operationally, it means we don’t answer to Wall Street – we don't need to generate returns to shareholders. Philosophically, being a not-for-profit means we’re guided by our mission to ensure all Californians have access to high-quality health care at an affordable price.\u003c/p>\u003c/blockquote>\n\u003cp>Well, the state's Franchise Tax Board may have found that something in that description does not conform with reality. In a story first \u003ca href=\"http://www.latimes.com/business/la-fi-blue-shield-california-20150318-story.html#page=1\" target=\"_blank\">reported by the L.A. Times\u003c/a> and confirmed by Blue Shield of California to KQED, the board has stripped the company of its tax-exempt status.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>“\u003c/em>\u003c/strong>Yes the loss of tax exemption is true and we have filed a formal protest of the decision with the FTB,\" Blue Shield said in an email. The tax board said the revocation occurred on Aug. 28, 2014, and the Times said the company must now file returns from 2013 on. When asked the reason for the revocation, the board responded that is not considered public information and could not be disclosed.\u003c/p>\n\u003cp>Whatever the reason, the Times said the move could transfer tens of millions of dollars each year from the company to the state. Calling the action highly unusual, the newspaper said it came on the heels of a state audit investigating the justification for the company's tax exemption.\u003c!--more-->\u003c/p>\n\u003cp>San Francisco-based Blue Shield has faced criticism over a number of issues for the past few years, including \u003ca href=\"http://articles.latimes.com/2011/may/26/business/la-fi-insurer-executive-pay-20110526\" target=\"_blank\">executive pay\u003c/a>, a proposal to \u003ca href=\"http://money.cnn.com/2011/01/07/news/companies/California_blue_shield_rate_hike/\" target=\"_blank\">hike rates 59 percent\u003c/a> (later dropped), and a large surplus of billions of dollars. It does not currently serve Medi-Cal patients (although it is in a deal to expand into the Medi-Cal market later this year), and it contributed millions to defeat Prop. 45, which lost at the ballot box last year and would have given California's insurance commissioner veto power over health insurance rate hikes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But perhaps no issue symbolized the lack of a common touch more than the company's \u003ca href=\"http://www.sfgate.com/bayarea/matier-ross/article/Blue-Shield-to-fete-some-members-in-style-at-new-5693340.php\" target=\"_blank\">spending at least $2.5 million on a luxury box\u003c/a> at the 49ers new Santa Clara stadium. The purchase prompted a \u003ca href=\"http://sanfrancisco.cbslocal.com/2014/09/11/blueshield-customers-plan-protest-of-nonprofits-2-5-million-skybox-at-levis-stadium/\" target=\"_blank\">protest \u003c/a>and a \u003ca href=\"http://petitions.moveon.org/couragecampaign/sign/stop-insurance-companies-7\" target=\"_blank\">petition, \u003c/a>and the advocacy group Consumer Watchdog sent a \u003ca href=\"http://www.consumerwatchdog.org/resources/ltrbsskybox.pdf\" target=\"_blank\">letter\u003c/a> to state Attorney General Kamala Harris stating the purchase was \"just the latest example of Blue Shield’s abuse of its privileged 'non-profit' tax status at the expense of California taxpayers and patients.\"\u003c/p>\n\u003cp>Consumer Watchdog today sent out a congratulatory email blast over the state's action. \"Just like the rest of us, Blue Shield will soon have to pay California taxes,\" the email said.\u003c/p>\n\u003cp>The L.A. Times story reported that Blue Shield of California's former public policy director, Michael Johnson, is launching a \"public campaign calling on executives to convert the insurer into a for-profit company and return billions of dollars to the public that could be used to bolster the state's healthcare safety net. He estimates the company could be worth as much as $10 billion.\"\u003c/p>\n\u003cp>Blue Shield spokesman Steve Shivinsky told the Times the company \"firmly believes it is fulfilling its not-for-profit mission and commitment to the community.\" In 2011, the company said it \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2011/10/blue-shield-follows-on-2-percent.html?page=all\" target=\"_blank\">would cap profits at 2 percent of revenue\u003c/a> and return nearly $300 million to customers and providers.\u003c/p>\n\u003cp>\u003cem>Update\u003c/em>: KQED's Julie Small today spoke with L.A. Times reporter Chad Terhune, who broke the story. He said although the Franchise Tax Board won't disclose the criteria it looked at in revoking Blue Shield's tax-exempt status, in general when nonprofit companies are audited in this way, the board would focus on what benefit they offer to the community and how they are different than for-profit businesses.\"Are you doing things for the poorest or neediest members of society?\" Terhune said. \"Are you offering free or subsidized health care? Are you going out of your way to be an insurer of last resort? Are your premiums and prices affordable?\"Terhune said the landscape is complicated for large nonprofit health insurers, who have to compete with their for-profit rivals on price. \"So you're going to have to do many of the same things. But you're getting a tax break, so you have to act differently.\"He said Blue Shield gives about $35 million per year to its charitable foundation. It has also given over $500 million in rebates to customers.\"They'd say,'We are different,'\" Terhune said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>We have also updated this story to indicate that Blue Shield has entered into an agreement to provide coverage to Medi-Cal recipients. The deal is expected to close later this year, a Blue Shield spokesman told State of Health. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24598\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/ari/4053409353/in/photolist-7bbMoa-7bbYQk-7bfwqs-7bd3c8-7bgMHE-7bcqci-7bgac3-7bgLko-7bcqtn-7bgfHS-7bcjnz-7bcoWv-7bbKqa-7bgaYm-7bbL6z-7bgMob-7bco7v-7bcrNH-7bckoB-7bcm7D-7bfsR5-7bcYNR-7bbHGz-7bcWSg-7bgaNu-7bfMHu-7bc2e2-7bgKrJ-7bckVk-7bg7sC-ptfyE4-7bfayY-7bbfHp-7bbkzP-7bcXFt-7bfvCY-7bcspp-7bf7RS-7bf56h-7bbikK-7bf29Y-7bbgJx-7bbf5F-7bbfAi-7bf4sG-7bbdZH-7bbe9c-7bf38o-7bbj74-7bf4Jy\">\u003cimg class=\"wp-image-24598 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/4053409353_87d696f4e8_o-640x428.jpg\" alt=\"(Steve Rhodes via Flickr)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Steve Rhodes via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>On the Blue Shield of California Web page called \"\u003ca href=\"https://www.blueshieldca.com/employer/knowledge-center/features/perspectives/not-for-profit.sp\" target=\"_blank\">What Does Being a Not-for-Profit Mean to Us\u003c/a>?\" the health insurer provides an answer:\u003c/p>\n\u003cblockquote>\u003cp>Operationally, it means we don’t answer to Wall Street – we don't need to generate returns to shareholders. Philosophically, being a not-for-profit means we’re guided by our mission to ensure all Californians have access to high-quality health care at an affordable price.\u003c/p>\u003c/blockquote>\n\u003cp>Well, the state's Franchise Tax Board may have found that something in that description does not conform with reality. In a story first \u003ca href=\"http://www.latimes.com/business/la-fi-blue-shield-california-20150318-story.html#page=1\" target=\"_blank\">reported by the L.A. Times\u003c/a> and confirmed by Blue Shield of California to KQED, the board has stripped the company of its tax-exempt status.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>“\u003c/em>\u003c/strong>Yes the loss of tax exemption is true and we have filed a formal protest of the decision with the FTB,\" Blue Shield said in an email. The tax board said the revocation occurred on Aug. 28, 2014, and the Times said the company must now file returns from 2013 on. When asked the reason for the revocation, the board responded that is not considered public information and could not be disclosed.\u003c/p>\n\u003cp>Whatever the reason, the Times said the move could transfer tens of millions of dollars each year from the company to the state. Calling the action highly unusual, the newspaper said it came on the heels of a state audit investigating the justification for the company's tax exemption.\u003c!--more-->\u003c/p>\n\u003cp>San Francisco-based Blue Shield has faced criticism over a number of issues for the past few years, including \u003ca href=\"http://articles.latimes.com/2011/may/26/business/la-fi-insurer-executive-pay-20110526\" target=\"_blank\">executive pay\u003c/a>, a proposal to \u003ca href=\"http://money.cnn.com/2011/01/07/news/companies/California_blue_shield_rate_hike/\" target=\"_blank\">hike rates 59 percent\u003c/a> (later dropped), and a large surplus of billions of dollars. It does not currently serve Medi-Cal patients (although it is in a deal to expand into the Medi-Cal market later this year), and it contributed millions to defeat Prop. 45, which lost at the ballot box last year and would have given California's insurance commissioner veto power over health insurance rate hikes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But perhaps no issue symbolized the lack of a common touch more than the company's \u003ca href=\"http://www.sfgate.com/bayarea/matier-ross/article/Blue-Shield-to-fete-some-members-in-style-at-new-5693340.php\" target=\"_blank\">spending at least $2.5 million on a luxury box\u003c/a> at the 49ers new Santa Clara stadium. The purchase prompted a \u003ca href=\"http://sanfrancisco.cbslocal.com/2014/09/11/blueshield-customers-plan-protest-of-nonprofits-2-5-million-skybox-at-levis-stadium/\" target=\"_blank\">protest \u003c/a>and a \u003ca href=\"http://petitions.moveon.org/couragecampaign/sign/stop-insurance-companies-7\" target=\"_blank\">petition, \u003c/a>and the advocacy group Consumer Watchdog sent a \u003ca href=\"http://www.consumerwatchdog.org/resources/ltrbsskybox.pdf\" target=\"_blank\">letter\u003c/a> to state Attorney General Kamala Harris stating the purchase was \"just the latest example of Blue Shield’s abuse of its privileged 'non-profit' tax status at the expense of California taxpayers and patients.\"\u003c/p>\n\u003cp>Consumer Watchdog today sent out a congratulatory email blast over the state's action. \"Just like the rest of us, Blue Shield will soon have to pay California taxes,\" the email said.\u003c/p>\n\u003cp>The L.A. Times story reported that Blue Shield of California's former public policy director, Michael Johnson, is launching a \"public campaign calling on executives to convert the insurer into a for-profit company and return billions of dollars to the public that could be used to bolster the state's healthcare safety net. He estimates the company could be worth as much as $10 billion.\"\u003c/p>\n\u003cp>Blue Shield spokesman Steve Shivinsky told the Times the company \"firmly believes it is fulfilling its not-for-profit mission and commitment to the community.\" In 2011, the company said it \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2011/10/blue-shield-follows-on-2-percent.html?page=all\" target=\"_blank\">would cap profits at 2 percent of revenue\u003c/a> and return nearly $300 million to customers and providers.\u003c/p>\n\u003cp>\u003cem>Update\u003c/em>: KQED's Julie Small today spoke with L.A. Times reporter Chad Terhune, who broke the story. He said although the Franchise Tax Board won't disclose the criteria it looked at in revoking Blue Shield's tax-exempt status, in general when nonprofit companies are audited in this way, the board would focus on what benefit they offer to the community and how they are different than for-profit businesses.\"Are you doing things for the poorest or neediest members of society?\" Terhune said. \"Are you offering free or subsidized health care? Are you going out of your way to be an insurer of last resort? Are your premiums and prices affordable?\"Terhune said the landscape is complicated for large nonprofit health insurers, who have to compete with their for-profit rivals on price. \"So you're going to have to do many of the same things. But you're getting a tax break, so you have to act differently.\"He said Blue Shield gives about $35 million per year to its charitable foundation. It has also given over $500 million in rebates to customers.\"They'd say,'We are different,'\" Terhune said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>We have also updated this story to indicate that Blue Shield has entered into an agreement to provide coverage to Medi-Cal recipients. The deal is expected to close later this year, a Blue Shield spokesman told State of Health. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feinstein and Boxer Say Pregnant Women Should Get Special Obamacare Enrollment",
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"content": "\u003cfigure id=\"attachment_24431\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000039661108_Large-e1426131426198.jpg\">\u003cimg class=\"size-large wp-image-24431\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000039661108_Large-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>U.S. Senators Barbara Boxer and Dianne Feinstein are calling on California's health insurance marketplace, Covered California, to allow women to sign up for coverage when they become pregnant.\u003c/p>\n\u003cp>Under the current rules of the Affordable Care Act, uninsured women who discover they're pregnant outside of open enrollment periods can only sign up for coverage once the baby is born. The senators \u003ca title=\"http://www.feinstein.senate.gov/public/index.cfm/press-releases?ContentRecord_id=ff4ba2b0-57b3-4296-b4ee-882840299968\" href=\"http://www.feinstein.senate.gov/public/index.cfm/press-releases?ContentRecord_id=ff4ba2b0-57b3-4296-b4ee-882840299968\" target=\"_blank\">sent a letter\u003c/a> to Covered California on Wednesday urging the agency to change the policy to make pregnancy a “qualifying life event” that allows women to enroll in coverage at that time.\u003c/p>\n\u003cp>“Allowing women to purchase health insurance during pregnancy will increase access to care and has the potential to improve health, save lives, and reduce future health costs,” the senators wrote.\u003c!--more-->\u003c/p>\n\u003cp>The letter comes a week after a group of Democratic senators \u003ca title=\"http://thehill.com/regulation/234465-dems-call-for-open-enrollment-for-pregnant-women\" href=\"http://thehill.com/regulation/234465-dems-call-for-open-enrollment-for-pregnant-women\" target=\"_blank\">called on federal health officials\u003c/a> to change the rule at the national level. More than 50 members of the House of Representatives are expected to deliver a similar letter on Thursday.\u003c/p>\n\u003cp>Christina Postolowski, health policy manager at Young Invincibles, an advocacy group pushing for the new policy, says a change in California could lead the way for the rest of the country.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“California doesn't have to wait for the federal government to act,” she says. “They can take the initiative and make this change now.”\u003c/p>\n\u003cp>But health insurance industry groups say this would encourage women to wait until they become pregnant to sign up. That would make it difficult for insurers to assess risk pools and set their prices.\u003c/p>\n\u003cp>“In order for the system to work, we need a broad range of people participating: people who are not currently using the health system and people who are,” says Nicole Kasabian Evans, spokesperson for the California Association of Health Plans.\u003c/p>\n\u003cp>Advocates say without the change, many women are forced to pay for prenatal care out of pocket; some may forego it altogether. That could lead to a pregnancy complication going undetected until it became an emergency.\u003c/p>\n\u003cp>“It puts young women in a very difficult position,” Postolowski says. “If something does happen and they end up in the ER, they could be left with tens of thousands of dollars of medical debt.”\u003c/p>\n\u003cp>She points out that California has led the nation on other maternity care policies. Before the Affordable Care Act, insurers were not required to offer maternity care in their plans. California passed a state law requiring maternity coverage two years before the Affordable Care Act made it national law.\u003c/p>\n\u003cp>Postolowski says creating a special enrollment exception for pregnant women would help correct a history of discrimination against women by insurers, including charging women more for coverage or denying coverage to women who have had a cesarean section.\u003c/p>\n\u003cp>“We think special enrollment would close those final gaps,” she said.\u003c/p>\n\u003cp>But Kasabian Evans of the California Association of Health Plans says that rules under the Affordable Care Act that forbid the denial of coverage to people with preexisting conditions and require insurers to cover maternity care can only work because the health law also requires all people to have insurance, whether they're sick or healthy.\u003c/p>\n\u003cp>“As soon as we start watering down the requirements that people have coverage, it could undermine the goals of health reform,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Before the Affordable Care Act became law, when people were allowed to sign up for coverage only when they needed it, prices skyrocketed, Evans said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24431\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000039661108_Large-e1426131426198.jpg\">\u003cimg class=\"size-large wp-image-24431\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000039661108_Large-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>U.S. Senators Barbara Boxer and Dianne Feinstein are calling on California's health insurance marketplace, Covered California, to allow women to sign up for coverage when they become pregnant.\u003c/p>\n\u003cp>Under the current rules of the Affordable Care Act, uninsured women who discover they're pregnant outside of open enrollment periods can only sign up for coverage once the baby is born. The senators \u003ca title=\"http://www.feinstein.senate.gov/public/index.cfm/press-releases?ContentRecord_id=ff4ba2b0-57b3-4296-b4ee-882840299968\" href=\"http://www.feinstein.senate.gov/public/index.cfm/press-releases?ContentRecord_id=ff4ba2b0-57b3-4296-b4ee-882840299968\" target=\"_blank\">sent a letter\u003c/a> to Covered California on Wednesday urging the agency to change the policy to make pregnancy a “qualifying life event” that allows women to enroll in coverage at that time.\u003c/p>\n\u003cp>“Allowing women to purchase health insurance during pregnancy will increase access to care and has the potential to improve health, save lives, and reduce future health costs,” the senators wrote.\u003c!--more-->\u003c/p>\n\u003cp>The letter comes a week after a group of Democratic senators \u003ca title=\"http://thehill.com/regulation/234465-dems-call-for-open-enrollment-for-pregnant-women\" href=\"http://thehill.com/regulation/234465-dems-call-for-open-enrollment-for-pregnant-women\" target=\"_blank\">called on federal health officials\u003c/a> to change the rule at the national level. More than 50 members of the House of Representatives are expected to deliver a similar letter on Thursday.\u003c/p>\n\u003cp>Christina Postolowski, health policy manager at Young Invincibles, an advocacy group pushing for the new policy, says a change in California could lead the way for the rest of the country.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“California doesn't have to wait for the federal government to act,” she says. “They can take the initiative and make this change now.”\u003c/p>\n\u003cp>But health insurance industry groups say this would encourage women to wait until they become pregnant to sign up. That would make it difficult for insurers to assess risk pools and set their prices.\u003c/p>\n\u003cp>“In order for the system to work, we need a broad range of people participating: people who are not currently using the health system and people who are,” says Nicole Kasabian Evans, spokesperson for the California Association of Health Plans.\u003c/p>\n\u003cp>Advocates say without the change, many women are forced to pay for prenatal care out of pocket; some may forego it altogether. That could lead to a pregnancy complication going undetected until it became an emergency.\u003c/p>\n\u003cp>“It puts young women in a very difficult position,” Postolowski says. “If something does happen and they end up in the ER, they could be left with tens of thousands of dollars of medical debt.”\u003c/p>\n\u003cp>She points out that California has led the nation on other maternity care policies. Before the Affordable Care Act, insurers were not required to offer maternity care in their plans. California passed a state law requiring maternity coverage two years before the Affordable Care Act made it national law.\u003c/p>\n\u003cp>Postolowski says creating a special enrollment exception for pregnant women would help correct a history of discrimination against women by insurers, including charging women more for coverage or denying coverage to women who have had a cesarean section.\u003c/p>\n\u003cp>“We think special enrollment would close those final gaps,” she said.\u003c/p>\n\u003cp>But Kasabian Evans of the California Association of Health Plans says that rules under the Affordable Care Act that forbid the denial of coverage to people with preexisting conditions and require insurers to cover maternity care can only work because the health law also requires all people to have insurance, whether they're sick or healthy.\u003c/p>\n\u003cp>“As soon as we start watering down the requirements that people have coverage, it could undermine the goals of health reform,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Before the Affordable Care Act became law, when people were allowed to sign up for coverage only when they needed it, prices skyrocketed, Evans said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24394\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000015590176_Large-21-e1426011478306.jpg\">\u003cimg class=\"size-large wp-image-24394\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/iStock_000015590176_Large-21-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Hundreds of pages of newly-found documents show that the sugar industry worked closely with the federal government in the late 1960s and early 1970s to determine a research agenda to prevent cavities in children, researchers who analyzed the documents say.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"The sugar industry … is following the tobacco industry's playbook.\" \u003c/aside>\n\u003cp>In \u003ca title=\"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001798\" href=\"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001798\" target=\"_blank\">the analysis\u003c/a>, published Wednesday in the journal PLOS Medicine, researchers concluded that industry influence starting in the late 1960s helped steer the National Institute of Dental Research, part of the National Institutes of Health, away from addressing the question of determining a safe level of sugar.\u003c/p>\n\u003cp>\"What this paper has shown is that our (NIH) was working toward potentially answering that question,\" said Cristin Kearns, a fellow at UC San Francisco and lead author of the analysis, \"and the sugar industry derailed them from doing the research to help to answer that question, so we're still debating (it) here in 2015.\"\u003c!--more-->\u003c/p>\n\u003cp>Kearns uncovered the 1,551 pages of documents at a public archive at the University of Illinois.\u003c/p>\n\u003cp>The documents show that an expert panel formed by the sugar industry included all but one member of the government panel that was examining priorities for research.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ultimately, a report from the industry was submitted to the government panel and became the foundation for research going forward. \"Seventy-eight percent of the sugar industry submission was incorporated into the NIDR’s call for research applications. Research that could have been harmful to sugar industry interests was omitted,\" the authors note.\u003c/p>\n\u003cp>\"What this shows is that sugar interests were running science manipulation in as sophisticated a manner as 'big tobacco' was back in the 50s and 60s,\" said UCSF Professor Stan Glantz, a co-author of the study and long time anti-tobacco advocate.\u003c/p>\n\u003cp>Marion Nestle, professor nutrition of New York University was not involved in the analysis, which she called \"incredibly revealing.\"\u003c/p>\n\u003cp>The paper \"makes it clear that the sugar industry systematically and deliberately adopted strategies to make sure that federal research agencies did not urge the public to cut down on sugar intake as a means to prevent tooth decay,\" she said.\u003c/p>\n\u003cp>\"I can attest that the sugar industry is especially aggressive in defending itself against any suggestion to eat less and is following the tobacco industry's playbook.\"\u003c/p>\n\u003cp>In a statement, the Sugar Association said it \"\u003cspan class=\"Apple-style-span\">questions the relevance of attempts to dredge up history when decades of modern science has provided answers regarding the role of diet in the pathogenesis of dental caries.\"\u003c/span>\u003c/p>\n\u003cp>The statement also says that the authors' \"use of attention-grabbing headlines and scare tactics that liken consumption of all-natural sugar ... to a known carcinogen is a 'textbook' play from the activist agenda.\"\u003c/p>\n\u003cp>The authors admit their analysis is limited because it \"provides a narrow window into the activities of just one sugar industry trade association\" and that they could not \"interview key actors.\"\u003c/p>\n\u003cp>\u003cstrong>A Long Hunt\u003c/strong>\u003c/p>\n\u003cp>Cristin Kearns found the papers after a long hunt. In 2007, she says, while attending a conference, she was handed a government pamphlet titled, \"How to Talk to Patients About Diabetes.\" She was startled that the diet advice didn't mention reducing sugar intake. It made her wonder if the sugar industry \"somehow impacted what the government can or cannot say about diet advice for diabetics?\"\u003c/p>\n\u003cp>She started searching online and, ultimately \u003ca title=\"http://www.motherjones.com/environment/2012/10/former-dentist-sugar-industry-lies\" href=\"http://www.motherjones.com/environment/2012/10/former-dentist-sugar-industry-lies\" target=\"_blank\">quit her day job\u003c/a>. After months of looking, she uncovered some documents and ultimately identified the documents discussed in the analysis today.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kearns says there are more documents to be found, \"just need time and money to do it.\" And, with an eye toward the history of tobacco litigation, she believes litigation is \"certainly a possibility\" in this case as well. \"We've only just begun to scratch the surface of understanding some of the tactics the sugar groups have implemented.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ultimately, a report from the industry was submitted to the government panel and became the foundation for research going forward. \"Seventy-eight percent of the sugar industry submission was incorporated into the NIDR’s call for research applications. Research that could have been harmful to sugar industry interests was omitted,\" the authors note.\u003c/p>\n\u003cp>\"What this shows is that sugar interests were running science manipulation in as sophisticated a manner as 'big tobacco' was back in the 50s and 60s,\" said UCSF Professor Stan Glantz, a co-author of the study and long time anti-tobacco advocate.\u003c/p>\n\u003cp>Marion Nestle, professor nutrition of New York University was not involved in the analysis, which she called \"incredibly revealing.\"\u003c/p>\n\u003cp>The paper \"makes it clear that the sugar industry systematically and deliberately adopted strategies to make sure that federal research agencies did not urge the public to cut down on sugar intake as a means to prevent tooth decay,\" she said.\u003c/p>\n\u003cp>\"I can attest that the sugar industry is especially aggressive in defending itself against any suggestion to eat less and is following the tobacco industry's playbook.\"\u003c/p>\n\u003cp>In a statement, the Sugar Association said it \"\u003cspan class=\"Apple-style-span\">questions the relevance of attempts to dredge up history when decades of modern science has provided answers regarding the role of diet in the pathogenesis of dental caries.\"\u003c/span>\u003c/p>\n\u003cp>The statement also says that the authors' \"use of attention-grabbing headlines and scare tactics that liken consumption of all-natural sugar ... to a known carcinogen is a 'textbook' play from the activist agenda.\"\u003c/p>\n\u003cp>The authors admit their analysis is limited because it \"provides a narrow window into the activities of just one sugar industry trade association\" and that they could not \"interview key actors.\"\u003c/p>\n\u003cp>\u003cstrong>A Long Hunt\u003c/strong>\u003c/p>\n\u003cp>Cristin Kearns found the papers after a long hunt. In 2007, she says, while attending a conference, she was handed a government pamphlet titled, \"How to Talk to Patients About Diabetes.\" She was startled that the diet advice didn't mention reducing sugar intake. It made her wonder if the sugar industry \"somehow impacted what the government can or cannot say about diet advice for diabetics?\"\u003c/p>\n\u003cp>She started searching online and, ultimately \u003ca title=\"http://www.motherjones.com/environment/2012/10/former-dentist-sugar-industry-lies\" href=\"http://www.motherjones.com/environment/2012/10/former-dentist-sugar-industry-lies\" target=\"_blank\">quit her day job\u003c/a>. After months of looking, she uncovered some documents and ultimately identified the documents discussed in the analysis today.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kearns says there are more documents to be found, \"just need time and money to do it.\" And, with an eye toward the history of tobacco litigation, she believes litigation is \"certainly a possibility\" in this case as well. \"We've only just begun to scratch the surface of understanding some of the tactics the sugar groups have implemented.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For Breast-feeding Teen Moms, High Schools Don't Make the Grade",
"title": "For Breast-feeding Teen Moms, High Schools Don't Make the Grade",
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"content": "\u003cfigure id=\"attachment_24374\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14473_photo-e1425671532570.jpg\">\u003cimg class=\"size-large wp-image-24374\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14473_photo-640x480.jpg\" alt=\"Norma Acker hangs out in the kitchen with her mom and her daughter. (Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Norma Acker (right) hangs out in the kitchen with her mother and her daughter, Samantha Grace. She breast-fed her for eight months. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>Norma Acker’s 3-year-old daughter Samantha Grace has opened a bottle of bright red fingernail polish without anyone noticing. Now it’s everywhere.\u003c/p>\n\u003caside class=\"pullquote alignleft\">California has strong employer laws to accommodate breast-feeding mothers, but high schools are different. \u003c/aside>\n\u003cp>“Oh Gracie!” says Acker. “Let me see. Give it to mommy. Go wash your hands.” She then laughs the laugh of a mother who has had many a day like this.\u003c/p>\n\u003cp>Parenting is hard, Acker says. Being a teen parent is even harder. Acker was barely 15 when she had Gracie.\u003c/p>\n\u003cp>Even though she was a young mother, she’d heard about the benefits of breast-feeding and decided she would try to breast-feed while attending her local high school in the Central Valley town of Reedley.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The people that can, should breast-feed,” she says. “Children need the extra vitamins and antibodies that breast milk has.”\u003c/p>\n\u003cp>\u003cstrong>Pressure to Skip Breast-feeding from Administrators, Friends\u003c/strong>\u003c/p>\n\u003cp>But she ran into some obstacles. For one, it was hard to find a private place where she could breast-feed or pump. When she told administrators she would likely need to pump every two hours, they gave her a list of all the possible cons: she would miss out on too much class time; she might lose credits; her grades might be affected.\u003c/p>\n\u003cp>Even the other young mothers thought she was odd for wanting to breast-feed. There was a lot of pressure to be more carefree.\u003c/p>\n\u003cp>“They were like, ‘Girl, why aren’t you out eating your lunch?’” Acker says.\u003c/p>\n\u003cp>She says she was encouraged to go a continuation school -- an alternative program that’s typically for at-risk kids. She finally agreed because it would be easier to breast-feed there. But it came with a cost. Acker says the school wasn't challenging.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/194623554\" 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>Genevieve Colvin of Breastfeed LA says Acker’s story is pretty common. She says while many teenage moms don’t choose to breast-feed, those who do cite barriers at school.\u003c/p>\n\u003cp>“They are worried about completing their assignments and not having appropriate accommodations,” she said.\u003c/p>\n\u003cp>In fact, Colvin says only 18 percent of LA County’s school districts have policies for lactation accommodations and that lack of consistency is statewide. She says outside agencies like Women, Infants and Children (WIC) advocate for lactating students by making sure they have a safe private place to breast-feed, but systemically, school districts don’t take an active role in implementing policy.\u003c/p>\n\u003cp>Colvin says that's a problem because teen moms are already at a disadvantage. It’s important, she says, that when a woman is pregnant during her high school years, she has every opportunity to improve the life of her child and that includes being encouraged to breast-feed.\u003c/p>\n\u003cp>California has some of the strongest laws in the country to support working mothers who breast-feed, she ways, but high schools are different.\u003c/p>\n\u003cp>“We have very little substantive language in our education code that actually provides students with the same accommodations,” she says.\u003c/p>\n\u003cp>\u003cstrong>New Bill Addresses Accommodations for Breast-feeding\u003c/strong>\u003c/p>\n\u003cp>Assemblywoman Cristina Garcia (D-Bell Gardens) wants to strengthen that language. She recently sponsored\u003ca title=\"https://legiscan.com/CA/text/AB302/id/1124035\" href=\"https://legiscan.com/CA/text/AB302/id/1124035\" target=\"_blank\"> Assembly Bill 302\u003c/a>. She says the bill is simple and to the point.\u003c/p>\n\u003cp>“It doesn’t say you must have a lactation room or a pumping room. It says if you have a student that needs to lactate, you will create accommodations for them,” Garcia says.\u003c/p>\n\u003cp>It’s one more way to encourage young mothers to breast-feed while keeping them in a regular high school setting, she believes.\u003c/p>\n\u003cp>“A student at a traditional high school is going to have more opportunities and more options than a student at a continuation school,” Garcia says. Teen parents are already at a disadvantage, “I want to make sure that ... we don’t add to the layer of disadvantages that are there.”\u003c/p>\n\u003cp>It’s a policy Norma Acker wishes were in place when she went to high school. She’s proud to say she breast-fed her daughter for eight months, and she would have done so no matter what the cost.\u003c/p>\n\u003cp>“If it meant me dropping out of high school just to make her well, then I would do that,” she says. “If it meant that I would fail as a person myself but be the best mom I could be for her, I would do that.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But Acker didn’t fail. She’s now in her second year of community college, and she’s still making sure her daughter eats well.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24374\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14473_photo-e1425671532570.jpg\">\u003cimg class=\"size-large wp-image-24374\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS14473_photo-640x480.jpg\" alt=\"Norma Acker hangs out in the kitchen with her mom and her daughter. (Alice Daniel/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Norma Acker (right) hangs out in the kitchen with her mother and her daughter, Samantha Grace. She breast-fed her for eight months. (Alice Daniel/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>Norma Acker’s 3-year-old daughter Samantha Grace has opened a bottle of bright red fingernail polish without anyone noticing. Now it’s everywhere.\u003c/p>\n\u003caside class=\"pullquote alignleft\">California has strong employer laws to accommodate breast-feeding mothers, but high schools are different. \u003c/aside>\n\u003cp>“Oh Gracie!” says Acker. “Let me see. Give it to mommy. Go wash your hands.” She then laughs the laugh of a mother who has had many a day like this.\u003c/p>\n\u003cp>Parenting is hard, Acker says. Being a teen parent is even harder. Acker was barely 15 when she had Gracie.\u003c/p>\n\u003cp>Even though she was a young mother, she’d heard about the benefits of breast-feeding and decided she would try to breast-feed while attending her local high school in the Central Valley town of Reedley.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The people that can, should breast-feed,” she says. “Children need the extra vitamins and antibodies that breast milk has.”\u003c/p>\n\u003cp>\u003cstrong>Pressure to Skip Breast-feeding from Administrators, Friends\u003c/strong>\u003c/p>\n\u003cp>But she ran into some obstacles. For one, it was hard to find a private place where she could breast-feed or pump. When she told administrators she would likely need to pump every two hours, they gave her a list of all the possible cons: she would miss out on too much class time; she might lose credits; her grades might be affected.\u003c/p>\n\u003cp>Even the other young mothers thought she was odd for wanting to breast-feed. There was a lot of pressure to be more carefree.\u003c/p>\n\u003cp>“They were like, ‘Girl, why aren’t you out eating your lunch?’” Acker says.\u003c/p>\n\u003cp>She says she was encouraged to go a continuation school -- an alternative program that’s typically for at-risk kids. She finally agreed because it would be easier to breast-feed there. But it came with a cost. Acker says the school wasn't challenging.\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/194623554&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/194623554'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Genevieve Colvin of Breastfeed LA says Acker’s story is pretty common. She says while many teenage moms don’t choose to breast-feed, those who do cite barriers at school.\u003c/p>\n\u003cp>“They are worried about completing their assignments and not having appropriate accommodations,” she said.\u003c/p>\n\u003cp>In fact, Colvin says only 18 percent of LA County’s school districts have policies for lactation accommodations and that lack of consistency is statewide. She says outside agencies like Women, Infants and Children (WIC) advocate for lactating students by making sure they have a safe private place to breast-feed, but systemically, school districts don’t take an active role in implementing policy.\u003c/p>\n\u003cp>Colvin says that's a problem because teen moms are already at a disadvantage. It’s important, she says, that when a woman is pregnant during her high school years, she has every opportunity to improve the life of her child and that includes being encouraged to breast-feed.\u003c/p>\n\u003cp>California has some of the strongest laws in the country to support working mothers who breast-feed, she ways, but high schools are different.\u003c/p>\n\u003cp>“We have very little substantive language in our education code that actually provides students with the same accommodations,” she says.\u003c/p>\n\u003cp>\u003cstrong>New Bill Addresses Accommodations for Breast-feeding\u003c/strong>\u003c/p>\n\u003cp>Assemblywoman Cristina Garcia (D-Bell Gardens) wants to strengthen that language. She recently sponsored\u003ca title=\"https://legiscan.com/CA/text/AB302/id/1124035\" href=\"https://legiscan.com/CA/text/AB302/id/1124035\" target=\"_blank\"> Assembly Bill 302\u003c/a>. She says the bill is simple and to the point.\u003c/p>\n\u003cp>“It doesn’t say you must have a lactation room or a pumping room. It says if you have a student that needs to lactate, you will create accommodations for them,” Garcia says.\u003c/p>\n\u003cp>It’s one more way to encourage young mothers to breast-feed while keeping them in a regular high school setting, she believes.\u003c/p>\n\u003cp>“A student at a traditional high school is going to have more opportunities and more options than a student at a continuation school,” Garcia says. Teen parents are already at a disadvantage, “I want to make sure that ... we don’t add to the layer of disadvantages that are there.”\u003c/p>\n\u003cp>It’s a policy Norma Acker wishes were in place when she went to high school. She’s proud to say she breast-fed her daughter for eight months, and she would have done so no matter what the cost.\u003c/p>\n\u003cp>“If it meant me dropping out of high school just to make her well, then I would do that,” she says. “If it meant that I would fail as a person myself but be the best mom I could be for her, I would do that.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But Acker didn’t fail. She’s now in her second year of community college, and she’s still making sure her daughter eats well.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Not Affected by Obamacare Court Challenge; At Least Not Yet",
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"content": "\u003cfigure id=\"attachment_24158\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/147229791-e1425431190239.jpg\">\u003cimg class=\"size-large wp-image-24158\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/147229791-640x439.jpg\" alt=\"(Chip Somodevilla/Getty Images)\" width=\"640\" height=\"439\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Chip Somodevilla/Getty Images) \u003ccite>(Chip Somodevilla/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/03/19/the-supreme-courts-4-health-care-reform-questions/\" href=\"http://ww2.kqed.org/stateofhealth/2012/03/19/the-supreme-courts-4-health-care-reform-questions/\" target=\"_blank\">been three years\u003c/a>, but the Affordable Care Act is before the Supreme Court again. The constitutionality of the law was settled then. This time, the question is subsidies. Oral arguments happen Wednesday.\u003c/p>\n\u003cp>The case is \u003ca title=\"http://www.scotusblog.com/case-files/cases/king-v-burwell/\" href=\"http://www.scotusblog.com/case-files/cases/king-v-burwell/\" target=\"_blank\">King v. Burwell\u003c/a>, and the heart of the matter is whether the ACA permits subsidies to be granted to people who live in the 34 states that use the federally-run marketplace, healthcare.gov.\u003c/p>\n\u003cp>Note well: people in California, and the 13 other states that set up their own insurance marketplaces are not affected by this case. No one is challenging the legality of the subsidies as a whole -- only whether they may legally go to people who live in states using healthcare.gov.\u003c!--more-->\u003c/p>\n\u003cp>Here's \u003ca title=\"http://www.npr.org/blogs/health/2015/02/27/389283469/5-things-to-know-about-the-latest-supreme-court-challenge-to-health-law\" href=\"http://www.npr.org/blogs/health/2015/02/27/389283469/5-things-to-know-about-the-latest-supreme-court-challenge-to-health-law\" target=\"_blank\">Kaiser Health News' Julie Rovner \u003c/a>on the part of the ACA in question:\u003c/p>\n\u003cblockquote>\u003cp>At issue in this case is a \u003ca href=\"https://www.law.cornell.edu/uscode/text/26/36B\" target=\"_blank\">line in the law\u003c/a> stipulating that subsidies are available to those who sign up for coverage \"through an exchange established by the state.\" In issuing \u003ca href=\"http://www.gpo.gov/fdsys/pkg/FR-2012-05-23/pdf/2012-12421.pdf\" target=\"_blank\">regulations to implement the subsidies\u003c/a> in 2012, however, the IRS said that subsidies would also be available to those enrolling through the federal health insurance exchange. The agency noted Congress had never discussed limiting the subsidies to state-run exchanges and that making subsidies available to all \"is consistent with the language, purpose and structure\" of the law as a whole.\u003c/p>\u003c/blockquote>\n\u003cp>But those challenging the law, Rovner says, insist that indeed Congress did intend to limit the subsidies to those buying insurance on a state exchange, like Covered California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If the Supreme Court rules against the Obama administration and invalidates those subsidies, \u003ca title=\"http://www.urban.org/UploadedPDF/2000062-The-Implications-King-vs-Burwell.pdf\" href=\"http://www.urban.org/UploadedPDF/2000062-The-Implications-King-vs-Burwell.pdf\" target=\"_blank\">more than 9 million people\u003c/a> in the 34 states that use healthcare.gov stand to lose their subsidies -- and it would be almost immediately after the ruling is handed down.\u003c/p>\n\u003cp>Without the subsidies, many people would likely cancel their insurance because it would become unaffordable. Yes, there's an individual mandate in the ACA, but people are exempt from it if they cannot find insurance that is affordable to them, defined as greater than 8 percent of your household income.\u003c/p>\n\u003cp>Once people start dropping insurance, \"the individual insurance markets in those states would probably melt down,\" says Larry Levitt, senior vice president at the Kaiser Family Foundation. That's because the health law's requirement of guaranteed issue -- that insurers must offer insurance to anyone who applies -- would still stand.\u003c/p>\n\u003cp>But those most likely to keep their coverage would be people who are sick, Levitt says, which would drive up premiums, without the healthy people to balance the risk pool.\u003c/p>\n\u003cp>At the Commonwealth Fund blog, \u003ca title=\"http://www.commonwealthfund.org/publications/blog/2015/feb/king-v-burwell-what-shutdown-could-mean-insurers\" href=\"http://www.commonwealthfund.org/publications/blog/2015/feb/king-v-burwell-what-shutdown-could-mean-insurers\" target=\"_blank\">Joel Ario has been writing\u003c/a> about this possibility:\u003c/p>\n\u003cblockquote>\u003cp>Should a Subsidy Shutdown happen this summer, insurers would suddenly have a risk pool filled with high-need, high-cost people, after having priced their 2015 premiums based on a balanced pool containing both healthy and sick people. Claims would quickly outpace premium revenue as insurers lose most of their low-cost, healthy customers but retain customers whose medical costs exceed their premiums.\u003c/p>\u003c/blockquote>\n\u003cp>If you're wondering about spill-over effects, insurance is sold state-by-state, so Californians and the people in the other 13 states with their own exchanges would continue to get subsidies. The individual insurance market would largely be unaffected.\u003c/p>\n\u003cp>\"You'd really have big differences between states in access to affordable coverage,\" Levitt said. \"It would very much be a north/south divide. It's really the south where states have not set up their own marketplaces.\"\u003c/p>\n\u003cp>Should the Supreme Court rule against the healthcare.gov subsidies, there's no straightforward solution in sight. Congress could pass a bill striking the line from the health law, but that's unlikely given Republican opposition to the law. Yes, states could set up their own exchanges and get the subsidies, but that cannot be done overnight. Plenty of governors and state legislatures won't want to set up a state exchange anyway because they have fought the ACA all along.\u003c/p>\n\u003cp>There could be bigger threats to the health law as a whole. \"There could be a move in Congress to repeal the Affordable Care Act and replace it with something else,\" Levitt says, \"but where that ends up is very unpredictable, it could easily end in stalemate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Supreme Court is expected to hand down their ruling in June. Decisions generally take effect 25 days after they are issued.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24158\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/147229791-e1425431190239.jpg\">\u003cimg class=\"size-large wp-image-24158\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/147229791-640x439.jpg\" alt=\"(Chip Somodevilla/Getty Images)\" width=\"640\" height=\"439\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Chip Somodevilla/Getty Images) \u003ccite>(Chip Somodevilla/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It's \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/03/19/the-supreme-courts-4-health-care-reform-questions/\" href=\"http://ww2.kqed.org/stateofhealth/2012/03/19/the-supreme-courts-4-health-care-reform-questions/\" target=\"_blank\">been three years\u003c/a>, but the Affordable Care Act is before the Supreme Court again. The constitutionality of the law was settled then. This time, the question is subsidies. Oral arguments happen Wednesday.\u003c/p>\n\u003cp>The case is \u003ca title=\"http://www.scotusblog.com/case-files/cases/king-v-burwell/\" href=\"http://www.scotusblog.com/case-files/cases/king-v-burwell/\" target=\"_blank\">King v. Burwell\u003c/a>, and the heart of the matter is whether the ACA permits subsidies to be granted to people who live in the 34 states that use the federally-run marketplace, healthcare.gov.\u003c/p>\n\u003cp>Note well: people in California, and the 13 other states that set up their own insurance marketplaces are not affected by this case. No one is challenging the legality of the subsidies as a whole -- only whether they may legally go to people who live in states using healthcare.gov.\u003c!--more-->\u003c/p>\n\u003cp>Here's \u003ca title=\"http://www.npr.org/blogs/health/2015/02/27/389283469/5-things-to-know-about-the-latest-supreme-court-challenge-to-health-law\" href=\"http://www.npr.org/blogs/health/2015/02/27/389283469/5-things-to-know-about-the-latest-supreme-court-challenge-to-health-law\" target=\"_blank\">Kaiser Health News' Julie Rovner \u003c/a>on the part of the ACA in question:\u003c/p>\n\u003cblockquote>\u003cp>At issue in this case is a \u003ca href=\"https://www.law.cornell.edu/uscode/text/26/36B\" target=\"_blank\">line in the law\u003c/a> stipulating that subsidies are available to those who sign up for coverage \"through an exchange established by the state.\" In issuing \u003ca href=\"http://www.gpo.gov/fdsys/pkg/FR-2012-05-23/pdf/2012-12421.pdf\" target=\"_blank\">regulations to implement the subsidies\u003c/a> in 2012, however, the IRS said that subsidies would also be available to those enrolling through the federal health insurance exchange. The agency noted Congress had never discussed limiting the subsidies to state-run exchanges and that making subsidies available to all \"is consistent with the language, purpose and structure\" of the law as a whole.\u003c/p>\u003c/blockquote>\n\u003cp>But those challenging the law, Rovner says, insist that indeed Congress did intend to limit the subsidies to those buying insurance on a state exchange, like Covered California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If the Supreme Court rules against the Obama administration and invalidates those subsidies, \u003ca title=\"http://www.urban.org/UploadedPDF/2000062-The-Implications-King-vs-Burwell.pdf\" href=\"http://www.urban.org/UploadedPDF/2000062-The-Implications-King-vs-Burwell.pdf\" target=\"_blank\">more than 9 million people\u003c/a> in the 34 states that use healthcare.gov stand to lose their subsidies -- and it would be almost immediately after the ruling is handed down.\u003c/p>\n\u003cp>Without the subsidies, many people would likely cancel their insurance because it would become unaffordable. Yes, there's an individual mandate in the ACA, but people are exempt from it if they cannot find insurance that is affordable to them, defined as greater than 8 percent of your household income.\u003c/p>\n\u003cp>Once people start dropping insurance, \"the individual insurance markets in those states would probably melt down,\" says Larry Levitt, senior vice president at the Kaiser Family Foundation. That's because the health law's requirement of guaranteed issue -- that insurers must offer insurance to anyone who applies -- would still stand.\u003c/p>\n\u003cp>But those most likely to keep their coverage would be people who are sick, Levitt says, which would drive up premiums, without the healthy people to balance the risk pool.\u003c/p>\n\u003cp>At the Commonwealth Fund blog, \u003ca title=\"http://www.commonwealthfund.org/publications/blog/2015/feb/king-v-burwell-what-shutdown-could-mean-insurers\" href=\"http://www.commonwealthfund.org/publications/blog/2015/feb/king-v-burwell-what-shutdown-could-mean-insurers\" target=\"_blank\">Joel Ario has been writing\u003c/a> about this possibility:\u003c/p>\n\u003cblockquote>\u003cp>Should a Subsidy Shutdown happen this summer, insurers would suddenly have a risk pool filled with high-need, high-cost people, after having priced their 2015 premiums based on a balanced pool containing both healthy and sick people. Claims would quickly outpace premium revenue as insurers lose most of their low-cost, healthy customers but retain customers whose medical costs exceed their premiums.\u003c/p>\u003c/blockquote>\n\u003cp>If you're wondering about spill-over effects, insurance is sold state-by-state, so Californians and the people in the other 13 states with their own exchanges would continue to get subsidies. The individual insurance market would largely be unaffected.\u003c/p>\n\u003cp>\"You'd really have big differences between states in access to affordable coverage,\" Levitt said. \"It would very much be a north/south divide. It's really the south where states have not set up their own marketplaces.\"\u003c/p>\n\u003cp>Should the Supreme Court rule against the healthcare.gov subsidies, there's no straightforward solution in sight. Congress could pass a bill striking the line from the health law, but that's unlikely given Republican opposition to the law. Yes, states could set up their own exchanges and get the subsidies, but that cannot be done overnight. Plenty of governors and state legislatures won't want to set up a state exchange anyway because they have fought the ACA all along.\u003c/p>\n\u003cp>There could be bigger threats to the health law as a whole. \"There could be a move in Congress to repeal the Affordable Care Act and replace it with something else,\" Levitt says, \"but where that ends up is very unpredictable, it could easily end in stalemate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Supreme Court is expected to hand down their ruling in June. Decisions generally take effect 25 days after they are issued.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Lawmakers Scrutinize Psychotropic Drug Prescriptions to Foster Kids",
"title": "California Lawmakers Scrutinize Psychotropic Drug Prescriptions to Foster Kids",
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"content": "\u003cp>In California, 63,000 children and teenagers are in foster care in private homes or group homes run by the state.\u003c/p>\n\u003cp>A quarter of them were prescribed potent psychotropic drugs.\u003c/p>\n\u003cp>That sobering statistic was unearthed in a \u003ca title=\"http://webspecial.mercurynews.com/druggedkids/\" href=\"http://webspecial.mercurynews.com/druggedkids/\" target=\"_blank\">Bay Area News Group investigation\u003c/a> last year, which analyzed a decade of state statistics. The drugs include \u003cspan class=\"Apple-style-span\">Lithium and Depakote as well as anti-psychotics such as Haldol, Risperdal and Abilify.\u003c/span>\u003c!--more-->\u003c/p>\n\u003cp>Former foster kids and public health officials addressed the issue in a hearing Tuesday. They told senators who oversee state agencies responsible for foster youth that the problem is most acute in group homes where half the youth are prescribed one or more psychotropic drugs.\u003c/p>\n\u003cp>“I remember lining up with more than half of the girls I was in group home settings with, to receive our meds” said Iris Hoffman, 18, “then proceed to class, sleep through our first classes, dozing off. This is more than half of us!”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hoffman testified that most of the girls wanted to get off the drugs, but were afraid to try.\u003c/p>\n\u003cp>“There are all kinds of punishments that you have to be fearful of,\" she said, \"if you are to refuse medication that is prescribed to you by a psychiatrist that only meets with you for an hour a month.”\u003c/p>\n\u003cp>Sen. Mike McGuire (D-San Rafael) chairs the Senate Oversight Committee for Human Services.\u003c/p>\n\u003cp>“All too often, wonder drugs have become the first response in this state,\" he said. “We all know we must do better.”\u003c/p>\n\u003cp>Over the last 10 years, McGuire said, Medi-Cal, the state's health insurance program for people who are low income, has spent $226 million on psychotropic medication. More than 70 percent of that money was spent on foster children.\u003c/p>\n\u003cp>McGuire pressed state agency representatives at the hearing on whether they agreed that prescription rates were far too high.\u003c/p>\n\u003cp>“There’s very deep concern about the volume,” responded Will Lightbourne, head of the Department of Social Services, the agency which oversees foster care.\u003c/p>\n\u003cp>Lightbourne said an overhaul of California’s foster care system already underway reflects that concern. The state seeks to expand alternative therapies for kids, restrict the use of psychotropic drugs -- especially prescribing drugs to control kids’ behavior -- and reduce the number of children sent to group homes and shorten their stays. “All that says, yes, we want to bring those numbers down,” Lightbourne said.\u003c/p>\n\u003cp>But he cautioned that it would be take years to achieve the reforms.\u003c/p>\n\u003cp>State lawmakers at the hearing planned to move forward with reforms of their own.\u003c/p>\n\u003cp>Sen. Jim Beall (D-San Jose), the chair of the Senate Committee on Mental Health, said he would introduce two bills to protect foster children.\u003c/p>\n\u003cp>One bill would require public health nurses to oversee foster kids’ medication; another would establish treatment protocols and oversight in group homes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Beall also co-sponsored a bill with Sen. Holly Mitchell (D-Los Angeles) to require state agencies to collect and share data on how many kids are taking psychotropic drugs, at what dose and for how long.\u003c/p>\n\n",
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"description": "In California, 63,000 children and teenagers are in foster care in private homes or group homes run by the state. A quarter of them were prescribed potent psychotropic drugs. That sobering statistic was unearthed in a Bay Area News Group investigation last year, which analyzed a decade of state statistics. The drugs include Lithium and Depakote as well",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In California, 63,000 children and teenagers are in foster care in private homes or group homes run by the state.\u003c/p>\n\u003cp>A quarter of them were prescribed potent psychotropic drugs.\u003c/p>\n\u003cp>That sobering statistic was unearthed in a \u003ca title=\"http://webspecial.mercurynews.com/druggedkids/\" href=\"http://webspecial.mercurynews.com/druggedkids/\" target=\"_blank\">Bay Area News Group investigation\u003c/a> last year, which analyzed a decade of state statistics. The drugs include \u003cspan class=\"Apple-style-span\">Lithium and Depakote as well as anti-psychotics such as Haldol, Risperdal and Abilify.\u003c/span>\u003c!--more-->\u003c/p>\n\u003cp>Former foster kids and public health officials addressed the issue in a hearing Tuesday. They told senators who oversee state agencies responsible for foster youth that the problem is most acute in group homes where half the youth are prescribed one or more psychotropic drugs.\u003c/p>\n\u003cp>“I remember lining up with more than half of the girls I was in group home settings with, to receive our meds” said Iris Hoffman, 18, “then proceed to class, sleep through our first classes, dozing off. This is more than half of us!”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hoffman testified that most of the girls wanted to get off the drugs, but were afraid to try.\u003c/p>\n\u003cp>“There are all kinds of punishments that you have to be fearful of,\" she said, \"if you are to refuse medication that is prescribed to you by a psychiatrist that only meets with you for an hour a month.”\u003c/p>\n\u003cp>Sen. Mike McGuire (D-San Rafael) chairs the Senate Oversight Committee for Human Services.\u003c/p>\n\u003cp>“All too often, wonder drugs have become the first response in this state,\" he said. “We all know we must do better.”\u003c/p>\n\u003cp>Over the last 10 years, McGuire said, Medi-Cal, the state's health insurance program for people who are low income, has spent $226 million on psychotropic medication. More than 70 percent of that money was spent on foster children.\u003c/p>\n\u003cp>McGuire pressed state agency representatives at the hearing on whether they agreed that prescription rates were far too high.\u003c/p>\n\u003cp>“There’s very deep concern about the volume,” responded Will Lightbourne, head of the Department of Social Services, the agency which oversees foster care.\u003c/p>\n\u003cp>Lightbourne said an overhaul of California’s foster care system already underway reflects that concern. The state seeks to expand alternative therapies for kids, restrict the use of psychotropic drugs -- especially prescribing drugs to control kids’ behavior -- and reduce the number of children sent to group homes and shorten their stays. “All that says, yes, we want to bring those numbers down,” Lightbourne said.\u003c/p>\n\u003cp>But he cautioned that it would be take years to achieve the reforms.\u003c/p>\n\u003cp>State lawmakers at the hearing planned to move forward with reforms of their own.\u003c/p>\n\u003cp>Sen. Jim Beall (D-San Jose), the chair of the Senate Committee on Mental Health, said he would introduce two bills to protect foster children.\u003c/p>\n\u003cp>One bill would require public health nurses to oversee foster kids’ medication; another would establish treatment protocols and oversight in group homes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Beall also co-sponsored a bill with Sen. Holly Mitchell (D-Los Angeles) to require state agencies to collect and share data on how many kids are taking psychotropic drugs, at what dose and for how long.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "More Pressure on Providers in Face of Medi-Cal Expansion",
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"content": "\u003cfigure id=\"attachment_23966\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/IMG_4338-e1424384287189.jpg\">\u003cimg class=\"size-large wp-image-23966\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/IMG_4338-640x480.jpg\" alt=\"Dr. Davi Pakter, of Berkeley LifeLong Clinic, prepares to see patients. (Julie Small/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Davi Pakter, of Berkeley LifeLong Clinic, (right) prepares to see patients. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Medi-Cal -- the public health insurance program for low-income Californians -- is growing faster under federal health care reform than the state expected. Twelve million residents -- nearly a third of the state’s population -- now rely on Medi-Cal, and that’s increased pressure to find more doctors willing and able to treat patients for what has historically been low reimbursement rates.\u003c/p>\n\u003cp>At the LifeLong Clinic in West Berkeley most of the patients waiting to see a doctor are on Medi-Cal. Among them, 26-year-old Amanda Hopkins, says she enrolled half a year ago when the state expanded the benefits program.\u003c/p>\n\u003cp>“It’s been relieving to have Medi-Cal and know that if something happened -- I needed an ambulance or there was an emergency -- I wouldn’t have to worry about being in debt thousands of dollars,\" she said.\u003c!--more-->\u003c/p>\n\u003cp>Hopkins says before she would not have gone to the doctor. “It’s nice to have this option, although it’s been taking a long time to be able to get an appointment.”\u003c/p>\n\u003cp>Hopkins says she had to wait five weeks for her first doctor’s visit.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Clinic medical director Dr. Davi Pakter says the long wait is one side effect of adding nearly three million people to Medi-Cal since January, 2014. At his clinic, the patients with the greatest need are seen first.\u003c/p>\n\u003cp>“We try very hard to arrange our schedules so that we can accommodate folks that are in urgent need,\" he said, \"and try to avoid sending folks to the emergency room -- which is a much higher cost and usually not in the best interest of the patient.”\u003c/p>\n\u003cp>Pakter says that means people who need a check-up or treatment for a less urgent condition can end up waiting one to two months.\u003c/p>\n\u003cp>A lot of Medi-Cal patients are turning to federally subsidized clinics like LifeLong because private practice doctors won’t accept Medi-Cal insurance.\u003c/p>\n\u003cp>“They’re not able to afford it,” says Dr. Del Morris, the president of the California Academy of Family Physicians. Morris says the state’s notoriously low reimbursement rate -- one of the lowest in the nation -- won’t cover the cost of caring for Medi-Cal patients.\u003c/p>\n\u003cp>“These patients, because of their social circumstance have a higher acuity level than an average patient of the same age,” he says. “These are complicated patients with complex problems and take up a lot of a physician’s time. To be taking on patients like this and lose money in the process is just not something most private practices are willing to do.”\u003c/p>\n\u003cp>Morris who’s also the medical director of the Stanislaus County Health Services Agency -- says Medi-Cal patients are often forced to get care at emergency rooms.\u003c/p>\n\u003cp>Morris expects the situation to worsen, unless state lawmakers take action.\u003c/p>\n\u003cp>A provision of the Affordable Care Act that temporarily boosted Medi-Cal reimbursement rates expired on December 31. Also, state lawmakers passed a ten percent cut to California’s reimbursement rates during the depths of the state’s recession \u003ca title=\"http://www.californiahealthline.org/insight/2015/will-twin-medical-cuts-affect-access\" href=\"http://www.californiahealthline.org/insight/2015/will-twin-medical-cuts-affect-access\" target=\"_blank\">took effect last month for primary care doctors\u003c/a>.\u003c/p>\n\u003cp>State lawmakers Sen. Ed Hernandez (D-La Puente) and Asm. Rob Bonta (D-Alameda) introduced \u003ca title=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0351-0400/ab_366_bill_20150217_introduced.htm\" href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0351-0400/ab_366_bill_20150217_introduced.htm\" target=\"_blank\">a bill this week\u003c/a> that would restore the higher reimbursement rates. But even if it passes, they’ll have to persuade Gov. Jerry Brown to sign it.\u003c/p>\n\u003cp>H.D. Palmer with the state’s finance department says the governor’s not budgeting for higher provider rates because California faces numerous fiscal uncertainties.\u003c/p>\n\u003cp>“So we have to be very careful and prudent about adopting any new major spending commitments or dealing with some of the difficult but necessary reductions that had to be made in recent years,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California’s spending on Medi-Cal will jump by $1.7 billion in a just a few years. Right now and through 2016, the federal government pays 100 percent of the cost of covering people who are eligible under the Medicaid expansion. From 2016 to 2020, the contribution will gradually decline to 90 percent, meaning California must pick up the rest.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23966\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/IMG_4338-e1424384287189.jpg\">\u003cimg class=\"size-large wp-image-23966\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/IMG_4338-640x480.jpg\" alt=\"Dr. Davi Pakter, of Berkeley LifeLong Clinic, prepares to see patients. (Julie Small/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Davi Pakter, of Berkeley LifeLong Clinic, (right) prepares to see patients. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Medi-Cal -- the public health insurance program for low-income Californians -- is growing faster under federal health care reform than the state expected. Twelve million residents -- nearly a third of the state’s population -- now rely on Medi-Cal, and that’s increased pressure to find more doctors willing and able to treat patients for what has historically been low reimbursement rates.\u003c/p>\n\u003cp>At the LifeLong Clinic in West Berkeley most of the patients waiting to see a doctor are on Medi-Cal. Among them, 26-year-old Amanda Hopkins, says she enrolled half a year ago when the state expanded the benefits program.\u003c/p>\n\u003cp>“It’s been relieving to have Medi-Cal and know that if something happened -- I needed an ambulance or there was an emergency -- I wouldn’t have to worry about being in debt thousands of dollars,\" she said.\u003c!--more-->\u003c/p>\n\u003cp>Hopkins says before she would not have gone to the doctor. “It’s nice to have this option, although it’s been taking a long time to be able to get an appointment.”\u003c/p>\n\u003cp>Hopkins says she had to wait five weeks for her first doctor’s visit.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Clinic medical director Dr. Davi Pakter says the long wait is one side effect of adding nearly three million people to Medi-Cal since January, 2014. At his clinic, the patients with the greatest need are seen first.\u003c/p>\n\u003cp>“We try very hard to arrange our schedules so that we can accommodate folks that are in urgent need,\" he said, \"and try to avoid sending folks to the emergency room -- which is a much higher cost and usually not in the best interest of the patient.”\u003c/p>\n\u003cp>Pakter says that means people who need a check-up or treatment for a less urgent condition can end up waiting one to two months.\u003c/p>\n\u003cp>A lot of Medi-Cal patients are turning to federally subsidized clinics like LifeLong because private practice doctors won’t accept Medi-Cal insurance.\u003c/p>\n\u003cp>“They’re not able to afford it,” says Dr. Del Morris, the president of the California Academy of Family Physicians. Morris says the state’s notoriously low reimbursement rate -- one of the lowest in the nation -- won’t cover the cost of caring for Medi-Cal patients.\u003c/p>\n\u003cp>“These patients, because of their social circumstance have a higher acuity level than an average patient of the same age,” he says. “These are complicated patients with complex problems and take up a lot of a physician’s time. To be taking on patients like this and lose money in the process is just not something most private practices are willing to do.”\u003c/p>\n\u003cp>Morris who’s also the medical director of the Stanislaus County Health Services Agency -- says Medi-Cal patients are often forced to get care at emergency rooms.\u003c/p>\n\u003cp>Morris expects the situation to worsen, unless state lawmakers take action.\u003c/p>\n\u003cp>A provision of the Affordable Care Act that temporarily boosted Medi-Cal reimbursement rates expired on December 31. Also, state lawmakers passed a ten percent cut to California’s reimbursement rates during the depths of the state’s recession \u003ca title=\"http://www.californiahealthline.org/insight/2015/will-twin-medical-cuts-affect-access\" href=\"http://www.californiahealthline.org/insight/2015/will-twin-medical-cuts-affect-access\" target=\"_blank\">took effect last month for primary care doctors\u003c/a>.\u003c/p>\n\u003cp>State lawmakers Sen. Ed Hernandez (D-La Puente) and Asm. Rob Bonta (D-Alameda) introduced \u003ca title=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0351-0400/ab_366_bill_20150217_introduced.htm\" href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0351-0400/ab_366_bill_20150217_introduced.htm\" target=\"_blank\">a bill this week\u003c/a> that would restore the higher reimbursement rates. But even if it passes, they’ll have to persuade Gov. Jerry Brown to sign it.\u003c/p>\n\u003cp>H.D. Palmer with the state’s finance department says the governor’s not budgeting for higher provider rates because California faces numerous fiscal uncertainties.\u003c/p>\n\u003cp>“So we have to be very careful and prudent about adopting any new major spending commitments or dealing with some of the difficult but necessary reductions that had to be made in recent years,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California’s spending on Medi-Cal will jump by $1.7 billion in a just a few years. Right now and through 2016, the federal government pays 100 percent of the cost of covering people who are eligible under the Medicaid expansion. From 2016 to 2020, the contribution will gradually decline to 90 percent, meaning California must pick up the rest.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Considering Enrollment 'Contingency Plans' Tied to Tax Deadline",
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"content": "\u003cfigure id=\"attachment_23105\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/coveredcaliforniashot.jpg\">\u003cimg class=\"size-large wp-image-23105\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/coveredcaliforniashot-640x392.jpg\" alt=\"Screenshot from the Covered California website. \" width=\"640\" height=\"392\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from the Covered California website.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California open enrollment ends this Sunday. Sort of.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Special enrollment for people who did not know about the tax penalty? \u003c/aside>\n\u003cp>For starters, the agency announced Thursday that people who start an application by this Sunday get until next Friday, Feb. 20, to finish it. That's similar to steps that Covered California \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/03/31/covered-california-extends-deadline-with-caveats/\" href=\"http://ww2.kqed.org/stateofhealth/2014/03/31/covered-california-extends-deadline-with-caveats/\" target=\"_blank\">has taken in the past. \u003c/a>\u003c/p>\n\u003cp>But advocates have long been frustrated with the timing of open enrollment. That's because of how penalties for lacking insurance are assessed -- on your taxes. The tax deadline is not for another two months, April 15.\u003c!--more-->\u003c/p>\n\u003cp>It's easy to imagine that plenty of people will discover the penalty as they file their taxes over the next two months -- and simultaneously discover they are locked out of buying insurance.\u003c/p>\n\u003cp>In a surprise, Peter Lee told me Thursday afternoon that Covered California is considering \"contingency plans.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/191032658\" 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>He said the agency will be \"looking actively\" at people who might not have understood there was a penalty. \"Do we make a special provision for them between now and the end of tax season?\" he said.\u003c/p>\n\u003cp>Lee stressed there has been no decision, that Covered California is focusing now on getting through open enrollment, \"but this is a major issue and we're going to be looking at this in the next week or two.\"\u003c/p>\n\u003cp>Lee said the move would not require action by its board. \"Covered California has the authority to adopt special enrollment criteria if consumers didn't have the opportunity and didn't have the information to enroll,\" Lee said.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access, an advocacy group, seemed intrigued by the idea. \"We were never big fans of the open enrollment period to begin with,\" he said.\u003c/p>\n\u003cp>Wright said that an additional enrollment period \"would attract generally healthy people into coverage,\" arguing that people who are sick are likely already in the system.\u003c/p>\n\u003cp>Wright said there was no federally mandated open enrollment period. His agency had advocated at the federal level to tie the open enrollment more closely to the tax season. The current open enrollment started Nov. 15 and runs through Sunday. \"You lose a lot of time during the holidays,\" Wright said, \"because no one is focused on (health insurance).\"\u003c/p>\n\u003cp>Nicole Evans, spokeswoman for the California Association of Health Plans, said, \"This is the first we've heard of it,\" and declined to comment as the organization had not received any \"official communication\" from Covered California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last year's open enrollment ran more than six months, Wright pointed out. The open enrollment period \"is not handed down in stone. We can take a look at it,\" he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23105\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/coveredcaliforniashot.jpg\">\u003cimg class=\"size-large wp-image-23105\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/coveredcaliforniashot-640x392.jpg\" alt=\"Screenshot from the Covered California website. \" width=\"640\" height=\"392\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from the Covered California website.\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California open enrollment ends this Sunday. Sort of.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Special enrollment for people who did not know about the tax penalty? \u003c/aside>\n\u003cp>For starters, the agency announced Thursday that people who start an application by this Sunday get until next Friday, Feb. 20, to finish it. That's similar to steps that Covered California \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/03/31/covered-california-extends-deadline-with-caveats/\" href=\"http://ww2.kqed.org/stateofhealth/2014/03/31/covered-california-extends-deadline-with-caveats/\" target=\"_blank\">has taken in the past. \u003c/a>\u003c/p>\n\u003cp>But advocates have long been frustrated with the timing of open enrollment. That's because of how penalties for lacking insurance are assessed -- on your taxes. The tax deadline is not for another two months, April 15.\u003c!--more-->\u003c/p>\n\u003cp>It's easy to imagine that plenty of people will discover the penalty as they file their taxes over the next two months -- and simultaneously discover they are locked out of buying insurance.\u003c/p>\n\u003cp>In a surprise, Peter Lee told me Thursday afternoon that Covered California is considering \"contingency plans.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/191032658&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/191032658'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He said the agency will be \"looking actively\" at people who might not have understood there was a penalty. \"Do we make a special provision for them between now and the end of tax season?\" he said.\u003c/p>\n\u003cp>Lee stressed there has been no decision, that Covered California is focusing now on getting through open enrollment, \"but this is a major issue and we're going to be looking at this in the next week or two.\"\u003c/p>\n\u003cp>Lee said the move would not require action by its board. \"Covered California has the authority to adopt special enrollment criteria if consumers didn't have the opportunity and didn't have the information to enroll,\" Lee said.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access, an advocacy group, seemed intrigued by the idea. \"We were never big fans of the open enrollment period to begin with,\" he said.\u003c/p>\n\u003cp>Wright said that an additional enrollment period \"would attract generally healthy people into coverage,\" arguing that people who are sick are likely already in the system.\u003c/p>\n\u003cp>Wright said there was no federally mandated open enrollment period. His agency had advocated at the federal level to tie the open enrollment more closely to the tax season. The current open enrollment started Nov. 15 and runs through Sunday. \"You lose a lot of time during the holidays,\" Wright said, \"because no one is focused on (health insurance).\"\u003c/p>\n\u003cp>Nicole Evans, spokeswoman for the California Association of Health Plans, said, \"This is the first we've heard of it,\" and declined to comment as the organization had not received any \"official communication\" from Covered California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last year's open enrollment ran more than six months, Wright pointed out. The open enrollment period \"is not handed down in stone. We can take a look at it,\" he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Statewide Soda Warning Bill Returns",
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"content": "\u003cfigure id=\"attachment_23175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS11135_450828518-lpr-e1419288401900.jpg\">\u003cimg class=\"size-large wp-image-23175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS11135_450828518-lpr-640x395.jpg\" alt=\"(Frederic J. Brown/AFP/Getty Images)\" width=\"640\" height=\"395\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Frederic J. Brown/AFP/Getty Images) \u003ccite>(Frederic J. Brown/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/2/soda-warning-label-bill-is-back\" href=\"http://www.californiahealthline.org/capitol-desk/2015/2/soda-warning-label-bill-is-back\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>State Sen. Bill Monning (D-Carmel) is not giving up in the battle to put a health-risk warning label on sugared drinks. On Wednesday, Monning reintroduced the legislation (\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0201-0250/sb_203_bill_20150211_introduced.htm\" target=\"_blank\">SB 203\u003c/a>) that failed to pass during the last session.\u003c/p>\n\u003cp>But expect a different result this year, Monning said.\u003c/p>\n\u003cp>\"We certainly hope for a different outcome this year, and again we expect strong resistance as we had last year,\" Monning said. \"But this is part of a larger general public health effort … Tobacco was a decades-long struggle. Now we see a change in the number of people who are affected by tobacco. We're in the early stages.\"\u003c!--more-->\u003c/p>\n\u003cp>The text of SB 203 it similar to last year's \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1000\" target=\"_blank\">SB 1000\u003c/a>, also authored by Monning, which passed a Senate floor vote but then failed to get out of the Assembly Committee on Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In that last vote, a number of Latino legislators in the committee either opposed the bill or abstained, and Monning said that was particularly disappointing to him, given the high rates of diabetes and obesity in the Latino population, particularly among young Latinos.\u003c/p>\n\u003cp>\"We know demographically Latinos are the hardest hit by childhood obesity and preventable diabetes, so it was a disappointment to see [that],\" Monning said.\u003c/p>\n\u003cp>Monning said he reintroduced the legislation because those conditions have reached \"public health crisis\" proportions.\u003c/p>\n\u003cp>\"It remains important because the crisis of preventable diabetes and obesity needs to be addressed, consumers need to know they have other options,\" he said. \"We consider this to be a public health crisis.\"\u003c/p>\n\u003cp>Last year, some argued that it's unfair to single out one type of food product -- sugary drinks including soda, energy drinks and sports drinks -- when other fattening or sugar-rich foods like doughnuts or candy wouldn't have warning labels. They also raised the concern of tax revenue that could be lost if consumption of those beverages declines.\u003c/p>\n\u003cp>\"A variety of arguments have been tried,\" Monning said. \"But it's not me as a politician that's saying it. It's scientists and researchers. It's the \u003cem>New England Journal of Medicine\u003c/em> all of the peer-reviewed literature not funded by the soda industry, all saying these sugary drinks are the leading culprit of childhood obesity and preventable diabetes.\"\u003c/p>\n\u003cp>The road to passage still will need to go through Assembly Health. Last year, the bill had eight votes in opposition and four votes in abstention on the committee -- and of those 12 legislators, nine are still on the committee. One of the abstaining members from last year (Rob Bonta, D-Alameda) is now chair of the committee.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>First stop for the bill will be the Senate Committee on Health, where Monning is one of nine committee members.\u003c/p>\n\n",
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"excerpt": "The bill failed last year, but Sen. Monning, who is backing the bill, is hoping for a better outcome this year.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23175\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS11135_450828518-lpr-e1419288401900.jpg\">\u003cimg class=\"size-large wp-image-23175\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS11135_450828518-lpr-640x395.jpg\" alt=\"(Frederic J. Brown/AFP/Getty Images)\" width=\"640\" height=\"395\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Frederic J. Brown/AFP/Getty Images) \u003ccite>(Frederic J. Brown/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/2/soda-warning-label-bill-is-back\" href=\"http://www.californiahealthline.org/capitol-desk/2015/2/soda-warning-label-bill-is-back\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>State Sen. Bill Monning (D-Carmel) is not giving up in the battle to put a health-risk warning label on sugared drinks. On Wednesday, Monning reintroduced the legislation (\u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0201-0250/sb_203_bill_20150211_introduced.htm\" target=\"_blank\">SB 203\u003c/a>) that failed to pass during the last session.\u003c/p>\n\u003cp>But expect a different result this year, Monning said.\u003c/p>\n\u003cp>\"We certainly hope for a different outcome this year, and again we expect strong resistance as we had last year,\" Monning said. \"But this is part of a larger general public health effort … Tobacco was a decades-long struggle. Now we see a change in the number of people who are affected by tobacco. We're in the early stages.\"\u003c!--more-->\u003c/p>\n\u003cp>The text of SB 203 it similar to last year's \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1000\" target=\"_blank\">SB 1000\u003c/a>, also authored by Monning, which passed a Senate floor vote but then failed to get out of the Assembly Committee on Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In that last vote, a number of Latino legislators in the committee either opposed the bill or abstained, and Monning said that was particularly disappointing to him, given the high rates of diabetes and obesity in the Latino population, particularly among young Latinos.\u003c/p>\n\u003cp>\"We know demographically Latinos are the hardest hit by childhood obesity and preventable diabetes, so it was a disappointment to see [that],\" Monning said.\u003c/p>\n\u003cp>Monning said he reintroduced the legislation because those conditions have reached \"public health crisis\" proportions.\u003c/p>\n\u003cp>\"It remains important because the crisis of preventable diabetes and obesity needs to be addressed, consumers need to know they have other options,\" he said. \"We consider this to be a public health crisis.\"\u003c/p>\n\u003cp>Last year, some argued that it's unfair to single out one type of food product -- sugary drinks including soda, energy drinks and sports drinks -- when other fattening or sugar-rich foods like doughnuts or candy wouldn't have warning labels. They also raised the concern of tax revenue that could be lost if consumption of those beverages declines.\u003c/p>\n\u003cp>\"A variety of arguments have been tried,\" Monning said. \"But it's not me as a politician that's saying it. It's scientists and researchers. It's the \u003cem>New England Journal of Medicine\u003c/em> all of the peer-reviewed literature not funded by the soda industry, all saying these sugary drinks are the leading culprit of childhood obesity and preventable diabetes.\"\u003c/p>\n\u003cp>The road to passage still will need to go through Assembly Health. Last year, the bill had eight votes in opposition and four votes in abstention on the committee -- and of those 12 legislators, nine are still on the committee. One of the abstaining members from last year (Rob Bonta, D-Alameda) is now chair of the committee.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>First stop for the bill will be the Senate Committee on Health, where Monning is one of nine committee members.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cancer Patients, Doctors Sue State to Allow Aid in Dying",
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"content": "\u003cfigure id=\"attachment_23592\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-21-at-10.25.17-PM-e1421908072640.png\">\u003cimg class=\"size-large wp-image-23592\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-21-at-10.25.17-PM-640x422.png\" alt=\"Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014 in Oregon. (Compassion and Choices/BrittanyFund.org)\" width=\"640\" height=\"422\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014, in Oregon.\u003cbr>(Compassion and Choices/BrittanyFund.org)\u003c/figcaption>\u003c/figure>\n\u003cp>Cancer patients and doctors are suing the state of California to allow physicians to prescribe lethal medication to terminally ill patients who request it. The lawsuit was filed Wednesday, just three weeks after lawmakers \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" target=\"_blank\">proposed an \"aid in dying\" bill.\u003c/a>\u003c/p>\n\u003cp>\"I want to be in control of my life and die a peaceful death here in California, which is my home,\" said Christie White, a plaintiff in the case.\u003c/p>\n\u003cp>She spent two years in the hospital battling leukemia. She's in partial remission now, but the sense of helplessness she felt during her treatment haunts her. She says she's suing the state so she can have more say over when and where she dies.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"It's time for California to get out of the way and let qualified patients like me make our own end-of-life decisions,\" she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>White says the state constitution guarantees rights to privacy and free speech that protect the choices she makes with her doctor.\u003c/p>\n\u003cp>Attorney Nico van Aelstyn says the lawsuit also challenges a 19th century state law, which makes it a felony to help another person commit suicide.\u003c/p>\n\u003cp>\"Of one thing I am sure,\" says van Aelstyn, \"the Legislature of 1874 did not contemplate the terrible end-of-life scenarios that our modern medical system has made commonplace.\"\u003c/p>\n\u003cp>Several groups are opposed to aid in dying, including disability rights advocates, who fear the practice could be abused by family members or health insurance companies.\u003c/p>\n\u003cp>Five other states allow aid in dying, including Washington, Oregon, Vermont, Montana and New Mexico. The courts authorized aid in dying in the latter two states.\u003c/p>\n\u003cp>Kathryn Tucker, an attorney with the Disability Rights Center in Los Angeles, argued the cases in Montana and New Mexico and is serving as co-counsel on the California case. She said the court system presents better chances of success for legalizing aid in dying, compared with legislative efforts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s very uncertain whether this is something that can be accomplished legislatively,” she said, citing several failed attempts in the past to pass a bill or a voter initiative in California. \"We’re hopeful the court will fulfill what is quintessentially the court’s responsibility, not the Legislature’s, which is to determine the scope of existing law.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23592\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-21-at-10.25.17-PM-e1421908072640.png\">\u003cimg class=\"size-large wp-image-23592\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-21-at-10.25.17-PM-640x422.png\" alt=\"Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014 in Oregon. (Compassion and Choices/BrittanyFund.org)\" width=\"640\" height=\"422\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014, in Oregon.\u003cbr>(Compassion and Choices/BrittanyFund.org)\u003c/figcaption>\u003c/figure>\n\u003cp>Cancer patients and doctors are suing the state of California to allow physicians to prescribe lethal medication to terminally ill patients who request it. The lawsuit was filed Wednesday, just three weeks after lawmakers \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" target=\"_blank\">proposed an \"aid in dying\" bill.\u003c/a>\u003c/p>\n\u003cp>\"I want to be in control of my life and die a peaceful death here in California, which is my home,\" said Christie White, a plaintiff in the case.\u003c/p>\n\u003cp>She spent two years in the hospital battling leukemia. She's in partial remission now, but the sense of helplessness she felt during her treatment haunts her. She says she's suing the state so she can have more say over when and where she dies.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"It's time for California to get out of the way and let qualified patients like me make our own end-of-life decisions,\" she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>White says the state constitution guarantees rights to privacy and free speech that protect the choices she makes with her doctor.\u003c/p>\n\u003cp>Attorney Nico van Aelstyn says the lawsuit also challenges a 19th century state law, which makes it a felony to help another person commit suicide.\u003c/p>\n\u003cp>\"Of one thing I am sure,\" says van Aelstyn, \"the Legislature of 1874 did not contemplate the terrible end-of-life scenarios that our modern medical system has made commonplace.\"\u003c/p>\n\u003cp>Several groups are opposed to aid in dying, including disability rights advocates, who fear the practice could be abused by family members or health insurance companies.\u003c/p>\n\u003cp>Five other states allow aid in dying, including Washington, Oregon, Vermont, Montana and New Mexico. The courts authorized aid in dying in the latter two states.\u003c/p>\n\u003cp>Kathryn Tucker, an attorney with the Disability Rights Center in Los Angeles, argued the cases in Montana and New Mexico and is serving as co-counsel on the California case. She said the court system presents better chances of success for legalizing aid in dying, compared with legislative efforts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s very uncertain whether this is something that can be accomplished legislatively,” she said, citing several failed attempts in the past to pass a bill or a voter initiative in California. \"We’re hopeful the court will fulfill what is quintessentially the court’s responsibility, not the Legislature’s, which is to determine the scope of existing law.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Got P.E.? Settlement Says Schools Must Prove They Provide It",
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"content": "\u003cfigure id=\"attachment_23798\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-e1422991871174.jpg\">\u003cimg class=\"wp-image-23798 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-640x427.jpg\" alt=\"Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams, \u003ca title=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" href=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" target=\"_blank\">EdSource\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>As schools tout the importance of exercise in an era of childhood obesity, a California parent and his lawyer have agreed to a settlement with \u003ca title=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" href=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" target=\"_blank\">dozens of districts across California \u003c/a>that will force elementary schools to prove they are providing at least the minimum amount of physical education required by state law.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Now there's another lawsuit against Oakland Unified and other districts. \u003c/aside>\n\u003cp>“We think it’s a huge accomplishment and it’s going to benefit public health in California,” said attorney Donald Driscoll, who represents Alameda parent Marc Babin and the advocacy group Cal200 in a\u003ca title=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" href=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" target=\"_blank\"> 2013 lawsuit\u003c/a> that alleges 37 school districts, including Los Angeles Unified, the largest district in the state, are out of compliance with state physical education law.\u003c/p>\n\u003cp>The districts, which educate more than 20 percent of elementary students grades 1 through 6 statewide, have agreed to a settlement that requires elementary school teachers to publicly document how many minutes of physical education students receive, according to lawyers involved in the case.\u003c!--more-->\u003c/p>\n\u003cp>Under \u003ca title=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" target=\"_blank\">the state education code\u003c/a>, schools are required to provide 200 minutes of physical education every 10 school days for elementary students, but physical education classes have sunk to the bottom of the priority list in many schools that focus on preparing students for standardized tests.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>All parties in the lawsuit have asked San Francisco Superior Court Judge Mary Wiss to grant final approval to the settlement, which is expected by late March. Babin is president of Cal200, which advocates for physical education; it takes its name from the 200-minute physical education requirement.\u003c/p>\n\u003cp>What began as a quest in 2009 by Driscoll to ensure that his 3rd-grade son was receiving state-mandated physical education time at Albany’s Cornell Elementary School has developed into a series of lawsuits filed by Driscoll, Babin and \u003ca title=\"http://cal200.org/\" href=\"http://cal200.org/\" target=\"_blank\">Cal200\u003c/a> to ensure that all elementary school students in the state are receiving the physical education instruction they are entitled to by law.\u003c/p>\n\u003cp>Public health \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" target=\"_blank\">advocates\u003c/a>, physical education teachers and the California Legislature have long urged districts to comply with physical education requirements, but those requirements are “rarely enforced,” according to a \u003ca title=\"http://tcenews.calendow.org/archives/california-physical-education\" href=\"http://tcenews.calendow.org/archives/california-physical-education\" target=\"_blank\">2008 report, “Physical Education Matters,”\u003c/a> by researchers at San Diego State University. The California Department of Education includes an evaluation of physical education in its cycle of compliance monitoring of districts, but according to the researchers at San Diego State, “There are no real consequences for failure to comply.”\u003c/p>\n\u003cp>A key legal turning point occurred during a 2009 lawsuit Driscoll filed against Albany Unified. When the district argued that the Education Code requirement of 200 minutes of physical education every 10 days was a goal and a guideline, not a mandate, a Sacramento Superior Court judge agreed and dismissed the case. But the California Third District Court of Appeals overturned that judgment and\u003ca title=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" href=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" target=\"_blank\"> ruled that physical education requirements were a mandate\u003c/a>, not a suggestion.\u003c/p>\n\u003cp>\u003cstrong>New Suit Filed Against Oakland Unified and Other Districts\u003c/strong>\u003c/p>\n\u003cp>Driscoll then teamed up with Babin, a retired investigator with the California Department of Insurance. Babin declined through Driscoll to be interviewed. But Driscoll said Babin likes the investigative challenge of the cases. “In a sense it’s an extension of the sorts of things he did as an investigator for the state,” he said.\u003c/p>\n\u003cp>They began to look into physical education instruction compliance in elementary schools across the state.\u003c/p>\n\u003cp>“I thought it was important to speak up not just for my son’s school but for the schools of other people’s kids,” Driscoll said.\u003c/p>\n\u003cp>They have no plans to stop.\u003c/p>\n\u003cp>“He’s just going to keep going after folks,” said Michael Fine, deputy superintendent for the Riverside Unified School District, one of the districts named in the lawsuit, Cal200 and Marc Babin v. San Francisco Unified School District et al. Asked if he was referring to Driscoll or Babin, Fine said, “Both. I think they’re going to pick off groups of districts.”\u003c/p>\n\u003cp>That appears to be happening already. In November, Babin and Cal200, represented by Driscoll, \u003ca title=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" href=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" target=\"_blank\">filed suit\u003c/a> against Oakland Unified School District et al., alleging that Oakland and other districts, which are to be named at a later date, are not compliant with elementary school physical education requirements.\u003c/p>\n\u003cp>Insurers have put school districts on notice. In 2013, the Alliance of Schools for Cooperative Insurance Programs, a public agency that provides insurance to about 100 California school districts, sent out a “risk alert” that Cal200 and Babin “are seeking additional districts” to sue. Districts should be prepared to prove they are providing the required minutes of physical education or that they have an action plan to do so, the alert stated.\u003c/p>\n\u003cp>Under the settlement agreement, elementary school teachers in the districts must report the minutes they spend teaching physical education, publish the schedule to parents and be subject to spot checks from principals. If teachers skip scheduled physical education instruction, they will note the reason why and report when those minutes were made up. The schedules will be submitted to local school boards for review.\u003c/p>\n\u003cp>While no one disputes the value of exercise in children’s development, budget cuts have reduced or eliminated credentialed physical education teaching positions in many elementary schools. As a result, classroom teachers are asked to squeeze in physical education while simultaneously improving academic test scores.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Jane Meredith Adams covers student health and well-being for \u003ca title=\"http://edsource.org\" href=\"http://edsource.org\" target=\"_blank\">EdSource.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23798\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-e1422991871174.jpg\">\u003cimg class=\"wp-image-23798 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/Kids-running-Santa-Rosa-elementary-640x427.jpg\" alt=\"Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Recess at Cox Academy in Oakland. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams, \u003ca title=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" href=\"http://edsource.org/2015/lawsuit-agreement-to-force-schools-to-provide-physical-education/73544#.VNEhmEvJ4Tt\" target=\"_blank\">EdSource\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>As schools tout the importance of exercise in an era of childhood obesity, a California parent and his lawyer have agreed to a settlement with \u003ca title=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" href=\"http://edsource.org/wp-content/uploads/2015/01/pe-lawsuit.png\" target=\"_blank\">dozens of districts across California \u003c/a>that will force elementary schools to prove they are providing at least the minimum amount of physical education required by state law.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Now there's another lawsuit against Oakland Unified and other districts. \u003c/aside>\n\u003cp>“We think it’s a huge accomplishment and it’s going to benefit public health in California,” said attorney Donald Driscoll, who represents Alameda parent Marc Babin and the advocacy group Cal200 in a\u003ca title=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" href=\"https://www.documentcloud.org/documents/1513042-1stamendedcomplaintcal200babin.html\" target=\"_blank\"> 2013 lawsuit\u003c/a> that alleges 37 school districts, including Los Angeles Unified, the largest district in the state, are out of compliance with state physical education law.\u003c/p>\n\u003cp>The districts, which educate more than 20 percent of elementary students grades 1 through 6 statewide, have agreed to a settlement that requires elementary school teachers to publicly document how many minutes of physical education students receive, according to lawyers involved in the case.\u003c!--more-->\u003c/p>\n\u003cp>Under \u003ca title=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51210-51212\" target=\"_blank\">the state education code\u003c/a>, schools are required to provide 200 minutes of physical education every 10 school days for elementary students, but physical education classes have sunk to the bottom of the priority list in many schools that focus on preparing students for standardized tests.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>All parties in the lawsuit have asked San Francisco Superior Court Judge Mary Wiss to grant final approval to the settlement, which is expected by late March. Babin is president of Cal200, which advocates for physical education; it takes its name from the 200-minute physical education requirement.\u003c/p>\n\u003cp>What began as a quest in 2009 by Driscoll to ensure that his 3rd-grade son was receiving state-mandated physical education time at Albany’s Cornell Elementary School has developed into a series of lawsuits filed by Driscoll, Babin and \u003ca title=\"http://cal200.org/\" href=\"http://cal200.org/\" target=\"_blank\">Cal200\u003c/a> to ensure that all elementary school students in the state are receiving the physical education instruction they are entitled to by law.\u003c/p>\n\u003cp>Public health \u003ca title=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" href=\"http://cwh.berkeley.edu/sites/default/files/primary_pdfs/PE_Toolkit_Presentation_9.13.pdf\" target=\"_blank\">advocates\u003c/a>, physical education teachers and the California Legislature have long urged districts to comply with physical education requirements, but those requirements are “rarely enforced,” according to a \u003ca title=\"http://tcenews.calendow.org/archives/california-physical-education\" href=\"http://tcenews.calendow.org/archives/california-physical-education\" target=\"_blank\">2008 report, “Physical Education Matters,”\u003c/a> by researchers at San Diego State University. The California Department of Education includes an evaluation of physical education in its cycle of compliance monitoring of districts, but according to the researchers at San Diego State, “There are no real consequences for failure to comply.”\u003c/p>\n\u003cp>A key legal turning point occurred during a 2009 lawsuit Driscoll filed against Albany Unified. When the district argued that the Education Code requirement of 200 minutes of physical education every 10 days was a goal and a guideline, not a mandate, a Sacramento Superior Court judge agreed and dismissed the case. But the California Third District Court of Appeals overturned that judgment and\u003ca title=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" href=\"http://www.leagle.com/decision/In%20CACO%2020101130059\" target=\"_blank\"> ruled that physical education requirements were a mandate\u003c/a>, not a suggestion.\u003c/p>\n\u003cp>\u003cstrong>New Suit Filed Against Oakland Unified and Other Districts\u003c/strong>\u003c/p>\n\u003cp>Driscoll then teamed up with Babin, a retired investigator with the California Department of Insurance. Babin declined through Driscoll to be interviewed. But Driscoll said Babin likes the investigative challenge of the cases. “In a sense it’s an extension of the sorts of things he did as an investigator for the state,” he said.\u003c/p>\n\u003cp>They began to look into physical education instruction compliance in elementary schools across the state.\u003c/p>\n\u003cp>“I thought it was important to speak up not just for my son’s school but for the schools of other people’s kids,” Driscoll said.\u003c/p>\n\u003cp>They have no plans to stop.\u003c/p>\n\u003cp>“He’s just going to keep going after folks,” said Michael Fine, deputy superintendent for the Riverside Unified School District, one of the districts named in the lawsuit, Cal200 and Marc Babin v. San Francisco Unified School District et al. Asked if he was referring to Driscoll or Babin, Fine said, “Both. I think they’re going to pick off groups of districts.”\u003c/p>\n\u003cp>That appears to be happening already. In November, Babin and Cal200, represented by Driscoll, \u003ca title=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" href=\"https://www.documentcloud.org/documents/1513063-cal200babin-oaklandunifed-relatedcase.html\" target=\"_blank\">filed suit\u003c/a> against Oakland Unified School District et al., alleging that Oakland and other districts, which are to be named at a later date, are not compliant with elementary school physical education requirements.\u003c/p>\n\u003cp>Insurers have put school districts on notice. In 2013, the Alliance of Schools for Cooperative Insurance Programs, a public agency that provides insurance to about 100 California school districts, sent out a “risk alert” that Cal200 and Babin “are seeking additional districts” to sue. Districts should be prepared to prove they are providing the required minutes of physical education or that they have an action plan to do so, the alert stated.\u003c/p>\n\u003cp>Under the settlement agreement, elementary school teachers in the districts must report the minutes they spend teaching physical education, publish the schedule to parents and be subject to spot checks from principals. If teachers skip scheduled physical education instruction, they will note the reason why and report when those minutes were made up. The schedules will be submitted to local school boards for review.\u003c/p>\n\u003cp>While no one disputes the value of exercise in children’s development, budget cuts have reduced or eliminated credentialed physical education teaching positions in many elementary schools. As a result, classroom teachers are asked to squeeze in physical education while simultaneously improving academic test scores.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Jane Meredith Adams covers student health and well-being for \u003ca title=\"http://edsource.org\" href=\"http://edsource.org\" target=\"_blank\">EdSource.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Ranks Dead Last in Spending on Diabetes Prevention",
"title": "California Ranks Dead Last in Spending on Diabetes Prevention",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23779\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000015895198_Large-e1422914274182.jpg\">\u003cimg class=\"size-large wp-image-23779\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000015895198_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Barbara Feder Ostrov,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org\" href=\"http://kaiserhealthnews.org/news/lots-of-responsibility-for-in-home-care-providers-but-no-training-required/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California spends less per person than any state on diabetes prevention programs, even as one in 12 California adults is estimated to suffer from the chronic disease, according to a new \u003ca href=\"http://www.auditor.ca.gov/reports/summary/2014-113\">report\u003c/a> from the California state auditor.\u003c/p>\n\u003cp>Using only federal grants, California spent just 3 cents per person on diabetes prevention in the 2012-2013 fiscal year, compared with New York’s 42 cents per person in state and federal money that year, the report noted.\u003c/p>\n\u003cp>No state funding is available for diabetes prevention in California, although the Department of Public Health has solicited the federal grants for programs in some counties, according to the report. The audit takes the agency to task for not doing more.\u003c!--more-->\u003c/p>\n\u003cp>A California Department of Public Health spokesman said no one was available for comment on Friday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Because of declines in federal funding, California in 2012 shuttered nine regional centers devoted to reducing gestational diabetes. Now it has just a \u003ca href=\"http://www.cdph.ca.gov/programs/cdapp/Pages/default.aspx\" target=\"_blank\">website\u003c/a> with information on the condition, which \u003ca href=\"http://www.cdc.gov/pcd/issues/2014/13_0415.htm\" target=\"_blank\">can affect nearly 10 percent of pregnancies\u003c/a>.\u003c/p>\n\u003cp>But the state is not alone in underfunding prevention efforts, according to advocates.\u003c/p>\n\u003cp>“I know we’re on the bottom of the pile on this, but what money is out there for diabetes is just a pittance across the country, when you look at the size of the problem of diabetes,” said Michael Chae, executive director of the American Diabetes Association’s regional office in Oakland. “I’d say you could take this report for most large states and it would read similarly.”\u003c/p>\n\u003cp>Diabetes is a chronic disease that occurs when the body either cannot make enough insulin to control blood sugar (Type 1) or cannot process insulin normally (Type 2). Although diabetes can be controlled with medications and lifestyle changes, including diet and exercise, the yearly health care and related costs of the disease have been estimated at $27.5 billion in California alone, according to the American Diabetes Association.\u003c/p>\n\u003cp>The state auditor’s report acknowledged that the state public health agency appropriately spends its federal dollars. It also recently received new federal grants for diabetes prevention efforts in four counties. But the report faulted the agency for not doing more to identify additional funding and for not expanding programs to other counties with high diabetes rates. Auditors were able to identify two additional federal grants totaling $1 million that the state could have applied for but did not.\u003c/p>\n\u003cp>The auditor described the public health agency’s stated goal of preventing diabetes in 380,000 people by 2022 as “lofty.” It concluded, however, that the agency “will need to do more than it has been able to in the past with its limited funding.”\u003c/p>\n\u003cp>Nationwide, \u003ca href=\"http://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html\" target=\"_blank\">nearly 30 million Americans live with diabetes\u003c/a> and about \u003ca href=\"http://www.cdc.gov/diabetes/newsroom/rates.html\" target=\"_blank\">1.7 million people are newly diagnosed\u003c/a> each year, according to the U.S. Centers for Disease Control and Prevention. \u003ca href=\"http://www.cdph.ca.gov/programs/cdcb/Documents/Heart%20DiseaseDiabetesPrev%20Fact%20Sheet.pdf\" target=\"_blank\">More than 2.3 million\u003c/a> California adults report they have been diagnosed with diabetes and many others are considered to have the disease but do not know it. Still others are considered to be at high risk, or “prediabetic,” based on their blood sugar levels.\u003c/p>\n\u003cp>Chae and other diabetes advocates said they have tried repeatedly over the years to persuade lawmakers to devote state money to diabetes prevention, to little avail.\u003c/p>\n\u003cp>It’s challenging to convince lawmakers and the public to devote more money to diabetes prevention, Chae said, because the disease is often unfairly characterized as a lifestyle problem caused by poor choices such as unhealthful eating and inadequate exercise. In addition, it progresses slowly, and symptoms are often invisible for years.\u003c/p>\n\u003cp>However, years of state reliance on federal grants alone has resulted in uncoordinated programs and staffers who come and go as the grants do, said Joan Werblun, a retired nurse and longtime advocate who helped found the \u003ca href=\"http://diabetescoalitionofcalifornia.org/\" target=\"_blank\">Diabetes Coalition of California\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When you get these grants, you’re so tied into the specifics of the grants, and most of the time, it’s about data collection on how the grant is going,” Werblun said. “That’s where the money’s going. The state’s very happy to point at their projects, but they’re very small and there’s no continuation when the money’s gone. What we need are more people in the communities doing the work.”\u003c/p>\n\n",
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"excerpt": "The state spent just 3 cents per person on diabetes prevention in 2012-2013.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23779\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000015895198_Large-e1422914274182.jpg\">\u003cimg class=\"size-large wp-image-23779\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000015895198_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Barbara Feder Ostrov,\u003c/strong> \u003ca title=\"http://kaiserhealthnews.org\" href=\"http://kaiserhealthnews.org/news/lots-of-responsibility-for-in-home-care-providers-but-no-training-required/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California spends less per person than any state on diabetes prevention programs, even as one in 12 California adults is estimated to suffer from the chronic disease, according to a new \u003ca href=\"http://www.auditor.ca.gov/reports/summary/2014-113\">report\u003c/a> from the California state auditor.\u003c/p>\n\u003cp>Using only federal grants, California spent just 3 cents per person on diabetes prevention in the 2012-2013 fiscal year, compared with New York’s 42 cents per person in state and federal money that year, the report noted.\u003c/p>\n\u003cp>No state funding is available for diabetes prevention in California, although the Department of Public Health has solicited the federal grants for programs in some counties, according to the report. The audit takes the agency to task for not doing more.\u003c!--more-->\u003c/p>\n\u003cp>A California Department of Public Health spokesman said no one was available for comment on Friday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Because of declines in federal funding, California in 2012 shuttered nine regional centers devoted to reducing gestational diabetes. Now it has just a \u003ca href=\"http://www.cdph.ca.gov/programs/cdapp/Pages/default.aspx\" target=\"_blank\">website\u003c/a> with information on the condition, which \u003ca href=\"http://www.cdc.gov/pcd/issues/2014/13_0415.htm\" target=\"_blank\">can affect nearly 10 percent of pregnancies\u003c/a>.\u003c/p>\n\u003cp>But the state is not alone in underfunding prevention efforts, according to advocates.\u003c/p>\n\u003cp>“I know we’re on the bottom of the pile on this, but what money is out there for diabetes is just a pittance across the country, when you look at the size of the problem of diabetes,” said Michael Chae, executive director of the American Diabetes Association’s regional office in Oakland. “I’d say you could take this report for most large states and it would read similarly.”\u003c/p>\n\u003cp>Diabetes is a chronic disease that occurs when the body either cannot make enough insulin to control blood sugar (Type 1) or cannot process insulin normally (Type 2). Although diabetes can be controlled with medications and lifestyle changes, including diet and exercise, the yearly health care and related costs of the disease have been estimated at $27.5 billion in California alone, according to the American Diabetes Association.\u003c/p>\n\u003cp>The state auditor’s report acknowledged that the state public health agency appropriately spends its federal dollars. It also recently received new federal grants for diabetes prevention efforts in four counties. But the report faulted the agency for not doing more to identify additional funding and for not expanding programs to other counties with high diabetes rates. Auditors were able to identify two additional federal grants totaling $1 million that the state could have applied for but did not.\u003c/p>\n\u003cp>The auditor described the public health agency’s stated goal of preventing diabetes in 380,000 people by 2022 as “lofty.” It concluded, however, that the agency “will need to do more than it has been able to in the past with its limited funding.”\u003c/p>\n\u003cp>Nationwide, \u003ca href=\"http://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html\" target=\"_blank\">nearly 30 million Americans live with diabetes\u003c/a> and about \u003ca href=\"http://www.cdc.gov/diabetes/newsroom/rates.html\" target=\"_blank\">1.7 million people are newly diagnosed\u003c/a> each year, according to the U.S. Centers for Disease Control and Prevention. \u003ca href=\"http://www.cdph.ca.gov/programs/cdcb/Documents/Heart%20DiseaseDiabetesPrev%20Fact%20Sheet.pdf\" target=\"_blank\">More than 2.3 million\u003c/a> California adults report they have been diagnosed with diabetes and many others are considered to have the disease but do not know it. Still others are considered to be at high risk, or “prediabetic,” based on their blood sugar levels.\u003c/p>\n\u003cp>Chae and other diabetes advocates said they have tried repeatedly over the years to persuade lawmakers to devote state money to diabetes prevention, to little avail.\u003c/p>\n\u003cp>It’s challenging to convince lawmakers and the public to devote more money to diabetes prevention, Chae said, because the disease is often unfairly characterized as a lifestyle problem caused by poor choices such as unhealthful eating and inadequate exercise. In addition, it progresses slowly, and symptoms are often invisible for years.\u003c/p>\n\u003cp>However, years of state reliance on federal grants alone has resulted in uncoordinated programs and staffers who come and go as the grants do, said Joan Werblun, a retired nurse and longtime advocate who helped found the \u003ca href=\"http://diabetescoalitionofcalifornia.org/\" target=\"_blank\">Diabetes Coalition of California\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When you get these grants, you’re so tied into the specifics of the grants, and most of the time, it’s about data collection on how the grant is going,” Werblun said. “That’s where the money’s going. The state’s very happy to point at their projects, but they’re very small and there’s no continuation when the money’s gone. What we need are more people in the communities doing the work.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"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.",
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"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?",
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"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",
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"perspectives": {
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"planet-money": {
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"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.",
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"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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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
"airtime": "SUN 12am-1am, SAT 2pm-3pm",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"source": "npr"
},
"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
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