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"disqusTitle": "KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers",
"title": "KQED’s #PriceCheck Project Shows Steep Variation in Prices Paid by Health Insurers",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/177363983\"]\u003c/p>\n\n",
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"excerpt": "Health care prices are wildly variable. KQED is crowdsourcing prices to show you exactly what tests and procedures cost.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19667\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\">\u003cimg class=\"size-full wp-image-19667\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg\" alt=\"(Illustration: Andy Warner)\" width=\"640\" height=\"206\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-400x129.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/06/RS10943_Facebook_Final-hpf-320x103.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Illustration: Andy Warner)\u003c/figcaption>\u003c/figure>\n\u003cp>Since June, KQED has been crowdsourcing health care prices.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For starters, insurers paid from $128 to $694 for a screening mammogram. \u003c/aside>\n\u003cp>Why turn to crowdsourcing? Because health care prices are notoriously opaque. Negotiated rates between insurance companies and providers, both doctors and hospitals, are sealed tight, by contract. We know there’s variation, but comparing what one insurance company pays with another is virtually impossible.\u003c/p>\n\u003cp>So \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">we asked you,\u003c/a> the members of our community, to share what you paid.\u003c/p>\n\u003cp>Together with our collaborators \u003ca title=\"http://www.scpr.org/price-check\" href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in Los Angeles\u003c/a> and \u003ca title=\"http://clearhealthcosts.com\" href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup dedicated to health cost transparency, we created a form to make it easy for people to share what they paid — and easy for consumers to see apples-to-apples comparisons of prices.\u003c!--more-->\u003c/p>\n\u003cp>First off, thank you! Hundreds of you shared what you paid for common health care procedures, and thousands more have searched our database, looking for concrete prices they can count on.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, we are also proud to report recognition from the medical community: the journal \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine invited me to write\u003c/a> a Viewpoint to inform doctors about PriceCheck findings. It was published Monday.\u003c/p>\n\u003cp>\u003cstrong>How PriceCheck Works\u003c/strong>\u003c/p>\n\u003cp>In PriceCheck we asked people to share prices for four common medical procedures: mammograms, lower-back MRIs, IUDs and diabetes test strips -- although plenty of people shared prices for other procedures, too. Our form can take virtually any share.\u003c/p>\n\u003cp>I described in JAMA Internal Medicine what happens next:\u003c/p>\n\u003cblockquote>\u003cp>“First, people enter the ‘charged' price. Next, people who do not have insurance and pay out of pocket enter the self-pay price. People with insurance can submit both what the insurer paid and their copay amount, if any. All shared costs are automatically fed into the database, which we pre-populated with cash prices for 30 to 35 ‘shoppable’ medical tests and procedures; these prices were collected by ClearHealthCosts.com.\"\u003c/p>\u003c/blockquote>\n\u003cp>We started with mammograms, because this test is done \u003ca title=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" href=\"http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\" target=\"_blank\">more than 38 million times a year\u003c/a> across the country. Since screening mammograms are a test that can be scheduled, women can, in theory, call around and select a facility based on price.\u003c/p>\n\u003cp>We thought we would find variation, and indeed we did.\u003c/p>\n\u003cp>Looking just at the San Francisco and Los Angeles metropolitan areas, we found that the variation in what insurers paid for screening mammograms ranged from $128 to $694.\u003c/p>\n\u003cp>Specifically in Los Angeles, our KPCC co-conspirator Rebecca Plevin\u003ca title=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\"> found one woman\u003c/a> whose insurer paid $600 more than the lowest-cost screening mammogram in Los Angeles. “I’m sure every woman who’s had a mammogram had the exact same experience I did,” this woman told Plevin. \"It was a friendly technician, but I don’t think that’s worth maybe $600 extra dollars.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Read the \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" href=\"http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2014.6793\" target=\"_blank\">JAMA Internal Medicine Viewpoint\u003c/a> about PriceCheck. \u003c/aside>\n\u003cp>In lower-back MRIs, we found that for \u003ca title=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT\u003c/a> code 72148, insurers paid from $467 to $1,567. But when looking beyond commercial insurers, we found even greater variation — from a low of $255 to a self-pay price of $6,221 at an academic medical center.\u003c/p>\n\u003cp>That $255 MRI was paid by Medicare — and was just a fraction of the $2,450 price the facility charged.\u003c/p>\n\u003cp>But the variation doesn’t stop there, as I described in JAMA Internal Medicine. Yet another person went to the same facility and was charged $603 for the same procedure, same CPT code. This patient had commercial insurance, but paid the entire amount out of pocket, the patient said in comments on our form, since “I had not yet met my deductible.”\u003c/p>\n\u003cp>For IUDs, women reported that prices insurers paid ranged from $440 to $1,230 (for both the device and insertion.)\u003c/p>\n\u003cp>We received very few formal submissions for diabetes test strips. But people shared their prices in comments on Facebook or blog posts. Culling from these informal shares, we found that cash prices for a box of 50 strips ranged from $9 to $88.\u003c/p>\n\u003cp>In \u003ca title=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" href=\"http://archinte.jamanetwork.com/article.aspx?articleid=1935928\" target=\"_blank\">an editorial\u003c/a>, JAMA Internal Medicine editor Rita Redberg, a UC San Francisco cardiologist, called PriceCheck \"bold\" and said that PriceCheck is starting to supply \"essential information\" about price information for common health care tests and procedures.\u003c/p>\n\u003cp>\u003cstrong>Why Price Matters\u003c/strong>\u003c/p>\n\u003cp>Until recently, consumers didn’t have much incentive to shop on price in health care. They might have paid only a manageable copay; insurance picked up the rest.\u003c/p>\n\u003cp>But today, many people have high-deductible health plans. So it might matter to you if the price your insurer negotiated at Facility A is hundreds of dollars more than at Facility B.\u003c/p>\n\u003cp>People told us in comments on stories we wrote and on Facebook of their frustration (“fury” might be a better word):\u003c/p>\n\u003cul>\n\u003cli>“High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/li>\n\u003cli>“I was told the procedure was $1850. I have a $7500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report he procedure to Blue Cross, that it would be $580.”\u003c/li>\n\u003cli>“How’s a civilian supposed to make sense of this?”\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>What About Quality?\u003c/strong>\u003c/p>\n\u003cp>We’ve received thoughtful and pointed questions on two fronts. First, many people ask about quality. Should people be shopping for health care procedures in the same way they shop for a computer or look for the best price on canned goods?\u003c/p>\n\u003cp>This is a reasonable question, but the problem is that cost and quality are unfortunately not connected in health care. There’s no evidence that getting the most expensive treatment or procedure will yield a better outcome. People are starting to wonder why they're paying dramatically more if that extra money isn't buying better health.\u003c/p>\n\u003cp>At PriceCheck, we believe that driving cost transparency helps drive quality discussions, too. \u003ca title=\"But thanks to a law enacted in October, Massachusetts health insurers now have to make all their prices public — in advance.\" href=\"But%20thanks%20to%20a%20law%20enacted%20in%20October,%20Massachusetts%20health%20insurers%20now%20have%20to%20make%20all%20their%20prices%20public%20%E2%80%94%20in%20advance.\" target=\"_blank\">A new law in Massachusetts\u003c/a> requires insurers to make their prices public, in advance. Patients can look up their own costs, based on their plan. Advocates are encouraging people to shop on price.\u003c/p>\n\u003cp>We also hear skepticism about the reliability of crowdsourced data. While I noted this important caveat in JAMA Internal Medicine, we are also firmly behind our community and the prices they share with us. Yes, these data are crowdsourced and as such may contain errors, I wrote, then added:\u003c/p>\n\u003cblockquote>\u003cp>“Yet people should be able to understand their medical bills and explanation of benefits statements. Some people who shared their prices provided contact information; we reached some of them to discuss their bills more fully.”\u003c/p>\u003c/blockquote>\n\u003cp>The PriceCheck form and database are open to you. Please visit and search our database for prices — or share what you paid. Help us make health costs transparent!\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Kaiser Nurses Plan 2-Day Strike: Premature Move or Strategic Step?",
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"content": "\u003cfigure id=\"attachment_20235\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-e1414092083605.jpg\">\u003cimg class=\"size-large wp-image-20235\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-640x480.jpg\" alt=\"Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser's Oakland Medical Center. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As many as 18,000 Kaiser Permanente nurses are preparing for a two-day strike that will start Tuesday. Nurses plan to leave their posts at 7 a.m. and picket outside 21 medical centers and clinics across Northern California.\u003c/p>\n\u003cp>The placards nurses carry and the chants they repeat will say little about salaries or pensions. No economic proposals have even been put on the bargaining table yet.\u003c/p>\n\u003cp>“This seems awfully quick to go to a strike,” says Joanne Spetz, an economics professor at the UC San Francisco School of Nursing. “I can’t recall a situation where a strike has come up where there has not been some kind of disagreement about wages and benefits as part of the package.”\u003c!--more-->\u003c/p>\n\u003cp>Instead, nurses are focusing on more than 35 operational proposals that remain unresolved after \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/14/kaiser-nurses-union-brace-for-upcoming-contract-battle/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/14/kaiser-nurses-union-brace-for-upcoming-contract-battle/\" target=\"_blank\">three months of bargaining\u003c/a>. These demands include a call to fill more than 2,000 nursing positions that have been vacated in the last three years, better protections for use of sick leave or more flexibility over breaks, and more training and education.\u003c/p>\n\u003cp>“Our main concern is patient care issues and safe staffing,” says Zenei Cortez, co-president of the California Nurses Association and chair of the bargaining team for the Kaiser nurses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She says Kaiser will only agree to changes that are “cost neutral,” which is one reason the proposals are stuck in limbo.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The main tension in the negotiations is over what's not being said. \u003c/span>Nurses say they are eager to incorporate the subject of wages and benefits into the negotiation. While they have made no formal economic proposals, they have stated that they are seeking the status quo: no cuts.\u003c/p>\n\u003cp>Kaiser is quiet on this. It has not put forward any of its own proposals yet. The hospital system said in a statement that it prefers to resolve a majority of the “other issues the union has already put on the table and then add our wage and benefit proposals to the mix.”\u003c/p>\n\u003cp>Experts say this is all unusual. But the move to isolate patient care demands from economics could be a strategy on either side, says Joanne Spetz, the UCSF professor.\u003c/p>\n\u003cfigure id=\"attachment_22456\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS12986_IMG_3982-sfi.jpg\">\u003cimg class=\"size-medium wp-image-22456\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS12986_IMG_3982-sfi-300x225.jpg\" alt=\"Kaiser Permanente is running ads in Northern California papers in advance of the proposed strike. (Lisa Aliferis/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente is running ads in Northern California papers in advance of the proposed strike. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Because the nurses’ patient-care proposals would both cost money and create a benefit to nurses in their working conditions –- by reducing workload, for example -– it makes sense that they would want to balance these requests against any proposed changes to salary and benefits.\u003c/p>\n\u003cp>“Usually these all get negotiated as a group,” says Spetz.\u003c/p>\n\u003cp>Kaiser may prefer to separate the issues as a way to strengthen its position when negotiating over wages and pensions -– nurses in California are among the few private professions to still have pensions.\u003c/p>\n\u003cp>But nurses may benefit from the separation, too, now that they’ve called a strike.\u003c/p>\n\u003cp>“To the extent the union can clearly state what exactly their concerns are and argue that Kaiser is not listening, that can bring a lot of public sympathy,” she says. “It does not benefit Kaiser to be perceived as (being) against patient safety.”\u003c/p>\n\u003cp>Both sides have leaned on the recent Ebola scare to try to win PR points with the public. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/14/ebola-now-an-issue-in-nurses-contract-bargaining/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/14/ebola-now-an-issue-in-nurses-contract-bargaining/\" target=\"_blank\">Nurses have demanded\u003c/a> better protective gear and more training for caring with potential Ebola patients -– calls that the Centers for Disease Control and Prevention heeded by updating its federal guidelines last month. Kaiser nurses say they still want more, and have timed the second day of their strike to coincide with nurse demonstrations across the country in a \"National Day of Action\" over Ebola preparedness.\u003c/p>\n\u003cp>Kaiser has tried to turn that argument around in light of the work stoppage.\u003c/p>\n\u003cp>\"We are baffled by the union's tactics at this critical time,\" read an ad that Kaiser ran in Northern California newspapers Monday. Calling a strike now, \"just as we are entering flu season, and when the nation and our members are concerned about the risk of Ebola, seems particularly irresponsible.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hospital system has hired and trained more than 2,800 temporary nurses to staff its medical centers while its regular nurses are on strike – a stopgap that costs as much as $20 million per day, Kaiser says. Some elective surgeries and non-urgent appointments will be rescheduled to ease pressure on the system.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20235\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-e1414092083605.jpg\">\u003cimg class=\"size-large wp-image-20235\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-640x480.jpg\" alt=\"Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser's Oakland Medical Center. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As many as 18,000 Kaiser Permanente nurses are preparing for a two-day strike that will start Tuesday. Nurses plan to leave their posts at 7 a.m. and picket outside 21 medical centers and clinics across Northern California.\u003c/p>\n\u003cp>The placards nurses carry and the chants they repeat will say little about salaries or pensions. No economic proposals have even been put on the bargaining table yet.\u003c/p>\n\u003cp>“This seems awfully quick to go to a strike,” says Joanne Spetz, an economics professor at the UC San Francisco School of Nursing. “I can’t recall a situation where a strike has come up where there has not been some kind of disagreement about wages and benefits as part of the package.”\u003c!--more-->\u003c/p>\n\u003cp>Instead, nurses are focusing on more than 35 operational proposals that remain unresolved after \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/14/kaiser-nurses-union-brace-for-upcoming-contract-battle/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/14/kaiser-nurses-union-brace-for-upcoming-contract-battle/\" target=\"_blank\">three months of bargaining\u003c/a>. These demands include a call to fill more than 2,000 nursing positions that have been vacated in the last three years, better protections for use of sick leave or more flexibility over breaks, and more training and education.\u003c/p>\n\u003cp>“Our main concern is patient care issues and safe staffing,” says Zenei Cortez, co-president of the California Nurses Association and chair of the bargaining team for the Kaiser nurses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She says Kaiser will only agree to changes that are “cost neutral,” which is one reason the proposals are stuck in limbo.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The main tension in the negotiations is over what's not being said. \u003c/span>Nurses say they are eager to incorporate the subject of wages and benefits into the negotiation. While they have made no formal economic proposals, they have stated that they are seeking the status quo: no cuts.\u003c/p>\n\u003cp>Kaiser is quiet on this. It has not put forward any of its own proposals yet. The hospital system said in a statement that it prefers to resolve a majority of the “other issues the union has already put on the table and then add our wage and benefit proposals to the mix.”\u003c/p>\n\u003cp>Experts say this is all unusual. But the move to isolate patient care demands from economics could be a strategy on either side, says Joanne Spetz, the UCSF professor.\u003c/p>\n\u003cfigure id=\"attachment_22456\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS12986_IMG_3982-sfi.jpg\">\u003cimg class=\"size-medium wp-image-22456\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS12986_IMG_3982-sfi-300x225.jpg\" alt=\"Kaiser Permanente is running ads in Northern California papers in advance of the proposed strike. (Lisa Aliferis/KQED)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente is running ads in Northern California papers in advance of the proposed strike. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Because the nurses’ patient-care proposals would both cost money and create a benefit to nurses in their working conditions –- by reducing workload, for example -– it makes sense that they would want to balance these requests against any proposed changes to salary and benefits.\u003c/p>\n\u003cp>“Usually these all get negotiated as a group,” says Spetz.\u003c/p>\n\u003cp>Kaiser may prefer to separate the issues as a way to strengthen its position when negotiating over wages and pensions -– nurses in California are among the few private professions to still have pensions.\u003c/p>\n\u003cp>But nurses may benefit from the separation, too, now that they’ve called a strike.\u003c/p>\n\u003cp>“To the extent the union can clearly state what exactly their concerns are and argue that Kaiser is not listening, that can bring a lot of public sympathy,” she says. “It does not benefit Kaiser to be perceived as (being) against patient safety.”\u003c/p>\n\u003cp>Both sides have leaned on the recent Ebola scare to try to win PR points with the public. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/14/ebola-now-an-issue-in-nurses-contract-bargaining/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/14/ebola-now-an-issue-in-nurses-contract-bargaining/\" target=\"_blank\">Nurses have demanded\u003c/a> better protective gear and more training for caring with potential Ebola patients -– calls that the Centers for Disease Control and Prevention heeded by updating its federal guidelines last month. Kaiser nurses say they still want more, and have timed the second day of their strike to coincide with nurse demonstrations across the country in a \"National Day of Action\" over Ebola preparedness.\u003c/p>\n\u003cp>Kaiser has tried to turn that argument around in light of the work stoppage.\u003c/p>\n\u003cp>\"We are baffled by the union's tactics at this critical time,\" read an ad that Kaiser ran in Northern California newspapers Monday. Calling a strike now, \"just as we are entering flu season, and when the nation and our members are concerned about the risk of Ebola, seems particularly irresponsible.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The hospital system has hired and trained more than 2,800 temporary nurses to staff its medical centers while its regular nurses are on strike – a stopgap that costs as much as $20 million per day, Kaiser says. Some elective surgeries and non-urgent appointments will be rescheduled to ease pressure on the system.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Village' Movement for Aging Seniors Faces Some Challenges",
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"content": "\u003cfigure id=\"attachment_16541\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-e1386288838603.jpg\">\u003cimg class=\"size-large wp-image-16541\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-640x512.jpg\" alt=\"(Patrick/Flickr)\" width=\"640\" height=\"512\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>“It takes a village” is a common refrain.\u003c/p>\n\u003cp>Now \"Villages\" -- yes, with a capital V -- are sweeping the U.S., looking to redefine how people age in their communities.\u003c/p>\n\u003cp>The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so, unless they have some support. These virtual villages link independent living seniors together. Members offer support to each other as they are able, and ask for support when they need it through an organized system.\u003c/p>\n\u003cp>Half of all villages in the U.S. started in the last three years. Because they are such a recent phenomenon, there have not been many studies about their outcomes.\u003c!--more-->\u003c/p>\n\u003cp>Now, the initial results from a retrospective,\u003ca title=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" href=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" target=\"_blank\"> three year study \u003c/a>from UC Berkeley find support for many of the movement’s positive claims. Butthe data, being presented at the Gerontological Society of America conference, also raises flags about the communities’ diversity and sustainability.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“People, by and large, report that the village has made a substantial difference in their life,” says Andrew Scharlach, a professor at UC Berkeley and the principal investigator of the ongoing study that includes in-person interviews with 300 residents at nine California villages.\u003c/p>\n\u003cp>The study has shown that over time village members’ desire to move out of their home and community decreased.\u003c/p>\n\u003cp>Also, 55 to 80 percent of respondents reported a jump in quality of life. The more involved they were with the village, the higher the impact.\u003c/p>\n\u003cp>But, Sharlach says, there are some caveats.\u003c/p>\n\u003cp>People in the study self-reported big gains in social connections — knowing more people, getting out of the house more, and interacting with people more than they used to.\u003c/p>\n\u003cp>But when the researchers looked at data from the 133 people they followed over the course of 12 months, there was no evidence that the number of interactions or social connections these people had, had actually changed.\u003c/p>\n\u003cp>“If you ask, the first day of the village, ‘How many people do you know? How often do you get out of the house? How many social activities are you participating in?’ and then you come back a year later and ask the exact same questions,” says Sharlach, “there’s not a significant difference.”\u003c/p>\n\u003cp>He says it’s possible one year may be too soon to see significant changes in numbers, or the questions may not be capturing the growth areas for people. Another possibility is that people join the village during transitions in life and their social circle doesn’t grow, it just shifts.\u003c/p>\n\u003cp>Village participants’ health outcomes are another area policy experts are eager for data about. Sharlach’s team is looking at changes over time in incidents of falls, emergency department visits and hospital admissions. But he says that data is still being processed.\u003c/p>\n\u003cp>The weakest points the study found were around diversity and sustainability.\u003c/p>\n\u003cp>Villages are 94 percent white, according to studies. If they are going to be a model to serve a greater aging population, Sharlach says, the challenges that communities have reflecting the whole population need to be addressed.\u003c/p>\n\u003cp>He says those could include some cultural barriers. The village model is aimed at helping individuals age in place, but in some cultures families and other communities are inextricably linked to their elders. That means adapting the model to serve existing communities.\u003c/p>\n\u003cp>Right now, though, given that they are largely white, Sharlach says that raises questions. “invite someone who is African-American, or Latino or Asian Pacific Islander to join a village,” he says. “And they come to a meeting that is based on social connections and these aren’t people who are naturally part of their social connections, are they going to want to join this club?”\u003c/p>\n\u003cp>Another challenge the study found was the sustainability of Villages.\u003c/p>\n\u003cp>Nationally, and also in California, about 50 percent of the budgets are covered by membership dues, but the other 50 percent has to be raised.\u003c/p>\n\u003cp>“Whether that’s through contracts and grants or through the government, [in order to succeed for the long term] that’s the area that really needs to be figured out,” says Sharlach.\u003c/p>\n\u003cp>The city of San Francisco stands out as a government that has supported its two villages. In February 2013 the city gave $50,000 each to the San Francisco Village and the NEXT Village. But these grants are the exception, not the rule.\u003c/p>\n\u003cp>Sharlach says the study shows there are great benefits to be had from the Village model, but the challenges suggest the model really needs to be models, plural, to serve the many communities that could take advantage of them.\u003c/p>\n\u003cp>The UC Berkeley study followed residents at nine communities in California. Most were suburban but it included the rural Community Connections program in Plumas County and the urban San Francisco Village were also included. The remaining study sites were Ashby Village (Berkeley), Avenidas (Palo Alto), Santa Barbara Village, Wise Connections (Santa Monica), Westchester Playa Village, Real Connections (Claremont-Pomona), and Tierra Santa in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachel Dornhelm wrote this story through a Fellowship from New America Media and the Gerontological Society of America, supported by AARP.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“People, by and large, report that the village has made a substantial difference in their life,” says Andrew Scharlach, a professor at UC Berkeley and the principal investigator of the ongoing study that includes in-person interviews with 300 residents at nine California villages.\u003c/p>\n\u003cp>The study has shown that over time village members’ desire to move out of their home and community decreased.\u003c/p>\n\u003cp>Also, 55 to 80 percent of respondents reported a jump in quality of life. The more involved they were with the village, the higher the impact.\u003c/p>\n\u003cp>But, Sharlach says, there are some caveats.\u003c/p>\n\u003cp>People in the study self-reported big gains in social connections — knowing more people, getting out of the house more, and interacting with people more than they used to.\u003c/p>\n\u003cp>But when the researchers looked at data from the 133 people they followed over the course of 12 months, there was no evidence that the number of interactions or social connections these people had, had actually changed.\u003c/p>\n\u003cp>“If you ask, the first day of the village, ‘How many people do you know? How often do you get out of the house? How many social activities are you participating in?’ and then you come back a year later and ask the exact same questions,” says Sharlach, “there’s not a significant difference.”\u003c/p>\n\u003cp>He says it’s possible one year may be too soon to see significant changes in numbers, or the questions may not be capturing the growth areas for people. Another possibility is that people join the village during transitions in life and their social circle doesn’t grow, it just shifts.\u003c/p>\n\u003cp>Village participants’ health outcomes are another area policy experts are eager for data about. Sharlach’s team is looking at changes over time in incidents of falls, emergency department visits and hospital admissions. But he says that data is still being processed.\u003c/p>\n\u003cp>The weakest points the study found were around diversity and sustainability.\u003c/p>\n\u003cp>Villages are 94 percent white, according to studies. If they are going to be a model to serve a greater aging population, Sharlach says, the challenges that communities have reflecting the whole population need to be addressed.\u003c/p>\n\u003cp>He says those could include some cultural barriers. The village model is aimed at helping individuals age in place, but in some cultures families and other communities are inextricably linked to their elders. That means adapting the model to serve existing communities.\u003c/p>\n\u003cp>Right now, though, given that they are largely white, Sharlach says that raises questions. “invite someone who is African-American, or Latino or Asian Pacific Islander to join a village,” he says. “And they come to a meeting that is based on social connections and these aren’t people who are naturally part of their social connections, are they going to want to join this club?”\u003c/p>\n\u003cp>Another challenge the study found was the sustainability of Villages.\u003c/p>\n\u003cp>Nationally, and also in California, about 50 percent of the budgets are covered by membership dues, but the other 50 percent has to be raised.\u003c/p>\n\u003cp>“Whether that’s through contracts and grants or through the government, [in order to succeed for the long term] that’s the area that really needs to be figured out,” says Sharlach.\u003c/p>\n\u003cp>The city of San Francisco stands out as a government that has supported its two villages. In February 2013 the city gave $50,000 each to the San Francisco Village and the NEXT Village. But these grants are the exception, not the rule.\u003c/p>\n\u003cp>Sharlach says the study shows there are great benefits to be had from the Village model, but the challenges suggest the model really needs to be models, plural, to serve the many communities that could take advantage of them.\u003c/p>\n\u003cp>The UC Berkeley study followed residents at nine communities in California. Most were suburban but it included the rural Community Connections program in Plumas County and the urban San Francisco Village were also included. The remaining study sites were Ashby Village (Berkeley), Avenidas (Palo Alto), Santa Barbara Village, Wise Connections (Santa Monica), Westchester Playa Village, Real Connections (Claremont-Pomona), and Tierra Santa in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachel Dornhelm wrote this story through a Fellowship from New America Media and the Gerontological Society of America, supported by AARP.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New State Funding Improves County Mental Health Services",
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"content": "\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>The Joslyn Center in Burbank is a place where older adults come for low-cost healthy meals and activities ranging from fitness and computer classes to music lessons.\u003c/p>\n\u003cp>But several times lately, the normally placid environment of the center has been disrupted. One client who uses the services was showing signs of mental illness. Renee Crawford coordinates social services at the Center.\u003c/p>\n\u003cp>“She gets very loud, very aggressive and very anxious,\" Crawford said, in reference to the troubled client. \"And then we have to go in and tell her, 'Calm down, relax, you can’t be this loud,' Then she gets very upset and very irate.”\u003c/p>\n\u003cp>The woman seemed to be suffering from paranoid delusions, and Crawford says the workers here aren’t trained to help her.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Staff gets very uncomfortable with it. We have called the police. We have asked her to leave the building.”\u003c/p>\n\u003cp>Until recently, there were few places for Crawford to go for help. But \u003ca title=\"http://www.treasurer.ca.gov/chffa/imhwa/\" href=\"http://www.treasurer.ca.gov/chffa/imhwa/\" target=\"_blank\">legislation passed last year\u003c/a> in Sacramento provides more than $140 million in grant funds for, among other things, mobile crisis support teams.\u003c/p>\n\u003cp>Because Crawford was worried her client might become violent, she turned to a service of the Burbank Police Department, called a Mental Health Evaluation Team. The team pairs a clinical psychologist and a patrol officer, who respond together to mental health crises. Psychologist Jennifer Hunt says the goal is to assess people and, if appropriate, connect them with mental health services. The team seeks to head off a confrontation that could land a person, like Crawford's client, either in the hospital or jail.\u003c/p>\n\u003cp>“We would want to make sure not only that we are addressing the needs that she continues to present,\" says Hunt, \"but also to make sure that everybody’s safe.”\u003c/p>\n\u003cp>Back in the patrol car, Kristiana Sanchez, the police officer who works with Hunt, says units like this one free up other patrols to focus on their primary mission -- fighting crime. Before crisis teams were in use, she says police officers wasted valuable time in waiting rooms.\u003c/p>\n\u003cp>“It took many officers out of the field to deal with transporting someone who was in a mental health crisis to the hospital and then sitting there for multiple hours,\" Sanchez says. \"And that took two officers for just one person.”\u003c/p>\n\u003cp>Now, says Sanchez, specially-trained officers like her are able to recognize the symptoms of mental disorders.\u003c/p>\n\u003cp>Linda Boyd, who started the emergency outreach bureau for Los Angeles County, says responding to mental illness requires very different skills from disarming criminals.\u003c/p>\n\u003cp>“We treat people with respect,\" Boyd says. \"We don’t rush in. … We give the person time to calm down. With folks who have a mental illness, you really have to slow down.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mobile crisis teams are expensive, and were only available in parts of the Los Angeles County until last year when lawmakers approved the Investment in Mental Health Wellness Act. It restored badly needed funding for psychiatric services. Now, with the new grant money, Los Angeles has more than a dozen new mobile crisis teams, and is doubling the number of its urgent care units -- places where people in a psychiatric emergency can go for help, instead of the hospital or jail.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>The Joslyn Center in Burbank is a place where older adults come for low-cost healthy meals and activities ranging from fitness and computer classes to music lessons.\u003c/p>\n\u003cp>But several times lately, the normally placid environment of the center has been disrupted. One client who uses the services was showing signs of mental illness. Renee Crawford coordinates social services at the Center.\u003c/p>\n\u003cp>“She gets very loud, very aggressive and very anxious,\" Crawford said, in reference to the troubled client. \"And then we have to go in and tell her, 'Calm down, relax, you can’t be this loud,' Then she gets very upset and very irate.”\u003c/p>\n\u003cp>The woman seemed to be suffering from paranoid delusions, and Crawford says the workers here aren’t trained to help her.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Staff gets very uncomfortable with it. We have called the police. We have asked her to leave the building.”\u003c/p>\n\u003cp>Until recently, there were few places for Crawford to go for help. But \u003ca title=\"http://www.treasurer.ca.gov/chffa/imhwa/\" href=\"http://www.treasurer.ca.gov/chffa/imhwa/\" target=\"_blank\">legislation passed last year\u003c/a> in Sacramento provides more than $140 million in grant funds for, among other things, mobile crisis support teams.\u003c/p>\n\u003cp>Because Crawford was worried her client might become violent, she turned to a service of the Burbank Police Department, called a Mental Health Evaluation Team. The team pairs a clinical psychologist and a patrol officer, who respond together to mental health crises. Psychologist Jennifer Hunt says the goal is to assess people and, if appropriate, connect them with mental health services. The team seeks to head off a confrontation that could land a person, like Crawford's client, either in the hospital or jail.\u003c/p>\n\u003cp>“We would want to make sure not only that we are addressing the needs that she continues to present,\" says Hunt, \"but also to make sure that everybody’s safe.”\u003c/p>\n\u003cp>Back in the patrol car, Kristiana Sanchez, the police officer who works with Hunt, says units like this one free up other patrols to focus on their primary mission -- fighting crime. Before crisis teams were in use, she says police officers wasted valuable time in waiting rooms.\u003c/p>\n\u003cp>“It took many officers out of the field to deal with transporting someone who was in a mental health crisis to the hospital and then sitting there for multiple hours,\" Sanchez says. \"And that took two officers for just one person.”\u003c/p>\n\u003cp>Now, says Sanchez, specially-trained officers like her are able to recognize the symptoms of mental disorders.\u003c/p>\n\u003cp>Linda Boyd, who started the emergency outreach bureau for Los Angeles County, says responding to mental illness requires very different skills from disarming criminals.\u003c/p>\n\u003cp>“We treat people with respect,\" Boyd says. \"We don’t rush in. … We give the person time to calm down. With folks who have a mental illness, you really have to slow down.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mobile crisis teams are expensive, and were only available in parts of the Los Angeles County until last year when lawmakers approved the Investment in Mental Health Wellness Act. It restored badly needed funding for psychiatric services. Now, with the new grant money, Los Angeles has more than a dozen new mobile crisis teams, and is doubling the number of its urgent care units -- places where people in a psychiatric emergency can go for help, instead of the hospital or jail.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_22350\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/5161_transform.jpg\">\u003cimg class=\"size-full wp-image-22350\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/5161_transform.jpg\" alt=\"The law would require health insurers to publicly disclose and justify their rates. (Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The law would require health insurers to publicly disclose and justify their rates. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, 12:30 a.m.\u003c/strong>\u003cbr>\nAt first glance, Proposition 45 seemed like a no-brainer for consumers. The measure would have given the state’s insurance commissioner the authority to reject excessive rate hikes in health insurance sold on the individual and small-business markets.\u003c/p>\n\u003cp>Consumers who had seen their premiums go up by double digits year after year clung to Prop. 45 as the savior.\u003c/p>\n\u003cp>“I felt like a frog in hot water that got hotter and hotter until it was boiling,” says Josh Libresco, a market researcher who has bought health insurance for his family on the individual market for 20 years.\u003c/p>\n\u003cp>\u003c!--more-->But consumer voices like this were overwhelmed in the conversation around Prop. 45 by health insurance companies, including Kaiser and Blue Cross Blue Shield, which raised $43.6 million to defeat the measure. The proponents raised just $2.5 million.\u003c/p>\n\u003cp>“Health insurance companies have a tremendous economic stake in the outcome,” says Daniel G. Newman, president and co-founder of MapLight, a nonpartisan research organization that tracks the influence of money on politics. “There’s also billions of dollars at stake for health care consumers, but consumers don’t have millions collectively to put in favor of a ballot measure.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The No side was further bolstered by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/02/fight-continues-over-ballot-measure-to-control-health-insurance-premiums/\" target=\"_blank\">concerns raised by Covered California\u003c/a>, the state agency tasked with implementing the Affordable Care Act in California. Board members and staff discussed various complications that could arise from Prop. 45 and complicate Covered California’s ability to carry out its mission, pitting the agency against the current commissioner, Dave Jones, in \u003ca href=\"http://ww2.kqed.org/stateofhealth/tag/proposition-45/\" target=\"_blank\">an unusual dispute between allies\u003c/a>.\u003c/p>\n\u003cp>The agency negotiates rates with insurers directly, and feared that a challenge to those rates under Prop. 45 could undo that work, delay final rates beyond federal deadlines or even cause insurers to withdraw plans from the state marketplace.\u003c/p>\n\u003cp>Insurance companies made Covered California an unlikely bedfellow, weaving its concerns into the industry’s ad campaign and urging people to vote no on Prop. 45 to \"protect the Affordable Care Act.\"\u003c/p>\n\u003cp>The influence of that campaign appears to have worked with voters. A poll from the middle of the summer showed 69 percent of likely voters favored Prop. 45 and giving the commissioner more power to control health insurance rates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>By election night, that support slipped to just about 40 percent.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22350\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/5161_transform.jpg\">\u003cimg class=\"size-full wp-image-22350\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/5161_transform.jpg\" alt=\"The law would require health insurers to publicly disclose and justify their rates. (Getty Images)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/5161_transform-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The law would require health insurers to publicly disclose and justify their rates. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, 12:30 a.m.\u003c/strong>\u003cbr>\nAt first glance, Proposition 45 seemed like a no-brainer for consumers. The measure would have given the state’s insurance commissioner the authority to reject excessive rate hikes in health insurance sold on the individual and small-business markets.\u003c/p>\n\u003cp>Consumers who had seen their premiums go up by double digits year after year clung to Prop. 45 as the savior.\u003c/p>\n\u003cp>“I felt like a frog in hot water that got hotter and hotter until it was boiling,” says Josh Libresco, a market researcher who has bought health insurance for his family on the individual market for 20 years.\u003c/p>\n\u003cp>\u003c!--more-->But consumer voices like this were overwhelmed in the conversation around Prop. 45 by health insurance companies, including Kaiser and Blue Cross Blue Shield, which raised $43.6 million to defeat the measure. The proponents raised just $2.5 million.\u003c/p>\n\u003cp>“Health insurance companies have a tremendous economic stake in the outcome,” says Daniel G. Newman, president and co-founder of MapLight, a nonpartisan research organization that tracks the influence of money on politics. “There’s also billions of dollars at stake for health care consumers, but consumers don’t have millions collectively to put in favor of a ballot measure.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The No side was further bolstered by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/02/fight-continues-over-ballot-measure-to-control-health-insurance-premiums/\" target=\"_blank\">concerns raised by Covered California\u003c/a>, the state agency tasked with implementing the Affordable Care Act in California. Board members and staff discussed various complications that could arise from Prop. 45 and complicate Covered California’s ability to carry out its mission, pitting the agency against the current commissioner, Dave Jones, in \u003ca href=\"http://ww2.kqed.org/stateofhealth/tag/proposition-45/\" target=\"_blank\">an unusual dispute between allies\u003c/a>.\u003c/p>\n\u003cp>The agency negotiates rates with insurers directly, and feared that a challenge to those rates under Prop. 45 could undo that work, delay final rates beyond federal deadlines or even cause insurers to withdraw plans from the state marketplace.\u003c/p>\n\u003cp>Insurance companies made Covered California an unlikely bedfellow, weaving its concerns into the industry’s ad campaign and urging people to vote no on Prop. 45 to \"protect the Affordable Care Act.\"\u003c/p>\n\u003cp>The influence of that campaign appears to have worked with voters. A poll from the middle of the summer showed 69 percent of likely voters favored Prop. 45 and giving the commissioner more power to control health insurance rates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>By election night, that support slipped to just about 40 percent.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_22355\" class=\"wp-caption aligncenter\" style=\"max-width: 639px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/6737_transform.jpg\">\u003cimg class=\"size-full wp-image-22355\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/6737_transform.jpg\" alt=\"The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice. (Getty Images)\" width=\"639\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform.jpg 639w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform-320x180.jpg 320w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, 10:50 p.m.\u003c/strong>\u003cbr>\nBy far the most expensive race in the state this election was Proposition 46. The three-part \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/30/prop-46-was-inspired-by-tragic-accident-pits-doctors-against-lawyers/\">“patient safety measure\u003c/a>\" inspired close to $60 million in spending from the No side, seven times the spending on the Yes side. Medical malpractice insurers wanted to make sure this one went down – and early voter returns indicate that it will.\u003c/p>\n\u003cp>“It’s apparent that people are being influenced by biased advertising,” says Daniel G. Newman, president and co-founder of MapLight, a nonpartisan research organization that tracks the influence of money on politics. “These political ads have very little to do with the substance of the measure. They have very simple messaging that is often misleading.”\u003c/p>\n\u003cp>The key piece of Prop. 46 would have adjusted the cap on medical malpractice awards for inflation, from $250,000 – an amount set in 1975 – to $1.1 million. This would have applied only to pain and suffering awards. Victims of medical malpractice, and their lawyers, pushed to raise the cap because they say it limits victims’ ability to find representation, especially when that victim is elderly or a child and cannot claim lost wages or other economic damages. Insurers said this would drive up the costs of premiums.\u003c!--more-->\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xKRh73IQ3Ekr2QOir9BhNGtFqhFaeiRK\"]\u003c/p>\n\u003cp>The other two pieces of Prop. 46 focused more directly on doctors. The measure would have required doctors to check a statewide database of drug prescriptions before issuing new prescriptions for narcotics, and would have required them to undergo random drug and alcohol testing.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Regardless of where voters’ own economic and consumer interests fell, the majority voted no, says Newman, because of the flood of ads produced by the No side.\u003c/p>\n\u003cp>“It’s as if you had a giant wall-sized TV screen on your left and a tiny cellphone screen on your right. And you as a voter are in the middle trying to make a decision,” he says. “You’re going to be overwhelmingly influenced by the giant TV screen, or the side that spends an overwhelming amount of money.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Early polls for Prop. 46 showed strong support in favor -- 58 percent of likely voters said they would vote yes. That support dwindled after campaign ads began in earnest, and ultimately fizzled to about a third of voters by Election Day.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22355\" class=\"wp-caption aligncenter\" style=\"max-width: 639px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/6737_transform.jpg\">\u003cimg class=\"size-full wp-image-22355\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/6737_transform.jpg\" alt=\"The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice. (Getty Images)\" width=\"639\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform.jpg 639w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/6737_transform-320x180.jpg 320w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The central fight in this complex initiative is whether to raise California’s 39-year-old cap on the amount of money that courts can award for pain and suffering to a victim of medical malpractice. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, 10:50 p.m.\u003c/strong>\u003cbr>\nBy far the most expensive race in the state this election was Proposition 46. The three-part \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/30/prop-46-was-inspired-by-tragic-accident-pits-doctors-against-lawyers/\">“patient safety measure\u003c/a>\" inspired close to $60 million in spending from the No side, seven times the spending on the Yes side. Medical malpractice insurers wanted to make sure this one went down – and early voter returns indicate that it will.\u003c/p>\n\u003cp>“It’s apparent that people are being influenced by biased advertising,” says Daniel G. Newman, president and co-founder of MapLight, a nonpartisan research organization that tracks the influence of money on politics. “These political ads have very little to do with the substance of the measure. They have very simple messaging that is often misleading.”\u003c/p>\n\u003cp>The key piece of Prop. 46 would have adjusted the cap on medical malpractice awards for inflation, from $250,000 – an amount set in 1975 – to $1.1 million. This would have applied only to pain and suffering awards. Victims of medical malpractice, and their lawyers, pushed to raise the cap because they say it limits victims’ ability to find representation, especially when that victim is elderly or a child and cannot claim lost wages or other economic damages. Insurers said this would drive up the costs of premiums.\u003c!--more-->\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xKRh73IQ3Ekr2QOir9BhNGtFqhFaeiRK\"]\u003c/p>\n\u003cp>The other two pieces of Prop. 46 focused more directly on doctors. The measure would have required doctors to check a statewide database of drug prescriptions before issuing new prescriptions for narcotics, and would have required them to undergo random drug and alcohol testing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Regardless of where voters’ own economic and consumer interests fell, the majority voted no, says Newman, because of the flood of ads produced by the No side.\u003c/p>\n\u003cp>“It’s as if you had a giant wall-sized TV screen on your left and a tiny cellphone screen on your right. And you as a voter are in the middle trying to make a decision,” he says. “You’re going to be overwhelmingly influenced by the giant TV screen, or the side that spends an overwhelming amount of money.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Early polls for Prop. 46 showed strong support in favor -- 58 percent of likely voters said they would vote yes. That support dwindled after campaign ads began in earnest, and ultimately fizzled to about a third of voters by Election Day.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_22337\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-e1415059485967.jpg\">\u003cimg class=\"size-large wp-image-22337\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-640x495.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"495\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: 2:30am 11/5/2014\u003c/strong>\u003c/p>\n\u003cp>Voters in Berkeley have passed the nation's first soda tax with a resounding 75 percent of the vote. More than 30 cities and states across the country have attempted such a tax, but have failed, at least in part because of big spending by the soda industry to defeat these measures.\u003c/p>\n\u003cp>But across the bay in San Francisco, a similar proposal failed to get the two-thirds supermajority it needed.\u003c/p>\n\u003cp>Berkeley's Measure D needed only a simple majority to pass. It will levy a penny-per-ounce tax on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" target=\"_blank\">most sugar-sweetened beverages\u003c/a> and is estimated to raise more than a million dollars per year. Proceeds will go to the general fund; Measure D calls for the creation of a health panel to advise Berkeley's City Council on appropriate health programs to receive funding.\u003c!--more-->\u003c/p>\n\u003cp>Campaign co-chair Josh Daniels called Berkeley's win a tipping point. \"I think you will now see many, many other cities and communities around the country looking at this as a genuine public policy to address the diabetes and obesity crisis that we face,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the San Francisco proposition did not pass, supporters there declared a victory of their own: more than half the voters approved the tax despite millions spent by the American Beverage Association to defeat it. \"So the fact that we were able to overcome $10 million dollars,\" said Proposition E co-author Supervisor Scott Wiener, \"and it looks like a majority of San Franciscans -- despite that $10 million -- will vote 'yes,' is pretty extraordinary.\"\u003c/p>\n\u003cp>Roger Salazar, a spokesman for both opposition campaigns, funded primarily by the beverage association, called Berkeley \"an anomaly\" and said that to expect to pass such a tax elsewhere in California was \"foolhardy.\"\u003c/p>\n\u003cp>Advocates are convinced he's wrong. Harold Goldstein is executive director with the California Center for Public Health Advocacy, and called the measure's passage \"remarkable.\"\u003c/p>\n\u003cp>\"What we learned here in Berkeley,\" he said, \"is that when voters learn the truth about sugary beverages, when they learn that they are one of the central causes of the growing diabetes epidemic, they want to tax it, they want to regulate these products.\"\u003c/p>\n\u003cp>Indeed, sugar-sweetened beverages are the primary source of added sugar in the American diet, and that added sugar is linked to increasing rates of diabetes.\u003c/p>\n\u003cp>Berkeley has a history of being first to a new cause that's later embraced more broadly, said Lori Dorfman, executive director for the Berkeley Media Studies Group. She noted that Berkeley was the first city to pass a clean indoor air ordinance. \"In the mid-70's, Berkeley made the first 'curb cut,' and now people in wheelchairs all over the country are not trapped in their homes any more.\"\u003c/p>\n\u003cp>Mexico enacted a soda tax earlier this year on January 1, and by summer, consumption had dropped 10 percent.\u003c/p>\n\u003cp>Kelly Brownell, dean of Duke University's school of public policy \u003ca title=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" href=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" target=\"_blank\">first proposed a soda tax\u003c/a> in the early 1990's. He called the votes in both Berkeley and San Francisco \"historic\" and, like other advocates, predicted other cities will soon follow suit, despite what soda companies might say publicly.\u003c/p>\n\u003cp>\"My guess is that inside their boardrooms, they know very well these taxes are the beginning of the future,\" he said. \"This is a wave starting to crest.\"\u003c/p>\n\u003cp>Brownell said that half the costs of diabetes and obesity are born by taxpayers, through the government health insurance programs Medicare and Medicaid. Those public costs \"justify the government getting involved, just like tobacco taxes,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Update: 12:25am 11/5\u003c/strong>\u003c/p>\n\u003cp>With 80 percent of precincts reported, Berkeley's Measure D has 75 percent \"yes\" to 25 percent \"no\" votes. It needs a simple majority to pass.\u003c/p>\n\u003cp>In San Francisco, 100 percent of precincts are now reporting. Proposition E needed a two-thirds supermajority to pass. It received 54.5 percent \"yes\" to 45.5 percent \"no.\"\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Many have tried, but none has yet succeeded.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Would 'send shudders through the soft drink industry.' \u003c/aside>\n\u003cp>Tuesday, voters in San Francisco or Berkeley will decide whether to impose a tax on sugar-sweetened beverages, the so-called soda tax. Similar attempts have failed more than two dozen times nationwide, including in the California cities of Richmond and El Monte in 2012 and in Telluride, Colorado, last year.\u003c/p>\n\u003cp>Sugar-sweetened beverages account for \u003ca title=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" href=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" target=\"_blank\">one-third of the added sugar \u003c/a>in the average American's diet, and advocates say that increasing consumption of sugar is driving up rates of Type 2 diabetes, heart disease and other health ills.\u003c/p>\n\u003cp>Opponents insist that the tax would disproportionately hurt people who are low income and that taxing people for what they choose to eat or drink is just bad policy.\u003c/p>\n\u003cp>And the opponents are spending big to drive those messages home. The \"no\" campaigns in both cities are funded largely by the American Beverage Association, which has spent more than a whopping $11 million to defeat the two measures -- $9 million in San Francisco and more than $2 million in Berkeley. Proponents have spent a mere fraction of those amounts. The biggest donor by far to either campaign is former New York City mayor Michael Bloomberg, who gave more than $600,000 and \u003ca title=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" href=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" target=\"_blank\">funded a TV ad \u003c/a>that aired during the World Series.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KVgksnAHQh4qGNYQaT88s4v51T0kBbxe\"]\u003c/p>\n\u003cp>San Francisco's Proposition E would levy a 2-cents-an-ounce tax, raising the price of a can of soda by 24 cents and a 12-pack almost $3. The revenue, estimated at $35 million to $54 million, is earmarked to be spent specifically on nutrition and physical activity programs. Because the tax is earmarked, it requires a two-thirds majority to pass.\u003c/p>\n\u003cp>That two-thirds majority is \"a very high hurdle,\" says Michael Jacobsen, executive director of the Washington, DC-based Center for Science in the Public Interest, but \"if San Francisco gets even 50 percent of the vote, that would be quite remarkable, and I think would send shudders through the soft drink industry.\"\u003c/p>\n\u003cp>Meanwhile, Berkeley's tax is 1-cent-an-ounce. The measure would raise more than $1 million, but the funds would go into the city's general fund -- which means it needs only a simple majority to pass.\u003c/p>\n\u003cp>Roger Salazar, spokesman for both anti-tax campaigns,\u003ca title=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" href=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" target=\"_blank\"> admits the race is tight\u003c/a>, but insists that Berkeley is no bellwether for the rest of the country.\u003c/p>\n\u003cp>Jacobsen disagrees. While Berkeley is a very progressive community, if the tax passes, \"it's a population accepting and taxing itself,\" he said. \"I think that will be an encouragement to other progressive cities and states. You can imagine Vermont, Madison, maybe Boston, thinking 'well, if they can do it in Berkeley, maybe we can do it here.'\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Mexico enacted a similar tax on January 1, and consumption of sugar-sweetened beverages dropped 10 percent by the summer.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22337\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-e1415059485967.jpg\">\u003cimg class=\"size-large wp-image-22337\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-640x495.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"495\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: 2:30am 11/5/2014\u003c/strong>\u003c/p>\n\u003cp>Voters in Berkeley have passed the nation's first soda tax with a resounding 75 percent of the vote. More than 30 cities and states across the country have attempted such a tax, but have failed, at least in part because of big spending by the soda industry to defeat these measures.\u003c/p>\n\u003cp>But across the bay in San Francisco, a similar proposal failed to get the two-thirds supermajority it needed.\u003c/p>\n\u003cp>Berkeley's Measure D needed only a simple majority to pass. It will levy a penny-per-ounce tax on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" target=\"_blank\">most sugar-sweetened beverages\u003c/a> and is estimated to raise more than a million dollars per year. Proceeds will go to the general fund; Measure D calls for the creation of a health panel to advise Berkeley's City Council on appropriate health programs to receive funding.\u003c!--more-->\u003c/p>\n\u003cp>Campaign co-chair Josh Daniels called Berkeley's win a tipping point. \"I think you will now see many, many other cities and communities around the country looking at this as a genuine public policy to address the diabetes and obesity crisis that we face,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the San Francisco proposition did not pass, supporters there declared a victory of their own: more than half the voters approved the tax despite millions spent by the American Beverage Association to defeat it. \"So the fact that we were able to overcome $10 million dollars,\" said Proposition E co-author Supervisor Scott Wiener, \"and it looks like a majority of San Franciscans -- despite that $10 million -- will vote 'yes,' is pretty extraordinary.\"\u003c/p>\n\u003cp>Roger Salazar, a spokesman for both opposition campaigns, funded primarily by the beverage association, called Berkeley \"an anomaly\" and said that to expect to pass such a tax elsewhere in California was \"foolhardy.\"\u003c/p>\n\u003cp>Advocates are convinced he's wrong. Harold Goldstein is executive director with the California Center for Public Health Advocacy, and called the measure's passage \"remarkable.\"\u003c/p>\n\u003cp>\"What we learned here in Berkeley,\" he said, \"is that when voters learn the truth about sugary beverages, when they learn that they are one of the central causes of the growing diabetes epidemic, they want to tax it, they want to regulate these products.\"\u003c/p>\n\u003cp>Indeed, sugar-sweetened beverages are the primary source of added sugar in the American diet, and that added sugar is linked to increasing rates of diabetes.\u003c/p>\n\u003cp>Berkeley has a history of being first to a new cause that's later embraced more broadly, said Lori Dorfman, executive director for the Berkeley Media Studies Group. She noted that Berkeley was the first city to pass a clean indoor air ordinance. \"In the mid-70's, Berkeley made the first 'curb cut,' and now people in wheelchairs all over the country are not trapped in their homes any more.\"\u003c/p>\n\u003cp>Mexico enacted a soda tax earlier this year on January 1, and by summer, consumption had dropped 10 percent.\u003c/p>\n\u003cp>Kelly Brownell, dean of Duke University's school of public policy \u003ca title=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" href=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" target=\"_blank\">first proposed a soda tax\u003c/a> in the early 1990's. He called the votes in both Berkeley and San Francisco \"historic\" and, like other advocates, predicted other cities will soon follow suit, despite what soda companies might say publicly.\u003c/p>\n\u003cp>\"My guess is that inside their boardrooms, they know very well these taxes are the beginning of the future,\" he said. \"This is a wave starting to crest.\"\u003c/p>\n\u003cp>Brownell said that half the costs of diabetes and obesity are born by taxpayers, through the government health insurance programs Medicare and Medicaid. Those public costs \"justify the government getting involved, just like tobacco taxes,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Update: 12:25am 11/5\u003c/strong>\u003c/p>\n\u003cp>With 80 percent of precincts reported, Berkeley's Measure D has 75 percent \"yes\" to 25 percent \"no\" votes. It needs a simple majority to pass.\u003c/p>\n\u003cp>In San Francisco, 100 percent of precincts are now reporting. Proposition E needed a two-thirds supermajority to pass. It received 54.5 percent \"yes\" to 45.5 percent \"no.\"\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Many have tried, but none has yet succeeded.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Would 'send shudders through the soft drink industry.' \u003c/aside>\n\u003cp>Tuesday, voters in San Francisco or Berkeley will decide whether to impose a tax on sugar-sweetened beverages, the so-called soda tax. Similar attempts have failed more than two dozen times nationwide, including in the California cities of Richmond and El Monte in 2012 and in Telluride, Colorado, last year.\u003c/p>\n\u003cp>Sugar-sweetened beverages account for \u003ca title=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" href=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" target=\"_blank\">one-third of the added sugar \u003c/a>in the average American's diet, and advocates say that increasing consumption of sugar is driving up rates of Type 2 diabetes, heart disease and other health ills.\u003c/p>\n\u003cp>Opponents insist that the tax would disproportionately hurt people who are low income and that taxing people for what they choose to eat or drink is just bad policy.\u003c/p>\n\u003cp>And the opponents are spending big to drive those messages home. The \"no\" campaigns in both cities are funded largely by the American Beverage Association, which has spent more than a whopping $11 million to defeat the two measures -- $9 million in San Francisco and more than $2 million in Berkeley. Proponents have spent a mere fraction of those amounts. The biggest donor by far to either campaign is former New York City mayor Michael Bloomberg, who gave more than $600,000 and \u003ca title=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" href=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" target=\"_blank\">funded a TV ad \u003c/a>that aired during the World Series.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>San Francisco's Proposition E would levy a 2-cents-an-ounce tax, raising the price of a can of soda by 24 cents and a 12-pack almost $3. The revenue, estimated at $35 million to $54 million, is earmarked to be spent specifically on nutrition and physical activity programs. Because the tax is earmarked, it requires a two-thirds majority to pass.\u003c/p>\n\u003cp>That two-thirds majority is \"a very high hurdle,\" says Michael Jacobsen, executive director of the Washington, DC-based Center for Science in the Public Interest, but \"if San Francisco gets even 50 percent of the vote, that would be quite remarkable, and I think would send shudders through the soft drink industry.\"\u003c/p>\n\u003cp>Meanwhile, Berkeley's tax is 1-cent-an-ounce. The measure would raise more than $1 million, but the funds would go into the city's general fund -- which means it needs only a simple majority to pass.\u003c/p>\n\u003cp>Roger Salazar, spokesman for both anti-tax campaigns,\u003ca title=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" href=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" target=\"_blank\"> admits the race is tight\u003c/a>, but insists that Berkeley is no bellwether for the rest of the country.\u003c/p>\n\u003cp>Jacobsen disagrees. While Berkeley is a very progressive community, if the tax passes, \"it's a population accepting and taxing itself,\" he said. \"I think that will be an encouragement to other progressive cities and states. You can imagine Vermont, Madison, maybe Boston, thinking 'well, if they can do it in Berkeley, maybe we can do it here.'\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Mexico enacted a similar tax on January 1, and consumption of sugar-sweetened beverages dropped 10 percent by the summer.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State Issues 'Tailored' Quarantine Guidelines for Travelers from Ebola-Affected Countries",
"title": "State Issues 'Tailored' Quarantine Guidelines for Travelers from Ebola-Affected Countries",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22272\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/Ebola_002-e1414611417497.jpg\">\u003cimg class=\"size-large wp-image-22272\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/Ebola_002-640x354.jpg\" alt=\"Gov. Jerry Brown meets with state officials, including Dr. Ron Chapman, state health officer, on \" width=\"640\" height=\"354\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Jerry Brown met last week with state officials, including state health officer Dr. Ron Chapman, center left. (Brad Alexander/Office of the Governor)\u003c/figcaption>\u003c/figure>\n\u003cp>Joining other states across the country, California's health officer has now added guidelines for a \"risk-based quarantine order\" for people traveling to California from one of the three Ebola-affected West African countries, Guinea, LIberia and Sierra Leone.\u003c/p>\n\u003caside class=\"pullquote alignleft\">California's guidelines consistent with those from the Centers for Disease Control \u003c/aside>\n\u003cp>At present there are no known or suspected cases of Ebola in California.\u003c/p>\n\u003cp>The state's order is directed at anyone traveling to California from one of the affected countries who has also had contact with someone who has a confirmed case of Ebola.\u003c/p>\n\u003cp>Dr. Ron Chapman, California's health officer, said the state is establishing a \"standard protocol requiring some level of quarantine for those at highest risk of contracting and spreading Ebola.\"\u003c!--more-->\u003c/p>\n\u003cp>Unlike New York or New Jersey, where governors have mandated 21-day quarantines on people, including health care workers, who have had direct contact with Ebola patients, California's policy is more flexible.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In California, it is local health officers who have the authority to order a quarantine. They are to review each person on a \"case-by-case\" basis, the state says. Quarantine may involve \"isolation at home,\" but can also be tailored to allow people who are at lower risk fewer restrictions, such as \"observation and monitoring.\"\u003c/p>\n\u003cp>San Francisco health officer Dr. Tomas Aragon drew a distinction between the quarantine order in California and those being implemented in New York and New Jersey. \"There's always the ethical balance between the good of the community and individual rights, so we try to select the least restrictive option that achives that public health goal,\" he said.\u003c/p>\n\u003cp>\"That’s what they didn’t do back East. They jumped to the most restrictive option, and the problem with jumping to the most restrictive option is that’s hard to defend legally, especially if there’s a less restrictive option.\"\u003c/p>\n\u003cp>The order should \"protect the health and safety of Californians,\" Chapman said. He also seemed to acknowledge the tension between protecting the health of Californians at home -- and not posing an unfair burden on returning health care workers, whom he called \"great humanitarians,\" who are caring for Ebola patients in Africa.\u003c/p>\n\u003cp>\"They will be treated with respect and dignity when they come home as these important public health actions are taken,\" Chapman said.\u003c/p>\n\u003cp>Guidelines from the Centers for Disease Control were \u003ca title=\"http://www.cdc.gov/media/releases/2014/s1027-revised-guidance-monitoring.html\" href=\"http://www.cdc.gov/media/releases/2014/s1027-revised-guidance-monitoring.html\" target=\"_blank\">updated earlier this week\u003c/a> and recommend that anyone returning from one of the three countries should be monitored for 21 days after they arrive in the U.S. The CDC guidelines also call for a \"case-by-case\" review for those it categorizes as being at \"some risk.\" This includes health care workers who have directly cared for Ebola patients.\u003c/p>\n\u003cp>These workers may be subject to \"additional restrictions,\" the CDC guidelines say, \"such as controlled movement, workplace exclusions, or restrictions on other activities.\"\u003c/p>\n\u003cp>The California Department of Public Health says that its guidelines are \"consistent with CDC\" and called its order today \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">supplemental operational guidance for California local health departments.\"\u003c/span>\u003c/p>\n\u003cp>The New England Journal of Medicine \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20\" target=\"_blank\">published an editorial\u003c/a> earlier this week criticizing the governors of New York and New Jersey for imposing mandatory 21-day quarantines of health care workers returning from West Africa who have cared for Ebola patients.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaci Hickox, a nurse who was subject to mandatory quarantine after arriving at Newark International Airport from treating Ebola patients in West Africa and then transferred to Maine, \u003ca title=\"http://www.nytimes.com/2014/10/30/us/kaci-hickox-nurse-under-ebola-quarantine-threatens-lawsuit.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news\" href=\"http://www.nytimes.com/2014/10/30/us/kaci-hickox-nurse-under-ebola-quarantine-threatens-lawsuit.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news\" target=\"_blank\">says she is giving Maine's health officials \u003c/a>until tomorrow to lift her quarantine. She says she may sue the state if it does not comply.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22272\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/Ebola_002-e1414611417497.jpg\">\u003cimg class=\"size-large wp-image-22272\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/Ebola_002-640x354.jpg\" alt=\"Gov. Jerry Brown meets with state officials, including Dr. Ron Chapman, state health officer, on \" width=\"640\" height=\"354\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gov. Jerry Brown met last week with state officials, including state health officer Dr. Ron Chapman, center left. (Brad Alexander/Office of the Governor)\u003c/figcaption>\u003c/figure>\n\u003cp>Joining other states across the country, California's health officer has now added guidelines for a \"risk-based quarantine order\" for people traveling to California from one of the three Ebola-affected West African countries, Guinea, LIberia and Sierra Leone.\u003c/p>\n\u003caside class=\"pullquote alignleft\">California's guidelines consistent with those from the Centers for Disease Control \u003c/aside>\n\u003cp>At present there are no known or suspected cases of Ebola in California.\u003c/p>\n\u003cp>The state's order is directed at anyone traveling to California from one of the affected countries who has also had contact with someone who has a confirmed case of Ebola.\u003c/p>\n\u003cp>Dr. Ron Chapman, California's health officer, said the state is establishing a \"standard protocol requiring some level of quarantine for those at highest risk of contracting and spreading Ebola.\"\u003c!--more-->\u003c/p>\n\u003cp>Unlike New York or New Jersey, where governors have mandated 21-day quarantines on people, including health care workers, who have had direct contact with Ebola patients, California's policy is more flexible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In California, it is local health officers who have the authority to order a quarantine. They are to review each person on a \"case-by-case\" basis, the state says. Quarantine may involve \"isolation at home,\" but can also be tailored to allow people who are at lower risk fewer restrictions, such as \"observation and monitoring.\"\u003c/p>\n\u003cp>San Francisco health officer Dr. Tomas Aragon drew a distinction between the quarantine order in California and those being implemented in New York and New Jersey. \"There's always the ethical balance between the good of the community and individual rights, so we try to select the least restrictive option that achives that public health goal,\" he said.\u003c/p>\n\u003cp>\"That’s what they didn’t do back East. They jumped to the most restrictive option, and the problem with jumping to the most restrictive option is that’s hard to defend legally, especially if there’s a less restrictive option.\"\u003c/p>\n\u003cp>The order should \"protect the health and safety of Californians,\" Chapman said. He also seemed to acknowledge the tension between protecting the health of Californians at home -- and not posing an unfair burden on returning health care workers, whom he called \"great humanitarians,\" who are caring for Ebola patients in Africa.\u003c/p>\n\u003cp>\"They will be treated with respect and dignity when they come home as these important public health actions are taken,\" Chapman said.\u003c/p>\n\u003cp>Guidelines from the Centers for Disease Control were \u003ca title=\"http://www.cdc.gov/media/releases/2014/s1027-revised-guidance-monitoring.html\" href=\"http://www.cdc.gov/media/releases/2014/s1027-revised-guidance-monitoring.html\" target=\"_blank\">updated earlier this week\u003c/a> and recommend that anyone returning from one of the three countries should be monitored for 21 days after they arrive in the U.S. The CDC guidelines also call for a \"case-by-case\" review for those it categorizes as being at \"some risk.\" This includes health care workers who have directly cared for Ebola patients.\u003c/p>\n\u003cp>These workers may be subject to \"additional restrictions,\" the CDC guidelines say, \"such as controlled movement, workplace exclusions, or restrictions on other activities.\"\u003c/p>\n\u003cp>The California Department of Public Health says that its guidelines are \"consistent with CDC\" and called its order today \"\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">supplemental operational guidance for California local health departments.\"\u003c/span>\u003c/p>\n\u003cp>The New England Journal of Medicine \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20\" target=\"_blank\">published an editorial\u003c/a> earlier this week criticizing the governors of New York and New Jersey for imposing mandatory 21-day quarantines of health care workers returning from West Africa who have cared for Ebola patients.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaci Hickox, a nurse who was subject to mandatory quarantine after arriving at Newark International Airport from treating Ebola patients in West Africa and then transferred to Maine, \u003ca title=\"http://www.nytimes.com/2014/10/30/us/kaci-hickox-nurse-under-ebola-quarantine-threatens-lawsuit.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news\" href=\"http://www.nytimes.com/2014/10/30/us/kaci-hickox-nurse-under-ebola-quarantine-threatens-lawsuit.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news\" target=\"_blank\">says she is giving Maine's health officials \u003c/a>until tomorrow to lift her quarantine. She says she may sue the state if it does not comply.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Here's What Would Be Taxed -- or Not -- in SF, Berkeley Soda Tax Measures",
"title": "Here's What Would Be Taxed -- or Not -- in SF, Berkeley Soda Tax Measures",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"wp-image-11293 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Both San Francisco and Berkeley have \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">measures on their November ballots \u003c/a>that would institute a tax on sugar-sweetened beverages. With less than a week to go until Election Day, we're getting down to the nitty-gritty. People want to know exactly what will be taxed -- and what won't.\u003c/p>\n\u003cp>First things first: The tax is on sugar-sweetened beverages, so diet sodas would not be taxed. After all, they do not have sugar or any other sweetener that has calories. Maybe the moniker \"soda tax\" is misleading here.\u003c/p>\n\u003cp>To find out if your favorite beverage would be taxed, ask yourself the following:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Does this drink contain added sugar\u003c/strong> (or another caloric sweetener such as high-fructose corn syrup)?\u003c/li>\n\u003cli>\u003cstrong>Does this drink have significant nutritional value\u003c/strong> (such as, say, milk does)?\u003c/li>\n\u003c/ul>\n\u003cp>If you answer \"yes\" to the first question and \"no\" to the second, your beverage is most likely subject to the proposed tax.\u003c/p>\n\u003cp>Here are drinks that are subject to the tax (farther down are exempt drinks):\u003c/p>\n\u003cfigure id=\"attachment_22244\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/kalebdf/517315536/in/photolist-MHnTo-57sm4r-auQ5u1-8BaTH2-7uy9Vn-7QfxsV-3jZk2D-bvJeAP-5njkwx-7YABEo-6eXTk4-xJ8Le-h3sMLv-7h9bj4-4ECKjf-bvmvt5-7Qde5Y-8LssN2-9ZYJCb-5nAKXL-oLF3Bp-8N6CeH-oLF3Be-8CRKqm-8m2bPN-5ZHacu-hjMsM6-57PtFj-7sm6bo-6f36vu-6EdH1P-dkScku-28Ck1M-GVq4B-6Ab35o-xHoHv-z5hyD-95bcnr-auMq7M-o7MHJu-op8q9N-5bkmdM-aYXygt-a3sk3i-6f3ebE-6eY1zn-bJ15Jt-9wAxH3-nJhhUX-9497i1\">\u003cimg class=\"size-large wp-image-22244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/517315536_9197f1aee4_oREV-640x571.jpg\" alt=\"(Kaleb Fulgham/Flickr)\" width=\"640\" height=\"571\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaleb Fulgham/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sodas\u003c/strong> -- such as regular Coke, Pepsi, 7 Up, etc. (But not diet sodas.) This includes sodas in bottles and cans, as well as fountain drinks. Both the Berkeley and San Francisco measures call for taxing the syrup used to make fountain drinks. The syrup is taxed according to the largest volume, in fluid ounces, that could be produced from the sugar-sweetened syrup. For example, if a distributor sells a 12-ounce bottle of syrup and that syrup can be used to make 144 ounces of beverage, the tax is levied on the 144 ounces of beverage.\u003c!--more-->\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_20568\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\">\u003cimg class=\"size-full wp-image-20568\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\" alt=\"Gatorade was one of the 21 beverages analyzed in the study. (Mike Mozart/Flickr)\" width=\"640\" height=\"478\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-320x239.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Mozart/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sports drinks\u003c/strong>, such as Gatorade. While the Gatorade label says that there are 14 grams of sugar in each 8-ounce serving, the bottles above are 20-ounces each. That means there are 35 grams of sugar in the bottle -- the equivalent of almost nine teaspoons of sugar. Energy drinks often are sugar-sweetened as well. Ditto, Vitamin Water.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_15792\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sweetened teas \u003c/strong>are especially popular with teens. The 23.5-ounce can of Arizona Green Tea pictured above contains 51 grams of sugar -- that's more than one-third of a cup. It would be subject to the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22258\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/allison_taylor/3307487000/in/photolist-63gJDW-5vPrAu-btqGXR-CUVTd-5DZgGN-CUVUm-8bRiqi-4rSwxW-6UZuVy-5nvvoL-fzvxsH-fzKRB3-5nre8F-Dd2Nr-6ybZ2z-4r4eDb-Czkfd-pc6t1W-dD5hy-6geTcA-dS68Yj-4s6cfN-4HiB6W-cNUx5W-e2dYas-94xiiR-9Rapr-33UurF-6eymr2-6ki4NZ-87hAP-6v3MMh-5nrexp-5nvvvQ-9QEpPd-ceSzom-pTifC-4xZdru-cUY7W-uvQ6P-iB6tw-6taomm-oFNSfz-BzFfB-J3bGJ-7RUnW6-7EN4HY-5anW1j-6wxjBy-6mojej\">\u003cimg class=\"size-large wp-image-22258\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/3307487000_ae79cac0b2_oCROP-640x515.jpg\" alt=\"(Allison Richards/Flickr)\" width=\"640\" height=\"515\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Allison Richards/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While 100 percent juice drinks are exempt from the tax (see further below), drinks that contain less than that are subject to the tax. For example, according to the \u003ca title=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" href=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" target=\"_blank\">Sunny D nutrition label\u003c/a>, the product contains 5 percent juice -- and added high-fructose corn syrup. The added corn syrup triggers the tax.\u003c/p>\n\u003chr>\n\u003cp>\u003ca title=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" href=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" target=\"_blank\">San Francisco's Proposition E\u003c/a> would levy a 2-cents-per-ounce tax on sugar-sweetened beverages that have at least 25 calories per 12-ounce drink. The tax revenue generated is earmarked to be spent on health programs. Since the tax is earmarked, it needs a two-thirds supermajority to pass.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca title=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" href=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" target=\"_blank\">Berkeley's Measure D\u003c/a> would levy a penny-per-ounce tax. Berkeley's tax would be levied on sugar-sweetened beverages that contain at least two calories per ounce. The tax revenue generated would go into the general fund, but Measure D also mandates the creation of a health panel to advise the city on health programs to fund. Because the tax is not earmarked for specific programs, it requires a simple majority to pass -- 50 percent plus one vote.\u003c/p>\n\u003cp>Both taxes are levied on the distributor of the beverages. The presumption its that the tax would ultimately be paid by consumers.\u003c/p>\n\u003chr>\n\u003cp>The San Francisco and Berkeley measures exempt certain categories of drinks from the tax. Those exempted products are as follows:\u003c/p>\n\u003cfigure id=\"attachment_22237\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-e1414537072213.jpg\">\u003cimg class=\"size-large wp-image-22237\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-640x425.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Infant formula. \u003c/strong>Full disclaimer that I have no idea whether that bottle actually contains infant formula or breast milk. But you get the idea. Infant formula is not subject to a sugar-sweetened beverage tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22238\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-e1414537672703.jpg\">\u003cimg class=\"size-large wp-image-22238\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>100 percent fruit juices\u003c/strong> are not subject to the tax. Neither are 100 percent vegetable juice or 100 percent fruit and vegetable drinks. Why? They do not have added sugar or other caloric sweeteners.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large.jpg\">\u003cimg class=\"size-large wp-image-22239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large-640x427.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>All milk products\u003c/strong>, including milk alternatives such as soy milk or almond milk. Yes, this includes flavored milk, including chocolate milk. All milk products would be exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22240\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-e1414538405773.jpg\">\u003cimg class=\"size-large wp-image-22240\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Meal replacement drinks \u003c/strong>and so-called medical foods, as well as weight-loss products, are exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22260\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-e1414600313492.jpg\">\u003cimg class=\"size-large wp-image-22260\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Alcohol would be exempt from the tax. The state of California \u003ca title=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" href=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" target=\"_blank\">already taxes alcohol\u003c/a>, and according to the state board of equalization, \u003ca title=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" href=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" target=\"_blank\">state law prohibits local jurisdictions\u003c/a> from imposing excise taxes on alcohol.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22241\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-e1414538691262.jpg\">\u003cimg class=\"size-large wp-image-22241\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-640x429.jpg\" alt=\"(Kyle Wilson/Flickr)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kyle Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Flavored coffee drinks. \u003c/strong>This category of beverages is the only one I've found that is somewhat tricky. If the drinks are pre-bottled and have added sugar, they are subject to the tax. But if they are made by a barista at, say, Starbucks, then the Berkeley and San Francisco measures handle coffee drinks differently.\u003c/p>\n\u003cp>In San Francisco, drinks prepared one by one (in other words, not pre-packaged) would not be taxed. The campaign manager for Yes on Proposition E told me that trying to assess the number of pumps of sweetener for each drink would pose an administrative burden on businesses.\u003c/p>\n\u003cp>But Berkeley would tax flavored coffee drinks made individually. The distributor would pay a tax based on the quantity of sweetener used according to the printed instructions. For example, Starbucks likely provides instruction about how many pumps of sweetener to put in each drink. The distributor would pay a tax according to that calculation.\u003c/p>\n\u003cp>If you buy an unsweetened coffee and then add the sweetener yourself, that additional sweetener is not taxed. In fact, if you buy any drink and add sugar or other caloric sweetener to it after you have purchased it, the additional sweetener will not be taxed. The tax is on the beverage, not on the sugar an individual adds to it.\u003c/p>\n\u003chr>\n\u003cp>People can debate the merits of a sugar-sweetened beverage tax. The American Beverage Association\u003ca title=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" href=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" target=\"_blank\"> is spending big\u003c/a> to defeat these taxes. One of its strategies, especially in Berkeley, is to insist that Measure D contains \"loopholes,\" and that it's confusing.\u003c/p>\n\u003cp>I frankly don't find it confusing. If your favorite drink contains added sugar and has little other nutritional value, then more than likely it is subject to the tax. If it has nutritional value, such as milk or meal replacement drinks, it is not.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "If a drink contains added sugar and lacks nutritional value, it will likely be subject to the tax. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"wp-image-11293 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Both San Francisco and Berkeley have \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">measures on their November ballots \u003c/a>that would institute a tax on sugar-sweetened beverages. With less than a week to go until Election Day, we're getting down to the nitty-gritty. People want to know exactly what will be taxed -- and what won't.\u003c/p>\n\u003cp>First things first: The tax is on sugar-sweetened beverages, so diet sodas would not be taxed. After all, they do not have sugar or any other sweetener that has calories. Maybe the moniker \"soda tax\" is misleading here.\u003c/p>\n\u003cp>To find out if your favorite beverage would be taxed, ask yourself the following:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Does this drink contain added sugar\u003c/strong> (or another caloric sweetener such as high-fructose corn syrup)?\u003c/li>\n\u003cli>\u003cstrong>Does this drink have significant nutritional value\u003c/strong> (such as, say, milk does)?\u003c/li>\n\u003c/ul>\n\u003cp>If you answer \"yes\" to the first question and \"no\" to the second, your beverage is most likely subject to the proposed tax.\u003c/p>\n\u003cp>Here are drinks that are subject to the tax (farther down are exempt drinks):\u003c/p>\n\u003cfigure id=\"attachment_22244\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/kalebdf/517315536/in/photolist-MHnTo-57sm4r-auQ5u1-8BaTH2-7uy9Vn-7QfxsV-3jZk2D-bvJeAP-5njkwx-7YABEo-6eXTk4-xJ8Le-h3sMLv-7h9bj4-4ECKjf-bvmvt5-7Qde5Y-8LssN2-9ZYJCb-5nAKXL-oLF3Bp-8N6CeH-oLF3Be-8CRKqm-8m2bPN-5ZHacu-hjMsM6-57PtFj-7sm6bo-6f36vu-6EdH1P-dkScku-28Ck1M-GVq4B-6Ab35o-xHoHv-z5hyD-95bcnr-auMq7M-o7MHJu-op8q9N-5bkmdM-aYXygt-a3sk3i-6f3ebE-6eY1zn-bJ15Jt-9wAxH3-nJhhUX-9497i1\">\u003cimg class=\"size-large wp-image-22244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/517315536_9197f1aee4_oREV-640x571.jpg\" alt=\"(Kaleb Fulgham/Flickr)\" width=\"640\" height=\"571\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaleb Fulgham/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sodas\u003c/strong> -- such as regular Coke, Pepsi, 7 Up, etc. (But not diet sodas.) This includes sodas in bottles and cans, as well as fountain drinks. Both the Berkeley and San Francisco measures call for taxing the syrup used to make fountain drinks. The syrup is taxed according to the largest volume, in fluid ounces, that could be produced from the sugar-sweetened syrup. For example, if a distributor sells a 12-ounce bottle of syrup and that syrup can be used to make 144 ounces of beverage, the tax is levied on the 144 ounces of beverage.\u003c!--more-->\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_20568\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\">\u003cimg class=\"size-full wp-image-20568\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\" alt=\"Gatorade was one of the 21 beverages analyzed in the study. (Mike Mozart/Flickr)\" width=\"640\" height=\"478\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-320x239.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Mozart/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sports drinks\u003c/strong>, such as Gatorade. While the Gatorade label says that there are 14 grams of sugar in each 8-ounce serving, the bottles above are 20-ounces each. That means there are 35 grams of sugar in the bottle -- the equivalent of almost nine teaspoons of sugar. Energy drinks often are sugar-sweetened as well. Ditto, Vitamin Water.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_15792\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sweetened teas \u003c/strong>are especially popular with teens. The 23.5-ounce can of Arizona Green Tea pictured above contains 51 grams of sugar -- that's more than one-third of a cup. It would be subject to the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22258\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/allison_taylor/3307487000/in/photolist-63gJDW-5vPrAu-btqGXR-CUVTd-5DZgGN-CUVUm-8bRiqi-4rSwxW-6UZuVy-5nvvoL-fzvxsH-fzKRB3-5nre8F-Dd2Nr-6ybZ2z-4r4eDb-Czkfd-pc6t1W-dD5hy-6geTcA-dS68Yj-4s6cfN-4HiB6W-cNUx5W-e2dYas-94xiiR-9Rapr-33UurF-6eymr2-6ki4NZ-87hAP-6v3MMh-5nrexp-5nvvvQ-9QEpPd-ceSzom-pTifC-4xZdru-cUY7W-uvQ6P-iB6tw-6taomm-oFNSfz-BzFfB-J3bGJ-7RUnW6-7EN4HY-5anW1j-6wxjBy-6mojej\">\u003cimg class=\"size-large wp-image-22258\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/3307487000_ae79cac0b2_oCROP-640x515.jpg\" alt=\"(Allison Richards/Flickr)\" width=\"640\" height=\"515\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Allison Richards/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While 100 percent juice drinks are exempt from the tax (see further below), drinks that contain less than that are subject to the tax. For example, according to the \u003ca title=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" href=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" target=\"_blank\">Sunny D nutrition label\u003c/a>, the product contains 5 percent juice -- and added high-fructose corn syrup. The added corn syrup triggers the tax.\u003c/p>\n\u003chr>\n\u003cp>\u003ca title=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" href=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" target=\"_blank\">San Francisco's Proposition E\u003c/a> would levy a 2-cents-per-ounce tax on sugar-sweetened beverages that have at least 25 calories per 12-ounce drink. The tax revenue generated is earmarked to be spent on health programs. Since the tax is earmarked, it needs a two-thirds supermajority to pass.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" href=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" target=\"_blank\">Berkeley's Measure D\u003c/a> would levy a penny-per-ounce tax. Berkeley's tax would be levied on sugar-sweetened beverages that contain at least two calories per ounce. The tax revenue generated would go into the general fund, but Measure D also mandates the creation of a health panel to advise the city on health programs to fund. Because the tax is not earmarked for specific programs, it requires a simple majority to pass -- 50 percent plus one vote.\u003c/p>\n\u003cp>Both taxes are levied on the distributor of the beverages. The presumption its that the tax would ultimately be paid by consumers.\u003c/p>\n\u003chr>\n\u003cp>The San Francisco and Berkeley measures exempt certain categories of drinks from the tax. Those exempted products are as follows:\u003c/p>\n\u003cfigure id=\"attachment_22237\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-e1414537072213.jpg\">\u003cimg class=\"size-large wp-image-22237\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-640x425.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Infant formula. \u003c/strong>Full disclaimer that I have no idea whether that bottle actually contains infant formula or breast milk. But you get the idea. Infant formula is not subject to a sugar-sweetened beverage tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22238\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-e1414537672703.jpg\">\u003cimg class=\"size-large wp-image-22238\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>100 percent fruit juices\u003c/strong> are not subject to the tax. Neither are 100 percent vegetable juice or 100 percent fruit and vegetable drinks. Why? They do not have added sugar or other caloric sweeteners.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large.jpg\">\u003cimg class=\"size-large wp-image-22239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large-640x427.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>All milk products\u003c/strong>, including milk alternatives such as soy milk or almond milk. Yes, this includes flavored milk, including chocolate milk. All milk products would be exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22240\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-e1414538405773.jpg\">\u003cimg class=\"size-large wp-image-22240\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Meal replacement drinks \u003c/strong>and so-called medical foods, as well as weight-loss products, are exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22260\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-e1414600313492.jpg\">\u003cimg class=\"size-large wp-image-22260\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Alcohol would be exempt from the tax. The state of California \u003ca title=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" href=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" target=\"_blank\">already taxes alcohol\u003c/a>, and according to the state board of equalization, \u003ca title=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" href=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" target=\"_blank\">state law prohibits local jurisdictions\u003c/a> from imposing excise taxes on alcohol.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22241\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-e1414538691262.jpg\">\u003cimg class=\"size-large wp-image-22241\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-640x429.jpg\" alt=\"(Kyle Wilson/Flickr)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kyle Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Flavored coffee drinks. \u003c/strong>This category of beverages is the only one I've found that is somewhat tricky. If the drinks are pre-bottled and have added sugar, they are subject to the tax. But if they are made by a barista at, say, Starbucks, then the Berkeley and San Francisco measures handle coffee drinks differently.\u003c/p>\n\u003cp>In San Francisco, drinks prepared one by one (in other words, not pre-packaged) would not be taxed. The campaign manager for Yes on Proposition E told me that trying to assess the number of pumps of sweetener for each drink would pose an administrative burden on businesses.\u003c/p>\n\u003cp>But Berkeley would tax flavored coffee drinks made individually. The distributor would pay a tax based on the quantity of sweetener used according to the printed instructions. For example, Starbucks likely provides instruction about how many pumps of sweetener to put in each drink. The distributor would pay a tax according to that calculation.\u003c/p>\n\u003cp>If you buy an unsweetened coffee and then add the sweetener yourself, that additional sweetener is not taxed. In fact, if you buy any drink and add sugar or other caloric sweetener to it after you have purchased it, the additional sweetener will not be taxed. The tax is on the beverage, not on the sugar an individual adds to it.\u003c/p>\n\u003chr>\n\u003cp>People can debate the merits of a sugar-sweetened beverage tax. The American Beverage Association\u003ca title=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" href=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" target=\"_blank\"> is spending big\u003c/a> to defeat these taxes. One of its strategies, especially in Berkeley, is to insist that Measure D contains \"loopholes,\" and that it's confusing.\u003c/p>\n\u003cp>I frankly don't find it confusing. If your favorite drink contains added sugar and has little other nutritional value, then more than likely it is subject to the tax. If it has nutritional value, such as milk or meal replacement drinks, it is not.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "State Set to Move Rural Seniors, Disabled to Medi-Cal Managed Care",
"title": "State Set to Move Rural Seniors, Disabled to Medi-Cal Managed Care",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5429\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-e1383937340166.jpg\">\u003cimg class=\"size-large wp-image-5429\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-620x465.jpg\" alt=\"(Ben Ramirez: Flickr)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ben Ramirez/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>About one month from now, the state is launching a program to shift a new set of Medi-Cal beneficiaries into Medi-Cal managed care plans. This time, the state is focusing on a shift in care for some of the frailest patients in rural counties.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Among many of these frail beneficiaries, there is deep fear about what's about to happen.\u003c/aside>\n\u003cp>On Dec. 1, about \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" target=\"_blank\">20,000 Medi-Cal seniors and persons with disabilities\u003c/a> in 28 rural counties will make the switch to managed care plans. It's a continuation of an extended effort by the state to expand Medi-Cal managed care to rural areas, said Mari Cantwell, chief deputy director of health care programs at the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"We started the rural expansion about a year ago, starting with non-disabled adults and children in 28 counties,\" Cantwell said. \"Still pending are the population of seniors and persons with disabilities (SPD's). That's not a very large number of people in comparison, about 20,000 people.\"\u003c!--more-->\u003c/p>\n\u003cp>However, it is a population with some big challenges, Cantwell said -- people with multiple conditions, medications and providers. That makes the transition tricky -- and also points out its importance, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"From our perspective, our managed care plans are able to provide better integrated care, they are doing risk assessments to see where the gaps in care might be,\" Cantwell said.\u003c/p>\n\u003cp>\"It is really about improving care so they can have their health plan help them navigate the system,\" she said.\u003c/p>\n\u003cp>Among many of these frail beneficiaries, though, there is deep fear about what's about to happen, said Steve Barrow, president and CEO of Advocates for Health, Economics and Development, a not-for-profit advocacy group for underserved areas, including rural California counties.\u003c/p>\n\u003cp>\"Just put yourself in their place,\" Barrow said. \"You establish specialty care in some place like Redding or Reno, and if you can't go to the same place, it would be pretty scary.\"\u003c/p>\n\u003cp>Rural counties have an alarming lack of specialty providers, Barrow said, so people might have difficulty finding one who treats their particular problem -- or set of problems -- within a manageable distance. And it's not just beneficiaries who have concerns about this particular transition, he said.\u003c/p>\n\u003cp>\"For the provider, it's scary because you're not sure you can handle all of these patients' problems [at managed care reimbursement rates]. And for health plans it's scary taking on these complex patients, because they're wondering now, \"How do we not lose our shirts on these patients?,\" Barrow said. \"There's plenty of fear to go around.\"\u003c/p>\n\u003cp>Rural care is more challenging because of the distances involved, on top of the scarcity of providers, Barrow said.\u003c/p>\n\u003cp>\"In rural areas you have extreme difficulties to establish specialists in the first place. There's also a huge shortage of primary care physicians in rural areas,\" Barrow said. \"I mean, the landscape is already difficult for people who are healthy.\"\u003c/p>\n\u003cp>Add in the inexperience of rural counties in dealing with managed care and you have a situation that's more difficult than any other state transition to Medi-Cal managed care, Barrow said.\u003cbr>\n\"They call it a safety net for a reason,\" Barrow said. \"It's very thin. It may be a small number of people, but this is big impact.\"\u003c/p>\n\u003cp>Cantwell said the department is aware of all of these concerns and officials hope to make this transition smoother than some of the others have been.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We certainly have applied lessons learned,\" Cantwell said. \"We are making sure health plans have data on people in advance of being enrolled in the plans. We are making sure there is more clarity on the continuity-of-care provision.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5429\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-e1383937340166.jpg\">\u003cimg class=\"size-large wp-image-5429\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-620x465.jpg\" alt=\"(Ben Ramirez: Flickr)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ben Ramirez/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>About one month from now, the state is launching a program to shift a new set of Medi-Cal beneficiaries into Medi-Cal managed care plans. This time, the state is focusing on a shift in care for some of the frailest patients in rural counties.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Among many of these frail beneficiaries, there is deep fear about what's about to happen.\u003c/aside>\n\u003cp>On Dec. 1, about \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" target=\"_blank\">20,000 Medi-Cal seniors and persons with disabilities\u003c/a> in 28 rural counties will make the switch to managed care plans. It's a continuation of an extended effort by the state to expand Medi-Cal managed care to rural areas, said Mari Cantwell, chief deputy director of health care programs at the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"We started the rural expansion about a year ago, starting with non-disabled adults and children in 28 counties,\" Cantwell said. \"Still pending are the population of seniors and persons with disabilities (SPD's). That's not a very large number of people in comparison, about 20,000 people.\"\u003c!--more-->\u003c/p>\n\u003cp>However, it is a population with some big challenges, Cantwell said -- people with multiple conditions, medications and providers. That makes the transition tricky -- and also points out its importance, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"From our perspective, our managed care plans are able to provide better integrated care, they are doing risk assessments to see where the gaps in care might be,\" Cantwell said.\u003c/p>\n\u003cp>\"It is really about improving care so they can have their health plan help them navigate the system,\" she said.\u003c/p>\n\u003cp>Among many of these frail beneficiaries, though, there is deep fear about what's about to happen, said Steve Barrow, president and CEO of Advocates for Health, Economics and Development, a not-for-profit advocacy group for underserved areas, including rural California counties.\u003c/p>\n\u003cp>\"Just put yourself in their place,\" Barrow said. \"You establish specialty care in some place like Redding or Reno, and if you can't go to the same place, it would be pretty scary.\"\u003c/p>\n\u003cp>Rural counties have an alarming lack of specialty providers, Barrow said, so people might have difficulty finding one who treats their particular problem -- or set of problems -- within a manageable distance. And it's not just beneficiaries who have concerns about this particular transition, he said.\u003c/p>\n\u003cp>\"For the provider, it's scary because you're not sure you can handle all of these patients' problems [at managed care reimbursement rates]. And for health plans it's scary taking on these complex patients, because they're wondering now, \"How do we not lose our shirts on these patients?,\" Barrow said. \"There's plenty of fear to go around.\"\u003c/p>\n\u003cp>Rural care is more challenging because of the distances involved, on top of the scarcity of providers, Barrow said.\u003c/p>\n\u003cp>\"In rural areas you have extreme difficulties to establish specialists in the first place. There's also a huge shortage of primary care physicians in rural areas,\" Barrow said. \"I mean, the landscape is already difficult for people who are healthy.\"\u003c/p>\n\u003cp>Add in the inexperience of rural counties in dealing with managed care and you have a situation that's more difficult than any other state transition to Medi-Cal managed care, Barrow said.\u003cbr>\n\"They call it a safety net for a reason,\" Barrow said. \"It's very thin. It may be a small number of people, but this is big impact.\"\u003c/p>\n\u003cp>Cantwell said the department is aware of all of these concerns and officials hope to make this transition smoother than some of the others have been.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We certainly have applied lessons learned,\" Cantwell said. \"We are making sure health plans have data on people in advance of being enrolled in the plans. We are making sure there is more clarity on the continuity-of-care provision.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds",
"title": "Fresno Pilots Asthma Program Aimed at Tapping Investors for Funds",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22223\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A.jpg\">\u003cimg class=\"size-large wp-image-22223\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/asthma-12A-640x426.jpg\" alt=\"Maura Vasquez tells health educator Nunu Sixay during a home visit on Tuesday, September 9, 2014, that her son, Jovani Garcia-Vasquez, 6, has not visited the emergency room since learning that administering his medication more regularly could help alleviate his asthma symptoms (Heidi de Marco/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">During a home visit Maura Vasquez (R) tells health educator Nunu Sixay that her son, Jovani, 6, has not been to the E.R. since learning that administering his medication more regularly could help alleviate his asthma. (Heidi de Marco/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" href=\"http://kaiserhealthnews.org/news/the-latest-in-public-health-funding-tapping-investors/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Inside her single-story home in the dry and dusty Central Valley, Dalia Mondragon scarcely sleeps. Several times a night, she tiptoes into her children’s rooms to make sure their chests are peacefully rising and falling.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Under the approach, investors fund a social impact bond; if a social program saves money -- investors make money.\u003c/aside>\n\u003cp>“I feel like any time they could stop breathing,” she says.\u003c/p>\n\u003cp>Mondragon and all four of her children have asthma -– a disease that has sent them to the hospital more times than she can count. So she is more than willing to open her home to Nunu Sixay, an asthma prevention worker trying to figure out what is triggering the attacks. On a recent visit, Sixay found some possible culprits: mold in the bathroom and aerosol furniture polish in the kitchen.\u003c/p>\n\u003cp>Sixay’s work visiting low-income families like the Mondragons is part of a public health experiment to help asthmatic children breathe easier and stay out of costly emergency rooms – with the aim of getting investors to pay for it.\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 plan is to create a “social impact bond,” a contract in which Wall Street and other investors agree to support programs with goals such as taxpayer savings and improved health outcomes. If the programs can demonstrate with solid evidence that they have met those goals, the investors recoup their principal and get a return, typically from the government.\u003c/p>\n\u003cp>The asthma project is among the first to focus on improving health outcomes. But a rising number of “pay for success” projects are planned or underway around the nation, including in Ohio, Connecticut, South Carolina and Massachusetts. One seeks to expand early childhood education in Utah, for instance, and another to reduce homelessness in Colorado.\u003c/p>\n\u003cp>Typically, private investors or foundations provide at least a portion of the seed money. Bank of America Merrill Lynch, for instance, raised $13.5 million from its investors for a New York project aimed at reducing recidivism and increasing employment among former inmates. Depending on the outcomes, which must be evaluated by an independent third party, the government will repay the investors and provide a return. Generally, it is a slice of taxpayer savings, ranging from 5 to 12 percent of the original investment.\u003c/p>\n\u003cp>“We were all excited about the idea of a whole new form of impact investing,” said Kirstin Hill, a managing director in Merrill Lynch’s global wealth management business.\u003c/p>\n\u003cp>The bonds, which first were devised in England, appeal to investors who want to see part of their portfolio go toward what they see as a social good. “People with lots of money are anxious to invest at least a portion in things like this, especially if you give them a reasonable return,” said John Vogel, who teaches business administration at Dartmouth’s Tuck School of Business.\u003c/p>\n\u003cp>Critics, however, say it’s too early to see what impact the bonds will have, and question whether the effects can be accurately measured. Some are skeptical that many private firms will invest.\u003c/p>\n\u003cp>\u003cstrong>Growing The Pie\u003c/strong>\u003c/p>\n\u003cp>Organizations are looking for ways to “grow the pie of funding that is available to the social sector” rather than relying only on philanthropic and government funds, said Rick Brush, CEO of Collective Health. The Connecticut company is helping to organize the Fresno project with Social Finance, a Boston nonprofit that designs social impact bonds.\u003c/p>\n\u003cp>Nirav Shah, director of Social Finance, said numerous health programs have a significant impact on patients but are outside of clinical settings so aren’t typically reimbursed by insurers.\u003c/p>\n\u003cp>In the asthma program, for example, a social impact bond could pay for home renovations such as stripping out carpet or getting rid of mold.\u003c/p>\n\u003cp>The Fresno project is still in its pilot stage: Organizers won’t start reaching out to investors until late next year Funding from banks, individuals and foundations would enable the asthma prevention program to expand from about 200 children to 3,500, they said. In this case, the returns could come from either the state or insurers, Shah said.\u003c/p>\n\u003cp>The pilot program, which is funded by a grant of about $1 million from The California Endowment, is using claims data to track ER visits and measure the savings before turning to investors. The estimated savings per child is more than $7,700.\u003c/p>\n\u003cp>\u003cstrong>Taking It To Heart\u003c/strong>\u003c/p>\n\u003cp>In Fresno, asthma prevention workers ask parents to commit to three changes in the home to help prevent asthma attacks. Throughout the year, they follow up with in-person visits and phone calls. “The little knowledge we give them they really take it to heart,” Sixay said.\u003c/p>\n\u003cp>One recent day, Sixay stopped by the cramped house of 6-year-old Jovani Garcia-Vasquez. His mother, Maura Vasquez, said she used to rush her son to the hospital every time he had an asthma flare-up. She said that a doctor had advised her not to give the inhaler to her son because he could get addicted to Albuterol. “So I didn’t give it to him, hardly ever,” she said.\u003c/p>\n\u003cp>After learning from Sixay that the medication actually helps relieve the asthma symptoms, Vasquez began administering it more regularly. She said she hasn’t had to take him to the ER since.\u003c/p>\n\u003cp>“I didn’t know how to help him,” she said. “Now I know.”\u003c/p>\n\u003cp>Sixay sat down with Jovani and asked him to point to faces that showed how he felt. When she asked “How is your asthma today?” he pointed to a happy face.\u003c/p>\n\u003cp>Sixay, who works for the Central California Asthma Collaborative, said she is taking small steps toward solving a big problem. Fresno has one of the highest childhood asthma rates in California, with a fifth of children ages 5 to 17 affected. The county also has high rates of asthma-related pediatric emergency room visits and hospitalizations, paid for primarily by Medi-Cal, California’s public insurance program for poor people. All told, about $35 million is spent countywide per year for hospital costs for children with asthma, according to Collective Health and Social Finance.\u003c/p>\n\u003cp>The region has relatively poor air quality, said Vipul Jain, a professor at UC San Francisco and pulmonologist at Fresno’s Community Regional Medical Center. “It’s this recurrent, vicious glob [of bad air] that never lets them free,” he said. Poverty, lack of regular care and poor housing conditions also contribute to high hospitalization rates, he said.\u003c/p>\n\u003cp>Jain said home interventions can certainly help, but good self-management, disease education and clinical care also are needed. Otherwise, “it’s not realistic to expect a significant change,” he said.\u003c/p>\n\u003cp>The Fresno project is collaborating with Clinica Sierra Vista, a community health center in Fresno, which is providing ongoing medical care. Each day, the clinic’s doctors see asthmatic children like Jose Lomelli, 11.\u003c/p>\n\u003cp>On a recent September morning, Jose’s mother, Hopie Castro, took him to the doctor because he was coughing and using his inhaler every few hours and she worried he would have to go to the emergency room.\u003c/p>\n\u003cp>Jose missed about a fifth of the last school year because of asthma and has gone to the hospital more than 15 times in the past several years, Castro said.\u003c/p>\n\u003cp>Dr. Kami Jow listened to Jose breathe and confirmed that he was having an asthma attack. He prescribed steroids, and he corrected him on using his inhaler so the medicine would flow into his lungs.\u003c/p>\n\u003cp>“How do I know when to take him to the emergency room?” she asked.\u003c/p>\n\u003cp>“You’ll see him working really hard to breathe,” he said.\u003c/p>\n\u003cp>Jow said he often sees families who don’t know what leads to asthma attacks or how or when to use medication. Rarely, he said, does he have the time to educate them thoroughly about the disease.\u003c/p>\n\u003cp>That’s where workers like Sixay come in.\u003c/p>\n\u003cp>She sees a lot of progress but faces occasional setbacks. The Mondragons, for instance, had made improvements at home –- then recently got a kitten. It’s cute, she told the family, but not good for the airways.\u003c/p>\n\u003cp>“It’s a process,” she said. “They are not all going to change overnight.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Five UC Hospitals Now Designated for Ebola Care",
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"content": "\u003cfigure id=\"attachment_22211\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/niallkennedy/23702800/in/photolist-36u1Y-fQENmN-a2k54V-a2k4di-fuTBNn-fv8VmC-fv8Vr5-aAJVmL-9XwVkc-9Zng3S-86ABEV-9z5yut-a5yBSs-gUUWm-bEhY1G-br6i7T-hEkThR-7fffPx-foVSaL-aAGbKz-c1TXUN-5txUFW-a5vAda-9w6Rby-8rCiUY-5ttuPi-9NBbVC-9NBaz7-9NBKoE-9NBPoY-9NyBcH-9NBSbf-9NBR5E-9NBeCo-86DJ8U-9NBnrw-9NytPn-86AyvH-9NBMx3-9NBddh-5txNjs-8K7gb8-8Kajgo-8KajEh-2itVUX-86Awkc-ockNaD-nT56zf-7MZnGe-7fjcXj\">\u003cimg class=\"size-large wp-image-22211\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/23702800_3537341e4e_o-640x326.jpg\" alt=\"UCSF is one of the five centers designated. (Niall Kennedy/Flickr)\" width=\"640\" height=\"326\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF is one of the five centers designated. (Niall Kennedy/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The five medical centers of the University of California \u003ca title=\"http://www.cdph.ca.gov/Pages/NR14-088.aspx\" href=\"http://www.cdph.ca.gov/Pages/NR14-088.aspx\" target=\"_blank\">will serve as designated Ebola treatment centers\u003c/a> should a person in the state become ill from the virus.\u003c/p>\n\u003cp>While public health officials are calling on all hospitals in California to redouble preparations for screening and isolating patients at risk for Ebola, those who are confirmed to have the virus will be transferred to a UC medical center in San Francisco, Davis, Irvine, Los Angeles, or San Diego.\u003c/p>\n\u003cp>“As a public university, stepping up to a public health crisis, like a potential Ebola outbreak, is what we do,” says Brooke Converse, spokesperson for the UC Office of the President. “Our overall mission as the University of California is to serve Californians and serve the taxpayers and the public.”\u003c!--more-->\u003c/p>\n\u003cp>Dr. Josh Adler, chief medical officer at UCSF Medical Center, says it makes sense to consolidate care to a handful hospitals. It can take two to three weeks to recover from Ebola and requires an incredible amount of resources for hospitals to provide the rigorous level care and infection control that's needed.\u003c/p>\n\u003cp>“It's easier to imagine that happening well in a smaller number of places that have really focused on it, rather than every hospital being able to sustain that for weeks on end,” he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still, even with the geographic spread of the UC Medical Centers, there are still gaps in the state, like the Central Valley, that do not have a designated Ebola treatment center. Adler says it would be good to have a few more hospitals so that patients who may become ill would not have to travel so far to be transferred.\u003c/p>\n\u003cp>The California Hospital Association says it plans to release a list next week of additional hospitals that will be able to receive patients with a confirmed diagnosis. Earlier this week Kaiser Northern California said that any Ebola patients that present within its system \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/23/california-hospitals-prepare-for-ebola/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/23/california-hospitals-prepare-for-ebola/\" target=\"_blank\">will be treated at one of two of its hospitals\u003c/a> -- Kaiser Oakland or Kaiser South Sacramento.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At present, there are no known or suspected cases of Ebola in California.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22211\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/niallkennedy/23702800/in/photolist-36u1Y-fQENmN-a2k54V-a2k4di-fuTBNn-fv8VmC-fv8Vr5-aAJVmL-9XwVkc-9Zng3S-86ABEV-9z5yut-a5yBSs-gUUWm-bEhY1G-br6i7T-hEkThR-7fffPx-foVSaL-aAGbKz-c1TXUN-5txUFW-a5vAda-9w6Rby-8rCiUY-5ttuPi-9NBbVC-9NBaz7-9NBKoE-9NBPoY-9NyBcH-9NBSbf-9NBR5E-9NBeCo-86DJ8U-9NBnrw-9NytPn-86AyvH-9NBMx3-9NBddh-5txNjs-8K7gb8-8Kajgo-8KajEh-2itVUX-86Awkc-ockNaD-nT56zf-7MZnGe-7fjcXj\">\u003cimg class=\"size-large wp-image-22211\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/23702800_3537341e4e_o-640x326.jpg\" alt=\"UCSF is one of the five centers designated. (Niall Kennedy/Flickr)\" width=\"640\" height=\"326\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF is one of the five centers designated. (Niall Kennedy/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The five medical centers of the University of California \u003ca title=\"http://www.cdph.ca.gov/Pages/NR14-088.aspx\" href=\"http://www.cdph.ca.gov/Pages/NR14-088.aspx\" target=\"_blank\">will serve as designated Ebola treatment centers\u003c/a> should a person in the state become ill from the virus.\u003c/p>\n\u003cp>While public health officials are calling on all hospitals in California to redouble preparations for screening and isolating patients at risk for Ebola, those who are confirmed to have the virus will be transferred to a UC medical center in San Francisco, Davis, Irvine, Los Angeles, or San Diego.\u003c/p>\n\u003cp>“As a public university, stepping up to a public health crisis, like a potential Ebola outbreak, is what we do,” says Brooke Converse, spokesperson for the UC Office of the President. “Our overall mission as the University of California is to serve Californians and serve the taxpayers and the public.”\u003c!--more-->\u003c/p>\n\u003cp>Dr. Josh Adler, chief medical officer at UCSF Medical Center, says it makes sense to consolidate care to a handful hospitals. It can take two to three weeks to recover from Ebola and requires an incredible amount of resources for hospitals to provide the rigorous level care and infection control that's needed.\u003c/p>\n\u003cp>“It's easier to imagine that happening well in a smaller number of places that have really focused on it, rather than every hospital being able to sustain that for weeks on end,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, even with the geographic spread of the UC Medical Centers, there are still gaps in the state, like the Central Valley, that do not have a designated Ebola treatment center. Adler says it would be good to have a few more hospitals so that patients who may become ill would not have to travel so far to be transferred.\u003c/p>\n\u003cp>The California Hospital Association says it plans to release a list next week of additional hospitals that will be able to receive patients with a confirmed diagnosis. Earlier this week Kaiser Northern California said that any Ebola patients that present within its system \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/23/california-hospitals-prepare-for-ebola/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/23/california-hospitals-prepare-for-ebola/\" target=\"_blank\">will be treated at one of two of its hospitals\u003c/a> -- Kaiser Oakland or Kaiser South Sacramento.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At present, there are no known or suspected cases of Ebola in California.\u003c/p>\n\n\u003c/div>\u003c/p>",
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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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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"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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"soldout": {
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"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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"tagline": "Local news to keep you rooted",
"info": "Host Devin Katayama walks you through the biggest story of the day with reporters and newsmakers.",
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