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"disqusTitle": "Why Advocates Say Brown's Veto of Livestock Antibiotics Bill is a Good Thing",
"title": "Why Advocates Say Brown's Veto of Livestock Antibiotics Bill is a Good Thing",
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"content": "\u003cfigure id=\"attachment_21893\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000005811185_Large-e1412270269953.jpg\">\u003cimg class=\"size-large wp-image-21893\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000005811185_Large-640x424.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB835\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB835\" target=\"_blank\">Senate Bill 835\u003c/a> was crafted as a measure aimed at limiting antibiotic use in livestock. To those concerned about the growing problem of antibiotic resistance, it might seem surprising that Gov. Jerry Brown vetoed the bill earlier this week. Yet advocates believe that in striking down the bill, California is poised to take a leading role on the issue.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'The governor sent a message that he isn’t going to accept fig-leaf solutions to tackle this problem.' -- Natural Resources Defense Council spokesman \u003c/aside>\n\u003cp>Here's why: Critics had assailed the bill as too industry-friendly and unlikely to make much impact on antibiotic resistance.\u003c/p>\n\u003cp>SB835 would have codified a recent Food and Drug Administration \u003ca title=\"http://www.npr.org/blogs/thesalt/2012/04/11/150432234/fda-launches-voluntary-plan-to-reduce-use-of-antibiotics-in-animals\" href=\"http://www.npr.org/blogs/thesalt/2012/04/11/150432234/fda-launches-voluntary-plan-to-reduce-use-of-antibiotics-in-animals\" target=\"_blank\">voluntary ban\u003c/a> on the use of antibiotics for growth-promoting purposes. The measure had sailed through the Legislature. But a coalition, including the Natural Resources Defense Council (NRDC), Consumers Union and several leading medical experts on antibiotic resistance, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">quietly created a campaign\u003c/a> urging the governor to veto the bill.\u003c!--more-->\u003c/p>\n\u003cp>The reformers argued that bolder action is needed because the use of antibiotics in farm animals remains prolific. Livestock consume an estimated 80 percent of all antibiotics in the U.S. Opponents of the bill argued that the bill left open a gaping loophole. They say some meat producers continue to use antibiotics for growth-promoting purposes and can do so legally by simply claiming they are doing so for disease prevention purposes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jonathan Kaplan, director of the NRDC’s food and agricultural program, says his organization had several meetings with Brown staffers in which they outlined reasons why Brown should veto the bill. “Mostly they just listened,\" he said. \"They were very focused on understanding what the bill would actually do and how it would impact antibiotic use.\"\u003c/p>\n\u003cp>It seems the advocates' message got through. In \u003ca title=\"http://gov.ca.gov/docs/SB_835_Veto_Message.pdf\" href=\"http://gov.ca.gov/docs/SB_835_Veto_Message.pdf\" target=\"_blank\">his veto statement\u003c/a>, the governor noted:\u003c/p>\n\u003cblockquote>\u003cp>The Centers for Disease Control and Prevention estimates conservatively that at least two million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States each year. Scientists around the world are warning that we are over-using these life-saving medicines in both human medicine and to raise animals.\u003c/p>\u003c/blockquote>\n\u003cp>Brown directed the state's Department of Food and Agriculture to work with legislators to find \"new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.\"\u003c/p>\n\u003cp>“The governor sent a message that he isn’t going to accept fig-leaf solutions to tackle this problem,” Kaplan said.\u003c/p>\n\u003cp>It would be hard not to see the veto as a rebuke of the California Assembly's Agricultural Committee. Earlier this year a more reform-minded antibiotics and livestock bill, sponsored by Assemblyman Kevin Mullin (D-San Mateo), \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/04/23/california-legislature-to-consider-antibiotic-ban-in-animals/\" href=\"http://ww2.kqed.org/stateofhealth/2014/04/23/california-legislature-to-consider-antibiotic-ban-in-animals/\" target=\"_blank\">was up for an initial vote\u003c/a> in the committee. Mullin’s bill would have made reporting antibiotic use a legal requirement, something public health experts say is badly needed in the U.S., and cut down on disease prevention loopholes.\u003c/p>\n\u003cp>At the time I interviewed one of the bill’s opponents, Bill Mattos, president of the California Poultry Federation. Mattos seemed surprised that the Mullin bill would even merit a story. With the seasoned air of a lobbyist who knows how to count votes, Mattos told me that the “Mullin bill was going nowhere.” He said that it was going to be killed in committee. Mattos suggested I instead cover the “more reasonable” Hill bill.\u003c/p>\n\u003cp>Mullin could count votes, too. Facing a near-unanimous defeat, the assemblyman withdrew his bill. \"Better to fight another day,\" said Mullin’s dejected-sounding chief of staff, Hugh Bower.\u003c/p>\n\u003cp>Committee members left no doubt they would have indeed rejected Mullin’s bill. In a hearing, committee chair Susan Talamantes Eggman (D-Stockton) suggested that the earlier bill had been insulting to veterinarians. “I happen to know the vet at Foster Farms, who is a seasoned professional.” Eggman went on to say that she thought that the Foster Farms veterinarian would no more abuse his license than she would as a licensed social worker.\u003c/p>\n\u003cp>But serious concerns about antibiotic practices at large chicken companies like Foster Farms are growing.\u003c/p>\n\u003cp>Last month a \u003ca title=\"http://www.reuters.com/investigates/special-report/farmaceuticals-the-drugs-fed-to-farm-animals-and-the-risks-posed-to-humans/\" href=\"http://www.reuters.com/investigates/special-report/farmaceuticals-the-drugs-fed-to-farm-animals-and-the-risks-posed-to-humans/\" target=\"_blank\">hard-hitting Reuters investigation\u003c/a> detailed how the nation’s largest poultry producers continue to routinely feed chickens an array of antibiotics -– not just when sickness strikes, but as standard practice.\u003c/p>\n\u003cp>In 2013 an antibiotic-resistant form of salmonella linked to Foster Farms chicken \u003ca title=\"http://www.cdc.gov/salmonella/heidelberg-10-13/\" href=\"http://www.cdc.gov/salmonella/heidelberg-10-13/\" target=\"_blank\">hospitalized hundreds of people\u003c/a>, mostly in California. Many patients had serious complications, including blood poisoning. A CDC official who helped investigate the outbreak told Reuters that the use of \u003ca title=\"http://iaspub.epa.gov/tdb/pages/contaminant/contaminantOverview.do?contaminantId=10240\" href=\"http://iaspub.epa.gov/tdb/pages/contaminant/contaminantOverview.do?contaminantId=10240\" target=\"_blank\">chlortetracycline\u003c/a> and penicillin by Foster Farms could have contributed to the resistance patterns.\u003c/p>\n\u003cp>Last week the company\u003ca title=\"http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-060-2014-release\" href=\"http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-060-2014-release\" target=\"_blank\"> issued a new recal\u003c/a>l for frozen chicken they say could be contaminated with listeria. No one has contracted the disease, but listeria is one of the most frightening foodborne illnesses. A \u003ca title=\"http://www.cdc.gov/listeria/outbreaks/cantaloupes-jensen-farms/082712/\" href=\"http://www.cdc.gov/listeria/outbreaks/cantaloupes-jensen-farms/082712/\" target=\"_blank\">2011-2012 outbreak\u003c/a>, traced to cantaloupes, killed 33 people.\u003c/p>\n\u003cp>The treatment for listeria is a regimen of antibiotics. But in a \u003ca title=\"http://www.jidc.org/index.php/journal/article/viewFile/24727506/1038\" href=\"http://www.jidc.org/index.php/journal/article/viewFile/24727506/1038\" target=\"_blank\">study earlier this year\u003c/a> from the Zurich-based Institute of Food, Nutrition and Health, researchers noted that the overuse of antibiotics as a feed additive in livestock may be leading to increased instances of antibiotic-resistant listeria, potentially making the disease even more lethal.\u003c/p>\n\u003cp>For decades the debate over antibiotics in livestock has been in a kind of stalemate. Reformers push for tough regulations and industry pushes back. But that equation appears to be changing.\u003c/p>\n\u003cp>This summer the iconic chicken company Perdue Chicken, responding to growing public health concerns and what their director of food safety, Bruce Stewart Brown, said was “feedback from their own customers,” \u003ca title=\"http://www.npr.org/blogs/thesalt/2014/02/14/276976353/americans-want-antibiotic-free-chicken-and-the-industry-is-listening\" href=\"http://www.npr.org/blogs/thesalt/2014/02/14/276976353/americans-want-antibiotic-free-chicken-and-the-industry-is-listening\" target=\"_blank\">announced new antibiotic standards \u003c/a>that match even the toughest European regulatory standards. The fast food company Chick-fil-A has gone even further, pledging to go \u003ca title=\"http://www.chick-fil-a.com/antibiotic-free\" href=\"http://www.chick-fil-a.com/antibiotic-free\" target=\"_blank\">antibiotic free\u003c/a>.\u003c/p>\n\u003cp>Meanwhile the Obama administration has added to the sense of urgency to do more to address concerns over antibiotic resistance. The White House said in a Sept. 18 \u003ca title=\"http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria\" href=\"http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria\" target=\"_blank\">executive order\u003c/a> that \u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan style=\"color: #500050\">\"\u003c/span>combating antibiotic-resistant bacteria is a national security priority\u003c/span>.” An accompanying report detailed mounting evidence linking antibiotic resistance in people with corresponding overuse of antibiotics in agriculture.\u003c/p>\n\u003cp>By sending a bill he found lacking back to the Legislature, Brown has put California in the position to have more than a symbolic impact on those calls for reform.\u003c/p>\n\u003cp>“California has a long tradition of being a national model,\" the NRDC's Kaplan said. \"We’ve seen it in the past with climate change. We are a major agricultural state, and we have a big population. If we change livestock production in California, then it becomes a significant model for the rest of the nation.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>If the legislative effort fails, Kaplan and other organizations that were involved in the lobbying effort to push for the veto said they would consider mounting a ballot initiative in 2016.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21893\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000005811185_Large-e1412270269953.jpg\">\u003cimg class=\"size-large wp-image-21893\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000005811185_Large-640x424.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>\u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB835\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB835\" target=\"_blank\">Senate Bill 835\u003c/a> was crafted as a measure aimed at limiting antibiotic use in livestock. To those concerned about the growing problem of antibiotic resistance, it might seem surprising that Gov. Jerry Brown vetoed the bill earlier this week. Yet advocates believe that in striking down the bill, California is poised to take a leading role on the issue.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'The governor sent a message that he isn’t going to accept fig-leaf solutions to tackle this problem.' -- Natural Resources Defense Council spokesman \u003c/aside>\n\u003cp>Here's why: Critics had assailed the bill as too industry-friendly and unlikely to make much impact on antibiotic resistance.\u003c/p>\n\u003cp>SB835 would have codified a recent Food and Drug Administration \u003ca title=\"http://www.npr.org/blogs/thesalt/2012/04/11/150432234/fda-launches-voluntary-plan-to-reduce-use-of-antibiotics-in-animals\" href=\"http://www.npr.org/blogs/thesalt/2012/04/11/150432234/fda-launches-voluntary-plan-to-reduce-use-of-antibiotics-in-animals\" target=\"_blank\">voluntary ban\u003c/a> on the use of antibiotics for growth-promoting purposes. The measure had sailed through the Legislature. But a coalition, including the Natural Resources Defense Council (NRDC), Consumers Union and several leading medical experts on antibiotic resistance, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/09/why-advocacy-groups-oppose-bill-limiting-use-of-antibiotics-in-animals/\" target=\"_blank\">quietly created a campaign\u003c/a> urging the governor to veto the bill.\u003c!--more-->\u003c/p>\n\u003cp>The reformers argued that bolder action is needed because the use of antibiotics in farm animals remains prolific. Livestock consume an estimated 80 percent of all antibiotics in the U.S. Opponents of the bill argued that the bill left open a gaping loophole. They say some meat producers continue to use antibiotics for growth-promoting purposes and can do so legally by simply claiming they are doing so for disease prevention purposes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jonathan Kaplan, director of the NRDC’s food and agricultural program, says his organization had several meetings with Brown staffers in which they outlined reasons why Brown should veto the bill. “Mostly they just listened,\" he said. \"They were very focused on understanding what the bill would actually do and how it would impact antibiotic use.\"\u003c/p>\n\u003cp>It seems the advocates' message got through. In \u003ca title=\"http://gov.ca.gov/docs/SB_835_Veto_Message.pdf\" href=\"http://gov.ca.gov/docs/SB_835_Veto_Message.pdf\" target=\"_blank\">his veto statement\u003c/a>, the governor noted:\u003c/p>\n\u003cblockquote>\u003cp>The Centers for Disease Control and Prevention estimates conservatively that at least two million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States each year. Scientists around the world are warning that we are over-using these life-saving medicines in both human medicine and to raise animals.\u003c/p>\u003c/blockquote>\n\u003cp>Brown directed the state's Department of Food and Agriculture to work with legislators to find \"new and effective ways to reduce the unnecessary antibiotics used for livestock and poultry.\"\u003c/p>\n\u003cp>“The governor sent a message that he isn’t going to accept fig-leaf solutions to tackle this problem,” Kaplan said.\u003c/p>\n\u003cp>It would be hard not to see the veto as a rebuke of the California Assembly's Agricultural Committee. Earlier this year a more reform-minded antibiotics and livestock bill, sponsored by Assemblyman Kevin Mullin (D-San Mateo), \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/04/23/california-legislature-to-consider-antibiotic-ban-in-animals/\" href=\"http://ww2.kqed.org/stateofhealth/2014/04/23/california-legislature-to-consider-antibiotic-ban-in-animals/\" target=\"_blank\">was up for an initial vote\u003c/a> in the committee. Mullin’s bill would have made reporting antibiotic use a legal requirement, something public health experts say is badly needed in the U.S., and cut down on disease prevention loopholes.\u003c/p>\n\u003cp>At the time I interviewed one of the bill’s opponents, Bill Mattos, president of the California Poultry Federation. Mattos seemed surprised that the Mullin bill would even merit a story. With the seasoned air of a lobbyist who knows how to count votes, Mattos told me that the “Mullin bill was going nowhere.” He said that it was going to be killed in committee. Mattos suggested I instead cover the “more reasonable” Hill bill.\u003c/p>\n\u003cp>Mullin could count votes, too. Facing a near-unanimous defeat, the assemblyman withdrew his bill. \"Better to fight another day,\" said Mullin’s dejected-sounding chief of staff, Hugh Bower.\u003c/p>\n\u003cp>Committee members left no doubt they would have indeed rejected Mullin’s bill. In a hearing, committee chair Susan Talamantes Eggman (D-Stockton) suggested that the earlier bill had been insulting to veterinarians. “I happen to know the vet at Foster Farms, who is a seasoned professional.” Eggman went on to say that she thought that the Foster Farms veterinarian would no more abuse his license than she would as a licensed social worker.\u003c/p>\n\u003cp>But serious concerns about antibiotic practices at large chicken companies like Foster Farms are growing.\u003c/p>\n\u003cp>Last month a \u003ca title=\"http://www.reuters.com/investigates/special-report/farmaceuticals-the-drugs-fed-to-farm-animals-and-the-risks-posed-to-humans/\" href=\"http://www.reuters.com/investigates/special-report/farmaceuticals-the-drugs-fed-to-farm-animals-and-the-risks-posed-to-humans/\" target=\"_blank\">hard-hitting Reuters investigation\u003c/a> detailed how the nation’s largest poultry producers continue to routinely feed chickens an array of antibiotics -– not just when sickness strikes, but as standard practice.\u003c/p>\n\u003cp>In 2013 an antibiotic-resistant form of salmonella linked to Foster Farms chicken \u003ca title=\"http://www.cdc.gov/salmonella/heidelberg-10-13/\" href=\"http://www.cdc.gov/salmonella/heidelberg-10-13/\" target=\"_blank\">hospitalized hundreds of people\u003c/a>, mostly in California. Many patients had serious complications, including blood poisoning. A CDC official who helped investigate the outbreak told Reuters that the use of \u003ca title=\"http://iaspub.epa.gov/tdb/pages/contaminant/contaminantOverview.do?contaminantId=10240\" href=\"http://iaspub.epa.gov/tdb/pages/contaminant/contaminantOverview.do?contaminantId=10240\" target=\"_blank\">chlortetracycline\u003c/a> and penicillin by Foster Farms could have contributed to the resistance patterns.\u003c/p>\n\u003cp>Last week the company\u003ca title=\"http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-060-2014-release\" href=\"http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-060-2014-release\" target=\"_blank\"> issued a new recal\u003c/a>l for frozen chicken they say could be contaminated with listeria. No one has contracted the disease, but listeria is one of the most frightening foodborne illnesses. A \u003ca title=\"http://www.cdc.gov/listeria/outbreaks/cantaloupes-jensen-farms/082712/\" href=\"http://www.cdc.gov/listeria/outbreaks/cantaloupes-jensen-farms/082712/\" target=\"_blank\">2011-2012 outbreak\u003c/a>, traced to cantaloupes, killed 33 people.\u003c/p>\n\u003cp>The treatment for listeria is a regimen of antibiotics. But in a \u003ca title=\"http://www.jidc.org/index.php/journal/article/viewFile/24727506/1038\" href=\"http://www.jidc.org/index.php/journal/article/viewFile/24727506/1038\" target=\"_blank\">study earlier this year\u003c/a> from the Zurich-based Institute of Food, Nutrition and Health, researchers noted that the overuse of antibiotics as a feed additive in livestock may be leading to increased instances of antibiotic-resistant listeria, potentially making the disease even more lethal.\u003c/p>\n\u003cp>For decades the debate over antibiotics in livestock has been in a kind of stalemate. Reformers push for tough regulations and industry pushes back. But that equation appears to be changing.\u003c/p>\n\u003cp>This summer the iconic chicken company Perdue Chicken, responding to growing public health concerns and what their director of food safety, Bruce Stewart Brown, said was “feedback from their own customers,” \u003ca title=\"http://www.npr.org/blogs/thesalt/2014/02/14/276976353/americans-want-antibiotic-free-chicken-and-the-industry-is-listening\" href=\"http://www.npr.org/blogs/thesalt/2014/02/14/276976353/americans-want-antibiotic-free-chicken-and-the-industry-is-listening\" target=\"_blank\">announced new antibiotic standards \u003c/a>that match even the toughest European regulatory standards. The fast food company Chick-fil-A has gone even further, pledging to go \u003ca title=\"http://www.chick-fil-a.com/antibiotic-free\" href=\"http://www.chick-fil-a.com/antibiotic-free\" target=\"_blank\">antibiotic free\u003c/a>.\u003c/p>\n\u003cp>Meanwhile the Obama administration has added to the sense of urgency to do more to address concerns over antibiotic resistance. The White House said in a Sept. 18 \u003ca title=\"http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria\" href=\"http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria\" target=\"_blank\">executive order\u003c/a> that \u003cspan class=\"Apple-style-span\" style=\"color: #000000\">\u003cspan style=\"color: #500050\">\"\u003c/span>combating antibiotic-resistant bacteria is a national security priority\u003c/span>.” An accompanying report detailed mounting evidence linking antibiotic resistance in people with corresponding overuse of antibiotics in agriculture.\u003c/p>\n\u003cp>By sending a bill he found lacking back to the Legislature, Brown has put California in the position to have more than a symbolic impact on those calls for reform.\u003c/p>\n\u003cp>“California has a long tradition of being a national model,\" the NRDC's Kaplan said. \"We’ve seen it in the past with climate change. We are a major agricultural state, and we have a big population. If we change livestock production in California, then it becomes a significant model for the rest of the nation.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If the legislative effort fails, Kaplan and other organizations that were involved in the lobbying effort to push for the veto said they would consider mounting a ballot initiative in 2016.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Brown Vetoes Adult Day Health Bill; Future of Program Unknown",
"title": "Brown Vetoes Adult Day Health Bill; Future of Program Unknown",
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"content": "\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6652\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-e1402507272914.jpg\">\u003cimg class=\"size-large wp-image-6652\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/OldPersonCaneGeneric-620x413.jpg\" alt=\"There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The state has tried to eliminate adult day health care in the past. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/governor-rejects-adult-day-health-bill-future-of-senior-program-now-up-in-air\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It puts everything up for grabs. It's a real step backward.\" \u003c/aside>\n\u003cp>The state \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" href=\"http://ww2.kqed.org/stateofhealth/2012/10/25/state-accused-of-denying-seniors-disabled-access-to-day-care/\" target=\"_blank\">has attempted to eliminate adult day health care\u003c/a> in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.\u003c/p>\n\u003cp>The veto Monday of \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1552\" target=\"_blank\">AB1552\u003c/a> by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state's Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month.\u003c!--more-->\u003c/p>\n\u003cp>\"It seems like the governor is picking at a scab,\" said Gary Passmore, vice president at the California Congress of Seniors. \"CBAS exists as a settlement, and we tried to establish that in law. And here we are again. … Without it existing in statute, it puts everything up for grabs. It's a real step backward.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Coincidentally yesterday, hundreds of senior care stakeholders, including Passmore, gathered in Sacramento for the annual SCAN Foundation conference on long-term care and services.\u003c/p>\n\u003cp>Lydia Missaelides, executive director of the California Association of Adult Day Services, also attended the conference and said the veto was troubling but does not spell elimination for the program.\u003c/p>\n\u003cp>\"It doesn't mean the demise or defeat of CBAS as a [Medi-Cal] benefit,\" Missaelides said. \"But it is a signal that the future of the benefit will be a deal between the state and CMS.\"\u003c/p>\n\u003cp>The veto raises questions, Missaelides said, such as whether the state and CMS might decide to change the benefit, or whether adult day health providers in counties not included in the Coordinated Care Initiative might be affected. Codifying current policy, she said, is not a big leap for the state to take.\u003c/p>\n\u003cp>\"It seemed like a simple thing to ask for,\" Missaelides said.\u003c/p>\n\u003cp>In the long run, said Passmore, it leaves the door open for amending the benefit -- by CMS or by Medi-Cal managed care health insurers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I guess we're going to leave it up to the managed care plans,\" Passmore said. \"What's going to happen is, plan by plan, those entities will decide what role CBAS plays in their range of services.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Brown Signs Package of Assisted-Living Reform Bills",
"title": "Brown Signs Package of Assisted-Living Reform Bills",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21850\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-e1412110038711.jpg\">\u003cimg class=\"size-large wp-image-21850\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-640x457.jpg\" alt=\"(Neon Tommy)\" width=\"640\" height=\"457\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Neon Tommy)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Deborah Schoch,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" href=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Gov. Jerry Brown signed into law Monday \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" target=\"_blank\">a bill \u003c/a>imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.\u003c/p>\n\u003cp>The top fine will now be $15,000, for violations causing death or serious injury, up from $150.\u003c/p>\n\u003cp>The relatively low fines were highlighted in a \u003ca title=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" href=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" target=\"_blank\">series of stories produced last year\u003c/a> by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\">The bill to increase fines\u003c/a>, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brown’s signature on the fine increase came one day after he signed nine other bills tightening state oversight of the more than 7,500 assisted-living homes in California, marking the state’s most sweeping overhaul of the industry in nearly three decades.\u003c/p>\n\u003cp>For the first time, assisted living residents will have a statutory bill of rights like the one protecting nursing home residents.\u003c/p>\n\u003cp>The homes’ staffs also will face stiffer training requirements, and owners will pay higher licensing fees. A staff member with CPR training must be present at homes at all times, and operators will be prohibited from punishing employees who call 911 to get emergency care for sick residents.\u003c/p>\n\u003cp>Brown’s signature on the reform package is a major victory for assisted living residents, said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, the state’s largest advocacy group for long-term care residents.\u003c/p>\n\u003cp>“We look at it as a good start,” said McGinnis. “But we’re not finished by any stretch of the imagination. And I don’t think the legislators are, either. I think they like the fact that they’re going to be changing people’s lives on an immediate basis.”\u003c/p>\n\u003cp>Many of the assisted-living bills that Brown did sign were backed by McGinnis's group and the California Assisted Living Association, the state’s largest industry association.\u003c/p>\n\u003cp>Both groups had pulled their support of the bill to raise fines after it was, in their view, weakened.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/169949480&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Four San Diego legislators played key roles in the reform effort: Democratic Assembly Speaker Toni Atkins and Democratic Sen. Marty Block; and Republican Assembly members Brian Maienschein of San Diego and Marie Waldron of Escondido.\u003c/p>\n\u003cp>Brown signed Atkins’ bill last month requiring that all assisted living facilities \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" target=\"_blank\">carry liability insurance\u003c/a>. Brown signed Block’s two bills Sunday.\u003c/p>\n\u003cp>Block said he intentionally chose the bill name SB-911 for one of his measures, which will protect facility employees who call for emergency care for sick residents. Some employees have said they fear calling 911 because managers say it reflects badly on a home’s record, he said.\u003c/p>\n\u003cp>The same bill raises the training mandate for administrators to 80 hours from 40. Brown also has signed a parallel bill, authored by Assembly Member Wesley Chesbro, D-Arcata, requiring more training for staff caring for residents, including those with dementia.\u003c/p>\n\u003cp>Sally Michael, president of the industry group California Assisted Living Association -- which, along with McGinnis’ group, supported a number of the reform measures -- said it is pleased by Brown’s actions, particularly his signing of the Chesbro bill and Block’s SB 911.\u003c/p>\n\u003cp>“These bills increase the number of hours required for assisted living caregiver and administrator training. They also improve the administrator testing process by making it more rigorous,” Michael said.\u003c/p>\n\u003cp>Block’s second bill boosts facility licensing fees by 10 percent, which, coupled with the administration’s separate 10 percent increase, will boost fees by 20 percent.\u003c/p>\n\u003cp>Block initially proposed a 30 percent increase. He said Monday that for now, the 20-percent hike is enough to provide much needed funds to the Department of Social Social Services, which regulates assisted living homes.\u003c/p>\n\u003cp>“This will be a game changer in terms of funding more inspections and other services,” Block said.\u003c/p>\n\u003cp>The other assisted living bills that Brown signed Sunday:\u003c/p>\n\u003cul>\n\u003cli>SB 895, mandating that homes fix problems found during state inspections within 10 days of being notified (Sen. Ellen Corbett, D-Hayward).\u003c/li>\n\u003cli>SB 1153, giving state regulators the power to halt new admissions to an assisted living home that has not immediately fixed major violations (Sen. Mark Leno, D-San Francisco).\u003c/li>\n\u003cli>AB 1751, requires residents to be represented on assisted living homes’ governing boards (Richard H. Bloom, D-Santa Monica).\u003c/li>\n\u003cli>AB 1899, requires that if an operator’s license is revoked or given up for abandoning a facility, that operator cannot get the license reinstated (Cheryl R. Brown, D-San Bernardino).\u003c/li>\n\u003cli>AB 2044, mandates that a supervisor or trained substitute be at the home 24 hours a day (Freddie Rodriguez, D-Chino).\u003c/li>\n\u003cli>AB 2171, Establishes a bill of rights for assisted living residents similar to the bill now protecting residents of California nursing homes (Bob Wieckowski, D-Fremont).\u003c/li>\n\u003c/ul>\n\u003cp>Including reform bills previously signed by Brown, the governor has approved all 13 assisted living bills passed by the Legislature.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">Four other bills failed to muster the needed votes\u003c/a> and get to his desk, including a bill requiring annual inspections of homes – now inspected a minimum of every five years – which foundered in the state Senate. Several legislators predict that a similar bill will be proposed next year. Another bill that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">would have required the state to build an online consumer rating system\u003c/a> so that consumers could compare facilities on quality also failed to get the governor's desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Based at the University of Southern California’s Annenberg School for Communication and Journalism, the Center is funded by the nonprofit California HealthCare Foundation.\u003c/em>\u003c/p>\n\n",
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"excerpt": "For starters, the highest fine regulators could levy for violations was a mere $150. Now it's $15,000.",
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"title": "Brown Signs Package of Assisted-Living Reform Bills | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21850\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-e1412110038711.jpg\">\u003cimg class=\"size-large wp-image-21850\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-640x457.jpg\" alt=\"(Neon Tommy)\" width=\"640\" height=\"457\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Neon Tommy)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Deborah Schoch,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" href=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Gov. Jerry Brown signed into law Monday \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" target=\"_blank\">a bill \u003c/a>imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.\u003c/p>\n\u003cp>The top fine will now be $15,000, for violations causing death or serious injury, up from $150.\u003c/p>\n\u003cp>The relatively low fines were highlighted in a \u003ca title=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" href=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" target=\"_blank\">series of stories produced last year\u003c/a> by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\">The bill to increase fines\u003c/a>, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brown’s signature on the fine increase came one day after he signed nine other bills tightening state oversight of the more than 7,500 assisted-living homes in California, marking the state’s most sweeping overhaul of the industry in nearly three decades.\u003c/p>\n\u003cp>For the first time, assisted living residents will have a statutory bill of rights like the one protecting nursing home residents.\u003c/p>\n\u003cp>The homes’ staffs also will face stiffer training requirements, and owners will pay higher licensing fees. A staff member with CPR training must be present at homes at all times, and operators will be prohibited from punishing employees who call 911 to get emergency care for sick residents.\u003c/p>\n\u003cp>Brown’s signature on the reform package is a major victory for assisted living residents, said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, the state’s largest advocacy group for long-term care residents.\u003c/p>\n\u003cp>“We look at it as a good start,” said McGinnis. “But we’re not finished by any stretch of the imagination. And I don’t think the legislators are, either. I think they like the fact that they’re going to be changing people’s lives on an immediate basis.”\u003c/p>\n\u003cp>Many of the assisted-living bills that Brown did sign were backed by McGinnis's group and the California Assisted Living Association, the state’s largest industry association.\u003c/p>\n\u003cp>Both groups had pulled their support of the bill to raise fines after it was, in their view, weakened.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/169949480&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Four San Diego legislators played key roles in the reform effort: Democratic Assembly Speaker Toni Atkins and Democratic Sen. Marty Block; and Republican Assembly members Brian Maienschein of San Diego and Marie Waldron of Escondido.\u003c/p>\n\u003cp>Brown signed Atkins’ bill last month requiring that all assisted living facilities \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" target=\"_blank\">carry liability insurance\u003c/a>. Brown signed Block’s two bills Sunday.\u003c/p>\n\u003cp>Block said he intentionally chose the bill name SB-911 for one of his measures, which will protect facility employees who call for emergency care for sick residents. Some employees have said they fear calling 911 because managers say it reflects badly on a home’s record, he said.\u003c/p>\n\u003cp>The same bill raises the training mandate for administrators to 80 hours from 40. Brown also has signed a parallel bill, authored by Assembly Member Wesley Chesbro, D-Arcata, requiring more training for staff caring for residents, including those with dementia.\u003c/p>\n\u003cp>Sally Michael, president of the industry group California Assisted Living Association -- which, along with McGinnis’ group, supported a number of the reform measures -- said it is pleased by Brown’s actions, particularly his signing of the Chesbro bill and Block’s SB 911.\u003c/p>\n\u003cp>“These bills increase the number of hours required for assisted living caregiver and administrator training. They also improve the administrator testing process by making it more rigorous,” Michael said.\u003c/p>\n\u003cp>Block’s second bill boosts facility licensing fees by 10 percent, which, coupled with the administration’s separate 10 percent increase, will boost fees by 20 percent.\u003c/p>\n\u003cp>Block initially proposed a 30 percent increase. He said Monday that for now, the 20-percent hike is enough to provide much needed funds to the Department of Social Social Services, which regulates assisted living homes.\u003c/p>\n\u003cp>“This will be a game changer in terms of funding more inspections and other services,” Block said.\u003c/p>\n\u003cp>The other assisted living bills that Brown signed Sunday:\u003c/p>\n\u003cul>\n\u003cli>SB 895, mandating that homes fix problems found during state inspections within 10 days of being notified (Sen. Ellen Corbett, D-Hayward).\u003c/li>\n\u003cli>SB 1153, giving state regulators the power to halt new admissions to an assisted living home that has not immediately fixed major violations (Sen. Mark Leno, D-San Francisco).\u003c/li>\n\u003cli>AB 1751, requires residents to be represented on assisted living homes’ governing boards (Richard H. Bloom, D-Santa Monica).\u003c/li>\n\u003cli>AB 1899, requires that if an operator’s license is revoked or given up for abandoning a facility, that operator cannot get the license reinstated (Cheryl R. Brown, D-San Bernardino).\u003c/li>\n\u003cli>AB 2044, mandates that a supervisor or trained substitute be at the home 24 hours a day (Freddie Rodriguez, D-Chino).\u003c/li>\n\u003cli>AB 2171, Establishes a bill of rights for assisted living residents similar to the bill now protecting residents of California nursing homes (Bob Wieckowski, D-Fremont).\u003c/li>\n\u003c/ul>\n\u003cp>Including reform bills previously signed by Brown, the governor has approved all 13 assisted living bills passed by the Legislature.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">Four other bills failed to muster the needed votes\u003c/a> and get to his desk, including a bill requiring annual inspections of homes – now inspected a minimum of every five years – which foundered in the state Senate. Several legislators predict that a similar bill will be proposed next year. Another bill that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">would have required the state to build an online consumer rating system\u003c/a> so that consumers could compare facilities on quality also failed to get the governor's desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Based at the University of Southern California’s Annenberg School for Communication and Journalism, the Center is funded by the nonprofit California HealthCare Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers",
"title": "Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21827\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Troy-Alana-Photo.jpg\">\u003cimg class=\"size-large wp-image-21827\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Troy-Alana-Photo-640x509.jpg\" alt=\"After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesy: Bob Pack)\" width=\"640\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesyof Bob Pack)\u003c/figcaption>\u003c/figure>\n\u003cp>Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville. Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch. In the afternoon, they changed out of their costumes and set out for a walk with their mother down Camino Tassajara. Destination: Baskin Robbins 31 Flavors.\u003c/p>\n\u003cp>“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, 'cause he liked counting the bubble gums that he would get.”\u003c/p>\n\u003cp>Bob Pack stayed home to rest. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there,” he says.\u003c/p>\n\u003cp>An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived.\u003c!--more-->\u003c/p>\n\u003cp>“I remember telling them I love them, and hang on. Just praying that they could hang on,” he says\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Troy and Alana were pronounced dead at the hospital. In the months after their death, Pack’s wife, Carmen, retreated into her Catholic faith. Bob Pack was angry.\u003c/p>\n\u003cp>“I think, for me to get through, I needed action,” he says, “and I needed to take action for justice for Troy and Alana, and also for doing something that I thought maybe I could change to benefit others in the future.”\u003c/p>\n\u003cp>That was nearly 11 years ago. Pack quit his tech job to become an advocate. Over the last decade, he has helped write seven bills in California's Legislature and has evolved into a savvy political player. None of his efforts have been bigger than the one he's working on for the November election: Proposition 46, the patient safety initiative. It's complex and has three distinct proposals.\u003c/p>\n\u003cp>\u003cstrong>Requires Doctors to Check Prescription Database\u003c/strong>\u003c/p>\n\u003cp>The first one, aimed at addressing “doctor shopping,” became a pet issue of Pack’s after the accident. Investigators found the driver who killed his kids was abusing prescription narcotics.\u003c/p>\n\u003cp>“She had gone to numerous doctors, saying that she was under different pain, neck pain, back pain, leg pain, elbow pain,” he says. “They, in my view, recklessly wrote prescriptions for her, for thousands of pills.”\u003c/p>\n\u003cp>Pack set out to help the state build a database where doctors can see how many times a patient has been prescribed serious narcotics, like Vicodin or Oxycontin. The result is the CURES database, or the Controlled Substance Utilization Review and Evaluation System.\u003c/p>\n\u003cp>Prop. 46 would make it mandatory for doctors to consult the database. California would become one of nine states requiring doctors to check before prescribing painkillers to first-time patients.\u003c/p>\n\u003cp>After passing similar laws, both Tennessee and New York saw a significant reduction in the number of narcotics prescriptions written. Studies have verified the correlation, but acknowledge that some of the reduction may be due to drug abusers turning to alternative sources or street drugs, like heroin.\u003c/p>\n\u003cp>Many doctors in California like the database. Some have called it “indispensable.” But they don’t like being told how to practice medicine.\u003c/p>\n\u003cp>“The problem with the current way the ballot measure is written is it makes it mandatory, to have that database checked,” says Dr. Richard Thorp, president of the California Medical Association (CMA), adding technical glitches have made the database unreliable.\u003c/p>\n\u003cp>\u003cstrong>Lifts Cap on Malpractice Awards\u003c/strong>\u003c/p>\n\u003cp>Doctors are also unhappy about another big piece of Prop 46: the proposed change to the cap on “pain and suffering” awards in medical malpractice lawsuits.\u003c/p>\n\u003cp>After his kids died, Bob Pack wanted to sue the doctors that prescribed drugs to the driver.\u003c/p>\n\u003cp>“I set out and talked to about eight lawyers,” he says.\u003c/p>\n\u003cp>They all turned him down. They told him a 1975 state law limited the malpractice award he could get to $250,000. That meant puny attorneys’ fees. The lawyers said it simply wasn’t cost effective for them to take his case.\u003c/p>\n\u003cp>“My reaction was ‘What?!’ That’s not democratic. That’s not America,” Pack says. “We all have the right to the court system.”\u003c/p>\n\u003cp>The law that set the cap is called MICRA, the \u003ca title=\"http://en.wikipedia.org/wiki/Medical_Injury_Compensation_Reform_Act\" href=\"http://en.wikipedia.org/wiki/Medical_Injury_Compensation_Reform_Act\" target=\"_blank\">Medical Injury Compensation Reform Act of 1975\u003c/a>, passed with the intention of keeping medical liability insurance costs low. Several other states followed suit. California’s law caps only non-economic damages, or pain and suffering awards. Economic damages –- money that accounts for medical expenses, or lost wages when a person can no longer work because of a medical mistake –- are not capped.\u003c/p>\n\u003cp>But economic damages were no help in a case like Pack’s. His children had no jobs and therefore no lost wages. And they were dead, so they had no ongoing medical bills.\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">A study from Emory University shows that \u003ca title=\" http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2147915\" href=\"//papers.ssrn.com/sol3/papers.cfm?abstract_id=2147915\" target=\"_blank\">medical malpractice caps limit access to legal representation\u003c/a> for up to 95 percent of victims.\u003c/span> Children, the elderly and other people with no or very low incomes who cannot claim economic damages are the most affected.\u003c/p>\n\u003cp>“So the victim gets victimized a second time, not only by the harm or the loss of a loved one, but then they get no accountability or justice through the legal system,” Pack says.\u003c/p>\n\u003cp>That’s why some states have ruled such caps on pain and suffering awards unconstitutional.\u003c/p>\n\u003cp>Pack thinks California’s non-economic malpractice award should at least be adjusted for inflation, so lawyers would be more willing to take legitimate cases. Prop. 46 would raise the cap from $250,000 to $1.1 million and provide an annual adjustment for inflation going forward.\u003c/p>\n\u003cp>But the CMA's Richard Thorp sees a big problem. “That will encourage additional lawsuits in the system.\" He argues more lawsuits will cause malpractice insurance premiums to go up, and those costs could drive doctors out of California.\u003c/p>\n\u003cp>“You’ll start to see it become more difficult to recruit doctors to California,” he says. “And you’ll see doctors in the middle of their career start to look at it and say, 'Maybe I can find a practice someplace else in another state where it will be more financially viable and I wouldn’t have to worry about the same number of malpractice cases as I’m going to have to face in California.' ”\u003c/p>\n\u003cp>About a dozen other states have caps on pain and suffering awards similar to California’s.\u003c/p>\n\u003cp>In a review of studies from the 1970s to the early 2000s, researchers writing for the Milbank Quarterly found that \u003ca title=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690332/\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690332/\" target=\"_blank\">damage caps do reduce malpractice insurance premiums\u003c/a>, but to what degree is a matter of debate, with study results ranging from 6 to 25 percent.\u003c/p>\n\u003cp>No evidence was found that this savings gets passed on to consumers in the form of lower health insurance premiums, partly because malpractice insurance constitutes such a small percentage –- less than 2 –- of overall health care costs.\u003c/p>\n\u003cp>The same review highlighted a study from the U.S. Department of Health and Human Services that found a link between doctor supply and non-economic damage caps. Specifically, rural counties in states where caps were set at $250,000 –- like California -– had 5.5 percent more surgeons and 5.4 percent more obstetricians/gynecologists, compared with states with a higher cap.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/170078338&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Studies were inconclusive on whether doctors practice more “defensive medicine” in states with caps -– ordering more tests and procedures to avoid making mistakes and being sued.\u003c/p>\n\u003cp>County governments are especially concerned about the potential costs associated with Prop. 46.\u003c/p>\n\u003cp>Twelve counties, including Los Angeles and San Francisco, operate their own hospital systems and would have to use taxpayer dollars to cover the costs of additional malpractice lawsuits. The state’s independent legislative analyst estimates that cost could be between tens of millions and hundreds of millions of dollars a year.\u003c/p>\n\u003cp>The LAO reports says some of that could be offset by savings from other parts of the measure, the prescription database and the most controversial piece of Prop. 46: doctor drug testing.\u003c/p>\n\u003cp>\u003cstrong>Mandates Drug & Alcohol Testing for Doctors\u003c/strong>\u003c/p>\n\u003cp>This has been the centerpiece of the \"Yes on Prop. 46\" campaign, inspiring campy ads of airline pilots and police officers dancing through the stalls of a public restroom.\u003c/p>\n\u003cp>“All…of…the….pilots do it. Astronauts do it. Even the school bus drivers do it,” the ad goes. “Let’s do it. Let’s pee in a cup.”\u003c/p>\n\u003cp>Adding doctors to that list seemed like an easy sell. Early polls indicated voters strongly favored the idea -– many thought it was already law. In fact, if Prop. 46 passes, California would be the first state in the country to require drug testing of doctors.\u003c/p>\n\u003cp>“We’re the only profession I know of that are charged to police ourselves,” says Stephen Loyd, a Tennessee physician who thinks California should lead the way in passing Prop. 46. For years, he says he practiced medicine while grappling with an addiction to painkillers. At his worst, he was taking 100 Vicodin pills a day.\u003c/p>\n\u003cp>“Here’s the scariest thing about it. I thought I was a better doctor. I thought I was sharper. Thought I didn’t need to sleep, thought I didn’t need to eat, I could go longer, I could see more patients,” he says. “But I wasn’t better, I was worse.”\u003c/p>\n\u003cp>Loyd’s father ultimately caught him using and forced him to go to rehab.\u003c/p>\n\u003cp>Prop. 46 would give the Medical Board of California a year to set up a system to test doctors for drug and alcohol use, both randomly and within 12 hours after an unexpected patient death or serious injury at the hospital.\u003c/p>\n\u003cp>Doctors groups say that goes too far.\u003c/p>\n\u003cp>“This approach is too heavy-handed and too inappropriate,” says CMA's Thorp. He says hospitals already have systems in place to suspend doctors who show up to work intoxicated.\u003c/p>\n\u003cp>“There’s very little tolerance for anyone to come in either acting or smelling or having any kind of sign of being under the influence,” he says.\u003c/p>\n\u003cp>But do doctors really snitch on each other? Loyd says no one ever reported him for being high.\u003c/p>\n\u003cp>“My colleagues all knew something was wrong. But nobody said anything,” he says. “They didn’t want to hurt my livelihood. They didn’t want to damage my reputation; they didn’t want to damage my practice.”\u003c/p>\n\u003cp>The two campaigns have fought back and forth over just how much of a problem there is with impaired doctors.\u003c/p>\n\u003cp>Prop. 46 backers cite estimates that, at any point in time, 1 to 2 percent of doctors are abusing drugs or alcohol. But they admit there are no firm data.\u003c/p>\n\u003cp>Regardless, Prop. 46 author Pack says, not enough is being done.\u003c/p>\n\u003cp>“The medical board has no authority and no mandate to be able to find out who these guys are, and weed them out or get them help,” he says.\u003c/p>\n\u003cp>Pack admits that drug testing was never part of his original plan for Prop 46. Increasing awards for victims of medical malpractice was his main goal. He says it was medical experts from the East Coast who caught wind of Prop. 46 and pushed the committee to add doctor drug testing.\u003c/p>\n\u003cp>“At first I had a mixed feeling, partially because my father-in-law is a doctor,” he says.\u003c/p>\n\u003cp>But he says the more research he did, the more he felt like drug testing was a core piece of patient safety.\u003c/p>\n\u003cp>Studies of workplace drug testing programs are actually inconclusive on whether testing deters employee drug use or reduces workplace accidents. A review of 23 studies in the upcoming issue of Accident Analysis and Prevention concluded: “The evidence base for the effectiveness of testing in improving workplace safety is at best tenuous.”\u003c/p>\n\u003cp>But the focus groups revealing voter support for the idea of doctor drug testing were convincing. That has opponents calling the provision nothing more than a political gimmick.\u003c/p>\n\u003cp>“The only reason that was added to the proposition is because it polled well with voters,” says Thorp. “They’re just hiding the fact that they’re trying to increase the cap on non-economic damages so that the payouts to trial attorneys can increase.”\u003c/p>\n\u003cp>But doctors and insurance companies are the big spenders in this campaign, amassing $57 million and making this the most expensive campaign of the fall election. They’re outspending lawyers 10 to 1 on ads aimed at swaying voters toward a no vote. None of them even mentions doctor drug testing.\u003c/p>\n\u003cp>“Proposition 46. What’s the real story? Well, start with the trial lawyers,” goes one opponent radio ad. “They wrote and paid for Prop. 46. And just as you might have guessed, they did it for money.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>These ads are everywhere. And it appears the blitz might be working. Early polls showed strong support for the measure during the summer – 58 percent. But \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/field-poll-shows-support-slipping-for-two-health-propositions/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/field-poll-shows-support-slipping-for-two-health-propositions/\" target=\"_blank\">that support is waning rapidly\u003c/a>, dropping to 34 percent support in mid-September. Twenty-nine percent of voters said they hadn’t yet decided.\u003c/p>\n\n",
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"excerpt": "Proposition 46 is called the 'patient safety initiative' and would do three distinct things.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21827\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Troy-Alana-Photo.jpg\">\u003cimg class=\"size-large wp-image-21827\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Troy-Alana-Photo-640x509.jpg\" alt=\"After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesy: Bob Pack)\" width=\"640\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesyof Bob Pack)\u003c/figcaption>\u003c/figure>\n\u003cp>Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville. Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch. In the afternoon, they changed out of their costumes and set out for a walk with their mother down Camino Tassajara. Destination: Baskin Robbins 31 Flavors.\u003c/p>\n\u003cp>“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, 'cause he liked counting the bubble gums that he would get.”\u003c/p>\n\u003cp>Bob Pack stayed home to rest. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there,” he says.\u003c/p>\n\u003cp>An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived.\u003c!--more-->\u003c/p>\n\u003cp>“I remember telling them I love them, and hang on. Just praying that they could hang on,” he says\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Troy and Alana were pronounced dead at the hospital. In the months after their death, Pack’s wife, Carmen, retreated into her Catholic faith. Bob Pack was angry.\u003c/p>\n\u003cp>“I think, for me to get through, I needed action,” he says, “and I needed to take action for justice for Troy and Alana, and also for doing something that I thought maybe I could change to benefit others in the future.”\u003c/p>\n\u003cp>That was nearly 11 years ago. Pack quit his tech job to become an advocate. Over the last decade, he has helped write seven bills in California's Legislature and has evolved into a savvy political player. None of his efforts have been bigger than the one he's working on for the November election: Proposition 46, the patient safety initiative. It's complex and has three distinct proposals.\u003c/p>\n\u003cp>\u003cstrong>Requires Doctors to Check Prescription Database\u003c/strong>\u003c/p>\n\u003cp>The first one, aimed at addressing “doctor shopping,” became a pet issue of Pack’s after the accident. Investigators found the driver who killed his kids was abusing prescription narcotics.\u003c/p>\n\u003cp>“She had gone to numerous doctors, saying that she was under different pain, neck pain, back pain, leg pain, elbow pain,” he says. “They, in my view, recklessly wrote prescriptions for her, for thousands of pills.”\u003c/p>\n\u003cp>Pack set out to help the state build a database where doctors can see how many times a patient has been prescribed serious narcotics, like Vicodin or Oxycontin. The result is the CURES database, or the Controlled Substance Utilization Review and Evaluation System.\u003c/p>\n\u003cp>Prop. 46 would make it mandatory for doctors to consult the database. California would become one of nine states requiring doctors to check before prescribing painkillers to first-time patients.\u003c/p>\n\u003cp>After passing similar laws, both Tennessee and New York saw a significant reduction in the number of narcotics prescriptions written. Studies have verified the correlation, but acknowledge that some of the reduction may be due to drug abusers turning to alternative sources or street drugs, like heroin.\u003c/p>\n\u003cp>Many doctors in California like the database. Some have called it “indispensable.” But they don’t like being told how to practice medicine.\u003c/p>\n\u003cp>“The problem with the current way the ballot measure is written is it makes it mandatory, to have that database checked,” says Dr. Richard Thorp, president of the California Medical Association (CMA), adding technical glitches have made the database unreliable.\u003c/p>\n\u003cp>\u003cstrong>Lifts Cap on Malpractice Awards\u003c/strong>\u003c/p>\n\u003cp>Doctors are also unhappy about another big piece of Prop 46: the proposed change to the cap on “pain and suffering” awards in medical malpractice lawsuits.\u003c/p>\n\u003cp>After his kids died, Bob Pack wanted to sue the doctors that prescribed drugs to the driver.\u003c/p>\n\u003cp>“I set out and talked to about eight lawyers,” he says.\u003c/p>\n\u003cp>They all turned him down. They told him a 1975 state law limited the malpractice award he could get to $250,000. That meant puny attorneys’ fees. The lawyers said it simply wasn’t cost effective for them to take his case.\u003c/p>\n\u003cp>“My reaction was ‘What?!’ That’s not democratic. That’s not America,” Pack says. “We all have the right to the court system.”\u003c/p>\n\u003cp>The law that set the cap is called MICRA, the \u003ca title=\"http://en.wikipedia.org/wiki/Medical_Injury_Compensation_Reform_Act\" href=\"http://en.wikipedia.org/wiki/Medical_Injury_Compensation_Reform_Act\" target=\"_blank\">Medical Injury Compensation Reform Act of 1975\u003c/a>, passed with the intention of keeping medical liability insurance costs low. Several other states followed suit. California’s law caps only non-economic damages, or pain and suffering awards. Economic damages –- money that accounts for medical expenses, or lost wages when a person can no longer work because of a medical mistake –- are not capped.\u003c/p>\n\u003cp>But economic damages were no help in a case like Pack’s. His children had no jobs and therefore no lost wages. And they were dead, so they had no ongoing medical bills.\u003c/p>\n\u003cp>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">A study from Emory University shows that \u003ca title=\" http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2147915\" href=\"//papers.ssrn.com/sol3/papers.cfm?abstract_id=2147915\" target=\"_blank\">medical malpractice caps limit access to legal representation\u003c/a> for up to 95 percent of victims.\u003c/span> Children, the elderly and other people with no or very low incomes who cannot claim economic damages are the most affected.\u003c/p>\n\u003cp>“So the victim gets victimized a second time, not only by the harm or the loss of a loved one, but then they get no accountability or justice through the legal system,” Pack says.\u003c/p>\n\u003cp>That’s why some states have ruled such caps on pain and suffering awards unconstitutional.\u003c/p>\n\u003cp>Pack thinks California’s non-economic malpractice award should at least be adjusted for inflation, so lawyers would be more willing to take legitimate cases. Prop. 46 would raise the cap from $250,000 to $1.1 million and provide an annual adjustment for inflation going forward.\u003c/p>\n\u003cp>But the CMA's Richard Thorp sees a big problem. “That will encourage additional lawsuits in the system.\" He argues more lawsuits will cause malpractice insurance premiums to go up, and those costs could drive doctors out of California.\u003c/p>\n\u003cp>“You’ll start to see it become more difficult to recruit doctors to California,” he says. “And you’ll see doctors in the middle of their career start to look at it and say, 'Maybe I can find a practice someplace else in another state where it will be more financially viable and I wouldn’t have to worry about the same number of malpractice cases as I’m going to have to face in California.' ”\u003c/p>\n\u003cp>About a dozen other states have caps on pain and suffering awards similar to California’s.\u003c/p>\n\u003cp>In a review of studies from the 1970s to the early 2000s, researchers writing for the Milbank Quarterly found that \u003ca title=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690332/\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690332/\" target=\"_blank\">damage caps do reduce malpractice insurance premiums\u003c/a>, but to what degree is a matter of debate, with study results ranging from 6 to 25 percent.\u003c/p>\n\u003cp>No evidence was found that this savings gets passed on to consumers in the form of lower health insurance premiums, partly because malpractice insurance constitutes such a small percentage –- less than 2 –- of overall health care costs.\u003c/p>\n\u003cp>The same review highlighted a study from the U.S. Department of Health and Human Services that found a link between doctor supply and non-economic damage caps. Specifically, rural counties in states where caps were set at $250,000 –- like California -– had 5.5 percent more surgeons and 5.4 percent more obstetricians/gynecologists, compared with states with a higher cap.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/170078338&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Studies were inconclusive on whether doctors practice more “defensive medicine” in states with caps -– ordering more tests and procedures to avoid making mistakes and being sued.\u003c/p>\n\u003cp>County governments are especially concerned about the potential costs associated with Prop. 46.\u003c/p>\n\u003cp>Twelve counties, including Los Angeles and San Francisco, operate their own hospital systems and would have to use taxpayer dollars to cover the costs of additional malpractice lawsuits. The state’s independent legislative analyst estimates that cost could be between tens of millions and hundreds of millions of dollars a year.\u003c/p>\n\u003cp>The LAO reports says some of that could be offset by savings from other parts of the measure, the prescription database and the most controversial piece of Prop. 46: doctor drug testing.\u003c/p>\n\u003cp>\u003cstrong>Mandates Drug & Alcohol Testing for Doctors\u003c/strong>\u003c/p>\n\u003cp>This has been the centerpiece of the \"Yes on Prop. 46\" campaign, inspiring campy ads of airline pilots and police officers dancing through the stalls of a public restroom.\u003c/p>\n\u003cp>“All…of…the….pilots do it. Astronauts do it. Even the school bus drivers do it,” the ad goes. “Let’s do it. Let’s pee in a cup.”\u003c/p>\n\u003cp>Adding doctors to that list seemed like an easy sell. Early polls indicated voters strongly favored the idea -– many thought it was already law. In fact, if Prop. 46 passes, California would be the first state in the country to require drug testing of doctors.\u003c/p>\n\u003cp>“We’re the only profession I know of that are charged to police ourselves,” says Stephen Loyd, a Tennessee physician who thinks California should lead the way in passing Prop. 46. For years, he says he practiced medicine while grappling with an addiction to painkillers. At his worst, he was taking 100 Vicodin pills a day.\u003c/p>\n\u003cp>“Here’s the scariest thing about it. I thought I was a better doctor. I thought I was sharper. Thought I didn’t need to sleep, thought I didn’t need to eat, I could go longer, I could see more patients,” he says. “But I wasn’t better, I was worse.”\u003c/p>\n\u003cp>Loyd’s father ultimately caught him using and forced him to go to rehab.\u003c/p>\n\u003cp>Prop. 46 would give the Medical Board of California a year to set up a system to test doctors for drug and alcohol use, both randomly and within 12 hours after an unexpected patient death or serious injury at the hospital.\u003c/p>\n\u003cp>Doctors groups say that goes too far.\u003c/p>\n\u003cp>“This approach is too heavy-handed and too inappropriate,” says CMA's Thorp. He says hospitals already have systems in place to suspend doctors who show up to work intoxicated.\u003c/p>\n\u003cp>“There’s very little tolerance for anyone to come in either acting or smelling or having any kind of sign of being under the influence,” he says.\u003c/p>\n\u003cp>But do doctors really snitch on each other? Loyd says no one ever reported him for being high.\u003c/p>\n\u003cp>“My colleagues all knew something was wrong. But nobody said anything,” he says. “They didn’t want to hurt my livelihood. They didn’t want to damage my reputation; they didn’t want to damage my practice.”\u003c/p>\n\u003cp>The two campaigns have fought back and forth over just how much of a problem there is with impaired doctors.\u003c/p>\n\u003cp>Prop. 46 backers cite estimates that, at any point in time, 1 to 2 percent of doctors are abusing drugs or alcohol. But they admit there are no firm data.\u003c/p>\n\u003cp>Regardless, Prop. 46 author Pack says, not enough is being done.\u003c/p>\n\u003cp>“The medical board has no authority and no mandate to be able to find out who these guys are, and weed them out or get them help,” he says.\u003c/p>\n\u003cp>Pack admits that drug testing was never part of his original plan for Prop 46. Increasing awards for victims of medical malpractice was his main goal. He says it was medical experts from the East Coast who caught wind of Prop. 46 and pushed the committee to add doctor drug testing.\u003c/p>\n\u003cp>“At first I had a mixed feeling, partially because my father-in-law is a doctor,” he says.\u003c/p>\n\u003cp>But he says the more research he did, the more he felt like drug testing was a core piece of patient safety.\u003c/p>\n\u003cp>Studies of workplace drug testing programs are actually inconclusive on whether testing deters employee drug use or reduces workplace accidents. A review of 23 studies in the upcoming issue of Accident Analysis and Prevention concluded: “The evidence base for the effectiveness of testing in improving workplace safety is at best tenuous.”\u003c/p>\n\u003cp>But the focus groups revealing voter support for the idea of doctor drug testing were convincing. That has opponents calling the provision nothing more than a political gimmick.\u003c/p>\n\u003cp>“The only reason that was added to the proposition is because it polled well with voters,” says Thorp. “They’re just hiding the fact that they’re trying to increase the cap on non-economic damages so that the payouts to trial attorneys can increase.”\u003c/p>\n\u003cp>But doctors and insurance companies are the big spenders in this campaign, amassing $57 million and making this the most expensive campaign of the fall election. They’re outspending lawyers 10 to 1 on ads aimed at swaying voters toward a no vote. None of them even mentions doctor drug testing.\u003c/p>\n\u003cp>“Proposition 46. What’s the real story? Well, start with the trial lawyers,” goes one opponent radio ad. “They wrote and paid for Prop. 46. And just as you might have guessed, they did it for money.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These ads are everywhere. And it appears the blitz might be working. Early polls showed strong support for the measure during the summer – 58 percent. But \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/field-poll-shows-support-slipping-for-two-health-propositions/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/field-poll-shows-support-slipping-for-two-health-propositions/\" target=\"_blank\">that support is waning rapidly\u003c/a>, dropping to 34 percent support in mid-September. Twenty-nine percent of voters said they hadn’t yet decided.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Marijuana Legalization Move Begins (Again) in California",
"title": "Marijuana Legalization Move Begins (Again) in California",
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"content": "\u003cfigure id=\"attachment_21743\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/200273897-001-e1411666544179.jpg\">\u003cimg class=\"size-large wp-image-21743\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/200273897-001-640x421.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"421\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Marijuana Policy Project, a national advocacy group, took the first formal steps Wednesday toward a 2016 ballot initiative to legalize marijuana in California.\u003c/p>\n\u003cp>The group officially filed papers with the secretary of state to register a new committee, the Marijuana Policy Project of California. The registration allows the committee to start soliciting and spending funds.\u003c/p>\n\u003cp>Ballot language will not be drafted until early 2015, but the goal is to regulate pot in a similar way to alcohol, the group says.\u003c!--more-->\u003c/p>\n\u003cp>\"Marijuana prohibition has had an enormously detrimental impact on California communities,\" said Rob Kampia, executive director of the \u003ca title=\"http://www.mpp.org\" href=\"http://www.mpp.org\" target=\"_blank\">Marijuana Policy Project\u003c/a> (MPP), in a statement. \"It's been ineffective, wasteful, and counterproductive. It's time for a more responsible approach.\"\u003c/p>\n\u003cp>In 2012, Colorado and Washington became the first states to legalize the sale of marijuana. In November, Oregon, Alaska and District of Columbia voters will also decide on legalization.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A similar initiative, \u003ca title=\"http://voterguide.sos.ca.gov/past/2010/general/propositions/19/\" href=\"http://voterguide.sos.ca.gov/past/2010/general/propositions/19/\" target=\"_blank\">Proposition 19\u003c/a>, failed in 2010 in California, 57 percent no to 43 percent yes. MPP spokesman Mason Tvert said the landscape is different now, pointing to a dramatic increase in support for legalization nationally, from the \"low 40s nationwide in 2010, then all of a sudden in 2014 it's polling in the 50s nationally.\"\u003c/p>\n\u003cp>So in California, he added, \"it stands to reason\" that the state would also see an increase in support. A \u003ca title=\"http://www.field.com/fieldpollonline/subscribers/Rls2455.pdf\" href=\"http://www.field.com/fieldpollonline/subscribers/Rls2455.pdf\" target=\"_blank\">Field Poll last December\u003c/a> found 55 percent of the state's voters now favor legalization.\u003c/p>\n\u003cp>2016 is a presidential election year, which generally means a higher voter turnout than Prop. 19 faced in 2010's midterm elections. Tvert believes that will help the legalization effort. \"When more people are voting,\" he said, \"it's a better snapshot of where people are.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>More from the Associated Press:\u003c/p>\n\u003cblockquote>\u003cp>League of California Cities lobbyist Tim Cromartie, whose group opposed the state's 2010 pot legalization initiative and until this year fought legislative efforts to give the state greater oversight of medical marijuana, said Wednesday that it was too soon to say what kind of opposition, if any, would greet a 2016 campaign.\u003c/p>\n\u003cp>Lynne Lyman, California director of the Drug Policy Alliance, said her group expects to play a major role in the legalization effort and already has started raising money. Lyman said the goal is to have an initiative written by next summer. She estimated that a pro-legalization campaign would cost $8 million to $12 million.\u003c/p>\n\u003cp>Even though California would be following in the steps of other states if a 2016 initiative passes, legalizing recreational marijuana use there would have far-reaching implications, Lyman said.\u003c/p>\n\u003cp>\"When an issue is taken up in California, it becomes a national issue,\" she said. \"What we really hope is that with a state this large taking that step, the federal government will be forced to address the ongoing issue of marijuana prohibition.\"\u003c/p>\u003c/blockquote>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21743\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/200273897-001-e1411666544179.jpg\">\u003cimg class=\"size-large wp-image-21743\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/200273897-001-640x421.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"421\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Marijuana Policy Project, a national advocacy group, took the first formal steps Wednesday toward a 2016 ballot initiative to legalize marijuana in California.\u003c/p>\n\u003cp>The group officially filed papers with the secretary of state to register a new committee, the Marijuana Policy Project of California. The registration allows the committee to start soliciting and spending funds.\u003c/p>\n\u003cp>Ballot language will not be drafted until early 2015, but the goal is to regulate pot in a similar way to alcohol, the group says.\u003c!--more-->\u003c/p>\n\u003cp>\"Marijuana prohibition has had an enormously detrimental impact on California communities,\" said Rob Kampia, executive director of the \u003ca title=\"http://www.mpp.org\" href=\"http://www.mpp.org\" target=\"_blank\">Marijuana Policy Project\u003c/a> (MPP), in a statement. \"It's been ineffective, wasteful, and counterproductive. It's time for a more responsible approach.\"\u003c/p>\n\u003cp>In 2012, Colorado and Washington became the first states to legalize the sale of marijuana. In November, Oregon, Alaska and District of Columbia voters will also decide on legalization.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A similar initiative, \u003ca title=\"http://voterguide.sos.ca.gov/past/2010/general/propositions/19/\" href=\"http://voterguide.sos.ca.gov/past/2010/general/propositions/19/\" target=\"_blank\">Proposition 19\u003c/a>, failed in 2010 in California, 57 percent no to 43 percent yes. MPP spokesman Mason Tvert said the landscape is different now, pointing to a dramatic increase in support for legalization nationally, from the \"low 40s nationwide in 2010, then all of a sudden in 2014 it's polling in the 50s nationally.\"\u003c/p>\n\u003cp>So in California, he added, \"it stands to reason\" that the state would also see an increase in support. A \u003ca title=\"http://www.field.com/fieldpollonline/subscribers/Rls2455.pdf\" href=\"http://www.field.com/fieldpollonline/subscribers/Rls2455.pdf\" target=\"_blank\">Field Poll last December\u003c/a> found 55 percent of the state's voters now favor legalization.\u003c/p>\n\u003cp>2016 is a presidential election year, which generally means a higher voter turnout than Prop. 19 faced in 2010's midterm elections. Tvert believes that will help the legalization effort. \"When more people are voting,\" he said, \"it's a better snapshot of where people are.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>More from the Associated Press:\u003c/p>\n\u003cblockquote>\u003cp>League of California Cities lobbyist Tim Cromartie, whose group opposed the state's 2010 pot legalization initiative and until this year fought legislative efforts to give the state greater oversight of medical marijuana, said Wednesday that it was too soon to say what kind of opposition, if any, would greet a 2016 campaign.\u003c/p>\n\u003cp>Lynne Lyman, California director of the Drug Policy Alliance, said her group expects to play a major role in the legalization effort and already has started raising money. Lyman said the goal is to have an initiative written by next summer. She estimated that a pro-legalization campaign would cost $8 million to $12 million.\u003c/p>\n\u003cp>Even though California would be following in the steps of other states if a 2016 initiative passes, legalizing recreational marijuana use there would have far-reaching implications, Lyman said.\u003c/p>\n\u003cp>\"When an issue is taken up in California, it becomes a national issue,\" she said. \"What we really hope is that with a state this large taking that step, the federal government will be forced to address the ongoing issue of marijuana prohibition.\"\u003c/p>\u003c/blockquote>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Medi-Cal Backlog Will Be 'Down Significantly' in Six Weeks",
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"content": "\u003cfigure id=\"attachment_21735\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/177132336.jpg\">\u003cimg class=\"size-large wp-image-21735\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/177132336-640x492.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"492\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title='Medi-Cal Application Backlog Down \"Significantly\" in Six Weeks' href=\"http://www.californiahealthline.org/capitol-desk/2014/9/medical-application-backlog-will-be-down-significantly-within-six-weeks\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>At an Assembly Committee on Health hearing yesterday, Department of Health Care Services Director Toby Douglas said the backlog of Medi-Cal applications -- at one point in March topping \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/03/nearly-a-million-people-backlogged-in-medi-cal-expansion/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/03/nearly-a-million-people-backlogged-in-medi-cal-expansion/\" target=\"_blank\">900,000 unprocessed eligibility claims\u003c/a> -- now is down to about 250,000 applications and will be \"down significantly\" from that by the start of November.\u003c/p>\n\u003cp>Douglas answered a number of concerns at the hearing, including announcing a shift in DHCS policy regarding asthma and allergy testing, as well as Denti-Cal and special-needs dental care issues.\u003c/p>\n\u003cp>The counties and DHCS, Douglas said, reduced the Medi-Cal application backlog by 650,000 over six months -- more than 100,000 a month. A similar pace in the next month-and-a-half would get it down to about 100,000 applications.\u003c!--more-->\u003c/p>\n\u003cp>\"If you look at the trajectory, I hope to take this down significantly over the next six weeks,\" Douglas said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That wasn't really good enough at the hearing for Assembly member Jim Patterson (R-Fresno).\u003c/p>\n\u003cp>\"I don't think I heard an answer to this,\" Patterson said. \"When do we anticipate ending the backlog?\"\u003c/p>\n\u003cp>\"We are going to continue to work through it,\" Douglas said. \"We want to get to that as soon as possible.\"\u003c/p>\n\u003cp>Patterson wanted to know specifically when the department would be done going through all the backlogged applications. \"I have to go back and tell my constituents about this,\" he said. \"What do I tell them? That it will never be zero?\"\u003c/p>\n\u003cp>Douglas said it wasn't only about clearing the older claims, but making sure the newer claims don't end up contributing in even greater numbers to the backlog. \"It gets back to getting the defects out of the [computer] system, so we're in a stable state,\" Douglas said.\u003c/p>\n\u003cp>Douglas also announced at the hearing that DHCS will change its Medi-Cal policy stance on ordering certain types of allergy tests. It was a shift to national standards that Assembly health committee chair Richard Pan (D-Sacramento) has lobbied DHCS to change for more than two years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For patients waiting months and months to get tested, this is an important victory,\" Pan said in a written statement after the hearing. \"Now a doctor can order tests to identify a patient's allergy and asthma triggers so they can avoid getting sick.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21735\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/177132336.jpg\">\u003cimg class=\"size-large wp-image-21735\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/177132336-640x492.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"492\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title='Medi-Cal Application Backlog Down \"Significantly\" in Six Weeks' href=\"http://www.californiahealthline.org/capitol-desk/2014/9/medical-application-backlog-will-be-down-significantly-within-six-weeks\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>At an Assembly Committee on Health hearing yesterday, Department of Health Care Services Director Toby Douglas said the backlog of Medi-Cal applications -- at one point in March topping \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/03/nearly-a-million-people-backlogged-in-medi-cal-expansion/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/03/nearly-a-million-people-backlogged-in-medi-cal-expansion/\" target=\"_blank\">900,000 unprocessed eligibility claims\u003c/a> -- now is down to about 250,000 applications and will be \"down significantly\" from that by the start of November.\u003c/p>\n\u003cp>Douglas answered a number of concerns at the hearing, including announcing a shift in DHCS policy regarding asthma and allergy testing, as well as Denti-Cal and special-needs dental care issues.\u003c/p>\n\u003cp>The counties and DHCS, Douglas said, reduced the Medi-Cal application backlog by 650,000 over six months -- more than 100,000 a month. A similar pace in the next month-and-a-half would get it down to about 100,000 applications.\u003c!--more-->\u003c/p>\n\u003cp>\"If you look at the trajectory, I hope to take this down significantly over the next six weeks,\" Douglas said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That wasn't really good enough at the hearing for Assembly member Jim Patterson (R-Fresno).\u003c/p>\n\u003cp>\"I don't think I heard an answer to this,\" Patterson said. \"When do we anticipate ending the backlog?\"\u003c/p>\n\u003cp>\"We are going to continue to work through it,\" Douglas said. \"We want to get to that as soon as possible.\"\u003c/p>\n\u003cp>Patterson wanted to know specifically when the department would be done going through all the backlogged applications. \"I have to go back and tell my constituents about this,\" he said. \"What do I tell them? That it will never be zero?\"\u003c/p>\n\u003cp>Douglas said it wasn't only about clearing the older claims, but making sure the newer claims don't end up contributing in even greater numbers to the backlog. \"It gets back to getting the defects out of the [computer] system, so we're in a stable state,\" Douglas said.\u003c/p>\n\u003cp>Douglas also announced at the hearing that DHCS will change its Medi-Cal policy stance on ordering certain types of allergy tests. It was a shift to national standards that Assembly health committee chair Richard Pan (D-Sacramento) has lobbied DHCS to change for more than two years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For patients waiting months and months to get tested, this is an important victory,\" Pan said in a written statement after the hearing. \"Now a doctor can order tests to identify a patient's allergy and asthma triggers so they can avoid getting sick.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Advocacy Groups File Lawsuit Over Medi-Cal Backlog",
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"content": "\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"Kaiser Health News\" href=\"http://capsules.kaiserhealthnews.org/index.php/2014/09/lawsuit-accuses-calif-of-denying-care-to-medi-cal-applicants/#more-30760\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.\u003c/aside>\n\u003cp>The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.\u003c/p>\n\u003cp>Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending.\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit cites several cases, including that of Tulare County resident Robert Rivera, who applied for Medi-Cal in January but died of a pulmonary embolism while the state was determining if he was eligible for the insurance. Two months after his death, Rivera’s mother received a letter saying that the benefits had been approved.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Los Angeles County resident Mark Mullin submitted an application in February 2014, but wasn’t approved until four months later — after he sought legal help. During the time his application was stuck in the backlog, Mullin had to undergo an emergency appendectomy.\u003c/p>\n\u003cp>The suit is asking the state to process cases within 45 days and to grant people Medi-Cal benefits while officials verify applicants’ incomes. The coalition is also asking the state to send notices to Medi-Cal applicants who have been waiting for 45 days notifying them of their right to go before an administrative law judge.\u003c/p>\n\u003cp>The long wait is “unacceptable,” said Katie Murphy, managing attorney at Neighborhood Legal Services of Los Angeles County. Murphy said she is concerned that the problems will get worse as more people apply for Medi-Cal. “If they are not fixed, more people will continue to wait and more will continue to suffer medical emergencies,” she said.\u003c/p>\n\u003cp>California Department of Health Care Services officials said they have been working closely with the counties and have reduced the backlog by 250,000 since early July. Many of the cases are still pending because of incorrect or incomplete information.\u003c/p>\n\u003cp>Department spokesman Tony Cava said people who need immediate care can get in-person assistance with their application at a county social services agency. They also can get their medical bills covered for care received while their applications were pending, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The lawsuit was filed by several organizations throughout California, including Neighborhood Legal Services of Los Angeles County, the National Health Law Program and Bay Area Legal Aid.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca title=\"Kaiser Health News\" href=\"http://capsules.kaiserhealthnews.org/index.php/2014/09/lawsuit-accuses-calif-of-denying-care-to-medi-cal-applicants/#more-30760\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.\u003c/aside>\n\u003cp>The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.\u003c/p>\n\u003cp>Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending.\u003c!--more-->\u003c/p>\n\u003cp>The lawsuit cites several cases, including that of Tulare County resident Robert Rivera, who applied for Medi-Cal in January but died of a pulmonary embolism while the state was determining if he was eligible for the insurance. Two months after his death, Rivera’s mother received a letter saying that the benefits had been approved.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Los Angeles County resident Mark Mullin submitted an application in February 2014, but wasn’t approved until four months later — after he sought legal help. During the time his application was stuck in the backlog, Mullin had to undergo an emergency appendectomy.\u003c/p>\n\u003cp>The suit is asking the state to process cases within 45 days and to grant people Medi-Cal benefits while officials verify applicants’ incomes. The coalition is also asking the state to send notices to Medi-Cal applicants who have been waiting for 45 days notifying them of their right to go before an administrative law judge.\u003c/p>\n\u003cp>The long wait is “unacceptable,” said Katie Murphy, managing attorney at Neighborhood Legal Services of Los Angeles County. Murphy said she is concerned that the problems will get worse as more people apply for Medi-Cal. “If they are not fixed, more people will continue to wait and more will continue to suffer medical emergencies,” she said.\u003c/p>\n\u003cp>California Department of Health Care Services officials said they have been working closely with the counties and have reduced the backlog by 250,000 since early July. Many of the cases are still pending because of incorrect or incomplete information.\u003c/p>\n\u003cp>Department spokesman Tony Cava said people who need immediate care can get in-person assistance with their application at a county social services agency. They also can get their medical bills covered for care received while their applications were pending, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The lawsuit was filed by several organizations throughout California, including Neighborhood Legal Services of Los Angeles County, the National Health Law Program and Bay Area Legal Aid.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "S.F. Supervisor Wiener Announces He's Taking HIV Preventive Drug",
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"content": "\u003cfigure id=\"attachment_21582\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/photo-e1410998460649.jpg\">\u003cimg class=\"size-large wp-image-21582\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/photo-640x480.jpg\" alt=\"San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco Supervisor Scott Wiener publicly announced Wednesday afternoon that he is taking Truvada, an FDA-approved drug that dramatically reduces the risk of HIV infection. He appears to be the first public official to make such an announcement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"My hope is that by disclosing my PrEP use… I can get more people thinking about PrEP as a possibility.\" \u003c/aside>\n\u003cp>Wiener said he began taking the medication earlier this year. This preventive approach is also referred to as pre-exposure prophylaxis or PrEP.\u003c/p>\n\u003cp>\"I am using PrEP as a personal health choice that I made in consultation with my physician,\" he said in an interview at his office at City Hall. \"My hope is that by disclosing my PrEP use publicly that I can help move the conversation forward and get more people thinking about PrEP as a possibility, and encouraging people to consult with their medical provider.\"\u003c/p>\n\u003cp>Truvada combines two different drugs into a single pill that, when taken daily, can reduce the risk of HIV infection by more than 90 percent. It was approved by the FDA in 2012, and was developed by the Foster City company Gilead. Both the \u003ca title=\"Pre-Exposure Prophylaxis\" href=\"http://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf\" target=\"_blank\">Centers for Disease Control\u003c/a> and the \u003ca title=\"WHO Consolidated Guidelines\" href=\"http://www.who.int/hiv/pub/guidelines/keypopulations/en/\" target=\"_blank\">World Health Organization\u003c/a> recommend its use by people who are at high risk of HIV infection. Still, it is the subject of debate, especially within the gay community.\u003c!--more-->\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/168221334\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height='166' iframe=\"true\" /]\u003c/p>\n\u003cp>Wiener, 44, was first elected to the Board of Supervisors in 2011 representing the Castro district. He says he started coming out as a gay man in 1990, at what he called the height of the AIDS epidemic.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Coming out in that environment was challenging and stressful,\" he said. \"Immediately associating sex with illness and death was very stressful and many, many people, I think, had that same experience.\" He spoke of friends who have started using PrEP recently who \"have told me that their general anxiety level around intimacy has gone down significantly.\"\u003c/p>\n\u003cp>Wiener said that only a few people knew that he was taking PrEP. James Loduca, vice president of philanthropy for the San Francisco AIDS Foundation, called Wiener's disclosure \"incredibly courageous.\"\u003c/p>\n\u003cp>\"We need more people like Supervisor Wiener,\" Loduca said. \"In my own personal network, many of my HIV-negative gay male friends are on PrEP. None of them talk about it publicly, and that is a reflection of the enormous stigma and shame that we still have around sex, around a desire to have intimacy. … It's an important watershed moment for our community that someone so visible steps forward and says 'PrEP is helping me.'\"\u003c/p>\n\u003cp>Wiener spoke openly of people availing themselves of all options to prevent acquiring the virus, including the use of condoms and being tested regularly. If someone becomes infected with HIV, identifying the infection sooner yields more immediate treatment, which can lead to improved long-term health outcomes.\u003c/p>\n\u003cp>\u003cspan style=\"color: #111111\">When taken to prevent HIV infection, Truvada\u003c/span>\u003ca style=\"color: #4774cc\" title=\"Truvada\" href=\"http://start.truvada.com/\" target=\"_blank\"> carries a risk of side effects\u003c/a>\u003cspan style=\"color: #111111\"> that include headache, abdominal pain and weight loss. Potentially serious side effects include kidney problems, liver damage and a buildup of lactic acid in the blood. Not everyone is affected. Wiener says he is not suffering from any side effects of the treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Move to Subsidize PrEP Treatment\u003c/strong>\u003c/p>\n\u003cp>Wiener's announcement comes on the eve of a rally to be held Thursday, coordinated by San Francisco Supervisor David Campos. Campos is calling for San Francisco to make PrEP available to San Franciscans regardless of income. New York Gov. Andrew Cuomo has made a\u003ca title=\"End AIDS in New York State\" href=\"https://www.governor.ny.gov/press/06292014-end-aids-epidemic\" target=\"_blank\"> similar proposal\u003c/a> for his state.\u003c/p>\n\u003cp>Despite a massive public health campaign to fight the spread of HIV, nationally there have been 50,000 new HIV infections every year for the last 20 years. \"PrEP is the first new tool in our fight to protect ourselves from HIV since the epidemic began,\" Campos said in a release.\u003c/p>\n\u003cp>Wiener backs the effort. \"In order for PrEP to be successful, we have to do three things,\" he said. \"We need to raise awareness about it, make sure people know about it. … We need to secondly remove the stigma around it, so people are able to talk about it, are able to consider it, and finally, we need to expand access.\"\u003c/p>\n\u003cp>But that kind of community-wide campaign is exactly the wrong idea, some advocates say.\u003c/p>\n\u003cp>\"To deploy (PrEP) as a community-wide preventive is a public health disaster in the making,\" said Ged Kenslea, spokesman for AIDS Healthcare Foundation, a global advocacy group. He stressed the organization is not opposed to the use of PrEP on a case-by-case basis.\u003c/p>\n\u003cp>\"The crucial problem is adherence to the medication,\" he said. He also pointed out that condoms are not only effective against protecting against HIV infection, but also against other sexually transmitted diseases \"for which PrEP does nothing.\" Kenslea said that he's worried that people \"seem to be throwing condoms out the window.\"\u003c/p>\n\u003cp>Dr. Robert Grant with the UCSF Gladstone Institute \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21091279\" target=\"_blank\">led the research \u003c/a>that ultimately showed Truvada's effectiveness as a preventive agent against HIV and has followed it since.\u003c/p>\n\u003cp>He said that there's \u003ca title=\"No Link Between Truvada and High Risk Sexual Behavior\" href=\"http://www.ucsf.edu/news/2013/12/110831/no-link-between-hiv-prevention-pill-truvada-and-increased-sexual-risk-behavior\" target=\"_blank\">no link \u003c/a>between PrEP and increasing high-risk sexual behavior. He also supports efforts to make PrEP available more widely and compared having a variety of tools to fight HIV with having a variety of methods of birth control available.\u003c/p>\n\u003cp>\"Just like contraception,\" he said. \"We're happy to have people using different methods. Same way with HIV. We have to have lots of different methods for people to use, so people can find one that's attractive to them.\"\u003c/p>\n\u003cp>Grant said that in his research \"we have not seen anyone become infected who has taken PrEP daily or nearly daily.\"\u003c/p>\n\u003cp>\u003cem>Wiener published an essay in the \u003ca title=\"Coming out of the PrEP Closet\" href=\"http://www.huffingtonpost.com/scott-wiener/coming-out-of-the-prep-closet_b_5832370.html\" target=\"_blank\">Huffington Post \u003c/a>Wednesday about his decision to use Truvada.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>UPDATE: The headline in an earlier version of this story inaccurately described the medication as an \"AIDS preventive.\" The drug protects against acquiring HIV, the virus that causes AIDS. KQED regrets the error.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21582\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/photo-e1410998460649.jpg\">\u003cimg class=\"size-large wp-image-21582\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/photo-640x480.jpg\" alt=\"San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>San Francisco Supervisor Scott Wiener publicly announced Wednesday afternoon that he is taking Truvada, an FDA-approved drug that dramatically reduces the risk of HIV infection. He appears to be the first public official to make such an announcement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"My hope is that by disclosing my PrEP use… I can get more people thinking about PrEP as a possibility.\" \u003c/aside>\n\u003cp>Wiener said he began taking the medication earlier this year. This preventive approach is also referred to as pre-exposure prophylaxis or PrEP.\u003c/p>\n\u003cp>\"I am using PrEP as a personal health choice that I made in consultation with my physician,\" he said in an interview at his office at City Hall. \"My hope is that by disclosing my PrEP use publicly that I can help move the conversation forward and get more people thinking about PrEP as a possibility, and encouraging people to consult with their medical provider.\"\u003c/p>\n\u003cp>Truvada combines two different drugs into a single pill that, when taken daily, can reduce the risk of HIV infection by more than 90 percent. It was approved by the FDA in 2012, and was developed by the Foster City company Gilead. Both the \u003ca title=\"Pre-Exposure Prophylaxis\" href=\"http://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf\" target=\"_blank\">Centers for Disease Control\u003c/a> and the \u003ca title=\"WHO Consolidated Guidelines\" href=\"http://www.who.int/hiv/pub/guidelines/keypopulations/en/\" target=\"_blank\">World Health Organization\u003c/a> recommend its use by people who are at high risk of HIV infection. Still, it is the subject of debate, especially within the gay community.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/168221334&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/168221334'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Wiener, 44, was first elected to the Board of Supervisors in 2011 representing the Castro district. He says he started coming out as a gay man in 1990, at what he called the height of the AIDS epidemic.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Coming out in that environment was challenging and stressful,\" he said. \"Immediately associating sex with illness and death was very stressful and many, many people, I think, had that same experience.\" He spoke of friends who have started using PrEP recently who \"have told me that their general anxiety level around intimacy has gone down significantly.\"\u003c/p>\n\u003cp>Wiener said that only a few people knew that he was taking PrEP. James Loduca, vice president of philanthropy for the San Francisco AIDS Foundation, called Wiener's disclosure \"incredibly courageous.\"\u003c/p>\n\u003cp>\"We need more people like Supervisor Wiener,\" Loduca said. \"In my own personal network, many of my HIV-negative gay male friends are on PrEP. None of them talk about it publicly, and that is a reflection of the enormous stigma and shame that we still have around sex, around a desire to have intimacy. … It's an important watershed moment for our community that someone so visible steps forward and says 'PrEP is helping me.'\"\u003c/p>\n\u003cp>Wiener spoke openly of people availing themselves of all options to prevent acquiring the virus, including the use of condoms and being tested regularly. If someone becomes infected with HIV, identifying the infection sooner yields more immediate treatment, which can lead to improved long-term health outcomes.\u003c/p>\n\u003cp>\u003cspan style=\"color: #111111\">When taken to prevent HIV infection, Truvada\u003c/span>\u003ca style=\"color: #4774cc\" title=\"Truvada\" href=\"http://start.truvada.com/\" target=\"_blank\"> carries a risk of side effects\u003c/a>\u003cspan style=\"color: #111111\"> that include headache, abdominal pain and weight loss. Potentially serious side effects include kidney problems, liver damage and a buildup of lactic acid in the blood. Not everyone is affected. Wiener says he is not suffering from any side effects of the treatment.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Move to Subsidize PrEP Treatment\u003c/strong>\u003c/p>\n\u003cp>Wiener's announcement comes on the eve of a rally to be held Thursday, coordinated by San Francisco Supervisor David Campos. Campos is calling for San Francisco to make PrEP available to San Franciscans regardless of income. New York Gov. Andrew Cuomo has made a\u003ca title=\"End AIDS in New York State\" href=\"https://www.governor.ny.gov/press/06292014-end-aids-epidemic\" target=\"_blank\"> similar proposal\u003c/a> for his state.\u003c/p>\n\u003cp>Despite a massive public health campaign to fight the spread of HIV, nationally there have been 50,000 new HIV infections every year for the last 20 years. \"PrEP is the first new tool in our fight to protect ourselves from HIV since the epidemic began,\" Campos said in a release.\u003c/p>\n\u003cp>Wiener backs the effort. \"In order for PrEP to be successful, we have to do three things,\" he said. \"We need to raise awareness about it, make sure people know about it. … We need to secondly remove the stigma around it, so people are able to talk about it, are able to consider it, and finally, we need to expand access.\"\u003c/p>\n\u003cp>But that kind of community-wide campaign is exactly the wrong idea, some advocates say.\u003c/p>\n\u003cp>\"To deploy (PrEP) as a community-wide preventive is a public health disaster in the making,\" said Ged Kenslea, spokesman for AIDS Healthcare Foundation, a global advocacy group. He stressed the organization is not opposed to the use of PrEP on a case-by-case basis.\u003c/p>\n\u003cp>\"The crucial problem is adherence to the medication,\" he said. He also pointed out that condoms are not only effective against protecting against HIV infection, but also against other sexually transmitted diseases \"for which PrEP does nothing.\" Kenslea said that he's worried that people \"seem to be throwing condoms out the window.\"\u003c/p>\n\u003cp>Dr. Robert Grant with the UCSF Gladstone Institute \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21091279\" target=\"_blank\">led the research \u003c/a>that ultimately showed Truvada's effectiveness as a preventive agent against HIV and has followed it since.\u003c/p>\n\u003cp>He said that there's \u003ca title=\"No Link Between Truvada and High Risk Sexual Behavior\" href=\"http://www.ucsf.edu/news/2013/12/110831/no-link-between-hiv-prevention-pill-truvada-and-increased-sexual-risk-behavior\" target=\"_blank\">no link \u003c/a>between PrEP and increasing high-risk sexual behavior. He also supports efforts to make PrEP available more widely and compared having a variety of tools to fight HIV with having a variety of methods of birth control available.\u003c/p>\n\u003cp>\"Just like contraception,\" he said. \"We're happy to have people using different methods. Same way with HIV. We have to have lots of different methods for people to use, so people can find one that's attractive to them.\"\u003c/p>\n\u003cp>Grant said that in his research \"we have not seen anyone become infected who has taken PrEP daily or nearly daily.\"\u003c/p>\n\u003cp>\u003cem>Wiener published an essay in the \u003ca title=\"Coming out of the PrEP Closet\" href=\"http://www.huffingtonpost.com/scott-wiener/coming-out-of-the-prep-closet_b_5832370.html\" target=\"_blank\">Huffington Post \u003c/a>Wednesday about his decision to use Truvada.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>UPDATE: The headline in an earlier version of this story inaccurately described the medication as an \"AIDS preventive.\" The drug protects against acquiring HIV, the virus that causes AIDS. KQED regrets the error.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_21548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\">\u003cimg class=\"size-full wp-image-21548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\" alt=\"Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn\u003c/strong>\u003c/p>\n\u003cp>California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California's low-income health program.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"He's doing things other kids can do. And it's those little moments, it makes you just so grateful.\"\u003c/aside>\n\u003cp>That makes California the first state in the nation to implement new federal standards on autism care.\u003c/p>\n\u003cp>The new benefit includes coverage of the clinical standard of care for autism treatment -- Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.\u003c/p>\n\u003cp>Of the 5 million children on Medi-Cal in California -- that's roughly half the state's total children -- there are an estimated 75,000 who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of those families is Jazzmon Wilson and her son Timothy. I recently met with them at their home in Rancho Cordova, outside of Sacramento. Timothy was playing a video game.\u003c/p>\n\u003cp>For most families, it was a familiar scene, the 6-year-old glued to his Super Mario game, leaping and dodging virtual pitfalls. But his mom, Jazzmon, still couldn't quite believe what she was seeing.\u003c/p>\n\u003cp>\"It's amazing, he's 6 now, and I never thought this was going to happen,\" she said, \"but he plays Mario. He can play it!\"\u003c/p>\n\u003cp>The fact that Timothy can understand how the video game works, and interact with it -- let alone sit still long enough to figure anything out in the game -- is a major accomplishment, she said.\u003c/p>\n\u003cp>\"He's doing things other kids can do, too,\" she said. \"And it's those little moments, it makes you just so grateful.\"\u003c/p>\n\u003cp>It wasn't always this way. Timothy has autism, and his mom described it as having a brain that was wired a little differently. She compared it to one of those frustrating cell phone conversations where there's a couple of seconds delay and people can't communicate with each other. She says her son Timothy had an 8-second delay.\u003c/p>\n\u003cp>And that's not all. At two-years-old he couldn't speak a single word. Not mama, not Dada, nothing. He would spin around. He would yell, constantly.\u003c/p>\n\u003cp>But once he started ABA therapy, his mom says, he was a different kid.\u003c/p>\n\u003cp>\"ABA is giving back to you the typical experiences you dreamed you were going to have when your kid was born,\" Wilson said said. \"All those LITTLE things.\"\u003c/p>\n\u003cp>Little things like sitting still, or making eye contact with his mother.\u003c/p>\n\u003cp>[contextly_sidebar id=\"8HS5mIp1dWbby2CCtkglRASdTy29I9kx\"]\u003c/p>\n\u003cp>The basic idea of ABA therapy is to rewire all the little steps most people take for granted. For example, an ABA therapist will reward a child for sitting down with so-called \"quiet hands\" for two seconds. Then a reward for five seconds, then 10, and so on.\u003c/p>\n\u003cp>After all of that, said Gregory Buch -- a behavorial psychologist in Roseville, north of Sacramento -- comes the arduous process of actually learning words.\u003c/p>\n\u003cp>\"The challenge is, if you have a child who is 3-years-old and has no language whatsoever, you've got about two years' of communications skills at least to teach them,\" Buch said.\u003c/p>\n\u003cp>\"So not only do they have to learn everything that an average child learns that they didn't learn,\" he said, \"they have to learn it faster than the average child learned it.\"\u003c/p>\n\u003cp>When you combine a slow learning process with starting out way behind, you need an intensive program to catch up, Buch said. But, he added, that's what works.\u003c/p>\n\u003cp>\"I think most kids [with autism] will benefit from some kind of ABA intervention,\" he said. \"And for some kids, that's a really dramatic gain.\"\u003c/p>\n\u003cp>This type of therapy has been a clinical standard of care for more than a decade, but that doesn't always mean people could access it.\u003c/p>\n\u003cp>The Legislature had to order private insurance companies two years ago to pay for it. But with Medi-Cal, coverage remained blocked. Until now.\u003c/p>\n\u003cp>\"We are extremely pleased and excited that we're adding this benefit,\" said Toby Douglas, director of the state Department of Health Care Services.\u003c/p>\n\u003cp>Douglas said California is first in the nation to act on new federal rules on autism care. California was just waiting for the federal go-ahead, he said.\u003c/p>\n\u003cp>\"It has been something that stakeholders [and] the state have been exploring for a long time,\" Douglas said.\u003c/p>\n\u003cp>Earlier this month, \u003ca title=\"Details of Autism Benefit Coming\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\">hundreds of stakeholders gathered\u003c/a> in a Sacramento auditorium to hash out the devilish details of implementing the benefit.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167855668&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Kristin Jacobson, president of \u003ca title=\"Autism Deserves Equal Coverage home page\" href=\"http://www.autismdeservesequalcoverage.com\" target=\"_blank\">Autism Deserves Equal Coverage\u003c/a>, was at that meeting, and she says there are still miles to go before everyone eligible for therapy gets the therapy.\u003c/p>\n\u003cp>\"This has been a really, really long struggle. We've been fighting for such a long time. We're encouraged, but we are going to remain very vigilant,\" she said.\u003c/p>\n\u003cp>\"If Medi-Cal doesn't make sure to contract with the vast majority of current existing providers, they will not have enough providers,\" Jacobson said. \"They will not be able to actually provide the benefit that they're saying.\"\u003c/p>\n\u003cp>However, she said, the bottom line is: After years of telling her autism clients \"No, no, no, no,\" now she's finally able to say \"Yes,\" Jacobson said. Her organization has p\u003ca title=\"How-To Guide to ABA Benefit\" href=\"http://autismdeservesequalcoverage.com/uploads/Medi-Cal_Autism_Benefit_How-To-Guide.pdf\" target=\"_blank\">roduced a fact sheet \u003c/a>to answer questions about the new benefit.\u003c/p>\n\u003cp>Jazzmon Wilson, back in her living room with Timothy, said the state's coverage couldn't have come at a better time. Timothy had a short course of therapy paid with proceeds from a legal settlement, but that's about to run out. Without the new Medi-Cal benefit, she said she didn't know what she would have done.\u003c/p>\n\u003cp>\"To have something that can bring a little bit of hope, it makes all the difference in the world,\" Wilson said. \"And so when he can do those things now, it makes … It makes life worth living, which is hard to say. It really is hard to say that.\"\u003c/p>\n\u003cp>The state still has plenty of work to do, as\u003ca title=\"Details Coming in Autism Benefit Rollout\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\"> it hasn't yet set provider rates or eligibility standards\u003c/a>. But for thousands of families across California, the coverage for ABA therapy may mean a taste of fresh hope in their lives.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior news editor with \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/\" target=\"_blank\">California Healthline\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Private insurers were required to cover a special therapy, but Medi-Cal kids were excluded. Until today.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\">\u003cimg class=\"size-full wp-image-21548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg\" alt=\"Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/RS12003_Jazzmon-and-Bubba-hpf-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn\u003c/strong>\u003c/p>\n\u003cp>California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California's low-income health program.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"He's doing things other kids can do. And it's those little moments, it makes you just so grateful.\"\u003c/aside>\n\u003cp>That makes California the first state in the nation to implement new federal standards on autism care.\u003c/p>\n\u003cp>The new benefit includes coverage of the clinical standard of care for autism treatment -- Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.\u003c/p>\n\u003cp>Of the 5 million children on Medi-Cal in California -- that's roughly half the state's total children -- there are an estimated 75,000 who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of those families is Jazzmon Wilson and her son Timothy. I recently met with them at their home in Rancho Cordova, outside of Sacramento. Timothy was playing a video game.\u003c/p>\n\u003cp>For most families, it was a familiar scene, the 6-year-old glued to his Super Mario game, leaping and dodging virtual pitfalls. But his mom, Jazzmon, still couldn't quite believe what she was seeing.\u003c/p>\n\u003cp>\"It's amazing, he's 6 now, and I never thought this was going to happen,\" she said, \"but he plays Mario. He can play it!\"\u003c/p>\n\u003cp>The fact that Timothy can understand how the video game works, and interact with it -- let alone sit still long enough to figure anything out in the game -- is a major accomplishment, she said.\u003c/p>\n\u003cp>\"He's doing things other kids can do, too,\" she said. \"And it's those little moments, it makes you just so grateful.\"\u003c/p>\n\u003cp>It wasn't always this way. Timothy has autism, and his mom described it as having a brain that was wired a little differently. She compared it to one of those frustrating cell phone conversations where there's a couple of seconds delay and people can't communicate with each other. She says her son Timothy had an 8-second delay.\u003c/p>\n\u003cp>And that's not all. At two-years-old he couldn't speak a single word. Not mama, not Dada, nothing. He would spin around. He would yell, constantly.\u003c/p>\n\u003cp>But once he started ABA therapy, his mom says, he was a different kid.\u003c/p>\n\u003cp>\"ABA is giving back to you the typical experiences you dreamed you were going to have when your kid was born,\" Wilson said said. \"All those LITTLE things.\"\u003c/p>\n\u003cp>Little things like sitting still, or making eye contact with his mother.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The basic idea of ABA therapy is to rewire all the little steps most people take for granted. For example, an ABA therapist will reward a child for sitting down with so-called \"quiet hands\" for two seconds. Then a reward for five seconds, then 10, and so on.\u003c/p>\n\u003cp>After all of that, said Gregory Buch -- a behavorial psychologist in Roseville, north of Sacramento -- comes the arduous process of actually learning words.\u003c/p>\n\u003cp>\"The challenge is, if you have a child who is 3-years-old and has no language whatsoever, you've got about two years' of communications skills at least to teach them,\" Buch said.\u003c/p>\n\u003cp>\"So not only do they have to learn everything that an average child learns that they didn't learn,\" he said, \"they have to learn it faster than the average child learned it.\"\u003c/p>\n\u003cp>When you combine a slow learning process with starting out way behind, you need an intensive program to catch up, Buch said. But, he added, that's what works.\u003c/p>\n\u003cp>\"I think most kids [with autism] will benefit from some kind of ABA intervention,\" he said. \"And for some kids, that's a really dramatic gain.\"\u003c/p>\n\u003cp>This type of therapy has been a clinical standard of care for more than a decade, but that doesn't always mean people could access it.\u003c/p>\n\u003cp>The Legislature had to order private insurance companies two years ago to pay for it. But with Medi-Cal, coverage remained blocked. Until now.\u003c/p>\n\u003cp>\"We are extremely pleased and excited that we're adding this benefit,\" said Toby Douglas, director of the state Department of Health Care Services.\u003c/p>\n\u003cp>Douglas said California is first in the nation to act on new federal rules on autism care. California was just waiting for the federal go-ahead, he said.\u003c/p>\n\u003cp>\"It has been something that stakeholders [and] the state have been exploring for a long time,\" Douglas said.\u003c/p>\n\u003cp>Earlier this month, \u003ca title=\"Details of Autism Benefit Coming\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\">hundreds of stakeholders gathered\u003c/a> in a Sacramento auditorium to hash out the devilish details of implementing the benefit.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167855668&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Kristin Jacobson, president of \u003ca title=\"Autism Deserves Equal Coverage home page\" href=\"http://www.autismdeservesequalcoverage.com\" target=\"_blank\">Autism Deserves Equal Coverage\u003c/a>, was at that meeting, and she says there are still miles to go before everyone eligible for therapy gets the therapy.\u003c/p>\n\u003cp>\"This has been a really, really long struggle. We've been fighting for such a long time. We're encouraged, but we are going to remain very vigilant,\" she said.\u003c/p>\n\u003cp>\"If Medi-Cal doesn't make sure to contract with the vast majority of current existing providers, they will not have enough providers,\" Jacobson said. \"They will not be able to actually provide the benefit that they're saying.\"\u003c/p>\n\u003cp>However, she said, the bottom line is: After years of telling her autism clients \"No, no, no, no,\" now she's finally able to say \"Yes,\" Jacobson said. Her organization has p\u003ca title=\"How-To Guide to ABA Benefit\" href=\"http://autismdeservesequalcoverage.com/uploads/Medi-Cal_Autism_Benefit_How-To-Guide.pdf\" target=\"_blank\">roduced a fact sheet \u003c/a>to answer questions about the new benefit.\u003c/p>\n\u003cp>Jazzmon Wilson, back in her living room with Timothy, said the state's coverage couldn't have come at a better time. Timothy had a short course of therapy paid with proceeds from a legal settlement, but that's about to run out. Without the new Medi-Cal benefit, she said she didn't know what she would have done.\u003c/p>\n\u003cp>\"To have something that can bring a little bit of hope, it makes all the difference in the world,\" Wilson said. \"And so when he can do those things now, it makes … It makes life worth living, which is hard to say. It really is hard to say that.\"\u003c/p>\n\u003cp>The state still has plenty of work to do, as\u003ca title=\"Details Coming in Autism Benefit Rollout\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/08/details-of-autism-benefits-like-provider-rates-coming-after-rollout/\" target=\"_blank\"> it hasn't yet set provider rates or eligibility standards\u003c/a>. But for thousands of families across California, the coverage for ABA therapy may mean a taste of fresh hope in their lives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior news editor with \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/\" target=\"_blank\">California Healthline\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Field Poll Shows Support Slipping for Two Health Propositions",
"title": "Field Poll Shows Support Slipping for Two Health Propositions",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21498\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS3730_voters-at-polling-place-Getty-scr-e1410456027533.jpg\">\u003cimg class=\"size-large wp-image-21498\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS3730_voters-at-polling-place-Getty-scr-640x352.jpg\" alt=\"(David Paul Morris/Getty Images)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Paul Morris/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A new \u003ca title=\"Field Poll on Props. 45 and 46\" href=\"http://www.field.com/fieldpollonline/subscribers/Rls2485.pdf\" target=\"_blank\">Field Poll\u003c/a> shows voter support dropping for two propositions on the November ballot.\u003c/p>\n\u003cp>Prop. 45 would give the state insurance commissioner the authority to reject excessive rate hikes. Support has dropped from 69 percent early in the summer to 41 percent in the current poll. Twenty-six percent are opposed and 33 percent are undecided.\u003c/p>\n\u003cp>Prop. 46 would require drug testing of doctors and increase the cap on pain and suffering awards in medical negligence lawsuits from $250,000 to $1.1 million. Early this summer, support stood at 58 percent; today it is 34 percent, with 30 percent opposed and 29 percent undecided.\u003c/p>\n\u003cp>\"This current poll is relatively big news on Prop. 46. I don't think its chances of passage are all that great,\" Field Poll director Mark DiCamillo \u003ca title=\"Field Poll on Propositions 45, 46\" href=\"http://www.sfgate.com/politics/article/Field-Poll-finds-support-slipping-for-Props-45-5747522.php\" target=\"_blank\">told the San Francisco Chronicle\u003c/a>. He added that it's harder to predict what might happen with Prop. 45.\u003c!--more-->\u003c/p>\n\u003cp>The opponents of both propositions are spending big to defeat the measures. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>From the\u003ca href=\"http://www.sfgate.com/politics/article/Field-Poll-finds-support-slipping-for-Props-45-5747522.php\" target=\"_blank\"> Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"color: #000000\">Prop. 45's leading supporters, including the state's insurance commissioner, \u003c/span>\u003ca style=\"color: #015660\" title=\"Insurance Commissioner Defends Health Insurance Initiative\" href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">Dave Jones\u003c/a>\u003cspan style=\"color: #000000\">, and the advocacy group \u003c/span>\u003ca style=\"color: #015660\" href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=politics&search=1&inlineLink=1&query=%22Consumer+Watchdog%22\" target=\"_blank\">Consumer Watchdog\u003c/a>\u003cspan style=\"color: #000000\">, have been largely outspent by the major health insurers and other companies. According to campaign reporting figures, the backers have raised just $450,000 as of Sept. 9 while opponents have spent $24 million to kill it.\u003c/span>\u003c/p>\n\u003cp>Prop. 46's detractors, physicians and medical malpractice companies, have contributed $59 million to persuade voters to reject the measure while its supporters have spent a comparatively paltry $4.5 million.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The poll was conducted from August 14-28, and included 467 voters considered likely to vote in the November election. It has a margin of error of plus or minus 4.8 percentage points.\u003c/p>\n\n",
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"excerpt": "Both measures had strong support early in the summer, but well below 50 percent today.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21498\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS3730_voters-at-polling-place-Getty-scr-e1410456027533.jpg\">\u003cimg class=\"size-large wp-image-21498\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS3730_voters-at-polling-place-Getty-scr-640x352.jpg\" alt=\"(David Paul Morris/Getty Images)\" width=\"640\" height=\"352\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Paul Morris/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A new \u003ca title=\"Field Poll on Props. 45 and 46\" href=\"http://www.field.com/fieldpollonline/subscribers/Rls2485.pdf\" target=\"_blank\">Field Poll\u003c/a> shows voter support dropping for two propositions on the November ballot.\u003c/p>\n\u003cp>Prop. 45 would give the state insurance commissioner the authority to reject excessive rate hikes. Support has dropped from 69 percent early in the summer to 41 percent in the current poll. Twenty-six percent are opposed and 33 percent are undecided.\u003c/p>\n\u003cp>Prop. 46 would require drug testing of doctors and increase the cap on pain and suffering awards in medical negligence lawsuits from $250,000 to $1.1 million. Early this summer, support stood at 58 percent; today it is 34 percent, with 30 percent opposed and 29 percent undecided.\u003c/p>\n\u003cp>\"This current poll is relatively big news on Prop. 46. I don't think its chances of passage are all that great,\" Field Poll director Mark DiCamillo \u003ca title=\"Field Poll on Propositions 45, 46\" href=\"http://www.sfgate.com/politics/article/Field-Poll-finds-support-slipping-for-Props-45-5747522.php\" target=\"_blank\">told the San Francisco Chronicle\u003c/a>. He added that it's harder to predict what might happen with Prop. 45.\u003c!--more-->\u003c/p>\n\u003cp>The opponents of both propositions are spending big to defeat the measures. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>From the\u003ca href=\"http://www.sfgate.com/politics/article/Field-Poll-finds-support-slipping-for-Props-45-5747522.php\" target=\"_blank\"> Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"color: #000000\">Prop. 45's leading supporters, including the state's insurance commissioner, \u003c/span>\u003ca style=\"color: #015660\" title=\"Insurance Commissioner Defends Health Insurance Initiative\" href=\"http://ww2.kqed.org/stateofhealth/2014/05/27/insurance-commissioner-defends-health-insurance-initiative/\" target=\"_blank\">Dave Jones\u003c/a>\u003cspan style=\"color: #000000\">, and the advocacy group \u003c/span>\u003ca style=\"color: #015660\" href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=politics&search=1&inlineLink=1&query=%22Consumer+Watchdog%22\" target=\"_blank\">Consumer Watchdog\u003c/a>\u003cspan style=\"color: #000000\">, have been largely outspent by the major health insurers and other companies. According to campaign reporting figures, the backers have raised just $450,000 as of Sept. 9 while opponents have spent $24 million to kill it.\u003c/span>\u003c/p>\n\u003cp>Prop. 46's detractors, physicians and medical malpractice companies, have contributed $59 million to persuade voters to reject the measure while its supporters have spent a comparatively paltry $4.5 million.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The poll was conducted from August 14-28, and included 467 voters considered likely to vote in the November election. It has a margin of error of plus or minus 4.8 percentage points.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_21417\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg\">\u003cimg class=\"size-full wp-image-21417\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg\" alt=\"Randen Patterson\" width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Randen Patterson left a research career in physiology at U.C. Davis when funding got too tight. He now owns a grocery store in Guinda, outside Davis. (Max Whittaker/Prime for NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Richard Harris\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/09/09/345289127/when-scientists-give-up\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ian Glomski thought he was going to make a difference in the fight to protect people from deadly anthrax germs. He had done everything right — attended one top university, landed an assistant professorship at another.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I shouldn't be a grocer right now. I should be training students. I should be doing deeper research. And I can't. I don't have an outlet for it.\" Former UC Davis professor\u003c/aside>\n\u003cp>But Glomski ran head-on into an unpleasant reality: These days, the scramble for money to conduct research has become stultifying.\u003c/p>\n\u003cp>So, he's giving up on science.\u003c/p>\n\u003cp>And he's not alone. Federal funding for biomedical research has declined by more than 20 percent in the past decade. There are far more scientists competing for grants than there is money to support them.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That crunch is forcing some people out of science altogether, either because they can't get research funding at all or, in Glomski's case, because the rat race has simply become too unpleasant.\u003c/p>\n\u003cp>\"My lab was well-funded until, basically, the moment I decided I wasn't going to work there anymore,\" he says during an interview on the porch swing of his home in Charlottesville, Va. \"And I probably could have scraped through there for the rest of my career, as I had been doing, but I would have had regrets.\"\u003c/p>\n\u003cp>Glomski's problem was that he could only get funding to do very predictable, unexciting research. When money gets tight, often only the most risk-averse ideas get funded, he and others say.\u003c/p>\n\u003cp>\"You're focusing basically on one idea you already have and making it as presentable as possible,\" he says. \"You're not spending time making new ideas. And it's making new ideas, for me personally, that I found rewarding. That's what my passion was about.\"\u003c/p>\n\u003cp>At his lab at the University of Virginia, Glomski had a new idea about how to study an anthrax infection as it spread through an animal — and doing this with scans, rather than having to cut the animal open.\u003c/p>\n\u003cp>\"I think if it did what I hoped it would, it would have revolutionized a lot of the research that I was focusing on,\" Glomski says. It would have given him important new insights, he thinks, into how this bacterium does its deadly damage.\u003c/p>\n\u003cfigure id=\"attachment_21408\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.npr.org/blogs/health/2014/09/09/342196432/by-the-numbers-search-nih-grant-data-by-institution\" target=\"_blank\">\u003cimg class=\"wp-image-21408 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-10-at-1.27.17-PM-300x166.png\" alt=\"Graph of NIH funding\" width=\"300\" height=\"166\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">NIH funding by year, in 2014 dollars. Click on the image to access a tool to look up funding changes by institution. (From NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>But it was not a surefire idea. Like a lot of science, it might not have worked at all. Glomski never found out. His repeated grant applications to the National Institutes of Health never made the cut. Funding is so competitive that reviewers shy away from ideas that might not pan out.\u003c/p>\n\u003cp>\"You actually have to be much more conservative these days than you used to,\" Glomski says, \"and being that conservative I think ultimately hurts the scientific enterprise.\" Society, he says, is \"losing out on the cutting-edge research that really is what pushes science forward.\"\u003c/p>\n\u003cp>Historically, payoffs in science come from out of the blue — oddball ideas or unexpected byways. Glomski says that's what research was like for him as he was getting his Ph.D. at the University of California, Berkeley. His lab leader there got funding to probe the frontiers. But Glomski sees that farsighted approach disappearing today.\u003c/p>\n\u003cp>\"That ultimately squashed my passion for what I was doing,\" he says. So two years ago, at the age of 41, he quit.\u003c/p>\n\u003cp>Instead of helping society improve its defenses against deadly anthrax, he's starting a liquor distillery, Vitae Spirits. He's actually excited about that. It's a big challenge, and it allows him to pursue an idea with passion, rather than with resignation.\u003c/p>\n\u003cp>Meanwhile, Randen Patterson is not passionate about his post-science career as a grocery store proprietor. He recently bought the Corner Store in the tiny town of Guinda, about 45 minutes from Davis.\u003c/p>\n\u003cp>Patterson, 43, once worked for Dr. Solomon Snyder at Johns Hopkins University in one of the top neuroscience laboratories in the world. His research is published in some of the most prestigious journals.\u003c/p>\n\u003cp>And Patterson got there against the odds. He was raised in a trailer park in Pennsylvania by a single parent, he says, and stumbled into science quite by accident. Mentors realized his potential and encouraged him to make a career of it.\u003c/p>\n\u003cp>He landed a tenure-track assistant professorship at Penn State University, and then moved on to a similar job at U.C. Davis.\u003c/p>\n\u003cp>But Patterson struggled his entire career to get grants to fund his research, which uses computer simulations to probe the complex chemistry that goes on inside living cells. And he chose an arcane corner of this field to focus his intellectual energy.\u003c/p>\n\u003cp>\"When I was a very young scientist, I told myself I would only work on the hardest questions because those were the ones that were worth working on,\" he says. \"And it has been to my advantage and my detriment.\"\u003c/p>\n\u003cp>Over the years, he has written a blizzard of grant proposals, but he couldn't convince his peers that his edgy ideas were worth taking a risk on. So, as the last of his funding dried up, he quit his academic job.\u003c/p>\n\u003cp>\"I shouldn't be a grocer right now,\" he says with a note of anger in his voice. \"I should be training students. I should be doing deeper research. And I can't. I don't have an outlet for it.\"\u003c/p>\n\u003cp>When the writing was on the wall a few years ago, Patterson says he bought his own souped-up computer so he could continue dabbling in research on the side. But those ideas aren't adding to the world's body of knowledge about biology.\u003c/p>\n\u003cp>\"The country has invested, in me alone, $5 million or $6 million, easily,\" Patterson says, thinking back on the funding he received for his education and his research. And he's just one of many feeling the brunt of the funding crunch.\u003c/p>\n\u003cp>There are no national statistics about how many people are giving up on academic science, but an NPR analysis of NIH data found that 3,400 scientists lost their sustaining grants between 2012 and 2013. Some will eventually get new funding, others will retire; but others, like Glomski and Patterson, will just give up.\u003c/p>\n\u003cp>\"We're taking all this money as a country we've invested ... and we're saying we don't care about it,\" Patterson says.\u003c/p>\n\u003cp>He watches with some trepidation as his daughter, a fresh college graduate, hopes to launch her own career in science.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The funding squeeze could persist for his daughter's generation as well. So Patterson is hoping she will settle on a field other than biomedical research — one where money isn't quite so tight.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21417\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg\">\u003cimg class=\"size-full wp-image-21417\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg\" alt=\"Randen Patterson\" width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/09/randen-patterson-1_slide-ad57b5b88f7ff9de1f1681a3ca1443a715fa61ff-s40-c85-e1410383673360-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Randen Patterson left a research career in physiology at U.C. Davis when funding got too tight. He now owns a grocery store in Guinda, outside Davis. (Max Whittaker/Prime for NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Richard Harris\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/09/09/345289127/when-scientists-give-up\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ian Glomski thought he was going to make a difference in the fight to protect people from deadly anthrax germs. He had done everything right — attended one top university, landed an assistant professorship at another.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I shouldn't be a grocer right now. I should be training students. I should be doing deeper research. And I can't. I don't have an outlet for it.\" Former UC Davis professor\u003c/aside>\n\u003cp>But Glomski ran head-on into an unpleasant reality: These days, the scramble for money to conduct research has become stultifying.\u003c/p>\n\u003cp>So, he's giving up on science.\u003c/p>\n\u003cp>And he's not alone. Federal funding for biomedical research has declined by more than 20 percent in the past decade. There are far more scientists competing for grants than there is money to support them.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That crunch is forcing some people out of science altogether, either because they can't get research funding at all or, in Glomski's case, because the rat race has simply become too unpleasant.\u003c/p>\n\u003cp>\"My lab was well-funded until, basically, the moment I decided I wasn't going to work there anymore,\" he says during an interview on the porch swing of his home in Charlottesville, Va. \"And I probably could have scraped through there for the rest of my career, as I had been doing, but I would have had regrets.\"\u003c/p>\n\u003cp>Glomski's problem was that he could only get funding to do very predictable, unexciting research. When money gets tight, often only the most risk-averse ideas get funded, he and others say.\u003c/p>\n\u003cp>\"You're focusing basically on one idea you already have and making it as presentable as possible,\" he says. \"You're not spending time making new ideas. And it's making new ideas, for me personally, that I found rewarding. That's what my passion was about.\"\u003c/p>\n\u003cp>At his lab at the University of Virginia, Glomski had a new idea about how to study an anthrax infection as it spread through an animal — and doing this with scans, rather than having to cut the animal open.\u003c/p>\n\u003cp>\"I think if it did what I hoped it would, it would have revolutionized a lot of the research that I was focusing on,\" Glomski says. It would have given him important new insights, he thinks, into how this bacterium does its deadly damage.\u003c/p>\n\u003cfigure id=\"attachment_21408\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.npr.org/blogs/health/2014/09/09/342196432/by-the-numbers-search-nih-grant-data-by-institution\" target=\"_blank\">\u003cimg class=\"wp-image-21408 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/Screen-Shot-2014-09-10-at-1.27.17-PM-300x166.png\" alt=\"Graph of NIH funding\" width=\"300\" height=\"166\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">NIH funding by year, in 2014 dollars. Click on the image to access a tool to look up funding changes by institution. (From NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>But it was not a surefire idea. Like a lot of science, it might not have worked at all. Glomski never found out. His repeated grant applications to the National Institutes of Health never made the cut. Funding is so competitive that reviewers shy away from ideas that might not pan out.\u003c/p>\n\u003cp>\"You actually have to be much more conservative these days than you used to,\" Glomski says, \"and being that conservative I think ultimately hurts the scientific enterprise.\" Society, he says, is \"losing out on the cutting-edge research that really is what pushes science forward.\"\u003c/p>\n\u003cp>Historically, payoffs in science come from out of the blue — oddball ideas or unexpected byways. Glomski says that's what research was like for him as he was getting his Ph.D. at the University of California, Berkeley. His lab leader there got funding to probe the frontiers. But Glomski sees that farsighted approach disappearing today.\u003c/p>\n\u003cp>\"That ultimately squashed my passion for what I was doing,\" he says. So two years ago, at the age of 41, he quit.\u003c/p>\n\u003cp>Instead of helping society improve its defenses against deadly anthrax, he's starting a liquor distillery, Vitae Spirits. He's actually excited about that. It's a big challenge, and it allows him to pursue an idea with passion, rather than with resignation.\u003c/p>\n\u003cp>Meanwhile, Randen Patterson is not passionate about his post-science career as a grocery store proprietor. He recently bought the Corner Store in the tiny town of Guinda, about 45 minutes from Davis.\u003c/p>\n\u003cp>Patterson, 43, once worked for Dr. Solomon Snyder at Johns Hopkins University in one of the top neuroscience laboratories in the world. His research is published in some of the most prestigious journals.\u003c/p>\n\u003cp>And Patterson got there against the odds. He was raised in a trailer park in Pennsylvania by a single parent, he says, and stumbled into science quite by accident. Mentors realized his potential and encouraged him to make a career of it.\u003c/p>\n\u003cp>He landed a tenure-track assistant professorship at Penn State University, and then moved on to a similar job at U.C. Davis.\u003c/p>\n\u003cp>But Patterson struggled his entire career to get grants to fund his research, which uses computer simulations to probe the complex chemistry that goes on inside living cells. And he chose an arcane corner of this field to focus his intellectual energy.\u003c/p>\n\u003cp>\"When I was a very young scientist, I told myself I would only work on the hardest questions because those were the ones that were worth working on,\" he says. \"And it has been to my advantage and my detriment.\"\u003c/p>\n\u003cp>Over the years, he has written a blizzard of grant proposals, but he couldn't convince his peers that his edgy ideas were worth taking a risk on. So, as the last of his funding dried up, he quit his academic job.\u003c/p>\n\u003cp>\"I shouldn't be a grocer right now,\" he says with a note of anger in his voice. \"I should be training students. I should be doing deeper research. And I can't. I don't have an outlet for it.\"\u003c/p>\n\u003cp>When the writing was on the wall a few years ago, Patterson says he bought his own souped-up computer so he could continue dabbling in research on the side. But those ideas aren't adding to the world's body of knowledge about biology.\u003c/p>\n\u003cp>\"The country has invested, in me alone, $5 million or $6 million, easily,\" Patterson says, thinking back on the funding he received for his education and his research. And he's just one of many feeling the brunt of the funding crunch.\u003c/p>\n\u003cp>There are no national statistics about how many people are giving up on academic science, but an NPR analysis of NIH data found that 3,400 scientists lost their sustaining grants between 2012 and 2013. Some will eventually get new funding, others will retire; but others, like Glomski and Patterson, will just give up.\u003c/p>\n\u003cp>\"We're taking all this money as a country we've invested ... and we're saying we don't care about it,\" Patterson says.\u003c/p>\n\u003cp>He watches with some trepidation as his daughter, a fresh college graduate, hopes to launch her own career in science.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Details of Autism Benefits -- Like Provider Rates -- Coming After Rollout",
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"content": "\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/capitol-desk/2014/9/autism-details-to-come-after-rollout\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>At the first stakeholder meeting last week to review California's new autism Medi-Cal coverage, state health officials said many details have yet to be worked out. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003ca title=\"Long-Sought Autism Treatment Now Covered by Medi-Cal\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/long-fought-autism-therapy-a-medi-cal-benefit-state-says/\" target=\"_blank\">New benefits, which include coverage of applied behavior analysis\u003c/a> -- also known as ABA therapy -- begin next week.\u003c/p>\n\u003cp>Department of Health Care Services officials said many details -- including the crucial figure of what the reimbursement rates will be -- still need to be worked out. Rates will be discussed at the next stakeholder meeting Oct. 16, officials said.\u003c!--more-->\u003c/p>\n\u003cp>The department still is on schedule to submit an autism coverage state plan amendment to the Centers for Medicare & Medicaid Services by Sept. 30, officials said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We will talk about rates later. We will have a separate session on rate setting,\" said Sarah Brooks, branch chief of the Medi-Cal managed care division at DHCS. \"We are working with different ABA providers so health plans can build their networks. We will be working with them to make sure we have proper network adequacy.\"\u003c/p>\n\u003cp>According to Laurie Weaver, chief of the benefits division at DHCS, the new benefit will cover the broad area of behavior health treatment, which includes ABA therapy as one type of treatment, but the department first will focus on ABA, since it's at the heart of the new benefit.\u003c/p>\n\u003cp>\"The state plan amendment will address ABA first, and we'll go from there,\" she said.\u003c/p>\n\u003cp>According to Abbie Totten, director of state programs for the California Association of Health Plans, it's unusual to launch a benefit before setting up the network.\u003c/p>\n\u003cp>\"You have to understand,\" Totten said to stakeholders at Thursday's meeting, \"we are implementing this benefit in a backwards manner. Usually when you implement a benefit you have time … you can develop all of those pieces, and we are not being provided that opportunity in this case.\"\u003c/p>\n\u003cp>The health plans will work with the state to implement the benefit as best they can -- but right now, she said, people will need to bear with the process, which may be rocky and a little confusing at first.\u003c/p>\n\u003cp>\"We have no rates, we have no idea what payment looks like, we have no idea what licensing or provider criteria will look like,\" Totten said.\u003c/p>\n\u003cp>\"So, just as a caution, we will work together on this. We are committed with the department to make this work, but we don't even have a [state plan amendment] that's approved yet,\" she said. \"We're going to do our best and try to make sure the providers are reimbursed properly.\"\u003c/p>\n\u003cp>\"This is day one,\" said Rene Mollow, deputy director of health care benefits and eligibility at DHCS.\u003c/p>\n\u003cp>\"You can look at this and say, 'Oh no, there's so much to do,' \" Mollow said. \"Or rather you can say, 'Wow, look at what we're doing here.' \"\u003c/p>\n\u003cp>Mollow said the department is committed to implementing the benefit with full involvement of stakeholders -- and that lengthens the process somewhat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are just starting down this pathway, and we know there will be improvements and there will be efforts to inform what the state of California will be doing,\" she said. \"It's a process. I would look at it as: day one. Woo-hoo!\"\u003c/p>\n\n",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"perspectives": {
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"order": 14
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
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