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"content": "\u003cfigure id=\"attachment_18812\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/wellWall.jpg\">\u003cimg class=\"size-large wp-image-18812\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/wellWall-640x574.jpg\" alt=\"(Lisa Aliferis/KQED)\" width=\"640\" height=\"574\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>Privacy activists are voicing concern that Walgreens pharmacies may endanger the confidentiality of customer records with a new business model that places pharmacists at a desk on the store floor.\u003c/p>\n\u003cp>The “Well Experience” model makes it much easier for customers to view pharmacists’ computer screens and documents on their desks, according to a \u003ca href=\"http://walgreenstrategywatch.org/behind-the-desk/\">report\u003c/a> prepared by the research arm of Change to Win, a labor-backed organization whose constituents include pharmacists and pharmacy technician unions.\u003c/p>\n\u003cp>“We have heard from pharmacists, not necessarily in our membership, who work in this model, who are very concerned about its implications for the practice of pharmacy,” said Nell Geiser, associate director of Change to Win Retail Initiatives.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Think about it for a moment. If you were to go to a doctor, would you want to be out in the lobby talking to your doctor?” — \u003cem>Beth Givens, director of the San Diego-based Privacy Rights Clearinghouse\u003c/em> \u003c/aside>\n\u003cp>“Pharmacists want to do their job well and serve the public, and they also want to protect their license, which is on the line if any error takes place in their pharmacy.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Change to Win is concerned about the possibility of increased thefts -- especially of narcotics -- as well as the risk of errors in formulating prescriptions under the new Walgreens model. The model removes pharmacists from their usual in-person supervisory role, Geiser said.\u003c!--more-->\u003c/p>\n\u003cp>The organization’s investigators visited 50 Well Experience pharmacies in Florida, Illinois and Indiana in September. Change to Win alleges that in 80 percent of the checks, pharmacists left their desks unattended, giving anyone nearby access to private medical information.\u003c/p>\n\u003cp>“Among the types of paper information unattended were doctors’ prescriptions; completed health test authorization forms including patient medical history or test results; and patient call lists, listing patient names, telephone phone numbers, and prescribed drugs,” the report states.\u003c/p>\n\u003cp>A follow-up investigation in November and last month included visits to stores in Arizona, Illinois and Indiana. Investigators found private patient information left unattended 73 percent of the time, Change to Win reported.\u003c/p>\n\u003cp>Beth Givens, director of the San Diego-based Privacy Rights Clearinghouse, called Well Experience a terrible idea.\u003c/p>\n\u003cp>“Think about it for a moment. If you were to go to a doctor, would you want to be out in the lobby talking to your doctor?” Givens said.\u003c/p>\n\u003cp>“In terms of privacy, especially with the sensitivity with the kind of information that (pharmacists) handle, it should be behind a locked door with access only by a window.\"\u003c/p>\n\u003cp>Lee Tien, a senior staff attorney with the Electronic Frontier Foundation, said he recently co-signed a letter with the American Civil Liberties Union to the California Board of Pharmacy, expressing similar concerns.\u003c/p>\n\u003cp>“We’re telling the board, ‘you should look at this very, very carefully, because (based on the Change to Win report) the track record doesn’t appear to be good,” Tien said.\u003c/p>\n\u003cp>Virginia Herold, executive director at the state Board of Pharmacy, said her agency began looking into Change to Win’s allegations last fall. In California, some 20 Walgreens stores have been configured to implement Well Experience, she said. But in all the random, unannounced inspections conducted to date, Board personnel have found pharmacists working in the pharmacy area, not in the desks on the shop floor, Herold said. She said the Board has not received any customer complaints about Well Experience.\u003c/p>\n\u003cp>The Change to Win report also questions pharmacists’ ability to oversee technicians while they are working at the shop floor desks. The work stations include video-monitoring capability, both to track medications and to enable pharmacists to check that prescriptions have been filled correctly.\u003c/p>\n\u003cp>Geiser questioned the effectiveness of such oversight.\u003c/p>\n\u003cp>In an emailed statement on Friday, Walgreens spokesman Phil Caruso claimed that “In each of the more than 30 states where we have presented our new model to the State Board of Pharmacy, we have been allowed to proceed with it or with some unique accommodations for state regulations.”\u003c/p>\n\u003cp>But John Gadea, Connecticut’s director of state drug control, said his department did question Well Experience in a review last year.\u003c/p>\n\u003cp>“There’s the (theft) issue, there’s the error issue, there’s the supervision issue, there’s the privacy issue that we were all concerned about here,” he said.\u003c/p>\n\u003cp>“The next move was for Walgreens to bring this in front of the board on a formal request. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18812\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/wellWall.jpg\">\u003cimg class=\"size-large wp-image-18812\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/wellWall-640x574.jpg\" alt=\"(Lisa Aliferis/KQED)\" width=\"640\" height=\"574\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>Privacy activists are voicing concern that Walgreens pharmacies may endanger the confidentiality of customer records with a new business model that places pharmacists at a desk on the store floor.\u003c/p>\n\u003cp>The “Well Experience” model makes it much easier for customers to view pharmacists’ computer screens and documents on their desks, according to a \u003ca href=\"http://walgreenstrategywatch.org/behind-the-desk/\">report\u003c/a> prepared by the research arm of Change to Win, a labor-backed organization whose constituents include pharmacists and pharmacy technician unions.\u003c/p>\n\u003cp>“We have heard from pharmacists, not necessarily in our membership, who work in this model, who are very concerned about its implications for the practice of pharmacy,” said Nell Geiser, associate director of Change to Win Retail Initiatives.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Think about it for a moment. If you were to go to a doctor, would you want to be out in the lobby talking to your doctor?” — \u003cem>Beth Givens, director of the San Diego-based Privacy Rights Clearinghouse\u003c/em> \u003c/aside>\n\u003cp>“Pharmacists want to do their job well and serve the public, and they also want to protect their license, which is on the line if any error takes place in their pharmacy.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Change to Win is concerned about the possibility of increased thefts -- especially of narcotics -- as well as the risk of errors in formulating prescriptions under the new Walgreens model. The model removes pharmacists from their usual in-person supervisory role, Geiser said.\u003c!--more-->\u003c/p>\n\u003cp>The organization’s investigators visited 50 Well Experience pharmacies in Florida, Illinois and Indiana in September. Change to Win alleges that in 80 percent of the checks, pharmacists left their desks unattended, giving anyone nearby access to private medical information.\u003c/p>\n\u003cp>“Among the types of paper information unattended were doctors’ prescriptions; completed health test authorization forms including patient medical history or test results; and patient call lists, listing patient names, telephone phone numbers, and prescribed drugs,” the report states.\u003c/p>\n\u003cp>A follow-up investigation in November and last month included visits to stores in Arizona, Illinois and Indiana. Investigators found private patient information left unattended 73 percent of the time, Change to Win reported.\u003c/p>\n\u003cp>Beth Givens, director of the San Diego-based Privacy Rights Clearinghouse, called Well Experience a terrible idea.\u003c/p>\n\u003cp>“Think about it for a moment. If you were to go to a doctor, would you want to be out in the lobby talking to your doctor?” Givens said.\u003c/p>\n\u003cp>“In terms of privacy, especially with the sensitivity with the kind of information that (pharmacists) handle, it should be behind a locked door with access only by a window.\"\u003c/p>\n\u003cp>Lee Tien, a senior staff attorney with the Electronic Frontier Foundation, said he recently co-signed a letter with the American Civil Liberties Union to the California Board of Pharmacy, expressing similar concerns.\u003c/p>\n\u003cp>“We’re telling the board, ‘you should look at this very, very carefully, because (based on the Change to Win report) the track record doesn’t appear to be good,” Tien said.\u003c/p>\n\u003cp>Virginia Herold, executive director at the state Board of Pharmacy, said her agency began looking into Change to Win’s allegations last fall. In California, some 20 Walgreens stores have been configured to implement Well Experience, she said. But in all the random, unannounced inspections conducted to date, Board personnel have found pharmacists working in the pharmacy area, not in the desks on the shop floor, Herold said. She said the Board has not received any customer complaints about Well Experience.\u003c/p>\n\u003cp>The Change to Win report also questions pharmacists’ ability to oversee technicians while they are working at the shop floor desks. The work stations include video-monitoring capability, both to track medications and to enable pharmacists to check that prescriptions have been filled correctly.\u003c/p>\n\u003cp>Geiser questioned the effectiveness of such oversight.\u003c/p>\n\u003cp>In an emailed statement on Friday, Walgreens spokesman Phil Caruso claimed that “In each of the more than 30 states where we have presented our new model to the State Board of Pharmacy, we have been allowed to proceed with it or with some unique accommodations for state regulations.”\u003c/p>\n\u003cp>But John Gadea, Connecticut’s director of state drug control, said his department did question Well Experience in a review last year.\u003c/p>\n\u003cp>“There’s the (theft) issue, there’s the error issue, there’s the supervision issue, there’s the privacy issue that we were all concerned about here,” he said.\u003c/p>\n\u003cp>“The next move was for Walgreens to bring this in front of the board on a formal request. That request never came.”\u003c/p>\n\u003cp>At the Maryland Board of Pharmacy, legislation and regulations manager Anna Jeffers said concerns over supervision led regulators to bar Well Experience last year.\u003c/p>\n\u003cp>In a follow-up interview Monday, Caruso voiced surprise at Gadea’s and Jeffers’ accounts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The information is not lining up with what I have,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Powerful Narcotic Painkiller Up For FDA Approval",
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"content": "\u003cfigure id=\"attachment_18805\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/470830705.jpg\">\u003cimg class=\"size-large wp-image-18805\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/470830705-640x640.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>by Rob Stein, \u003ca href=\"http://www.npr.org/blogs/health/2014/04/22/302889772/powerful-narcotic-painkiller-up-for-fda-approval\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>The Food and Drug Administration is trying to decide whether to approve a powerful new prescription painkiller that's designed to relieve severe pain quickly, and with fewer side effects than other opioids.\u003c/p>\n\u003cp>While some pain experts say the medicine could provide a valuable alternative for some patients in intense pain, the drug (called Moxduo) is also prompting concern that it could exacerbate the epidemic of abuse of prescription painkillers and overdoses.\u003c/p>\n\u003cp>An FDA advisory committee is holding a daylong hearing Tuesday to decide whether to recommend that the agency approve the drug.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This is a product that is very easy to misuse, very easy to crush and snort or crush and inject,\" says addiction specialist Andrew Kolodny. \u003c/aside>\n\u003cp>Moxduo for the first time combines morphine and oxycodone in one capsule. It's designed to provide quick relief to patients suffering severe pain from accidents or surgeries, such as knee replacements, back surgeries or cancer operations, says Ed Rudnic, COO of QRxPharma, the company that makes Moxduo.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The drug allows patients to take lower doses of the two narcotics than they'd need if they took either of the medicines alone, Rudnic says.\u003c/p>\n\u003cp>\"We believe that we've achieved some benefit in reducing the risk of some of the respiratory complications of these strong opioids,\" he says.\u003c/p>\n\u003cp>Suppressed breathing and other respiratory complications are the most serious risks of these drugs — the main reason people die from taking too much.\u003c/p>\n\u003cp>Some pain experts think the idea behind Moxduo is a good one. A lot of patients can't take enough morphine or oxycodone to ease their discomfort because of the risk to breathing and other side effects, such as nausea, vomiting, dizziness and severe itchiness.\u003c/p>\n\u003cp>\u003c!--more-->Patients who could theoretically benefit from such a pill are \"normal people like you and me,\" says Dr. Joseph Audette of Harvard Medical School. \"And then suddenly we get in a terrible accident or have surgery and ... we need something. And the typical agents are used, and suddenly all these terrible side effects come up.\"\u003c/p>\n\u003cp>But Audette is not convinced the company has yet proved that Moxduo has fewer side effects.\u003c/p>\n\u003cp>\"They haven't really done the hard work of absolutely showing ... in humans with real pain problems that synergy is making a big difference,\" Audette says, \"compared to just using the agents that we [already] have available.\"\u003c/p>\n\u003cp>And some experts worry that Moxduo will come with its own problems.\u003c/p>\n\u003cp>\"I have serious concerns about this product,\" says Andrew Kolodny, an addiction specialist at Phoenix House. He also leads the Physicians for Responsible Opioid Prescribing, which is fighting for tighter control of prescription painkillers.\u003c/p>\n\u003cp>Millions of people are addicted to these legal narcotics already, Kolodny says, with thousands dying from overdoses each year. Moxduo, he worries, would only make that worse.\u003c/p>\n\u003cp>\"This is pure morphine and pure oxycodone,\" he says. \"This is a product that is very easy to misuse, very easy to crush and snort or crush and inject. So it's significantly more dangerous than the products that it would be competing with.\" Kolodny cites Vicodin and Percocet as competing drugs that contain multiple other ingredients (in addition to a narcotic) that make them more difficult to abuse in those ways.\u003c/p>\n\u003cp>Patients in severe pain already have plenty of options, he says, and a marketing push to prescribe Moxduo could spell trouble.\u003c/p>\n\u003cp>\"If they get this product put on the market and are able to have a sales force going in and out of doctors' offices encouraging prescribing with the marketing claim that this is somehow a safer product ... I believe that's likely to exacerbate an already severe public health crisis,\" Kolodny tells Shots.\u003c/p>\n\u003cp>For his part, Rudnic argues that the manufacturer already has good evidence that Moxduo is a safer painkiller with fewer side effects. And he disputes the claims that Moxduo is easier to abuse.\u003c/p>\n\u003cp>\"I understand abuse and I understand the anguish that some of these people have that have lost a loved one to a drug overdose,\" says Rudnic. \"I lost a brother to a drug overdose in 2002 and it was really tough.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rudnic promises his company will set up a system to quickly spot any signs that Moxduo is being misused. QRxPharma is also developing a version of the drug, Rudnic says, that would make it harder to abuse.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18805\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/470830705.jpg\">\u003cimg class=\"size-large wp-image-18805\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/470830705-640x640.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>by Rob Stein, \u003ca href=\"http://www.npr.org/blogs/health/2014/04/22/302889772/powerful-narcotic-painkiller-up-for-fda-approval\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>The Food and Drug Administration is trying to decide whether to approve a powerful new prescription painkiller that's designed to relieve severe pain quickly, and with fewer side effects than other opioids.\u003c/p>\n\u003cp>While some pain experts say the medicine could provide a valuable alternative for some patients in intense pain, the drug (called Moxduo) is also prompting concern that it could exacerbate the epidemic of abuse of prescription painkillers and overdoses.\u003c/p>\n\u003cp>An FDA advisory committee is holding a daylong hearing Tuesday to decide whether to recommend that the agency approve the drug.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This is a product that is very easy to misuse, very easy to crush and snort or crush and inject,\" says addiction specialist Andrew Kolodny. \u003c/aside>\n\u003cp>Moxduo for the first time combines morphine and oxycodone in one capsule. It's designed to provide quick relief to patients suffering severe pain from accidents or surgeries, such as knee replacements, back surgeries or cancer operations, says Ed Rudnic, COO of QRxPharma, the company that makes Moxduo.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The drug allows patients to take lower doses of the two narcotics than they'd need if they took either of the medicines alone, Rudnic says.\u003c/p>\n\u003cp>\"We believe that we've achieved some benefit in reducing the risk of some of the respiratory complications of these strong opioids,\" he says.\u003c/p>\n\u003cp>Suppressed breathing and other respiratory complications are the most serious risks of these drugs — the main reason people die from taking too much.\u003c/p>\n\u003cp>Some pain experts think the idea behind Moxduo is a good one. A lot of patients can't take enough morphine or oxycodone to ease their discomfort because of the risk to breathing and other side effects, such as nausea, vomiting, dizziness and severe itchiness.\u003c/p>\n\u003cp>\u003c!--more-->Patients who could theoretically benefit from such a pill are \"normal people like you and me,\" says Dr. Joseph Audette of Harvard Medical School. \"And then suddenly we get in a terrible accident or have surgery and ... we need something. And the typical agents are used, and suddenly all these terrible side effects come up.\"\u003c/p>\n\u003cp>But Audette is not convinced the company has yet proved that Moxduo has fewer side effects.\u003c/p>\n\u003cp>\"They haven't really done the hard work of absolutely showing ... in humans with real pain problems that synergy is making a big difference,\" Audette says, \"compared to just using the agents that we [already] have available.\"\u003c/p>\n\u003cp>And some experts worry that Moxduo will come with its own problems.\u003c/p>\n\u003cp>\"I have serious concerns about this product,\" says Andrew Kolodny, an addiction specialist at Phoenix House. He also leads the Physicians for Responsible Opioid Prescribing, which is fighting for tighter control of prescription painkillers.\u003c/p>\n\u003cp>Millions of people are addicted to these legal narcotics already, Kolodny says, with thousands dying from overdoses each year. Moxduo, he worries, would only make that worse.\u003c/p>\n\u003cp>\"This is pure morphine and pure oxycodone,\" he says. \"This is a product that is very easy to misuse, very easy to crush and snort or crush and inject. So it's significantly more dangerous than the products that it would be competing with.\" Kolodny cites Vicodin and Percocet as competing drugs that contain multiple other ingredients (in addition to a narcotic) that make them more difficult to abuse in those ways.\u003c/p>\n\u003cp>Patients in severe pain already have plenty of options, he says, and a marketing push to prescribe Moxduo could spell trouble.\u003c/p>\n\u003cp>\"If they get this product put on the market and are able to have a sales force going in and out of doctors' offices encouraging prescribing with the marketing claim that this is somehow a safer product ... I believe that's likely to exacerbate an already severe public health crisis,\" Kolodny tells Shots.\u003c/p>\n\u003cp>For his part, Rudnic argues that the manufacturer already has good evidence that Moxduo is a safer painkiller with fewer side effects. And he disputes the claims that Moxduo is easier to abuse.\u003c/p>\n\u003cp>\"I understand abuse and I understand the anguish that some of these people have that have lost a loved one to a drug overdose,\" says Rudnic. \"I lost a brother to a drug overdose in 2002 and it was really tough.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rudnic promises his company will set up a system to quickly spot any signs that Moxduo is being misused. QRxPharma is also developing a version of the drug, Rudnic says, that would make it harder to abuse.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Los Angeles, How Pharmacists Are Improving Patients' Health ",
"title": "In Los Angeles, How Pharmacists Are Improving Patients' Health ",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_18779\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/140319_pharmacist254_0-e1398097423659.jpg\">\u003cimg class=\"size-large wp-image-18779\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/140319_pharmacist254_0-640x426.jpg\" alt=\"Dr. Sarah Ma goes over medications and dosages with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sarah Ma, a pharmacist with USC, goes over medications with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Laurie Udesky,\u003c/strong>\u003ca href=\"http://centerforhealthreporting.org/article/increased-responsibility-pays-health-dividends\" target=\"_blank\"> CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Jose Navarro regularly trekked to the drugstore after being diagnosed as a diabetic seven years ago. In a sign of transformation in the local fight against diabetes, the pharmacist is now coming to him.\u003c/p>\n\u003cp>On a recent day Sarah Ma, a 28-year-old USC clinical pharmacist, set up shop at Navarro’s kitchen table in Santa Ana.\u003c/p>\n\u003cp>She checked Navarro’s blood pressure and blood sugar, examined his feet for cuts or infection, and refilled his monthly pill box. On previous visits she had changed the hour he took some medications, altered some doses, and discontinued others.\u003c/p>\n\u003cp>She inspected the refrigerator. “I see carrots, eggs, beets, cheese and yogurt that I haven’t seen before,” she said, delighted.\u003c/p>\n\u003cp>It wasn’t all great news. Navarro, 78, had told Ma that the pastry he had at breakfast was tiny. Actually, it engulfed half the plate Ma brought with her to illustrate what portions to eat of different food groups.\u003c!--more-->\u003c/p>\n\u003cp>Ma began working closely with Navarro last October. Now, he feels much better, which means he’s not a candidate for an emergency room or expensive hospitalization.\u003c/p>\n\u003cp>It also means an important new tool is emerging in the effort to contain diabetes, which afflicts one in 10 adults in Los Angeles County, one in 14 in Orange County, and can lead to amputations, blindness or death. Direct medical spending on the disease in Los Angeles County alone tops $6 billion annually.\u003c/p>\n\u003cp>More broadly, it also means that pharmacists in California may be on a path to take a much larger role in patient care, and in controlling health care costs.\u003c/p>\n\u003cp>\u003cstrong>Early, Impressive Results\u003c/strong>\u003c/p>\n\u003cp>Ma is part of a three year, $12-million study run by the USC School of Pharmacy and funded by the federal Centers for Medicare and Medicaid Services. Several teams from the school, including professional and student pharmacists, have fanned out to safety net clinics in Los Angeles and Orange counties to test whether patients will benefit if pharmacists’ scope of practice expands into territory normally handled by physicians, including greater autonomy in filling prescriptions and more direct contact with high-risk clients.\u003c/p>\n\u003cp>The early results are impressive:\u003c/p>\n\u003cul>\n\u003cli>Nearly nine of 10 patients who had out-of-control blood pressure saw their readings drop below hypertension levels and remain there within 45 days of working with the pharmacy teams, according to Steve Chen, an associate professor of pharmacy at USC and a developer of the study.\u003c/li>\n\u003cli>Similarly, diabetes patients whose blood sugar levels had been too high were twice as likely to have them under control within six months if they worked with a pharmacist team.\u003c/li>\n\u003cli>In the program’s first 11 months, pharmacists corrected 19,696 medication problems among 1,993 patients, an astonishing nine medication problems per patient.\u003c/li>\n\u003cli>Even more alarming, more than 2,000 of those problems – including excessive dosing, duplication, and drug interactions – were potentially dangerous to patients. In a recent example, a patient with poor kidney function was taking two blood pressure medications that combined could have spiked potassium to a level “that could have literally stopped his heart,” Chen said.\u003c/li>\n\u003cli>Study coordinators project a 25 percent decrease in hospitalizations for the estimated 6,000 patients in the project.\u003c/li>\n\u003c/ul>\n\u003cp>The results are preliminary and unpublished, since the study will continue into next year. When the research is published it is likely to add to the debate over how to contain medical costs.\u003c/p>\n\u003cp>The study began October 1, 2012 at five clinics run by AltaMed Health Services Corp. in underserved neighborhoods in El Monte, West Covina, Boyle Heights, Pico Rivera and Huntington Beach.\u003c/p>\n\u003cp>Three-person USC teams – clinical pharmacist, a pharmacy resident and a pharmacy technician – became primary caregivers for hypertension and blood pressure patients, and others with chronic illnesses. They initiated increased clinic visits, or made house calls as needed. The study has since been expanded to 11 AltaMed clinics in Orange and Los Angeles Counties.\u003c/p>\n\u003cp>Lobbyists for pharmacists in Sacramento pointed to the study as they successfully argued last year for bumping up pharmacists’ authority. A California law that went into effect this January codified a new class of “advanced practice pharmacists” who can enter collaborative agreements with physicians to start, change or discontinue medications, and help manage chronic diseases.\u003c/p>\n\u003cp>\u003cstrong>Initial Resistance from Doctors\u003c/strong>\u003c/p>\n\u003cp>At the outset many AltaMed doctors were rankled by the pharmacy teams.\u003c/p>\n\u003cp>“Quite frankly there was a fair amount of anxiety up front from physicians,” said Dr. Michael Hochman, AltaMed’s director of innovation. The idea that pharmacists could take charge of a drug regimen was a particular concern. “One question I got frequently was ‘Why did I go to medical school?” Hochman said.\u003c/p>\n\u003cp>AltaMed doctors have since been won over, Hochman said, especially after referring perplexing cases to the pharmacists. Hochman says on any given day every AltaMed doctor in the study clinics refers two to three patients to the pharmacist teams.\u003c/p>\n\u003cp>The pharmacists often find that they have to do a lot of educating\u003cstrong>. \u003c/strong>Sarah Ma said she has encountered great resistance to taking insulin among the mostly Latino population the clinics serve.\u003c/p>\n\u003cp>“Patients will come in and say insulin can cause blindness, amputations, it can cause me to go to the hospital. They’ll say my neighbor or my uncle or son or somebody started insulin and they died,” said Ma. “You have to ask them a lot of questions and try to elicit answers to help them connect the dots.”\u003c/p>\n\u003cp>Michelle Lee, a USC clinical pharmacist at AltaMed’s Boyle Heights clinic, recently asked Alfredo Perez, a 46-year-old diabetes patient, if he’d taken his insulin as prescribed.\u003c/p>\n\u003cp>“I did but I stopped because my vision became blurry for two days,” he responded.\u003c/p>\n\u003cp>“I’m scared to take insulin,” he told a reporter. “I’m afraid that once I start, I’ll never be off of it.”\u003c/p>\n\u003cp>Lee had spent months trying to gently coax Perez to take insulin. Each time he resisted, she asked him to try a lower dose. On this day she noted that his blood sugar was 93, more than 63 points above what it should be for the time of day, and she tried a more direct strategy.\u003c/p>\n\u003cp>“You’ve had high sugars for a long time. It’s going to damage your eyes, you’re going to lose your eyesight,” she said with authority. Instead of waiting two weeks for the next appointment, Lee asked Perez to return in a week and try a very small dose of insulin, and he agreed to do so.\u003c/p>\n\u003cp>\u003cstrong>Likely Cost Savings\u003c/strong>\u003c/p>\n\u003cp>Although such patient encounters are time consuming, many studies suggest that when clinical pharmacists work on primary care teams, overall healthcare costs plummet.\u003c/p>\n\u003cp>A recent report by the U.S. Public Health Service found that every dollar invested in clinical pharmacy services saved about 10 dollars in health spending, as patients better understood how to manage their illnesses and avoid expensive treatments that result from missed or misapplied medications\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>Although the USC/AltaMed study is still 17 months from completion, there has already been interest in duplicating the project.\u003c/p>\n\u003cp>Robert Beltran, the chief medical officer for Brand New Day, a Medicare Specialty Health Plan that serves 6,000 members in Los Angeles, Orange, Riverside, San Bernardino and Kings Counties, said he plans to start a pharmacist team program in Orange County and the Inland Empire in late spring or this summer.\u003c/p>\n\u003cp>When asked about whether AltaMed will continue the pharmacist program after the grant runs out, Altamed’s Hochman said, “That’s the million dollar question. We have proven to ourselves beyond a reasonable doubt that the (USC-led pharmacist teams) are a very high-value service to patients.”\u003c/p>\n\u003cp>But typically, clinics like AltaMed don’t get reimbursed by Medi-Cal, Medicare, or private insurance for pharmacist services. “We are hopeful it will become a reimbursed service for us in the near future,” he said.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003c/div>\n\u003cp>[contextly_auto_sidebar id=\"uPCv7ELLO6PmiIKvr6zeDyDCdW31Nw02\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Pharmacists from USC are fanning out to safety net clinics in Los Angeles as part of 3 year study.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_18779\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/140319_pharmacist254_0-e1398097423659.jpg\">\u003cimg class=\"size-large wp-image-18779\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/140319_pharmacist254_0-640x426.jpg\" alt=\"Dr. Sarah Ma goes over medications and dosages with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sarah Ma, a pharmacist with USC, goes over medications with diabetes patient Joe Navarro. (Credit: Anacleto Rapping)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Laurie Udesky,\u003c/strong>\u003ca href=\"http://centerforhealthreporting.org/article/increased-responsibility-pays-health-dividends\" target=\"_blank\"> CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Jose Navarro regularly trekked to the drugstore after being diagnosed as a diabetic seven years ago. In a sign of transformation in the local fight against diabetes, the pharmacist is now coming to him.\u003c/p>\n\u003cp>On a recent day Sarah Ma, a 28-year-old USC clinical pharmacist, set up shop at Navarro’s kitchen table in Santa Ana.\u003c/p>\n\u003cp>She checked Navarro’s blood pressure and blood sugar, examined his feet for cuts or infection, and refilled his monthly pill box. On previous visits she had changed the hour he took some medications, altered some doses, and discontinued others.\u003c/p>\n\u003cp>She inspected the refrigerator. “I see carrots, eggs, beets, cheese and yogurt that I haven’t seen before,” she said, delighted.\u003c/p>\n\u003cp>It wasn’t all great news. Navarro, 78, had told Ma that the pastry he had at breakfast was tiny. Actually, it engulfed half the plate Ma brought with her to illustrate what portions to eat of different food groups.\u003c!--more-->\u003c/p>\n\u003cp>Ma began working closely with Navarro last October. Now, he feels much better, which means he’s not a candidate for an emergency room or expensive hospitalization.\u003c/p>\n\u003cp>It also means an important new tool is emerging in the effort to contain diabetes, which afflicts one in 10 adults in Los Angeles County, one in 14 in Orange County, and can lead to amputations, blindness or death. Direct medical spending on the disease in Los Angeles County alone tops $6 billion annually.\u003c/p>\n\u003cp>More broadly, it also means that pharmacists in California may be on a path to take a much larger role in patient care, and in controlling health care costs.\u003c/p>\n\u003cp>\u003cstrong>Early, Impressive Results\u003c/strong>\u003c/p>\n\u003cp>Ma is part of a three year, $12-million study run by the USC School of Pharmacy and funded by the federal Centers for Medicare and Medicaid Services. Several teams from the school, including professional and student pharmacists, have fanned out to safety net clinics in Los Angeles and Orange counties to test whether patients will benefit if pharmacists’ scope of practice expands into territory normally handled by physicians, including greater autonomy in filling prescriptions and more direct contact with high-risk clients.\u003c/p>\n\u003cp>The early results are impressive:\u003c/p>\n\u003cul>\n\u003cli>Nearly nine of 10 patients who had out-of-control blood pressure saw their readings drop below hypertension levels and remain there within 45 days of working with the pharmacy teams, according to Steve Chen, an associate professor of pharmacy at USC and a developer of the study.\u003c/li>\n\u003cli>Similarly, diabetes patients whose blood sugar levels had been too high were twice as likely to have them under control within six months if they worked with a pharmacist team.\u003c/li>\n\u003cli>In the program’s first 11 months, pharmacists corrected 19,696 medication problems among 1,993 patients, an astonishing nine medication problems per patient.\u003c/li>\n\u003cli>Even more alarming, more than 2,000 of those problems – including excessive dosing, duplication, and drug interactions – were potentially dangerous to patients. In a recent example, a patient with poor kidney function was taking two blood pressure medications that combined could have spiked potassium to a level “that could have literally stopped his heart,” Chen said.\u003c/li>\n\u003cli>Study coordinators project a 25 percent decrease in hospitalizations for the estimated 6,000 patients in the project.\u003c/li>\n\u003c/ul>\n\u003cp>The results are preliminary and unpublished, since the study will continue into next year. When the research is published it is likely to add to the debate over how to contain medical costs.\u003c/p>\n\u003cp>The study began October 1, 2012 at five clinics run by AltaMed Health Services Corp. in underserved neighborhoods in El Monte, West Covina, Boyle Heights, Pico Rivera and Huntington Beach.\u003c/p>\n\u003cp>Three-person USC teams – clinical pharmacist, a pharmacy resident and a pharmacy technician – became primary caregivers for hypertension and blood pressure patients, and others with chronic illnesses. They initiated increased clinic visits, or made house calls as needed. The study has since been expanded to 11 AltaMed clinics in Orange and Los Angeles Counties.\u003c/p>\n\u003cp>Lobbyists for pharmacists in Sacramento pointed to the study as they successfully argued last year for bumping up pharmacists’ authority. A California law that went into effect this January codified a new class of “advanced practice pharmacists” who can enter collaborative agreements with physicians to start, change or discontinue medications, and help manage chronic diseases.\u003c/p>\n\u003cp>\u003cstrong>Initial Resistance from Doctors\u003c/strong>\u003c/p>\n\u003cp>At the outset many AltaMed doctors were rankled by the pharmacy teams.\u003c/p>\n\u003cp>“Quite frankly there was a fair amount of anxiety up front from physicians,” said Dr. Michael Hochman, AltaMed’s director of innovation. The idea that pharmacists could take charge of a drug regimen was a particular concern. “One question I got frequently was ‘Why did I go to medical school?” Hochman said.\u003c/p>\n\u003cp>AltaMed doctors have since been won over, Hochman said, especially after referring perplexing cases to the pharmacists. Hochman says on any given day every AltaMed doctor in the study clinics refers two to three patients to the pharmacist teams.\u003c/p>\n\u003cp>The pharmacists often find that they have to do a lot of educating\u003cstrong>. \u003c/strong>Sarah Ma said she has encountered great resistance to taking insulin among the mostly Latino population the clinics serve.\u003c/p>\n\u003cp>“Patients will come in and say insulin can cause blindness, amputations, it can cause me to go to the hospital. They’ll say my neighbor or my uncle or son or somebody started insulin and they died,” said Ma. “You have to ask them a lot of questions and try to elicit answers to help them connect the dots.”\u003c/p>\n\u003cp>Michelle Lee, a USC clinical pharmacist at AltaMed’s Boyle Heights clinic, recently asked Alfredo Perez, a 46-year-old diabetes patient, if he’d taken his insulin as prescribed.\u003c/p>\n\u003cp>“I did but I stopped because my vision became blurry for two days,” he responded.\u003c/p>\n\u003cp>“I’m scared to take insulin,” he told a reporter. “I’m afraid that once I start, I’ll never be off of it.”\u003c/p>\n\u003cp>Lee had spent months trying to gently coax Perez to take insulin. Each time he resisted, she asked him to try a lower dose. On this day she noted that his blood sugar was 93, more than 63 points above what it should be for the time of day, and she tried a more direct strategy.\u003c/p>\n\u003cp>“You’ve had high sugars for a long time. It’s going to damage your eyes, you’re going to lose your eyesight,” she said with authority. Instead of waiting two weeks for the next appointment, Lee asked Perez to return in a week and try a very small dose of insulin, and he agreed to do so.\u003c/p>\n\u003cp>\u003cstrong>Likely Cost Savings\u003c/strong>\u003c/p>\n\u003cp>Although such patient encounters are time consuming, many studies suggest that when clinical pharmacists work on primary care teams, overall healthcare costs plummet.\u003c/p>\n\u003cp>A recent report by the U.S. Public Health Service found that every dollar invested in clinical pharmacy services saved about 10 dollars in health spending, as patients better understood how to manage their illnesses and avoid expensive treatments that result from missed or misapplied medications\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>Although the USC/AltaMed study is still 17 months from completion, there has already been interest in duplicating the project.\u003c/p>\n\u003cp>Robert Beltran, the chief medical officer for Brand New Day, a Medicare Specialty Health Plan that serves 6,000 members in Los Angeles, Orange, Riverside, San Bernardino and Kings Counties, said he plans to start a pharmacist team program in Orange County and the Inland Empire in late spring or this summer.\u003c/p>\n\u003cp>When asked about whether AltaMed will continue the pharmacist program after the grant runs out, Altamed’s Hochman said, “That’s the million dollar question. We have proven to ourselves beyond a reasonable doubt that the (USC-led pharmacist teams) are a very high-value service to patients.”\u003c/p>\n\u003cp>But typically, clinics like AltaMed don’t get reimbursed by Medi-Cal, Medicare, or private insurance for pharmacist services. “We are hopeful it will become a reimbursed service for us in the near future,” he said.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003c/div>\n\u003cp>[contextly_auto_sidebar id=\"uPCv7ELLO6PmiIKvr6zeDyDCdW31Nw02\"]\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Male in Life, Female in Death: The Story of Christopher Lee’s Death Certificate",
"title": "Male in Life, Female in Death: The Story of Christopher Lee’s Death Certificate",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18754\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg\">\u003cimg class=\"size-full wp-image-18754\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg\" alt=\"Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.\" width=\"640\" height=\"294\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf-400x184.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf-320x147.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Matt Levin\u003c/strong>\u003c/p>\n\u003cp>Death certificates are typically pretty boring documents. A box for name, a box for date, a box for place and time, for cause of death. A bureaucratic afterthought to help family and friends settle the affairs of a deceased loved one.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I looked at it, and it said 'female' on it. And I asked her, ‘Why does it say female? He was male.'\"\u003c/aside>\n\u003cp>A death certificate was not on the forefront of Chino Scott-Chung’s mind as he waited for the ashes of his best friend, Christopher Lee. Lee, 48, had committed suicide in December 2012, and Scott-Chung was still reeling from the death of the friend who had served as best man in his wedding.\u003c/p>\n\u003cp>After receiving the ashes, Scott-Chung prepared to leave when the employee from the Oakland cremation services company handed him Lee’s death certificate.\u003c/p>\n\u003cp>Scott-Chung immediately noticed something was wrong. Something that Christopher would never have consented to if he were still alive.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I looked at it, and it said female on it,” said Scott-Chung. “And I asked her, ‘Why does it say female? He was male. You must have made a mistake.’”\u003c/p>\n\u003cp>Lee was a female-to-male transgender person, and had identified as male for two decades. His driver’s license, which Scott-Chung and his spouse had turned over to the Alameda County coroner shortly after Lee’s death, identified Lee as male.\u003c/p>\n\u003cp>But on Lee’s death certificate, under the box marked “SEX”, was the word “female.”\u003c/p>\n\u003cp>“That can’t be,” Scott-Chung remembered telling the cremation company employee. “He’s a man, and he has lived as man for close to twenty years.”\u003c/p>\n\u003cp>The employee explained to Lee that the death certificate was filled out by the Alameda County coroner’s office, and that gender on the form is typically determined by the presence of male or female genitalia.\u003c/p>\n\u003cp>While Lee identified as male and had secondary male sex characteristics like facial hair, he had not undergone sex reassignment surgery, and so retained female reproductive anatomy.\u003c/p>\n\u003cp>Scott-Chung was shocked. It wasn’t just that he believed a public document incorrectly identified Lee’s gender. It’s that Lee had spent much of his adult life as a public figure in the Bay Area transgender community, and was in many respects a pioneer in the transgender rights movement.\u003c/p>\n\u003cp>Lee had co-founded the \u003ca href=\"http://www.sftff.org/\">Transgender Film Festival\u003c/a>, then known as “Tranny Fest”, in San Francisco in 1997. The festival, which screens works that seek to counter negative stereotypes about transgender people, was the first of its kind in North America and is still hosted annually in Bay Area theaters.\u003c/p>\n\u003cp>In 2002, Lee served as the first female-to-male transgender grand marshal of the San Francisco LGBT Pride Parade. He made several films about the transgender experience, including the autobiographical “Christopher’s Chronicles.”\u003c/p>\n\u003cp>“When they put RIP on people’s tombstones, it’s rest in peace” said Maya Scott-Chung, Chino’s spouse and a close friend of Lee’s. “And I just felt like Christopher’s spirit will not rest in peace with a death certificate that says female.”\u003c/p>\n\u003cp>Shortly after receiving Lee’s death certificate, the couple contacted the Transgender Law Center, an Oakland-based legal services and advocacy organization, to see what they could do to amend the document.\u003c/p>\n\u003cp>\"Under current law, we were actually surprised to learn that there's essentially no guidance to people filling out death certificates about what they should put for sex,\" said Ilona Turner, legal director for the Transgender Law Center.\u003c/p>\n\u003cp>“Whenever transgender people pass away, it’s completely up to the discretion, education, knowledge, of that individual coroner or funeral director to use their best judgment in the face of what is sometimes conflicting information.”\u003c/p>\n\u003cp>Such conflicting information could arise in the form of reproductive genitalia of one sex and secondary sex characteristics of another, such as in Lee’s case. Because the cost of sex reassignment surgery is generally prohibitively high and often not covered by health insurance, this is common among transgender people.\u003c/p>\n\u003cp>Adding to the uncertainty, coroners and funeral directors typically rely on the next of kin of the deceased when filling out vital information on a death certificate, including name, age, occupation, and sex. This may be problematic for many transgender people who are estranged from their biological families because of their gender transition.\u003c/p>\n\u003cp>“This is one of those elements that can come up where people may disagree as to what should be included on the death certificate, what the deceased wanted to have included in terms of their gender,” said Bob Achermann, executive director of the California Funeral Directors Association.\u003c/p>\n\u003cp>Achermann says this could leave funeral directors in legally vulnerable territory.\u003c/p>\n\u003cp>“You don’t want to put yourself in the middle, expose yourself to liability because you can’t resolve a conflict between two parties saying totally contrary things.”\u003c/p>\n\u003cp>The legal limbo surrounding transgender death certificates prompted Transgender Law Center and Equality California, a gay rights group, to push for new legislation in the state capitol this year. The \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1551-1600/ab_1577_cfa_20140321_162401_asm_comm.html\" target=\"_blank\">“Respect After Death Act”\u003c/a>, introduced by Assemblymember Toni Atkins (D-San Diego), requires that individuals completing a death certificate record the decedent’s sex to reflect his or her gender identity, not simply sexual anatomy.\u003c/p>\n\u003cp>The bill, AB 1577, passed a health committee vote earlier this month and awaits a May hearing in the Assembly Appropriations Committee. It specifies legal documents that officials should defer to when determining gender on a death certificate. These documents include a birth certificate, a court order approving a name or gender change, a passport, proof of clinical treatment for gender transition, and a valid driver’s license. In the event of a conflict, such documents would trump preferences of next-of-kin.\u003c/p>\n\u003cp>The bill would also shield coroners and funeral directors from lawsuits if they fill out death certificates according to these new protocols.\u003c/p>\n\u003cp>“Passing AB 1577 will ensure that transgender people who have memorialized their gender transition can be recognized properly at death with simple, objective criteria,” Atkins said during the bill’s hearing.\u003c/p>\n\u003cp>Atkins has taken on transgender issues as part of her legislative agenda. Last year, Atkins co-authored \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1251-1300/ab_1266_bill_20130812_chaptered.html\" target=\"_blank\">AB 1266\u003c/a>, which allowed transgender students to use facilities like bathrooms that conform to their gender identity. She also sponsored separate legislation that makes it easier for transgender people to change the name and gender listed on their birth certificate. Atkins will become the first lesbian Assembly Speaker later this spring.\u003c/p>\n\u003cp>Capitol Resource Institute, a family values advocacy group, has registered opposition to the bill, arguing that it would give legal authority to non-family members to influence the recording of gender on a death certificate. The group did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Turner, the attorney from the Transgender Law Center, argues that the bill is one step in a broader effort against the posthumous “mis-gendering” of transgender people. Lawyers from the organization say they’ve heard of cases where family bury the transgender deceased in clothes of their birth gender, rather than how the person dressed as an adult.\u003c/p>\n\u003cp>“It's incredibly painful to the family, friends, and broader community members of a transgender person who passed away when that person is wrongly gendered after their death,” said Turner. “It sends a message, really a pretty strong signal to the rest of the community, that your wishes around your gender, your identity, your life as this person, who you are doesn't matter and can be completely erased once you're not here to stand up for yourself.”\u003c/p>\n\u003cp>As far as Lee’s death certificate is concerned, Chino and Maya Scott-Chung are currently in the process of attempting to amend it. While Lee was not close to his biological family for many reasons, the family has deferred to the Scott-Chungs to settle Lee’s affairs. The family declined to be interviewed by KQED.\u003c/p>\n\u003cp>An amended death certificate in California does not replace the original certificate -- an amended version is simply attached to the original. Once the amendment process is complete, if someone requested Lee’s death certificate as a public record, they would see two genders: the original “female” on the old certificate, and “male” on the corrected one.\u003c/p>\n\u003cp>\u003cem>Additional reporting by April Dembosky. \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>More:\u003c/strong> \u003ca href=\"http://www.californiareport.org/archive/R201404181630/b\" target=\"_blank\">Transgender Activist's Death Opens Political Battle\u003c/a>\u003cstrong> (The California Report Magazine)\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"6mSHroZjr9uZ5jyrrJgUO3oMZjGOUsVL\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18754\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg\">\u003cimg class=\"size-full wp-image-18754\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg\" alt=\"Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.\" width=\"640\" height=\"294\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf-400x184.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS9694_christopher-long-hpf-320x147.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Matt Levin\u003c/strong>\u003c/p>\n\u003cp>Death certificates are typically pretty boring documents. A box for name, a box for date, a box for place and time, for cause of death. A bureaucratic afterthought to help family and friends settle the affairs of a deceased loved one.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“I looked at it, and it said 'female' on it. And I asked her, ‘Why does it say female? He was male.'\"\u003c/aside>\n\u003cp>A death certificate was not on the forefront of Chino Scott-Chung’s mind as he waited for the ashes of his best friend, Christopher Lee. Lee, 48, had committed suicide in December 2012, and Scott-Chung was still reeling from the death of the friend who had served as best man in his wedding.\u003c/p>\n\u003cp>After receiving the ashes, Scott-Chung prepared to leave when the employee from the Oakland cremation services company handed him Lee’s death certificate.\u003c/p>\n\u003cp>Scott-Chung immediately noticed something was wrong. Something that Christopher would never have consented to if he were still alive.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I looked at it, and it said female on it,” said Scott-Chung. “And I asked her, ‘Why does it say female? He was male. You must have made a mistake.’”\u003c/p>\n\u003cp>Lee was a female-to-male transgender person, and had identified as male for two decades. His driver’s license, which Scott-Chung and his spouse had turned over to the Alameda County coroner shortly after Lee’s death, identified Lee as male.\u003c/p>\n\u003cp>But on Lee’s death certificate, under the box marked “SEX”, was the word “female.”\u003c/p>\n\u003cp>“That can’t be,” Scott-Chung remembered telling the cremation company employee. “He’s a man, and he has lived as man for close to twenty years.”\u003c/p>\n\u003cp>The employee explained to Lee that the death certificate was filled out by the Alameda County coroner’s office, and that gender on the form is typically determined by the presence of male or female genitalia.\u003c/p>\n\u003cp>While Lee identified as male and had secondary male sex characteristics like facial hair, he had not undergone sex reassignment surgery, and so retained female reproductive anatomy.\u003c/p>\n\u003cp>Scott-Chung was shocked. It wasn’t just that he believed a public document incorrectly identified Lee’s gender. It’s that Lee had spent much of his adult life as a public figure in the Bay Area transgender community, and was in many respects a pioneer in the transgender rights movement.\u003c/p>\n\u003cp>Lee had co-founded the \u003ca href=\"http://www.sftff.org/\">Transgender Film Festival\u003c/a>, then known as “Tranny Fest”, in San Francisco in 1997. The festival, which screens works that seek to counter negative stereotypes about transgender people, was the first of its kind in North America and is still hosted annually in Bay Area theaters.\u003c/p>\n\u003cp>In 2002, Lee served as the first female-to-male transgender grand marshal of the San Francisco LGBT Pride Parade. He made several films about the transgender experience, including the autobiographical “Christopher’s Chronicles.”\u003c/p>\n\u003cp>“When they put RIP on people’s tombstones, it’s rest in peace” said Maya Scott-Chung, Chino’s spouse and a close friend of Lee’s. “And I just felt like Christopher’s spirit will not rest in peace with a death certificate that says female.”\u003c/p>\n\u003cp>Shortly after receiving Lee’s death certificate, the couple contacted the Transgender Law Center, an Oakland-based legal services and advocacy organization, to see what they could do to amend the document.\u003c/p>\n\u003cp>\"Under current law, we were actually surprised to learn that there's essentially no guidance to people filling out death certificates about what they should put for sex,\" said Ilona Turner, legal director for the Transgender Law Center.\u003c/p>\n\u003cp>“Whenever transgender people pass away, it’s completely up to the discretion, education, knowledge, of that individual coroner or funeral director to use their best judgment in the face of what is sometimes conflicting information.”\u003c/p>\n\u003cp>Such conflicting information could arise in the form of reproductive genitalia of one sex and secondary sex characteristics of another, such as in Lee’s case. Because the cost of sex reassignment surgery is generally prohibitively high and often not covered by health insurance, this is common among transgender people.\u003c/p>\n\u003cp>Adding to the uncertainty, coroners and funeral directors typically rely on the next of kin of the deceased when filling out vital information on a death certificate, including name, age, occupation, and sex. This may be problematic for many transgender people who are estranged from their biological families because of their gender transition.\u003c/p>\n\u003cp>“This is one of those elements that can come up where people may disagree as to what should be included on the death certificate, what the deceased wanted to have included in terms of their gender,” said Bob Achermann, executive director of the California Funeral Directors Association.\u003c/p>\n\u003cp>Achermann says this could leave funeral directors in legally vulnerable territory.\u003c/p>\n\u003cp>“You don’t want to put yourself in the middle, expose yourself to liability because you can’t resolve a conflict between two parties saying totally contrary things.”\u003c/p>\n\u003cp>The legal limbo surrounding transgender death certificates prompted Transgender Law Center and Equality California, a gay rights group, to push for new legislation in the state capitol this year. The \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1551-1600/ab_1577_cfa_20140321_162401_asm_comm.html\" target=\"_blank\">“Respect After Death Act”\u003c/a>, introduced by Assemblymember Toni Atkins (D-San Diego), requires that individuals completing a death certificate record the decedent’s sex to reflect his or her gender identity, not simply sexual anatomy.\u003c/p>\n\u003cp>The bill, AB 1577, passed a health committee vote earlier this month and awaits a May hearing in the Assembly Appropriations Committee. It specifies legal documents that officials should defer to when determining gender on a death certificate. These documents include a birth certificate, a court order approving a name or gender change, a passport, proof of clinical treatment for gender transition, and a valid driver’s license. In the event of a conflict, such documents would trump preferences of next-of-kin.\u003c/p>\n\u003cp>The bill would also shield coroners and funeral directors from lawsuits if they fill out death certificates according to these new protocols.\u003c/p>\n\u003cp>“Passing AB 1577 will ensure that transgender people who have memorialized their gender transition can be recognized properly at death with simple, objective criteria,” Atkins said during the bill’s hearing.\u003c/p>\n\u003cp>Atkins has taken on transgender issues as part of her legislative agenda. Last year, Atkins co-authored \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1251-1300/ab_1266_bill_20130812_chaptered.html\" target=\"_blank\">AB 1266\u003c/a>, which allowed transgender students to use facilities like bathrooms that conform to their gender identity. She also sponsored separate legislation that makes it easier for transgender people to change the name and gender listed on their birth certificate. Atkins will become the first lesbian Assembly Speaker later this spring.\u003c/p>\n\u003cp>Capitol Resource Institute, a family values advocacy group, has registered opposition to the bill, arguing that it would give legal authority to non-family members to influence the recording of gender on a death certificate. The group did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Turner, the attorney from the Transgender Law Center, argues that the bill is one step in a broader effort against the posthumous “mis-gendering” of transgender people. Lawyers from the organization say they’ve heard of cases where family bury the transgender deceased in clothes of their birth gender, rather than how the person dressed as an adult.\u003c/p>\n\u003cp>“It's incredibly painful to the family, friends, and broader community members of a transgender person who passed away when that person is wrongly gendered after their death,” said Turner. “It sends a message, really a pretty strong signal to the rest of the community, that your wishes around your gender, your identity, your life as this person, who you are doesn't matter and can be completely erased once you're not here to stand up for yourself.”\u003c/p>\n\u003cp>As far as Lee’s death certificate is concerned, Chino and Maya Scott-Chung are currently in the process of attempting to amend it. While Lee was not close to his biological family for many reasons, the family has deferred to the Scott-Chungs to settle Lee’s affairs. The family declined to be interviewed by KQED.\u003c/p>\n\u003cp>An amended death certificate in California does not replace the original certificate -- an amended version is simply attached to the original. Once the amendment process is complete, if someone requested Lee’s death certificate as a public record, they would see two genders: the original “female” on the old certificate, and “male” on the corrected one.\u003c/p>\n\u003cp>\u003cem>Additional reporting by April Dembosky. \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>More:\u003c/strong> \u003ca href=\"http://www.californiareport.org/archive/R201404181630/b\" target=\"_blank\">Transgender Activist's Death Opens Political Battle\u003c/a>\u003cstrong> (The California Report Magazine)\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Prisons Are Main Source of California's Psychiatric Housing",
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"content": "\u003cfigure id=\"attachment_18708\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS7994_sign02_GDC-hpf.jpg\">\u003cimg class=\"size-full wp-image-18708\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/RS7994_sign02_GDC-hpf.jpg\" alt=\"(Photo/Gregory D. Cook)\" width=\"640\" height=\"455\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS7994_sign02_GDC-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS7994_sign02_GDC-hpf-400x284.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/04/RS7994_sign02_GDC-hpf-320x228.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo/Gregory D. Cook)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Hannah Guzik,\u003c/strong> \u003ca href=\"http://www.healthycal.org/archives/15351\" target=\"_blank\">HealthyCal\u003c/a>\u003c/p>\n\u003cp>California's jails and prisons hold far more people with severe psychiatric illnesses than state hospitals, according to a recent \u003ca href=\"http://www.tacreports.org/storage/documents/treatment-behind-bars/treatment-behind-bars.pdf\" target=\"_blank\">report\u003c/a> from the Treatment Advocacy Center and the National Sheriffs’ Association.\u003c/p>\n\u003cp>“For a state with 38 million people -- 1 in every 8 Americans lives in California -- there are almost no public psychiatric beds available for individuals with serious mental illness,” the report says.\u003c/p>\n\u003cp>Four state hospitals -- Metropolitan, Patton, Napa, and Atascadero -- have just over 4,500 beds, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga is used almost exclusively for sexually violent predators.\u003c!--more-->\u003c/p>\n\u003cp>California's major prisons house more than 33,000 mentally ill inmates. That’s 28 percent of the 120,000 inmates in those prisons.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, 26 of California’s 58 counties have no psychiatric inpatient beds.\u003c/p>\n\u003cp>“For mentally ill individuals who need to be hospitalized briefly to become stabilized on medication, this leaves few options,” the authors of the report write.\u003c/p>\n\u003cp>The Affordable Care Act has expanded treatment coverage for those with certain mental illnesses, but some advocates say it doesn’t go far enough. It doesn’t require states to have a certain number of inpatient psychiatric beds, for example.\u003c/p>\n\u003cp>California jails and prisons are also ill equipped to effectively treat patients with mental illness, the report says.\u003c/p>\n\u003cp>Last Thursday, a federal judge ruled that the state’s treatment of mentally ill inmates is unconstitutional because it involves cruel and unusual punishment through excessive use of pepper spray and isolation.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.utsandiego.com/news/2014/apr/10/judge-california-mistreating-mentally-ill-inmates/\" target=\"_blank\">Associated Press\u003c/a> reported that the ruling came after the public release of videotapes made by prison guards. The footage shows the guards throwing chemical grenades and pumping large amounts of pepper spray into the cells of mentally ill inmates, some of whom are heard screaming.\u003c/p>\n\u003cp>“Most of the videos were horrific,” U.S. District Court Judge Lawrence Karlton wrote in his 74-page ruling.\u003c/p>\n\u003cp>Karlton ordered the state to update its polices on the use of pepper spray and isolation units, but did not ban the methods.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eh6W1IrHJWuw9tf2dKncOFFFNYKD8JHc\"]\u003c/p>\n\n",
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"content": "\u003cp>The 2014 enrollment period for the Affordable Care Act closes tonight. For some people the new health law is a godsend. Others barely noticed its existence.\u003c/p>\n\u003cp>Donna Zeuli and her husband lost their insurance when he retired two years ago. Private insurers denied them both because of pre-existing conditions and the COBRA plan offered through his union was too expensive. So they decided to take their chances and wait for Obamacare to take effect.\u003c/p>\n\u003cp>Then, last fall, Zeuli had a mini stroke at her home in Magalia, Calif., in the foothills of Chico, and was rushed to the ER.\u003c/p>\n\u003cp>“You can’t believe the angst I had about not having insurance,” says Zeuli, 55. “The only thing I could think about was how much is this going to cost me. Do the minimum. But make sure I’m not gonna die.”\u003c!--more-->\u003c/p>\n\u003cp>She spent one night in the hospital and came out with an $11,000 bill. She says that’s why she was one of the first in line when the insurance marketplace opened in California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“As soon as I was able to sign up,” she says. “As of January first, we had insurance.”\u003c/p>\n\u003cp>Bruce Bergren, 60, doesn't share the enthusiasm. He’s a carpenter in Hermosa Beach and he decided to watch the Obamacare deadline come and go.\u003c/p>\n\u003cp>“The problem is right now, business hasn’t been that good so it’s kind of an expense I can’t really afford,” he says.\u003c/p>\n\u003cp>He heard warnings about a tax penalty and reports about financial assistance from the government to make monthly premiums more affordable. But when it came down to it, Bergren had other budget priorities.\u003c/p>\n\u003cp>“I have some debt to get rid of and, rent’s high so that’s one of my biggest expenses,” he says. “And running a business, ya know, replacing tools and stuff, that’s not cheap.”\u003c/p>\n\u003cp>He says he's waiting for lawmakers to pass free, universal health care. Then he'll be interested.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For people who want to complete an application for a health plan, check www.coveredca.com for instructions. But act fast. The deadline is at 11:59 p.m. tonight.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The 2014 enrollment period for the Affordable Care Act closes tonight. For some people the new health law is a godsend. Others barely noticed its existence.\u003c/p>\n\u003cp>Donna Zeuli and her husband lost their insurance when he retired two years ago. Private insurers denied them both because of pre-existing conditions and the COBRA plan offered through his union was too expensive. So they decided to take their chances and wait for Obamacare to take effect.\u003c/p>\n\u003cp>Then, last fall, Zeuli had a mini stroke at her home in Magalia, Calif., in the foothills of Chico, and was rushed to the ER.\u003c/p>\n\u003cp>“You can’t believe the angst I had about not having insurance,” says Zeuli, 55. “The only thing I could think about was how much is this going to cost me. Do the minimum. But make sure I’m not gonna die.”\u003c!--more-->\u003c/p>\n\u003cp>She spent one night in the hospital and came out with an $11,000 bill. She says that’s why she was one of the first in line when the insurance marketplace opened in California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“As soon as I was able to sign up,” she says. “As of January first, we had insurance.”\u003c/p>\n\u003cp>Bruce Bergren, 60, doesn't share the enthusiasm. He’s a carpenter in Hermosa Beach and he decided to watch the Obamacare deadline come and go.\u003c/p>\n\u003cp>“The problem is right now, business hasn’t been that good so it’s kind of an expense I can’t really afford,” he says.\u003c/p>\n\u003cp>He heard warnings about a tax penalty and reports about financial assistance from the government to make monthly premiums more affordable. But when it came down to it, Bergren had other budget priorities.\u003c/p>\n\u003cp>“I have some debt to get rid of and, rent’s high so that’s one of my biggest expenses,” he says. “And running a business, ya know, replacing tools and stuff, that’s not cheap.”\u003c/p>\n\u003cp>He says he's waiting for lawmakers to pass free, universal health care. Then he'll be interested.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For people who want to complete an application for a health plan, check www.coveredca.com for instructions. But act fast. The deadline is at 11:59 p.m. tonight.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Prescription: Take New Medicare Data With A Dose of Caution",
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"content": "\u003cfigure id=\"attachment_18638\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/457044123-e1397083447936.jpg\">\u003cimg class=\"size-large wp-image-18638\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/457044123-640x425.jpg\" alt=\"The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Mark Memmott,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2014/04/09/300857727/dose-of-caution-prescribed-when-evaluating-new-medicare-data?utm_source=npr&utm_campaign=nprnews&utm_medium=twitter\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The headlines about one of Wednesday's big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:\u003c/p>\n\u003cp>— \"Sliver of Medicare Doctors Get Big Share of Payouts.\" (\u003ca href=\"http://www.nytimes.com/2014/04/09/business/sliver-of-medicare-doctors-get-big-share-of-payouts.html?_r=0\" target=\"_blank\">\u003cem>The New York Times\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>— \"Small Slice of Doctors Account for Big Chunk of Medicare Costs.\" (\u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702303456104579490043350808268?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303456104579490043350808268.html\" target=\"_blank\">\u003cem>The Wall Street Journal\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>— \"Release of Medicare doctor payments shows some huge payouts.\" (\u003ca href=\"http://www.latimes.com/business/la-fi-medicare-doctor-pay-20140409,0,3335569,full.story#axzz2yOEkavMY\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here's \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=300829164\" target=\"_blank\">how The Associated Press sums up the news\u003c/a>:\u003c!--more-->\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>Medicare paid a tiny group of doctors $3 million or more apiece in 2012. One got nearly $21 million.\u003c/p>\n\u003cp>Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.\u003c/p>\n\u003cp>Topping Medicare's list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor's personal jet for trips to the Dominican Republic. Medicare paid Melgen $20.8 million.\u003c/p>\n\u003cp>AP's analysis found that a small sliver of the more than 825,000 individual physicians in Medicare's claims data base — just 344 physicians — took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>Watch for more on this as the day continues from NPR's Julie Rovner \u003ca href=\"http://www.npr.org/blogs/health/\" target=\"_blank\">and the Shots blog\u003c/a>. The figures do raise questions. As the AP notes, \"about 1 in 4 of the top-paid doctors — 87 of them — practice in Florida, a state known both for high Medicare spending and widespread fraud.\"\u003c/p>\n\u003cp>But here are some cautionary thoughts from Charles Ornstein, a senior reporter with ProPublica in New York. He's \u003ca href=\"http://healthjournalism.org/blog/2014/04/caution-in-order-when-tackling-newly-released-medicare-data/\" target=\"_blank\">posted them on Covering Health\u003c/a>, a blog from the Association of Health Care Journalists:\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>There are many reasons why a doctor may receive large payments from Medicare.\u003cstrong> \u003c/strong>For one, the doctor may treat exclusively Medicare patients. In such cases, the doctor's payments would naturally look larger compared to peers who also see a lot of privately insured patients (this is called a provider's payer mix). Another explanation is that the doctor may provide services, such as eye surgery or cancer care, that are reimbursed at higher rates than typical office visits. A third explanation is that the provider may have other professionals billing under his/her Medicare number, which is allowed in some circumstances.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>The\u003cem> L.A. Times\u003c/em> makes the same point:\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>Federal officials cautioned against drawing sweeping conclusions about individual doctors from the numbers. High payouts do not necessarily indicate improper billing or fraud, they say. Payments could be driven higher because providers were treating sicker patients who required more treatment or because their practice was focused more on Medicare patients.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>Still, the \u003cem>Times\u003c/em> adds that \"the data could serve as an early warning for potential waste and abuse.\"\u003c/p>\n\u003cp>The \u003cem>Journal\u003c/em> \u003ca href=\"http://projects.wsj.com/medicarebilling/\" target=\"_blank\">has an interactive tool online\u003c/a> that allows users to search the database \"by provider name, specialty and location to see the types and number of procedures performed and the amounts paid to each provider by Medicare.\"\u003c/p>\n\u003cp>It also recaps the \"\u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702303456104579490043350808268?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303456104579490043350808268.html\" target=\"_blank\">long and winding road\u003c/a>\" to the release of the data, which includes a 1979 court decision that granted the American Medical Association's request to bar releasing such information. That injunction was vacated in 2013.\u003c/p>\n\u003cp>Note: The data do not reveal personal information about any of the physicians' patients.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"Ez2JLdRg7FuuAEv7o7wTIvYxATRufJBW\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18638\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/457044123-e1397083447936.jpg\">\u003cimg class=\"size-large wp-image-18638\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/457044123-640x425.jpg\" alt=\"The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Mark Memmott,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thetwo-way/2014/04/09/300857727/dose-of-caution-prescribed-when-evaluating-new-medicare-data?utm_source=npr&utm_campaign=nprnews&utm_medium=twitter\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The headlines about one of Wednesday's big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:\u003c/p>\n\u003cp>— \"Sliver of Medicare Doctors Get Big Share of Payouts.\" (\u003ca href=\"http://www.nytimes.com/2014/04/09/business/sliver-of-medicare-doctors-get-big-share-of-payouts.html?_r=0\" target=\"_blank\">\u003cem>The New York Times\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>— \"Small Slice of Doctors Account for Big Chunk of Medicare Costs.\" (\u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702303456104579490043350808268?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303456104579490043350808268.html\" target=\"_blank\">\u003cem>The Wall Street Journal\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>— \"Release of Medicare doctor payments shows some huge payouts.\" (\u003ca href=\"http://www.latimes.com/business/la-fi-medicare-doctor-pay-20140409,0,3335569,full.story#axzz2yOEkavMY\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a>)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here's \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=300829164\" target=\"_blank\">how The Associated Press sums up the news\u003c/a>:\u003c!--more-->\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>Medicare paid a tiny group of doctors $3 million or more apiece in 2012. One got nearly $21 million.\u003c/p>\n\u003cp>Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.\u003c/p>\n\u003cp>Topping Medicare's list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor's personal jet for trips to the Dominican Republic. Medicare paid Melgen $20.8 million.\u003c/p>\n\u003cp>AP's analysis found that a small sliver of the more than 825,000 individual physicians in Medicare's claims data base — just 344 physicians — took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>Watch for more on this as the day continues from NPR's Julie Rovner \u003ca href=\"http://www.npr.org/blogs/health/\" target=\"_blank\">and the Shots blog\u003c/a>. The figures do raise questions. As the AP notes, \"about 1 in 4 of the top-paid doctors — 87 of them — practice in Florida, a state known both for high Medicare spending and widespread fraud.\"\u003c/p>\n\u003cp>But here are some cautionary thoughts from Charles Ornstein, a senior reporter with ProPublica in New York. He's \u003ca href=\"http://healthjournalism.org/blog/2014/04/caution-in-order-when-tackling-newly-released-medicare-data/\" target=\"_blank\">posted them on Covering Health\u003c/a>, a blog from the Association of Health Care Journalists:\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>There are many reasons why a doctor may receive large payments from Medicare.\u003cstrong> \u003c/strong>For one, the doctor may treat exclusively Medicare patients. In such cases, the doctor's payments would naturally look larger compared to peers who also see a lot of privately insured patients (this is called a provider's payer mix). Another explanation is that the doctor may provide services, such as eye surgery or cancer care, that are reimbursed at higher rates than typical office visits. A third explanation is that the provider may have other professionals billing under his/her Medicare number, which is allowed in some circumstances.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>The\u003cem> L.A. Times\u003c/em> makes the same point:\u003c/p>\n\u003cblockquote>\n\u003cdiv>\n\u003cp>Federal officials cautioned against drawing sweeping conclusions about individual doctors from the numbers. High payouts do not necessarily indicate improper billing or fraud, they say. Payments could be driven higher because providers were treating sicker patients who required more treatment or because their practice was focused more on Medicare patients.\u003c/p>\n\u003c/div>\n\u003c/blockquote>\n\u003cp>Still, the \u003cem>Times\u003c/em> adds that \"the data could serve as an early warning for potential waste and abuse.\"\u003c/p>\n\u003cp>The \u003cem>Journal\u003c/em> \u003ca href=\"http://projects.wsj.com/medicarebilling/\" target=\"_blank\">has an interactive tool online\u003c/a> that allows users to search the database \"by provider name, specialty and location to see the types and number of procedures performed and the amounts paid to each provider by Medicare.\"\u003c/p>\n\u003cp>It also recaps the \"\u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702303456104579490043350808268?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303456104579490043350808268.html\" target=\"_blank\">long and winding road\u003c/a>\" to the release of the data, which includes a 1979 court decision that granted the American Medical Association's request to bar releasing such information. That injunction was vacated in 2013.\u003c/p>\n\u003cp>Note: The data do not reveal personal information about any of the physicians' patients.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"Ez2JLdRg7FuuAEv7o7wTIvYxATRufJBW\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_18556\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo.jpg\">\u003cimg class=\"size-large wp-image-18556\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo-640x529.jpg\" alt=\"Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\" width=\"640\" height=\"529\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\u003c/figcaption>\u003c/figure>\n\u003cp>A new campaign is underway to legalize physician-assisted suicide in California. Advocates launched a series of online ads last week to begin raising awareness. Still, it could take years for the effort to yield any results.\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003caside class=\"pullquote alignleft\">\"Having choice helps me feel I have some control.\" \u003c/aside>\n\u003cp>Since the early 1990s, lawmakers and activists have tried and failed several times to pass a death with dignity law in California. Under such a law doctors could prescribe lethal medications to patients who are terminally ill. Oregon and Washington permit the practice.\u003c/p>\n\u003cp>“California is a large state. It’s a politically complicated state,” says Barbara Coombs Lee, president of Compassion and Choices. Her advocacy group is leading the effort to try again to pass a law through the legislature or ballot proposition that would make aid in dying accessible in California.\u003c!--more-->\u003c/p>\n\u003cp>Coombs Lee says most people want the prescription not to take the drug -- but just to have it.\u003c/p>\n\u003cp>“It’s having the medication that gives them the sense of comfort and control, peace of mind. They call it their security blanket, their insurance policy,” she says.\u003c/p>\n\u003cp>That’s what it comes down to for San Mateo resident Jennifer Glass. When she was diagnosed with lung cancer last year, her mind immediately raced to a vision of a messy, chaotic death.\u003c/p>\n\u003cp>“The idea that my life is going to end was not so frightening to me,” she says. “The idea that I might drown in my own lung fluid while my family watches me suffer. That is terrifying.\u003c/p>\n\u003cp>Glass, 50, says at least having the option of controlling when and how she dies would bring her peace.\u003c/p>\n\u003cp>“There’s nothing that can prepare you for when you’re doctor looks you in the eye and tells you, 'you have cancer,'” she says. “But having choice helps me feel I have some control over a situation that is uncontrollable.”\u003c/p>\n\u003cp>Her cancer is being managed now. But with California’s fraught history over this issue, it will take some time to see results.\u003c/p>\n\u003cp>“The time is now,” says Coombs Lee. “We all together have made a commitment to see aid in dying accessible, transparent, available to Californians within five years.”\u003c/p>\n\u003c/div>\n\u003cp>[contextly_auto_sidebar id=\"Ivyr6AcIFcTADfQwgC7qu3U9hQk3lTTo\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_18556\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo.jpg\">\u003cimg class=\"size-large wp-image-18556\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/Jennifer-Glass-March-2013-chemo-640x529.jpg\" alt=\"Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\" width=\"640\" height=\"529\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)\u003c/figcaption>\u003c/figure>\n\u003cp>A new campaign is underway to legalize physician-assisted suicide in California. Advocates launched a series of online ads last week to begin raising awareness. Still, it could take years for the effort to yield any results.\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003caside class=\"pullquote alignleft\">\"Having choice helps me feel I have some control.\" \u003c/aside>\n\u003cp>Since the early 1990s, lawmakers and activists have tried and failed several times to pass a death with dignity law in California. Under such a law doctors could prescribe lethal medications to patients who are terminally ill. Oregon and Washington permit the practice.\u003c/p>\n\u003cp>“California is a large state. It’s a politically complicated state,” says Barbara Coombs Lee, president of Compassion and Choices. Her advocacy group is leading the effort to try again to pass a law through the legislature or ballot proposition that would make aid in dying accessible in California.\u003c!--more-->\u003c/p>\n\u003cp>Coombs Lee says most people want the prescription not to take the drug -- but just to have it.\u003c/p>\n\u003cp>“It’s having the medication that gives them the sense of comfort and control, peace of mind. They call it their security blanket, their insurance policy,” she says.\u003c/p>\n\u003cp>That’s what it comes down to for San Mateo resident Jennifer Glass. When she was diagnosed with lung cancer last year, her mind immediately raced to a vision of a messy, chaotic death.\u003c/p>\n\u003cp>“The idea that my life is going to end was not so frightening to me,” she says. “The idea that I might drown in my own lung fluid while my family watches me suffer. That is terrifying.\u003c/p>\n\u003cp>Glass, 50, says at least having the option of controlling when and how she dies would bring her peace.\u003c/p>\n\u003cp>“There’s nothing that can prepare you for when you’re doctor looks you in the eye and tells you, 'you have cancer,'” she says. “But having choice helps me feel I have some control over a situation that is uncontrollable.”\u003c/p>\n\u003cp>Her cancer is being managed now. But with California’s fraught history over this issue, it will take some time to see results.\u003c/p>\n\u003cp>“The time is now,” says Coombs Lee. “We all together have made a commitment to see aid in dying accessible, transparent, available to Californians within five years.”\u003c/p>\n\u003c/div>\n\u003cp>[contextly_auto_sidebar id=\"Ivyr6AcIFcTADfQwgC7qu3U9hQk3lTTo\"]\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_18516\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/aaskov/112790000/in/photolist-aY5xb-eqHar-6JgR6c-7aPrJE-amYd2Q-6M6hhk-fnAWoQ-7y8QpJ-7y528t-8Wv48S-8Wv3Lq-8Ws9yc-a7DaaP-6TjF7E-7Z3yuh-9sJMoa-5nQNmj-6TfECX-9sJK1P-96cAM2-9H2tAU-7gwUhJ-fCSk7A-5BTfo4-6nW4H7-7g9bdv-91RMPq-8oatox-bzxgw8-7giQfJ-fsf8U1-96p3NQ-7Zt1VA-7RdeeC-cS6mfd-7Z3eWu-7Z3s1J-7Z3sHG-4xGkuk-7giQbJ-7fDE7M-94zoDd-acZbfn-94we9P-cXx7qy-5zY4sx-4WqyBr-7YZeri-cgtd2q-iLvckU\">\u003cimg class=\"size-large wp-image-18516\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/112790000_e74d54321b_b-640x480.jpg\" alt='Under the new law San Diego, pictured above, will no longer be categorized as \"rural.\" (vinhdicated/Flickr)' width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Under the new law San Diego, pictured above, will no longer be categorized as \"rural.\" (vinhdicated/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A new federal law will change how doctors get paid in California, making it easier for patients in 14 California counties to find a doctor who accepts Medicare.\u003c/p>\n\u003cp>The law, signed by President Obama on Tuesday night, fixes an outdated Medicare formula that set rates based on urban or rural designations established in the 1960s, with places like San Diego, Sacramento, and Santa Cruz falling into the “rural” category.\u003c/p>\n\u003cp>So even as rent for office space and other costs of practicing medicine rose with the local economy in those places, doctors were still paid the same rates as doctors in remote, rural areas like Humboldt or Modoc.\u003c!--more-->\u003c/p>\n\u003cp>At those rates, doctors said they couldn't afford to treat Medicare patients.\u003c/p>\n\u003cp>“It was a dry spell,” said Dr. Larry DeGhetaldi, a family physician in Santa Cruz. In the mid-2000s, his medical group had to turn patients away for years because they couldn't recruit enough doctors. He watched medical school graduates set up shop in neighboring Silicon Valley instead, where they could get paid 25 percent more.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Why not drive 40 minutes and make $30,000 or $40,000 more a year,” he said.\u003c/p>\n\u003cp>So Dr. DeGhetaldi went to his local Congressman, Sam Farr. He found the same problem in 13 other high-cost counties Medicare had mis-categorized as low-cost rural.\u003c/p>\n\u003cp>“California was losing $54 million a year in revenue,” Farr said.\u003c/p>\n\u003cp>After 15 years of political wrangling, Farr finally ushered in a new law that updates the payment formula in California.\u003c/p>\n\u003cp>“The reimbursement money that the doctors will receive will allow them to pick up more patients, allow them to stay in practice if they couldn't afford to,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will still have to wait to feel the difference. The new reimbursement rates don't kick in until 2017 and they will be phased in over six years.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18516\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/aaskov/112790000/in/photolist-aY5xb-eqHar-6JgR6c-7aPrJE-amYd2Q-6M6hhk-fnAWoQ-7y8QpJ-7y528t-8Wv48S-8Wv3Lq-8Ws9yc-a7DaaP-6TjF7E-7Z3yuh-9sJMoa-5nQNmj-6TfECX-9sJK1P-96cAM2-9H2tAU-7gwUhJ-fCSk7A-5BTfo4-6nW4H7-7g9bdv-91RMPq-8oatox-bzxgw8-7giQfJ-fsf8U1-96p3NQ-7Zt1VA-7RdeeC-cS6mfd-7Z3eWu-7Z3s1J-7Z3sHG-4xGkuk-7giQbJ-7fDE7M-94zoDd-acZbfn-94we9P-cXx7qy-5zY4sx-4WqyBr-7YZeri-cgtd2q-iLvckU\">\u003cimg class=\"size-large wp-image-18516\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/112790000_e74d54321b_b-640x480.jpg\" alt='Under the new law San Diego, pictured above, will no longer be categorized as \"rural.\" (vinhdicated/Flickr)' width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Under the new law San Diego, pictured above, will no longer be categorized as \"rural.\" (vinhdicated/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A new federal law will change how doctors get paid in California, making it easier for patients in 14 California counties to find a doctor who accepts Medicare.\u003c/p>\n\u003cp>The law, signed by President Obama on Tuesday night, fixes an outdated Medicare formula that set rates based on urban or rural designations established in the 1960s, with places like San Diego, Sacramento, and Santa Cruz falling into the “rural” category.\u003c/p>\n\u003cp>So even as rent for office space and other costs of practicing medicine rose with the local economy in those places, doctors were still paid the same rates as doctors in remote, rural areas like Humboldt or Modoc.\u003c!--more-->\u003c/p>\n\u003cp>At those rates, doctors said they couldn't afford to treat Medicare patients.\u003c/p>\n\u003cp>“It was a dry spell,” said Dr. Larry DeGhetaldi, a family physician in Santa Cruz. In the mid-2000s, his medical group had to turn patients away for years because they couldn't recruit enough doctors. He watched medical school graduates set up shop in neighboring Silicon Valley instead, where they could get paid 25 percent more.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Why not drive 40 minutes and make $30,000 or $40,000 more a year,” he said.\u003c/p>\n\u003cp>So Dr. DeGhetaldi went to his local Congressman, Sam Farr. He found the same problem in 13 other high-cost counties Medicare had mis-categorized as low-cost rural.\u003c/p>\n\u003cp>“California was losing $54 million a year in revenue,” Farr said.\u003c/p>\n\u003cp>After 15 years of political wrangling, Farr finally ushered in a new law that updates the payment formula in California.\u003c/p>\n\u003cp>“The reimbursement money that the doctors will receive will allow them to pick up more patients, allow them to stay in practice if they couldn't afford to,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will still have to wait to feel the difference. The new reimbursement rates don't kick in until 2017 and they will be phased in over six years.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Report Finds Dramatic Racial Disparities for California Kids",
"title": "New Report Finds Dramatic Racial Disparities for California Kids",
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"content": "\u003cfigure id=\"attachment_18470\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/health-equity.jpg\">\u003cimg class=\"size-large wp-image-18470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/health-equity-640x436.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"436\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images) \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Many children of color in the state face different health and education opportunities from the earliest years.\u003c/p>\n\u003cp>That's according to a \u003ca href=\"http://www.aecf.org/KnowledgeCenter/Publications.aspx?pubguid=%7B5B863B11-62C7-41EC-9F7F-6D12125C4DC2%7D\" target=\"_blank\">new study \u003c/a>from the Annie E. Casey Foundation.\u003c/p>\n\u003cp>The report looked at factors like birthweight, access to preschool and, later, reading and math proficiency. The researchers then created an index that weighted these and other social markers to measure a child's opportunity to thrive later on.\u003c/p>\n\u003cp>The findings were stark. On a scale of 0 to 1000 (with 1000 being the highest), Asian and Pacific Islander children in California scored 768, Whites 748, American Indians 529, Latinos 405, and African American children 395.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"A multicultural state needs multicultural solutions,\" Nadereh Pourat, UCLA Center for Health Policy Research\u003c/aside>\n\u003cp>The report gives this analogy for thinking about the results. Think about a power grid that brings power to an area. A \"prosperity grid\" offers critical links to help kids succeed - in this case whether someone in their household has a high school diploma, their parents income, and achievement levels at their school.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The inability of children of color to connect to this network through their neighborhoods clearly has significant consequences for their healthy development and well-being,\" the authors wrote.\u003c!--more-->Sarah de Guia, director of government affairs at the California Pan-Ethnic Health Network (CPEHN), said she is grateful that the Casey foundation is collecting and analyzing the data by race and ethnicity. De Guia said she would like to see more of this analysis.\u003c/p>\n\u003cp>\"We push for breaking the data out [by ethnic and racial groups] at CPEHN. It is critical for a deeper understanding of the numbers. But sometimes there is pushback to collecting the data,\" says de Guia.\u003c/p>\n\u003cp>De Guia said different communities have different needs and whether a proposed policy works may hinge on language or cultural understandings.\u003c/p>\n\u003cp>\"We need to understand exactly what is going on to make better policies,\" said de Guia.\u003c/p>\n\u003cp>While health markers, beyond birthweight, were not explicit in the child well-being index, de Guia says health is reflected in social markers - it's hard to do well in school if you don't feel well - and, she says conversely, social issues can't be improved without taking health into account.\u003c/p>\n\u003cp>\"It is very important that we look at all policies through a health lens,\" said de Guia. She says everything from the environment where children live, to the available transportation to whether there are school-based health centers are factors that affect the whole child.\u003c/p>\n\u003cp>To Ted Lempert, the president of Children Now, an Oakland-based child advocacy organization, the study is a vital piece of information about the future of the state.\u003c/p>\n\u003cp>\"Three quarters of kids starting kindergarten today in California are children of color,\" said Lempert.\u003c/p>\n\u003cp>\"What this study points out is we need to get serious about every single kid having access to quality early learning, quality K-12 and quality health. If we focus that way, our future is going to be a lot better off and we're also going to close these racial disparities,\" said Lempert.\u003c/p>\n\u003cp>While the study was released on an auspicious day - as Affordable Care Act new enrollments were tallied - Nadereh Pourat, professor of health services at the UCLA School of Public Health, says that the study is a good reminder of the work that needs to be done.\u003c/p>\n\u003cp>\"A multicultural state needs multicultural solutions,\" said Pourat. While expanding access to health care providers is a first step to reducing health disparities, it is not a total solution.\u003c/p>\n\u003cp>Now, she said, it is time to focus on improving the actual care the people of different races and ethnicities experience.\u003c/p>\n\u003cp>\"If you need a translator you generally know that the care might not be as good as if you can speak the language,\" said Pourat.\u003c/p>\n\u003cp>Pourat says California can improve its marks on equity by focusing on this clinical piece of the puzzle going forward.\u003c/p>\n\u003cp>Amid all of this news, though, the study did offer a few relative bright spots for California.\u003c/p>\n\u003cp>The national study's authors pointed to California as a positive example for the state's steps last year on education reform. The Local Control Funding Formula is meant to reallocate money to schools with the largest numbers of at risk students. It also gives the schools more say over how to target their resources.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And while many experts agree that access to health care is only the beginning of addressing healthcare inequities, Covered California got an early start and outperformed many states' efforts to enroll the uninsured.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18470\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/health-equity.jpg\">\u003cimg class=\"size-large wp-image-18470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/health-equity-640x436.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"436\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images) \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Many children of color in the state face different health and education opportunities from the earliest years.\u003c/p>\n\u003cp>That's according to a \u003ca href=\"http://www.aecf.org/KnowledgeCenter/Publications.aspx?pubguid=%7B5B863B11-62C7-41EC-9F7F-6D12125C4DC2%7D\" target=\"_blank\">new study \u003c/a>from the Annie E. Casey Foundation.\u003c/p>\n\u003cp>The report looked at factors like birthweight, access to preschool and, later, reading and math proficiency. The researchers then created an index that weighted these and other social markers to measure a child's opportunity to thrive later on.\u003c/p>\n\u003cp>The findings were stark. On a scale of 0 to 1000 (with 1000 being the highest), Asian and Pacific Islander children in California scored 768, Whites 748, American Indians 529, Latinos 405, and African American children 395.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"A multicultural state needs multicultural solutions,\" Nadereh Pourat, UCLA Center for Health Policy Research\u003c/aside>\n\u003cp>The report gives this analogy for thinking about the results. Think about a power grid that brings power to an area. A \"prosperity grid\" offers critical links to help kids succeed - in this case whether someone in their household has a high school diploma, their parents income, and achievement levels at their school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The inability of children of color to connect to this network through their neighborhoods clearly has significant consequences for their healthy development and well-being,\" the authors wrote.\u003c!--more-->Sarah de Guia, director of government affairs at the California Pan-Ethnic Health Network (CPEHN), said she is grateful that the Casey foundation is collecting and analyzing the data by race and ethnicity. De Guia said she would like to see more of this analysis.\u003c/p>\n\u003cp>\"We push for breaking the data out [by ethnic and racial groups] at CPEHN. It is critical for a deeper understanding of the numbers. But sometimes there is pushback to collecting the data,\" says de Guia.\u003c/p>\n\u003cp>De Guia said different communities have different needs and whether a proposed policy works may hinge on language or cultural understandings.\u003c/p>\n\u003cp>\"We need to understand exactly what is going on to make better policies,\" said de Guia.\u003c/p>\n\u003cp>While health markers, beyond birthweight, were not explicit in the child well-being index, de Guia says health is reflected in social markers - it's hard to do well in school if you don't feel well - and, she says conversely, social issues can't be improved without taking health into account.\u003c/p>\n\u003cp>\"It is very important that we look at all policies through a health lens,\" said de Guia. She says everything from the environment where children live, to the available transportation to whether there are school-based health centers are factors that affect the whole child.\u003c/p>\n\u003cp>To Ted Lempert, the president of Children Now, an Oakland-based child advocacy organization, the study is a vital piece of information about the future of the state.\u003c/p>\n\u003cp>\"Three quarters of kids starting kindergarten today in California are children of color,\" said Lempert.\u003c/p>\n\u003cp>\"What this study points out is we need to get serious about every single kid having access to quality early learning, quality K-12 and quality health. If we focus that way, our future is going to be a lot better off and we're also going to close these racial disparities,\" said Lempert.\u003c/p>\n\u003cp>While the study was released on an auspicious day - as Affordable Care Act new enrollments were tallied - Nadereh Pourat, professor of health services at the UCLA School of Public Health, says that the study is a good reminder of the work that needs to be done.\u003c/p>\n\u003cp>\"A multicultural state needs multicultural solutions,\" said Pourat. While expanding access to health care providers is a first step to reducing health disparities, it is not a total solution.\u003c/p>\n\u003cp>Now, she said, it is time to focus on improving the actual care the people of different races and ethnicities experience.\u003c/p>\n\u003cp>\"If you need a translator you generally know that the care might not be as good as if you can speak the language,\" said Pourat.\u003c/p>\n\u003cp>Pourat says California can improve its marks on equity by focusing on this clinical piece of the puzzle going forward.\u003c/p>\n\u003cp>Amid all of this news, though, the study did offer a few relative bright spots for California.\u003c/p>\n\u003cp>The national study's authors pointed to California as a positive example for the state's steps last year on education reform. The Local Control Funding Formula is meant to reallocate money to schools with the largest numbers of at risk students. It also gives the schools more say over how to target their resources.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And while many experts agree that access to health care is only the beginning of addressing healthcare inequities, Covered California got an early start and outperformed many states' efforts to enroll the uninsured.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Could Healthy San Francisco Help People Buy Obamacare Plans?",
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"content": "\u003cfigure id=\"attachment_18438\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/RS4616_001-2-e1396305151339.jpg\">\u003cimg class=\" wp-image-18438\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/RS4616_001-2-640x426.jpg\" alt=\"RS4616_001-2\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>A lot of San Franciscans are saying \"no thanks\" to the Affordable Care Act. As the cost of living rises in the city, even subsidized health insurance doesn't feel affordable to many residents.\u003c/p>\n\u003cp>Supervisor David Campos says that, as a result, not enough people in the city are signing up for health insurance. He wants to change that.\u003c/p>\n\u003cp>\"Without supplemental help, many people won't get insurance,\" he says.\u003c!--more-->\u003c/p>\n\u003cp>For example, a person who makes less than $46,000/year can get financial assistance from the federal government to help pay the health insurance premium. That subsidy could bring a monthly payment for a silver plan originally quoted at $400 down to $200. But Campos says that's still too much for many local residents who are struggling to pay skyrocketing rents.\u003c/p>\n\u003cp>\"The subsidies that are provided are the same nationwide. A subsidy of 'X' amount in Iowa means something different in San Francisco,\" he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He will introduce an amendment to San Francisco health law at Tuesday's board of supervisors meeting. He wants to redirect money that local businesses pay to fund the city's current health coverage program, Healthy San Francisco, to create additional subsidies. That could potentially cut monthly payments in half again, perhaps bringing monthly premiums under $100, depending on how businesses choose to comply. If passed, the new law will take effect October 1, 2014.\u003c/p>\n\n",
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"excerpt": "SF supervisor wants people to be able to use Healthy SF money to pay premiums on Obamacare plans.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18438\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/RS4616_001-2-e1396305151339.jpg\">\u003cimg class=\" wp-image-18438\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/RS4616_001-2-640x426.jpg\" alt=\"RS4616_001-2\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Deborah Svoboda/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>A lot of San Franciscans are saying \"no thanks\" to the Affordable Care Act. As the cost of living rises in the city, even subsidized health insurance doesn't feel affordable to many residents.\u003c/p>\n\u003cp>Supervisor David Campos says that, as a result, not enough people in the city are signing up for health insurance. He wants to change that.\u003c/p>\n\u003cp>\"Without supplemental help, many people won't get insurance,\" he says.\u003c!--more-->\u003c/p>\n\u003cp>For example, a person who makes less than $46,000/year can get financial assistance from the federal government to help pay the health insurance premium. That subsidy could bring a monthly payment for a silver plan originally quoted at $400 down to $200. But Campos says that's still too much for many local residents who are struggling to pay skyrocketing rents.\u003c/p>\n\u003cp>\"The subsidies that are provided are the same nationwide. A subsidy of 'X' amount in Iowa means something different in San Francisco,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>He will introduce an amendment to San Francisco health law at Tuesday's board of supervisors meeting. He wants to redirect money that local businesses pay to fund the city's current health coverage program, Healthy San Francisco, to create additional subsidies. That could potentially cut monthly payments in half again, perhaps bringing monthly premiums under $100, depending on how businesses choose to comply. If passed, the new law will take effect October 1, 2014.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Higher Autism Numbers Announced as Feds Introduce Early Screening Program",
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"content": "\u003cfigure id=\"attachment_18394\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661.jpg\">\u003cimg class=\"size-large wp-image-18394\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every two years, the federal government announces the rate of autism. This is what NPR's \u003ca href=\"http://www.npr.org/blogs/health/2014/03/27/295317351/higher-autism-numbers-may-not-mean-more-kids-actually-have-it\" target=\"_blank\">shots blog\u003c/a> had to say about \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w\" target=\"_blank\">today's numbers\u003c/a>, which show 1 in 68 children in the U.S. have an autism spectrum disorder.\u003c/p>\n\u003cblockquote>\u003cp>That's a remarkable jump from just two years ago, when the figure was 1 in 88 and an even bigger jump from 2007, when it was just 1 in 150.\u003c/p>\n\u003cp>But officials at the Centers for Disease Control and Prevention officials say the agency's skyrocketing estimates don't necessarily mean that kids are more likely to have autism now than they were 10 years ago.\u003c/p>\n\u003cp>\"It may be that we're getting better at identifying autism,\" says Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental disabilities.\u003c/p>\u003c/blockquote>\n\u003cp>For one thing, the prevalence seems to vary in different communities and among children of different races. The CDC found white children are far more likely to be identified with autism, even though scientists don't believe the rates are truly different between whites, Hispanics or blacks.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What we need to focus on is getting more people identified so they can get the supports they need,\" Shannon Rosa, Bay Area parent advocate. \u003c/aside>\n\u003cp>That means that the discrepancy lies in the diagnosis and services available in different communities. The shots blog points out the work of George Washington University anthropologist Roy Richard Grinker.\u003c/p>\n\u003cp>Along with other researchers, he studied autism prevalence in South Korea. They found that 1 in 38 children there met the criteria for autism spectrum disorder. Grinker thinks that the US number is likely closer to the one they saw in South Korea. Which means that in two years the CDC estimate will likely tick higher still.\u003c/p>\n\u003cp>\u003c!--more-->The Autistic Self Advocacy Network issued a statement saying that the CDC numbers show there are big disparities in diagnoses. For example, boys were 4-5 times more likely to be diagnosed than girls. And when it comes to race, white children were about a third more likely to be identified with Autism Specrum Disorder (ASD) than black children and almost 50% more likely to be identified with ASD than Hispanic children.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>All of this makes another federal announcement by the Department of Health and Human Services today even more relevant.\u003c/p>\n\u003cp>The US government is launching a program called \u003ca href=\"http://www.acf.hhs.gov/press/watch-me-thrive-promotes-early-developmental-and-behavioral-screening-for-kids\" target=\"_blank\">Watch Me Thrive\u003c/a>. The idea is that by giving parents, caregivers, early childhood teachers and physicians of children under 5 more information about screening for developmental delays, more children will receive services faster. And officials say earlier intervention can lead to more positive outcomes in education and life.\u003c/p>\n\u003cp>Shannon Rosa, a parent-advocate in the Bay Area, said this is something that has been needed for a long time.\u003c/p>\n\u003cp>\"What we need to focus on is getting more people identified so they can get the supports they need,\" she said.\u003c/p>\n\u003cp>Rosa says she finds it really distressing that there are kids out there that need services but because they haven't been diagnosed, they are not getting them. She says that can exacerbate the challenges they face.\u003c/p>\n\u003cp>\"The rate of anxiety disorder in people with autism is incredibly high,\" she said. \"You have kids that are being bullied, the teachers are expecting to have them perform at the same rate as other classmates. And this doesn’t have to happen if they’re given the proper support.\"\u003c/p>\n\u003cp>She cautions however, that any HHS program needs to strike a careful tone for parents of youngsters when they present developmental milestones.\u003c/p>\n\u003cp>\"I hope they say 'It’s great if they meet these milestones, and if not here are the resources. We’ve got your back no matter what,\" said Rosa.\u003c/p>\n\u003cp>Dr. Irva Hertz-Piccioto, Deputy Director of the UC Davis Children's Center for Environmental Health, says she thinks this program could specifically help with the diagnosis inequities.\u003c/p>\n\u003cp>\"People who live in communities with low resources of all types usually don’t have as much access and face various barriers, like transportation, to what screening programs do exist,\" she said. \"It looks like it could be a great thing, but we’ll have to keep an eye out for how they disseminate the information and how well it’s managed .\"\u003c/p>\n\u003cp>The practical details about how the program will be implemented in California are still unclear. But Nancy Lungren, a spokesperson for the California Department of Developmental Services, says it looks only positive.\u003c/p>\n\u003cp>\"We like the idea of this new initiative.\" she said. \"More resources are always welcome.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lungren said the new initiative will complement the outreach that is being done at 21 regional centers around the state.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18394\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661.jpg\">\u003cimg class=\"size-large wp-image-18394\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/183682661-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every two years, the federal government announces the rate of autism. This is what NPR's \u003ca href=\"http://www.npr.org/blogs/health/2014/03/27/295317351/higher-autism-numbers-may-not-mean-more-kids-actually-have-it\" target=\"_blank\">shots blog\u003c/a> had to say about \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w\" target=\"_blank\">today's numbers\u003c/a>, which show 1 in 68 children in the U.S. have an autism spectrum disorder.\u003c/p>\n\u003cblockquote>\u003cp>That's a remarkable jump from just two years ago, when the figure was 1 in 88 and an even bigger jump from 2007, when it was just 1 in 150.\u003c/p>\n\u003cp>But officials at the Centers for Disease Control and Prevention officials say the agency's skyrocketing estimates don't necessarily mean that kids are more likely to have autism now than they were 10 years ago.\u003c/p>\n\u003cp>\"It may be that we're getting better at identifying autism,\" says Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental disabilities.\u003c/p>\u003c/blockquote>\n\u003cp>For one thing, the prevalence seems to vary in different communities and among children of different races. The CDC found white children are far more likely to be identified with autism, even though scientists don't believe the rates are truly different between whites, Hispanics or blacks.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What we need to focus on is getting more people identified so they can get the supports they need,\" Shannon Rosa, Bay Area parent advocate. \u003c/aside>\n\u003cp>That means that the discrepancy lies in the diagnosis and services available in different communities. The shots blog points out the work of George Washington University anthropologist Roy Richard Grinker.\u003c/p>\n\u003cp>Along with other researchers, he studied autism prevalence in South Korea. They found that 1 in 38 children there met the criteria for autism spectrum disorder. Grinker thinks that the US number is likely closer to the one they saw in South Korea. Which means that in two years the CDC estimate will likely tick higher still.\u003c/p>\n\u003cp>\u003c!--more-->The Autistic Self Advocacy Network issued a statement saying that the CDC numbers show there are big disparities in diagnoses. For example, boys were 4-5 times more likely to be diagnosed than girls. And when it comes to race, white children were about a third more likely to be identified with Autism Specrum Disorder (ASD) than black children and almost 50% more likely to be identified with ASD than Hispanic children.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>All of this makes another federal announcement by the Department of Health and Human Services today even more relevant.\u003c/p>\n\u003cp>The US government is launching a program called \u003ca href=\"http://www.acf.hhs.gov/press/watch-me-thrive-promotes-early-developmental-and-behavioral-screening-for-kids\" target=\"_blank\">Watch Me Thrive\u003c/a>. The idea is that by giving parents, caregivers, early childhood teachers and physicians of children under 5 more information about screening for developmental delays, more children will receive services faster. And officials say earlier intervention can lead to more positive outcomes in education and life.\u003c/p>\n\u003cp>Shannon Rosa, a parent-advocate in the Bay Area, said this is something that has been needed for a long time.\u003c/p>\n\u003cp>\"What we need to focus on is getting more people identified so they can get the supports they need,\" she said.\u003c/p>\n\u003cp>Rosa says she finds it really distressing that there are kids out there that need services but because they haven't been diagnosed, they are not getting them. She says that can exacerbate the challenges they face.\u003c/p>\n\u003cp>\"The rate of anxiety disorder in people with autism is incredibly high,\" she said. \"You have kids that are being bullied, the teachers are expecting to have them perform at the same rate as other classmates. And this doesn’t have to happen if they’re given the proper support.\"\u003c/p>\n\u003cp>She cautions however, that any HHS program needs to strike a careful tone for parents of youngsters when they present developmental milestones.\u003c/p>\n\u003cp>\"I hope they say 'It’s great if they meet these milestones, and if not here are the resources. We’ve got your back no matter what,\" said Rosa.\u003c/p>\n\u003cp>Dr. Irva Hertz-Piccioto, Deputy Director of the UC Davis Children's Center for Environmental Health, says she thinks this program could specifically help with the diagnosis inequities.\u003c/p>\n\u003cp>\"People who live in communities with low resources of all types usually don’t have as much access and face various barriers, like transportation, to what screening programs do exist,\" she said. \"It looks like it could be a great thing, but we’ll have to keep an eye out for how they disseminate the information and how well it’s managed .\"\u003c/p>\n\u003cp>The practical details about how the program will be implemented in California are still unclear. But Nancy Lungren, a spokesperson for the California Department of Developmental Services, says it looks only positive.\u003c/p>\n\u003cp>\"We like the idea of this new initiative.\" she said. \"More resources are always welcome.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lungren said the new initiative will complement the outreach that is being done at 21 regional centers around the state.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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"info": "",
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"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"ted-radio-hour": {
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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