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"content": "\u003cfigure id=\"attachment_18321\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/179075797-e1395791377566.jpg\">\u003cimg class=\"size-large wp-image-18321\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/179075797-640x419.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"419\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California -- and 44 other states -- received failing grades in a new analysis on transparency of health care prices.\u003ca href=\"http://www.catalyzepaymentreform.org/images/documents/2014Report.pdf\" target=\"_blank\"> The report \u003c/a>comes from Berkeley-based Catalyst for Payment Reform (CPR), and it shows that consumers remain pretty much in the dark if they want to figure out, in advance, what a treatment or procedure will cost.\u003c/p>\n\u003cp>\"Very few states have done anything meaningful to help consumers understand what their health care costs were going to be,\" said Suzanne Delbanco, executive director of the organization.\u003c/p>\n\u003cp>CPR looked primarily at laws and regulations around price transparency, as well as whether a state had a consumer-facing website where people could easily look up price information.\u003c/p>\n\u003cp>While California has taken \"important symbolic steps\" by passing price transparency laws, Delbanco said, \"what hasn't happened is turning that information into something that's useful to consumers.\"\u003c!--more-->\u003c/p>\n\u003cp>The state's \u003ca href=\"http://oshpd.ca.gov\" target=\"_blank\">Office of Statewide Planning and Development\u003c/a> does compile information -- but it's based on the amount charged, as opposed to the amount that's actually paid by insurance companies or a consumer. In health care, there's almost always a discount off the \"charge\" price, so that original amount is virtually meaningless to consumers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many -- but not all -- insurance companies provide tools to their members to help them determine how much a specific procedure might cost. Some large employers might have these tools, too. But CPR believes a statewide \"all payer claims database\" -- a repository of data from all insurance companies, Medi-Cal, Medicare, even dental and prescription drug plans -- would be a \"superior source of price information for consumers because they contain data on what was actually paid for all services and procedures from a broad group of payers.\"\u003c/p>\n\u003cp>Maribeth Shannon is with the California Healthcare Foundation and was not affiliated with the report. She said she thought CPR's grading was \"a little harsh,\" -- she thought that the OSHPD charge data was of some use. But it was \"nowhere near where we need it to be.\"\u003c/p>\n\u003cp>\"California does not have legislation requiring health plans submit (actual price paid) data anywhere, so it's impossible to build a website,\" she said.\u003c/p>\n\u003cp>Providers and insurance companies often keep these negotiated prices sealed, but Shannon argues that \"consumers have a right to know what things are going to cost them.\"\u003c/p>\n\u003cp>Especially in an era of increasing use of higher deductible health plans, including in plans under the Affordable Care Act, more tools for consumers to calculate costs can lead to a more competitive pricing environment, Shannon said.\u003c/p>\n\u003cp>\"There's a clear direction to put more financial responsibility on individual patients, and if you're giving them that responsibility, you really need to give them tools to make those decisions.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"AyUnhvNXKkUu2Jt6OHn5irLhdREhBBdZ\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many -- but not all -- insurance companies provide tools to their members to help them determine how much a specific procedure might cost. Some large employers might have these tools, too. But CPR believes a statewide \"all payer claims database\" -- a repository of data from all insurance companies, Medi-Cal, Medicare, even dental and prescription drug plans -- would be a \"superior source of price information for consumers because they contain data on what was actually paid for all services and procedures from a broad group of payers.\"\u003c/p>\n\u003cp>Maribeth Shannon is with the California Healthcare Foundation and was not affiliated with the report. She said she thought CPR's grading was \"a little harsh,\" -- she thought that the OSHPD charge data was of some use. But it was \"nowhere near where we need it to be.\"\u003c/p>\n\u003cp>\"California does not have legislation requiring health plans submit (actual price paid) data anywhere, so it's impossible to build a website,\" she said.\u003c/p>\n\u003cp>Providers and insurance companies often keep these negotiated prices sealed, but Shannon argues that \"consumers have a right to know what things are going to cost them.\"\u003c/p>\n\u003cp>Especially in an era of increasing use of higher deductible health plans, including in plans under the Affordable Care Act, more tools for consumers to calculate costs can lead to a more competitive pricing environment, Shannon said.\u003c/p>\n\u003cp>\"There's a clear direction to put more financial responsibility on individual patients, and if you're giving them that responsibility, you really need to give them tools to make those decisions.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"AyUnhvNXKkUu2Jt6OHn5irLhdREhBBdZ\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Advocates Want State to Delay Health Transition for Elderly and Disabled",
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"content": "\u003cfigure id=\"attachment_18225\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/457342679-e1395342707265.jpg\">\u003cimg class=\"size-large wp-image-18225\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/457342679-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Next month, a federal pilot program aimed at improving care for the most vulnerable is set to start rolling out in some California counties.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dhcs.ca.gov/Pages/DualsDemonstration.aspx\" target=\"_blank\">Cal MediConnect\u003c/a> is supposed to help seniors and disabled people in seven California counties get better coordinated health services -- from in-home caregivers to physicians. Those who are affected will automatically be rolled into the program. They have the opportunity, though, to make choices about where and how they will get their care.\u003c/p>\n\u003cp>But some advocates say information about making those choices has been unclear and is coming too late.\u003c/p>\n\u003cp>With four counties set to roll out the program in April and May, they are calling on the state to put the program on hold.\u003c/p>\n\u003cp>\"We sent (the state) a letter with five other organizations saying there should be a delay,\" said Amber Cutler, a staff attorney with the National Senior Citizens Law Center. \"They are always putting out fires (with this) and have no time to prepare to prevent problems. That is particularly troublesome when thinking about adding Los Angeles and Alameda in July. We’re talking about hundreds of thousands of people who will be affected.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>KQED health reporter April Dembosky explained the goal of the program this way in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/07/new-health-plan-for-the-poor-elderly-dual-eligible-raises-questions/\" target=\"_blank\">her story\u003c/a> last month:\u003c/p>\n\u003cblockquote>\u003cp>(Cal MediConnect is) part of a national pilot project under the Affordable Care Act (ACA) aimed at helping the country’s sickest patients get better care. More than 1 million people in the state currently receive health benefits from two government programs: Medi-Cal for people who are low income \u003cem>and \u003c/em>Medicare for people over 65 and the disabled. In policy circles, they’re known as the “dual eligibles.” The new project streamlines the two plans into one for this population. It also incorporates community-based services and in-home services, all under one umbrella.\u003c/p>\u003c/blockquote>\n\u003cp>Cutler said that while the process has moved along well in San Mateo County, which has few enrollees and is already set up for the changes, she is concerned about misleading letters about the transition and poor help center guidance for dual-eligibles in Riverside, San Bernardino and San Diego counties.\u003c/p>\n\u003cp>Cutler said that letters have gone out late in those counties, and some people who shouldn't have received them did.\u003c/p>\n\u003cp>In an email statement, Anthony Cava, a spokesperson for the Department of Health Care Services told State of Health, \"Cal MediConnect is a tremendous opportunity to improve care and quality of life for Californians eligible for both Medi-Cal and Medicare. The current system is very fragmented for these individuals ... Cal MediConnect is designed to help fix that.\"\u003c/p>\n\u003cp>Cava said that the state had received the letter requesting a delay from advocates, but said \"Because of our extensive efforts to work with stakeholders, counties, and health plans to ensure operational readiness, and as the health plans have undergone extensive readiness reviews with the Centers for Medicare & Medicaid Services, we believe that the program is ready to offer quality, coordinated health care for dual eligibles.”\u003c/p>\n\u003cp>Meanwhile, two researchers at the UCLA Center for Health Policy Research have just released updated results from a longitudinal study of dual-eligibles called \u003ca href=\"http://healthpolicy.ucla.edu/programs/health-disparities/elder-health/Pages/The-HOME-Project.aspx\" target=\"_blank\">the HOME Project\u003c/a>.\u003c/p>\n\u003cp>In a webinar, research scientist Kathryn Kietzman said their study found most consumers who qualify for both Medicare and Medi-Cal are managing a complex and fragile web of services and some have unmet needs.\u003c/p>\n\u003cp>She added that many have developed complex relationships with providers that help them keep their care afloat. This requires everything from managing transportation to therapy appointments as well as creating a relationship with primary care physicians. These are all built up over time.\u003c/p>\n\u003cp>The UCLA team recommended that the state should maximize its efforts to ensure consumers are well informed and that they are also supported so that they can make educated choices in the new program.\u003c/p>\n\u003cp>Cutler said that's just why a delay in the program is called for.\u003c/p>\n\u003cp>She adds that it would also help because, with the implementation of the ACA, the state and consumers are dealing with many other changes in the health system.\u003c/p>\n\u003cp>\"The clients’ confusion is compounded because they don’t know if the notices are coming because of 'Obamacare.' They’ve been told they’re not affected, but now they’re getting all these letters,\" said Cutler.\u003c/p>\n\u003cp>California is one of the first of nine states that are participating in the three-year federal pilot project. Seven counties are affected. San Mateo, San Diego, San Bernardino and Riverside plans will go into effect in April and May. Alameda and Los Angeles plans take effect in July, and Santa Clara will start next January.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you believe you are affected by the new Cal MediConnect program and have questions, call 800-434-0222 to be connected to the Health Insurance Counseling and Advocacy Program in your county.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>KQED health reporter April Dembosky explained the goal of the program this way in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/07/new-health-plan-for-the-poor-elderly-dual-eligible-raises-questions/\" target=\"_blank\">her story\u003c/a> last month:\u003c/p>\n\u003cblockquote>\u003cp>(Cal MediConnect is) part of a national pilot project under the Affordable Care Act (ACA) aimed at helping the country’s sickest patients get better care. More than 1 million people in the state currently receive health benefits from two government programs: Medi-Cal for people who are low income \u003cem>and \u003c/em>Medicare for people over 65 and the disabled. In policy circles, they’re known as the “dual eligibles.” The new project streamlines the two plans into one for this population. It also incorporates community-based services and in-home services, all under one umbrella.\u003c/p>\u003c/blockquote>\n\u003cp>Cutler said that while the process has moved along well in San Mateo County, which has few enrollees and is already set up for the changes, she is concerned about misleading letters about the transition and poor help center guidance for dual-eligibles in Riverside, San Bernardino and San Diego counties.\u003c/p>\n\u003cp>Cutler said that letters have gone out late in those counties, and some people who shouldn't have received them did.\u003c/p>\n\u003cp>In an email statement, Anthony Cava, a spokesperson for the Department of Health Care Services told State of Health, \"Cal MediConnect is a tremendous opportunity to improve care and quality of life for Californians eligible for both Medi-Cal and Medicare. The current system is very fragmented for these individuals ... Cal MediConnect is designed to help fix that.\"\u003c/p>\n\u003cp>Cava said that the state had received the letter requesting a delay from advocates, but said \"Because of our extensive efforts to work with stakeholders, counties, and health plans to ensure operational readiness, and as the health plans have undergone extensive readiness reviews with the Centers for Medicare & Medicaid Services, we believe that the program is ready to offer quality, coordinated health care for dual eligibles.”\u003c/p>\n\u003cp>Meanwhile, two researchers at the UCLA Center for Health Policy Research have just released updated results from a longitudinal study of dual-eligibles called \u003ca href=\"http://healthpolicy.ucla.edu/programs/health-disparities/elder-health/Pages/The-HOME-Project.aspx\" target=\"_blank\">the HOME Project\u003c/a>.\u003c/p>\n\u003cp>In a webinar, research scientist Kathryn Kietzman said their study found most consumers who qualify for both Medicare and Medi-Cal are managing a complex and fragile web of services and some have unmet needs.\u003c/p>\n\u003cp>She added that many have developed complex relationships with providers that help them keep their care afloat. This requires everything from managing transportation to therapy appointments as well as creating a relationship with primary care physicians. These are all built up over time.\u003c/p>\n\u003cp>The UCLA team recommended that the state should maximize its efforts to ensure consumers are well informed and that they are also supported so that they can make educated choices in the new program.\u003c/p>\n\u003cp>Cutler said that's just why a delay in the program is called for.\u003c/p>\n\u003cp>She adds that it would also help because, with the implementation of the ACA, the state and consumers are dealing with many other changes in the health system.\u003c/p>\n\u003cp>\"The clients’ confusion is compounded because they don’t know if the notices are coming because of 'Obamacare.' They’ve been told they’re not affected, but now they’re getting all these letters,\" said Cutler.\u003c/p>\n\u003cp>California is one of the first of nine states that are participating in the three-year federal pilot project. Seven counties are affected. San Mateo, San Diego, San Bernardino and Riverside plans will go into effect in April and May. Alameda and Los Angeles plans take effect in July, and Santa Clara will start next January.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you believe you are affected by the new Cal MediConnect program and have questions, call 800-434-0222 to be connected to the Health Insurance Counseling and Advocacy Program in your county.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Medi-Cal Cuts Undermining Senior Programs, Facilities, Advocates Say",
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"content": "\u003cfigure id=\"attachment_18046\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/125841436-e1394241359756.jpg\">\u003cimg class=\"size-large wp-image-18046\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/125841436-640x466.jpg\" alt=\"Protestors carry signs against proposed Medi-Cal cuts outside San Francisco city hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"466\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Protestors carry signs against proposed Medi-Cal cuts outside San Francisco City Hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>The irony of the situation was not lost on Linda Trowbridge, CEO of the Center for Elders' Independence in Oakland.\u003c/p>\n\u003cp>At an Assembly hearing in Sacramento last week, Trowbridge said funding for California's Program of All-Inclusive Care for the Elderly -- or PACE -- has been systematically cut over the past six years and yet it is often cited as the model of care the state would like to pursue.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Adult day health care is essentially skilled nursing care in a community setting, and this Medi-Cal rate reduction threatens our whole industry.\"\u003c/aside>\n\u003cp>The federally subsidized program is aimed at providing and coordinating care to allow seniors and people with disabilities to remain living at home.\u003c/p>\n\u003cp>\"Everybody who is in this program would otherwise be in a skilled nursing facility,\" Trowbridge said. The program saves the state money, she said, pointing to estimates that PACE centers cost 11 percent of what it would cost to have people go to nursing facilities. Ironically, the PACE program is one of the state's models for its Coordinated Care Initiative for dual eligibles, Trowbridge said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It is an integrated system that CCI is modeled on today,\" Trowbridge said.\u003c/p>\n\u003cp>PACE centers are having a tough time maintaining the same level of service with fewer dollars, she said. The most recent reduction -- a 10 percent Medi-Cal reimbursement cut passed by the Legislature in 2011 that started to go into effect at the end of last year -- is the most crippling, Trowbridge said.\u003c/p>\n\u003cp>An Assembly bill introduced last month aims to reverse the 10 percent cut to Medi-Cal, California's Medicaid program. Whether or not \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1805\" target=\"_blank\">AB 1805\u003c/a> by Assembly member Nancy Skinner (D-Berkeley) is approved, the governor and the state's Department of Health Care Services have the discretion to exempt specific providers from the cut. They have exempted several types of providers in order to maintain access to care, but the state feels disinclined to exempt many more of them, according to DHCS Director Toby Douglas.\u003c/p>\n\u003cp>\"We have continued to refine our reductions,\" Douglas said. \"But at this point, we don't see any need to make any further changes to legislators' decision on the 10 percent reduction.\"\u003c/p>\n\u003cp>Advocates for seniors and the disabled think the need is critical, though.\u003c/p>\n\u003cp>Adult day health care is another type of service for seniors and the disabled, who are at risk of being institutionalized.\u003c/p>\n\u003cp>\"Adult day health care is essentially skilled nursing care in a community setting,\" said Debbie Toth, executive director of Rehabilitation Services of Northern California in Pleasant Hill. \"Same staffing, same therapy. And this Medi-Cal rate reduction threatens our whole industry.\"\u003c/p>\n\u003cp>\"We have had 50 centers close during [the past two years] and in that time, about 16 percent of our industry has been wiped out,\" Toth said. \"Our situation is a little more dire in that we have five centers that in two months will close if that rate is not restored.\"\u003c/p>\n\u003cp>Toth said the rate reduction has affected access to services, and that will only intensify over time.\u003c/p>\n\u003cp>\"People will lose services. One of the arguments the department has made is that people will still have access to services and that this has not caused an access issue -- but it has caused an access issue,\" Toth said.\u003c/p>\n\u003cp>Douglas said state officials will keep tabs on the situation.\u003c/p>\n\u003cp>\"As we continue to move forward,\" Douglas said, \"we will continue to monitor access, looking at it through many dimensions.\"\u003c/p>\n\u003cp>\u003cstrong>California Among Lowest in Medicaid Reimbursement\u003c/strong>\u003c/p>\n\u003cp>California is among the lowest in the nation in Medicaid payments to providers, \u003ca href=\"http://www.chcf.org/publications/2009/04/medical-physician-and-dentist-fees-a-comparison-to-other-medicaid-programs-and-medicare\" target=\"_blank\">according to a 2009 study\u003c/a> funded by the California HealthCare Foundation, which publishes \u003cem>California Healthline\u003c/em>. The low ranking in that study was two years before the 10 percent cut was approved and more than four years before it began to take effect.\u003c/p>\n\u003cp>The access picture is bigger than just rates, though, Douglas said.\u003c/p>\n\u003cp>\"Clearly rates are one of many important components,\" he said. \"But there are many other pieces of the puzzle -- particularly in California, where 70 percent of the Medi-Cal patients are in Medi-Cal managed care.\"\u003c/p>\n\u003cp>In managed care, Douglas said, the situation is a little different. \"What we see in our plans, they don't pay fee-for-service rates,\" he said. \"In terms of monitoring, it's not just about providers, it's also about utilization. ... These are all factors we look at.\"\u003c/p>\n\u003cp>Nathan Allen, an OB-GYN physician in Sacramento, had a different view. As a graduate of UC-Davis School of Medicine three decades ago, he said, \"It was impressed on me then, the need for community service.\" He set up practice in an underserved area of Sacramento called Del Paso Heights, and said he sees primarily Medi-Cal patients there.\u003c/p>\n\u003cp>\"I've dedicated my life to this. But I had to close my office in Del Paso Heights because of the reimbursement rate reduction,\" Allen said.\u003c/p>\n\u003cp>\"Physicians like me are going to go out of business because we can't afford to continue doing what we've dedicated our lives to be doing,\" he said.\u003c/p>\n\u003cp>Assembly member Shirley Weber (D-San Diego), chair of the Assembly budget subcommittee on health and human services, said the arithmetic seemed simple to her.\u003c/p>\n\u003cp>\"People should be able to break even, or even be able to make a little bit more,\" Weber said. \"We shouldn't have people going into poverty to serve the poor.\"\u003c/p>\n\u003cp>What is now an access problem could become an access crisis, she said, once an estimated two million Californians are added to Medi-Cal ranks in the near future.\u003c/p>\n\u003cp>\"Clearly we can't keep adding people to our rolls and not have the physicians they need,\" Weber said. \"I hear too many stories that tell me they can't stay in business with what we pay. If you're in business, you have to add and subtract, and you have to have enough to cover the people you serve.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"c3SqHZYr1CtsnJWyXOck1j2NFfD93Qw9\"]\u003c/p>\n\n",
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"excerpt": "\"Model of care\" programs -- that help seniors live at home, not nursing homes -- have had to close.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18046\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/125841436-e1394241359756.jpg\">\u003cimg class=\"size-large wp-image-18046\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/125841436-640x466.jpg\" alt=\"Protestors carry signs against proposed Medi-Cal cuts outside San Francisco city hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)\" width=\"640\" height=\"466\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Protestors carry signs against proposed Medi-Cal cuts outside San Francisco City Hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>The irony of the situation was not lost on Linda Trowbridge, CEO of the Center for Elders' Independence in Oakland.\u003c/p>\n\u003cp>At an Assembly hearing in Sacramento last week, Trowbridge said funding for California's Program of All-Inclusive Care for the Elderly -- or PACE -- has been systematically cut over the past six years and yet it is often cited as the model of care the state would like to pursue.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Adult day health care is essentially skilled nursing care in a community setting, and this Medi-Cal rate reduction threatens our whole industry.\"\u003c/aside>\n\u003cp>The federally subsidized program is aimed at providing and coordinating care to allow seniors and people with disabilities to remain living at home.\u003c/p>\n\u003cp>\"Everybody who is in this program would otherwise be in a skilled nursing facility,\" Trowbridge said. The program saves the state money, she said, pointing to estimates that PACE centers cost 11 percent of what it would cost to have people go to nursing facilities. Ironically, the PACE program is one of the state's models for its Coordinated Care Initiative for dual eligibles, Trowbridge said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It is an integrated system that CCI is modeled on today,\" Trowbridge said.\u003c/p>\n\u003cp>PACE centers are having a tough time maintaining the same level of service with fewer dollars, she said. The most recent reduction -- a 10 percent Medi-Cal reimbursement cut passed by the Legislature in 2011 that started to go into effect at the end of last year -- is the most crippling, Trowbridge said.\u003c/p>\n\u003cp>An Assembly bill introduced last month aims to reverse the 10 percent cut to Medi-Cal, California's Medicaid program. Whether or not \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1805\" target=\"_blank\">AB 1805\u003c/a> by Assembly member Nancy Skinner (D-Berkeley) is approved, the governor and the state's Department of Health Care Services have the discretion to exempt specific providers from the cut. They have exempted several types of providers in order to maintain access to care, but the state feels disinclined to exempt many more of them, according to DHCS Director Toby Douglas.\u003c/p>\n\u003cp>\"We have continued to refine our reductions,\" Douglas said. \"But at this point, we don't see any need to make any further changes to legislators' decision on the 10 percent reduction.\"\u003c/p>\n\u003cp>Advocates for seniors and the disabled think the need is critical, though.\u003c/p>\n\u003cp>Adult day health care is another type of service for seniors and the disabled, who are at risk of being institutionalized.\u003c/p>\n\u003cp>\"Adult day health care is essentially skilled nursing care in a community setting,\" said Debbie Toth, executive director of Rehabilitation Services of Northern California in Pleasant Hill. \"Same staffing, same therapy. And this Medi-Cal rate reduction threatens our whole industry.\"\u003c/p>\n\u003cp>\"We have had 50 centers close during [the past two years] and in that time, about 16 percent of our industry has been wiped out,\" Toth said. \"Our situation is a little more dire in that we have five centers that in two months will close if that rate is not restored.\"\u003c/p>\n\u003cp>Toth said the rate reduction has affected access to services, and that will only intensify over time.\u003c/p>\n\u003cp>\"People will lose services. One of the arguments the department has made is that people will still have access to services and that this has not caused an access issue -- but it has caused an access issue,\" Toth said.\u003c/p>\n\u003cp>Douglas said state officials will keep tabs on the situation.\u003c/p>\n\u003cp>\"As we continue to move forward,\" Douglas said, \"we will continue to monitor access, looking at it through many dimensions.\"\u003c/p>\n\u003cp>\u003cstrong>California Among Lowest in Medicaid Reimbursement\u003c/strong>\u003c/p>\n\u003cp>California is among the lowest in the nation in Medicaid payments to providers, \u003ca href=\"http://www.chcf.org/publications/2009/04/medical-physician-and-dentist-fees-a-comparison-to-other-medicaid-programs-and-medicare\" target=\"_blank\">according to a 2009 study\u003c/a> funded by the California HealthCare Foundation, which publishes \u003cem>California Healthline\u003c/em>. The low ranking in that study was two years before the 10 percent cut was approved and more than four years before it began to take effect.\u003c/p>\n\u003cp>The access picture is bigger than just rates, though, Douglas said.\u003c/p>\n\u003cp>\"Clearly rates are one of many important components,\" he said. \"But there are many other pieces of the puzzle -- particularly in California, where 70 percent of the Medi-Cal patients are in Medi-Cal managed care.\"\u003c/p>\n\u003cp>In managed care, Douglas said, the situation is a little different. \"What we see in our plans, they don't pay fee-for-service rates,\" he said. \"In terms of monitoring, it's not just about providers, it's also about utilization. ... These are all factors we look at.\"\u003c/p>\n\u003cp>Nathan Allen, an OB-GYN physician in Sacramento, had a different view. As a graduate of UC-Davis School of Medicine three decades ago, he said, \"It was impressed on me then, the need for community service.\" He set up practice in an underserved area of Sacramento called Del Paso Heights, and said he sees primarily Medi-Cal patients there.\u003c/p>\n\u003cp>\"I've dedicated my life to this. But I had to close my office in Del Paso Heights because of the reimbursement rate reduction,\" Allen said.\u003c/p>\n\u003cp>\"Physicians like me are going to go out of business because we can't afford to continue doing what we've dedicated our lives to be doing,\" he said.\u003c/p>\n\u003cp>Assembly member Shirley Weber (D-San Diego), chair of the Assembly budget subcommittee on health and human services, said the arithmetic seemed simple to her.\u003c/p>\n\u003cp>\"People should be able to break even, or even be able to make a little bit more,\" Weber said. \"We shouldn't have people going into poverty to serve the poor.\"\u003c/p>\n\u003cp>What is now an access problem could become an access crisis, she said, once an estimated two million Californians are added to Medi-Cal ranks in the near future.\u003c/p>\n\u003cp>\"Clearly we can't keep adding people to our rolls and not have the physicians they need,\" Weber said. \"I hear too many stories that tell me they can't stay in business with what we pay. If you're in business, you have to add and subtract, and you have to have enough to cover the people you serve.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"c3SqHZYr1CtsnJWyXOck1j2NFfD93Qw9\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Prison Officials Hope to Resume Admissions at Stockton Health Care Facility",
"title": "Prison Officials Hope to Resume Admissions at Stockton Health Care Facility",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_18004\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/PrisonPic_JulieSmall-e1394049286187.jpg\">\u003cimg class=\"size-large wp-image-18004\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/PrisonPic_JulieSmall-640x480.jpg\" alt=\"The single-story housing units at the California Health Care Facility in Stockton provide wheelchair access, around-the-clock care for inmates. (Julie Small/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The single-story housing units at the California Health Care Facility in Stockton provide wheelchair access, around-the-clock care for inmates. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small\u003c/strong>\u003c/p>\n\u003cp>California prison officials are hoping to resume transfers of sick inmates to a new, state-of-the-art medical facility in Stockton later this month. While not licensed as a hospital, the prison medical facility provides high-level, round-the-clock care to inmates with the most complex medical conditions.\u003c/p>\n\u003cp>The federal overseer of inmate health care halted admissions at the prison in late January, citing unsanitary conditions and shortages of staff and supplies that have persisted for months.\u003c/p>\n\u003cp>The state spent $839 million to build the California Health Care Facility located at the southern edge of Stockton. The single-story housing was designed with rooms and doorways large enough to fit gurneys, wheelchairs, and medical equipment to care for 1,700 inmates with complex medical conditions. But shortly after the facility opened in July 2013, staff and inmates reported problems getting essential medical and personal hygiene supplies.\u003c!--more-->\u003c/p>\n\u003cp>Inmate Larry Walters, who is serving time for rape, robbery and kidnapping, suffers from high blood pressure and diabetes. \"Not one day since I been here has everything went right” he said. \"The medication is missing, the supplies is missing, they got no insulin, or the food is missing.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rebekah Evenson an attorney with the Prison Law Office who monitors conditions in the prisons, heard similar complaints when she visited last fall. She says many nurses lacked gauze and gloves. They couldn’t get the right size diapers and catheters for some incontinent inmates. “Diapers and catheters that don’t fit will leak” Evenson explained. “People were sitting in their own feces or urine because they didn’t have the basic supplies they needed.”\u003c/p>\n\u003cp>Evenson returned to the Stockton facility early this year and found the same problems. She also learned of a prisoner who had died there.\u003c/p>\n\u003cp>“He had pressed his call button,” she said, “and the prisoners who lived near him said staff just didn’t respond for a half-an-hour to an hour. By the time they arrived he’d already lost consciousness.”\u003c/p>\n\u003cp>Shortly after the inmate died, the federal receiver in charge of prison medical care halted new admissions at the facility. In \u003ca href=\"http://www.cphcs.ca.gov/docs/court/T25_20140201_TriAnnualReport.pdf\" target=\"_blank\">court papers\u003c/a> he accused prison officials of treating inmates' medical care as a “second-class priority.”\u003c/p>\n\u003cp>California Health Care Facility warden Ron Rackley disputes that charge.\u003c/p>\n\u003cp>“We certainly have an electrified fence, and we certainly have convicted felons,\" Rackley said, \"but the primary mission here is to facilitate a high level of health care to the highest level of medical risk patients. We take that very seriously.”\u003c/p>\n\u003cp>Rackley declined to comment on the inmate death while the Department of Corrections and Rehabilitation investigates. He says some of the problems are being exaggerated and that the supply shortages were normal glitches that occur when opening a new facility.\u003c/p>\n\u003cp>“To state that the conditions were unsanitary as a generalization, I don’t think is fair and I don’t believe it’s an accurate assessment either.\"\u003c/p>\n\u003cp>Rackley said that many of the items staff said they couldn’t get their hands on were actually stocked in the warehouse on the edge of prison grounds.\u003c/p>\n\u003cp>On a tour of that warehouse, manager Derrick Greenwood explained that medical staff can re-order supplies using a bar code scanner. He said his staff can usually fill and deliver it on the same day. It’s an efficient system, he says, “if you do it correctly.”\u003c/p>\n\u003cp>The problem, Greenwood said, was a lack of training for medical staff placing orders.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/138093649&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Not all the problems at the California Health Care Facility relate to supply issues -- or even to the Department of Corrections and Rehabilitation.\u003c/p>\n\u003cp>It is the responsibility of the federal receiver to hire and manage medical staff and to set medical procedures and policies, such as how and when to respond when inmates hit their call buttons for help.\u003c/p>\n\u003cp>“We press the call buttons, they’re ignored,” said Anthony Enos, an inmate who lives on the unit adjacent to where the inmate died in January. “They won’t answer them in a timely fashion.”\u003c/p>\n\u003cp>Enos was convicted in Orange County for drug possession and carjacking. He thinks the prison needs more medical staff, so that they can respond immediately.\u003c/p>\n\u003cp>“You don’t know if a guy is choking on something, or having a hard time breathing, having a heart attack or what not,” Enos said.\u003c/p>\n\u003cp>But Jackie Clark, hired by the receiver as the new medical CEO of the Stockton facility, said that policies are clear. “We do have a written policy on that, and the policy is that the nursing staff will respond to call lights ‘as soon as possible.’”\u003c/p>\n\u003cp>The federal receiver transferred Clark to the facility in December and gave her full authority to hire more staff. Clark wouldn’t comment on the inmate who died but acknowledges she’s had to boost medical staff.\u003c/p>\n\u003cp>Clark also asked warden Rackley to increase the number of custody officers to escort inmates to medical appointments -- after Clark discovered nursing staff left their units to do that. “And so that practice I have stopped.” Clark said.\u003c/p>\n\u003cp>The Department of Corrections and Rehabilitation is working up a proposal to increase custody staff at the prison. If the state legislature approves the proposal, it would take effect in July.\u003c/p>\n\u003cp>The federal receiver hopes to reopen admissions at the California Health Care Facility in the next couple of weeks. Spokeswoman Joyce Hayhoe says they’ve sent teams to make recommendations.\u003c/p>\n\u003cp>“We’re talking to the staff and the inmates to determine if they are getting the necessary support and that things are running better,\" Hayhoe said.\u003c/p>\n\u003cp>The receiver’s teams recently found that supplies, such as gloves and catheters, are now getting to the units that need them.\u003c/p>\n\u003cp>“We’ve noticed a definite improvement since January. Now what we need to determine is -- are the improvements that we’ve made sustainable?\" Hayhoe asked.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The federal receiver says the California Health Care Facility was built to economize the treatment of the state’s sickest inmates. Closing new admissions slowed down that process, but inmates who need that kind of care can receive it at other prisons.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18004\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/PrisonPic_JulieSmall-e1394049286187.jpg\">\u003cimg class=\"size-large wp-image-18004\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/03/PrisonPic_JulieSmall-640x480.jpg\" alt=\"The single-story housing units at the California Health Care Facility in Stockton provide wheelchair access, around-the-clock care for inmates. (Julie Small/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The single-story housing units at the California Health Care Facility in Stockton provide wheelchair access, around-the-clock care for inmates. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small\u003c/strong>\u003c/p>\n\u003cp>California prison officials are hoping to resume transfers of sick inmates to a new, state-of-the-art medical facility in Stockton later this month. While not licensed as a hospital, the prison medical facility provides high-level, round-the-clock care to inmates with the most complex medical conditions.\u003c/p>\n\u003cp>The federal overseer of inmate health care halted admissions at the prison in late January, citing unsanitary conditions and shortages of staff and supplies that have persisted for months.\u003c/p>\n\u003cp>The state spent $839 million to build the California Health Care Facility located at the southern edge of Stockton. The single-story housing was designed with rooms and doorways large enough to fit gurneys, wheelchairs, and medical equipment to care for 1,700 inmates with complex medical conditions. But shortly after the facility opened in July 2013, staff and inmates reported problems getting essential medical and personal hygiene supplies.\u003c!--more-->\u003c/p>\n\u003cp>Inmate Larry Walters, who is serving time for rape, robbery and kidnapping, suffers from high blood pressure and diabetes. \"Not one day since I been here has everything went right” he said. \"The medication is missing, the supplies is missing, they got no insulin, or the food is missing.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rebekah Evenson an attorney with the Prison Law Office who monitors conditions in the prisons, heard similar complaints when she visited last fall. She says many nurses lacked gauze and gloves. They couldn’t get the right size diapers and catheters for some incontinent inmates. “Diapers and catheters that don’t fit will leak” Evenson explained. “People were sitting in their own feces or urine because they didn’t have the basic supplies they needed.”\u003c/p>\n\u003cp>Evenson returned to the Stockton facility early this year and found the same problems. She also learned of a prisoner who had died there.\u003c/p>\n\u003cp>“He had pressed his call button,” she said, “and the prisoners who lived near him said staff just didn’t respond for a half-an-hour to an hour. By the time they arrived he’d already lost consciousness.”\u003c/p>\n\u003cp>Shortly after the inmate died, the federal receiver in charge of prison medical care halted new admissions at the facility. In \u003ca href=\"http://www.cphcs.ca.gov/docs/court/T25_20140201_TriAnnualReport.pdf\" target=\"_blank\">court papers\u003c/a> he accused prison officials of treating inmates' medical care as a “second-class priority.”\u003c/p>\n\u003cp>California Health Care Facility warden Ron Rackley disputes that charge.\u003c/p>\n\u003cp>“We certainly have an electrified fence, and we certainly have convicted felons,\" Rackley said, \"but the primary mission here is to facilitate a high level of health care to the highest level of medical risk patients. We take that very seriously.”\u003c/p>\n\u003cp>Rackley declined to comment on the inmate death while the Department of Corrections and Rehabilitation investigates. He says some of the problems are being exaggerated and that the supply shortages were normal glitches that occur when opening a new facility.\u003c/p>\n\u003cp>“To state that the conditions were unsanitary as a generalization, I don’t think is fair and I don’t believe it’s an accurate assessment either.\"\u003c/p>\n\u003cp>Rackley said that many of the items staff said they couldn’t get their hands on were actually stocked in the warehouse on the edge of prison grounds.\u003c/p>\n\u003cp>On a tour of that warehouse, manager Derrick Greenwood explained that medical staff can re-order supplies using a bar code scanner. He said his staff can usually fill and deliver it on the same day. It’s an efficient system, he says, “if you do it correctly.”\u003c/p>\n\u003cp>The problem, Greenwood said, was a lack of training for medical staff placing orders.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/138093649&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Not all the problems at the California Health Care Facility relate to supply issues -- or even to the Department of Corrections and Rehabilitation.\u003c/p>\n\u003cp>It is the responsibility of the federal receiver to hire and manage medical staff and to set medical procedures and policies, such as how and when to respond when inmates hit their call buttons for help.\u003c/p>\n\u003cp>“We press the call buttons, they’re ignored,” said Anthony Enos, an inmate who lives on the unit adjacent to where the inmate died in January. “They won’t answer them in a timely fashion.”\u003c/p>\n\u003cp>Enos was convicted in Orange County for drug possession and carjacking. He thinks the prison needs more medical staff, so that they can respond immediately.\u003c/p>\n\u003cp>“You don’t know if a guy is choking on something, or having a hard time breathing, having a heart attack or what not,” Enos said.\u003c/p>\n\u003cp>But Jackie Clark, hired by the receiver as the new medical CEO of the Stockton facility, said that policies are clear. “We do have a written policy on that, and the policy is that the nursing staff will respond to call lights ‘as soon as possible.’”\u003c/p>\n\u003cp>The federal receiver transferred Clark to the facility in December and gave her full authority to hire more staff. Clark wouldn’t comment on the inmate who died but acknowledges she’s had to boost medical staff.\u003c/p>\n\u003cp>Clark also asked warden Rackley to increase the number of custody officers to escort inmates to medical appointments -- after Clark discovered nursing staff left their units to do that. “And so that practice I have stopped.” Clark said.\u003c/p>\n\u003cp>The Department of Corrections and Rehabilitation is working up a proposal to increase custody staff at the prison. If the state legislature approves the proposal, it would take effect in July.\u003c/p>\n\u003cp>The federal receiver hopes to reopen admissions at the California Health Care Facility in the next couple of weeks. Spokeswoman Joyce Hayhoe says they’ve sent teams to make recommendations.\u003c/p>\n\u003cp>“We’re talking to the staff and the inmates to determine if they are getting the necessary support and that things are running better,\" Hayhoe said.\u003c/p>\n\u003cp>The receiver’s teams recently found that supplies, such as gloves and catheters, are now getting to the units that need them.\u003c/p>\n\u003cp>“We’ve noticed a definite improvement since January. Now what we need to determine is -- are the improvements that we’ve made sustainable?\" Hayhoe asked.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The federal receiver says the California Health Care Facility was built to economize the treatment of the state’s sickest inmates. Closing new admissions slowed down that process, but inmates who need that kind of care can receive it at other prisons.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Food Labels to Focus on Calories, Sugar",
"title": "New Food Labels to Focus on Calories, Sugar",
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"content": "\u003cfigure id=\"attachment_17920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/dannynic/8407037563/sizes/l/\">\u003cimg class=\"size-large wp-image-17920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/8407037563_11bbebbee2_b-640x470.jpg\" alt=\"Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/02/27/283055089/first-look-the-fdas-nutrition-label-gets-a-makeover\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ready for a reality check about how many calories you're eating or drinking?\u003c/p>\n\u003cp>The proposed new nutrition facts panel may help.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I've been hoping for years that the FDA would list added sugars,\" -- Marion Nestle, NYU Nutrition Professor \u003c/aside>\n\u003cp>The Obama administration Thursday released its proposed tweaks to the iconic black and white panel that we're all accustomed to seeing on food packages.\u003c/p>\n\u003cp>The most visible change is that calorie counts are bigger and bolder — to give them greater emphasis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, serving sizes start to reflect the way most of us really eat. Take, for example, ice cream. The current serving size is a half-cup. But who eats that little?\u003c/p>\n\u003cp>Under the proposed new label, the serving size would become 1 cup. So, when you scoop a bowl of mint chocolate chip, the calorie count that you see on the label will probably be much closer to what you're actually eating.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Another example: A 20-ounce bottle of soda would be labeled as one serving. And with that, the calorie count at the top would come closer to reality.\u003c/p>\n\u003cp>Another significant change: The new panel will include a separate line for added sugars.\u003c/p>\n\u003cp>This is aimed at helping consumers distinguish between the sugars that are naturally found in foods (such as the sugar in raisins found in cereal) from the refined sugars that \u003ca href=\"http://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar\" target=\"_blank\">food manufacturers add to their products\u003c/a>.\u003c/p>\n\u003cp>\"I've been hoping for years that the FDA would list added sugars,\" Marion Nestle, a professor of nutrition at New York University, tells us. \"I definitely think it's helpful.\"\u003c/p>\n\u003cp>As we've reported, there's a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/sugar-is-a-risk-for-heart-disease-too/\" target=\"_blank\">solid body of evidence\u003c/a> linking excessive sugar consumption to an increased risk of heart disease and other ailments.\u003c/p>\n\u003cp>And the intent here, senior administration officials say, is to help cue Americans to consume less of it. Despite industry opposition to the listing of added sugars, officials say they're confident the science is strong enough to justify adding it to the label.\u003c/p>\n\u003cfigure id=\"attachment_17917\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM.png\">\u003cimg class=\"size-large wp-image-17917\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM-640x553.png\" alt=\"Proposed new food label from the Food and Drug Administration. \" width=\"640\" height=\"553\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposed new food label from the Food and Drug Administration.\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xMOBk5ALaPzOtje43iBVRVTPGrSv2FkY\"]\u003c/p>\n\n",
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"excerpt": "The Obama administration Thursday released its proposed tweaks to the iconic black and white panel that we're all accustomed to seeing on food packages.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17920\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/dannynic/8407037563/sizes/l/\">\u003cimg class=\"size-large wp-image-17920\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/8407037563_11bbebbee2_b-640x470.jpg\" alt=\"Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\" width=\"640\" height=\"470\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Many processed foods, including bottled tomato sauce, have added sugars, which would be required under the proposed label. (Danny Nicholson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Allison Aubrey,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/thesalt/2014/02/27/283055089/first-look-the-fdas-nutrition-label-gets-a-makeover\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Ready for a reality check about how many calories you're eating or drinking?\u003c/p>\n\u003cp>The proposed new nutrition facts panel may help.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I've been hoping for years that the FDA would list added sugars,\" -- Marion Nestle, NYU Nutrition Professor \u003c/aside>\n\u003cp>The Obama administration Thursday released its proposed tweaks to the iconic black and white panel that we're all accustomed to seeing on food packages.\u003c/p>\n\u003cp>The most visible change is that calorie counts are bigger and bolder — to give them greater emphasis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, serving sizes start to reflect the way most of us really eat. Take, for example, ice cream. The current serving size is a half-cup. But who eats that little?\u003c/p>\n\u003cp>Under the proposed new label, the serving size would become 1 cup. So, when you scoop a bowl of mint chocolate chip, the calorie count that you see on the label will probably be much closer to what you're actually eating.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Another example: A 20-ounce bottle of soda would be labeled as one serving. And with that, the calorie count at the top would come closer to reality.\u003c/p>\n\u003cp>Another significant change: The new panel will include a separate line for added sugars.\u003c/p>\n\u003cp>This is aimed at helping consumers distinguish between the sugars that are naturally found in foods (such as the sugar in raisins found in cereal) from the refined sugars that \u003ca href=\"http://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar\" target=\"_blank\">food manufacturers add to their products\u003c/a>.\u003c/p>\n\u003cp>\"I've been hoping for years that the FDA would list added sugars,\" Marion Nestle, a professor of nutrition at New York University, tells us. \"I definitely think it's helpful.\"\u003c/p>\n\u003cp>As we've reported, there's a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/04/sugar-is-a-risk-for-heart-disease-too/\" target=\"_blank\">solid body of evidence\u003c/a> linking excessive sugar consumption to an increased risk of heart disease and other ailments.\u003c/p>\n\u003cp>And the intent here, senior administration officials say, is to help cue Americans to consume less of it. Despite industry opposition to the listing of added sugars, officials say they're confident the science is strong enough to justify adding it to the label.\u003c/p>\n\u003cfigure id=\"attachment_17917\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM.png\">\u003cimg class=\"size-large wp-image-17917\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Screen-Shot-2014-02-27-at-10.55.04-AM-640x553.png\" alt=\"Proposed new food label from the Food and Drug Administration. \" width=\"640\" height=\"553\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposed new food label from the Food and Drug Administration.\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"xMOBk5ALaPzOtje43iBVRVTPGrSv2FkY\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Memo to Washington: Lessons Learned From California's Obamacare Rollout",
"title": "Memo to Washington: Lessons Learned From California's Obamacare Rollout",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16531\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450630139-e1386185604738.jpg\">\u003cimg class=\"size-large wp-image-16531\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450630139-640x426.jpg\" alt=\"Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the same time that California was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/19/california-exceeds-its-target-for-enrollment-in-obamacare-plans/\" target=\"_blank\">releasing its latest enrollment numbers\u003c/a> under Obamacare on Wednesday morning, advocates, experts and government officials at all levels gathered in Washington, D.C. to talk about … the Affordable Care Act in California.\u003c/p>\n\u003cp>Certainly, the rollout of Obamacare in the state has not been without its challenges and yet -- California has 12 percent of the nation's population and nearly 25 percent of all sign-ups nationwide. In addition to the more than 800,000 people currently enrolled in California, another 877,000 Californians are likely to be eligible for Medi-Cal. That's on top of another 652,000 people who transitioned to Medi-Cal from the Low Income Health Program (more on that in a minute). That's well over 2 million people total.\u003c/p>\n\u003cp>Diana Dooley, secretary of California's Health and Human Services Agency, wasn't about to gloat. \"California is certainly not ready to put up a mission-accomplished banner,\" she noted. But there was a lot of respect for California -- and a desire to learn -- from those in the room at the briefing.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Low Income Health Program Was Key \u003c/strong>\u003c/p>\n\u003cp>While it's been quite \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/this-program-was-bigger-than-covered-california-why-did-we-ignore-it\" target=\"_blank\">underreported\u003c/a>, the Low Income Health Program (LIHP) is one pillar of the ACA's success in California. Toby Douglas, director of California's Department of Health Care Services, said they \"thought it was a stretch goal\" to enroll 500,000 people in 2010 when the state began implementation of the program.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Despite concerns that the transition from LIHP to Medi-Cal would be bumpy, it \"really was a smooth transition,\" said Dr. Mitch Katz, director of the Los Angeles County Department of Health Services. Katz said that adding people into LIHP over several years, instead of all at once into Medi-Cal on Jan. 1, made for a much smoother expansion of Medi-Cal.\u003c/p>\n\u003cp>Linked to the Medi-Cal expansion is the importance of changes to the delivery system. \"Insurance is not health care,\" Katz said. \"We still want to leave people feeling cared for. That's a huge change for Los Angeles, which traditionally has had an episodic, emergency room-driven\" system of providing health care.\u003c/p>\n\u003cp>Several speakers talked about moving people into primary-care medical homes -- as happened to enrollees in the Low Income Health Program, Douglas said -- to better coordinate their care.\u003c/p>\n\u003cp>\u003cstrong>Challenges Remain\u003c/strong>\u003c/p>\n\u003cp>While acknowledging the state's successes, Anthony Wright of Health Access pointed to what he thinks are the challenges that remain: undocumented immigrants who are not eligible for ACA benefits; people earning more than 400 percent of poverty and not eligible for subsidies, but above 10 percent of income to pay for health insurance; and the \"kid glitch\" -- those with employer-based health insurance who are exempt from subsidies to cover their children but can't afford insurance for dependents.\u003c/p>\n\u003cp>\"I wish the conversation would change to trying to make the system work for everybody,\" Wright said.\u003c/p>\n\u003cp>Rachel Garfield, senior researcher with the Kaiser Family Foundation, presented findings about \u003ca href=\"http://kff.org/uninsured/report/the-uninsured-at-the-starting-line-in-california-california-findings-from-the-2013-kaiser-survey-of-low-income-americans-and-the-aca/\" target=\"_blank\">California's uninsured\u003c/a>. More than 2,500 adults were interviewed in the weeks leading up to the opening of the Covered California marketplace on Oct. 1, 2013 -- and the foundation plans to follow the people they surveyed to assess how the ACA changes how people use the health care system and to track what happens to people who remain uninsured, despite the ACA.\u003c/p>\n\u003cp>Of adults under 65 who are uninsured:\u003c/p>\n\u003cul>\n\u003cli>52 percent have income less than 138 percent of the federal poverty level (the cutoff for the Medicaid expansion)\u003c/li>\n\u003cli>52 percent are Hispanic\u003c/li>\n\u003cli>64 percent are U.S. citizens and another 17 percent are legal immigrants\u003c/li>\n\u003c/ul>\n\u003cp>In addition, 67 percent had no preventive care visit in the past year -- yet 30 percent have an \"ongoing health condition\" or take a medication on a regular basis.\u003c/p>\n\u003cp>Presumably at least some of those uninsured have since enrolled in coverage, either Medi-Cal or Covered California, but still, Garfield noted, they need help to \"navigate the health care system.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"UJBW8MPkrKEePWZWaMmAS7WhIusRsTlr\"]\u003c/p>\n\n",
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"excerpt": "Certainly, the rollout of Obamacare in the state has not been without its challenges, and yet -- California has 12 percent of the nation's population and nearly 25 percent of all sign-ups nationwide. In addition to the more than 800,000 people currently enrolled in California, another 877,000 Californians are likely to be eligible for Medi-Cal. That's on top of another 652,000 people who transitioned to Medi-Cal from the Low Income Health Program (more on that in a minute). That's well over 2 million people total.",
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"title": "Memo to Washington: Lessons Learned From California's Obamacare Rollout | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16531\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450630139-e1386185604738.jpg\">\u003cimg class=\"size-large wp-image-16531\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450630139-640x426.jpg\" alt=\"Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images) \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the same time that California was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/19/california-exceeds-its-target-for-enrollment-in-obamacare-plans/\" target=\"_blank\">releasing its latest enrollment numbers\u003c/a> under Obamacare on Wednesday morning, advocates, experts and government officials at all levels gathered in Washington, D.C. to talk about … the Affordable Care Act in California.\u003c/p>\n\u003cp>Certainly, the rollout of Obamacare in the state has not been without its challenges and yet -- California has 12 percent of the nation's population and nearly 25 percent of all sign-ups nationwide. In addition to the more than 800,000 people currently enrolled in California, another 877,000 Californians are likely to be eligible for Medi-Cal. That's on top of another 652,000 people who transitioned to Medi-Cal from the Low Income Health Program (more on that in a minute). That's well over 2 million people total.\u003c/p>\n\u003cp>Diana Dooley, secretary of California's Health and Human Services Agency, wasn't about to gloat. \"California is certainly not ready to put up a mission-accomplished banner,\" she noted. But there was a lot of respect for California -- and a desire to learn -- from those in the room at the briefing.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Low Income Health Program Was Key \u003c/strong>\u003c/p>\n\u003cp>While it's been quite \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2014/this-program-was-bigger-than-covered-california-why-did-we-ignore-it\" target=\"_blank\">underreported\u003c/a>, the Low Income Health Program (LIHP) is one pillar of the ACA's success in California. Toby Douglas, director of California's Department of Health Care Services, said they \"thought it was a stretch goal\" to enroll 500,000 people in 2010 when the state began implementation of the program.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Despite concerns that the transition from LIHP to Medi-Cal would be bumpy, it \"really was a smooth transition,\" said Dr. Mitch Katz, director of the Los Angeles County Department of Health Services. Katz said that adding people into LIHP over several years, instead of all at once into Medi-Cal on Jan. 1, made for a much smoother expansion of Medi-Cal.\u003c/p>\n\u003cp>Linked to the Medi-Cal expansion is the importance of changes to the delivery system. \"Insurance is not health care,\" Katz said. \"We still want to leave people feeling cared for. That's a huge change for Los Angeles, which traditionally has had an episodic, emergency room-driven\" system of providing health care.\u003c/p>\n\u003cp>Several speakers talked about moving people into primary-care medical homes -- as happened to enrollees in the Low Income Health Program, Douglas said -- to better coordinate their care.\u003c/p>\n\u003cp>\u003cstrong>Challenges Remain\u003c/strong>\u003c/p>\n\u003cp>While acknowledging the state's successes, Anthony Wright of Health Access pointed to what he thinks are the challenges that remain: undocumented immigrants who are not eligible for ACA benefits; people earning more than 400 percent of poverty and not eligible for subsidies, but above 10 percent of income to pay for health insurance; and the \"kid glitch\" -- those with employer-based health insurance who are exempt from subsidies to cover their children but can't afford insurance for dependents.\u003c/p>\n\u003cp>\"I wish the conversation would change to trying to make the system work for everybody,\" Wright said.\u003c/p>\n\u003cp>Rachel Garfield, senior researcher with the Kaiser Family Foundation, presented findings about \u003ca href=\"http://kff.org/uninsured/report/the-uninsured-at-the-starting-line-in-california-california-findings-from-the-2013-kaiser-survey-of-low-income-americans-and-the-aca/\" target=\"_blank\">California's uninsured\u003c/a>. More than 2,500 adults were interviewed in the weeks leading up to the opening of the Covered California marketplace on Oct. 1, 2013 -- and the foundation plans to follow the people they surveyed to assess how the ACA changes how people use the health care system and to track what happens to people who remain uninsured, despite the ACA.\u003c/p>\n\u003cp>Of adults under 65 who are uninsured:\u003c/p>\n\u003cul>\n\u003cli>52 percent have income less than 138 percent of the federal poverty level (the cutoff for the Medicaid expansion)\u003c/li>\n\u003cli>52 percent are Hispanic\u003c/li>\n\u003cli>64 percent are U.S. citizens and another 17 percent are legal immigrants\u003c/li>\n\u003c/ul>\n\u003cp>In addition, 67 percent had no preventive care visit in the past year -- yet 30 percent have an \"ongoing health condition\" or take a medication on a regular basis.\u003c/p>\n\u003cp>Presumably at least some of those uninsured have since enrolled in coverage, either Medi-Cal or Covered California, but still, Garfield noted, they need help to \"navigate the health care system.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"UJBW8MPkrKEePWZWaMmAS7WhIusRsTlr\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Bill Would Extend Health Coverage to Undocumented Immigrants",
"title": "New Bill Would Extend Health Coverage to Undocumented Immigrants",
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"content": "\u003cfigure id=\"attachment_14038\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-e1375404453328.jpg\">\u003cimg class=\"size-large wp-image-14038\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-620x356.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"356\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Anna Gorman\u003c/strong>, \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2014/02/california-bill-would-extend-health-coverage-to-all-residents/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://legiscan.com/CA/bill/SB1005/2013\" target=\"_blank\">SB 1005\u003c/a>, would extend state-funded Medi-Cal to low-income immigrants who, because they are in the country without permission, are now eligible only for emergency and pregnancy coverage. It would also create a marketplace similar to Covered California to offer insurance policies to higher income immigrants who lack legal status.\u003c/p>\n\u003caside class=\"pullquote alignleft\">It’s not clear how much the new coverage would cost or how the state would fund it.\u003c/aside>\n\u003cp>Sen. Ricardo Lara, a Democrat who represents Long Beach and southeast Los Angeles, announced the proposed legislation at a press conference Friday. He said immigrants contribute to the California economy and deserve to have access to health insurance.\u003c!--more-->\u003c/p>\n\u003cp>“While we’ve made enormous strides to reduce California’s uninsured population with the implementation of the Affordable Care Act, we won’t have a truly healthy state until everyone has access to quality, affordable coverage,” he said in a statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An estimated 2.3 to 2.6 million immigrants live in California illegally –- more than in any other state. About 1 million are believed to be uninsured, while many of the others purchase their own policies or are covered through employer plans.\u003c/p>\n\u003cp>Currently, those who are uninsured can receive medical care at community and free clinics and in some counties, through public hospitals and health facilities.\u003c/p>\n\u003cp>Ira Mehlman, spokesman for the Federation for American Immigration Reform, a group that opposes illegal immigration, said the proposed legislation is clearly an end-run around what Congress intended under the health law. But Mehlman said the effort didn’t surprise him: The proposal comes just months after the California legislature approved special driver’s licenses for those living here without legal permission.\u003c/p>\n\u003cp>“There isn’t anything [the California legislature] is not going to give people who are in the country illegally,” he said.\u003c/p>\n\u003cp>Most of the state’s Medi-Cal recipients receive services paid for by a combination of federal and state funds. The new proposal would be paid for entirely by the state.\u003c/p>\n\u003cp>Diana Dooley, secretary of the state’s Health and Human Services Agency, has said that California health officials are aware of the need to cover immigrants who lack legal status. But she said the priority for now is covering people who are eligible for coverage under the Affordable Care Act.\u003c/p>\n\u003cp>It’s not clear how much the new coverage would cost or how the state would fund it. That would depend on how many people came forward. Fear of deportation often keeps people from seeking public services, advocates for immigrants’ rights said.\u003c/p>\n\u003cp>These advocates and other activists argue that the legislation would lower health care spending in California by enabling immigrants to receive regular check-ups, reducing their reliance on emergency rooms.\u003c/p>\n\u003cp>They also argue that it could help the state by bringing more families of mixed immigration status out of the shadows.\u003c/p>\n\u003cp>“Opening the door to all Californians means it’s more likely that those already eligible take advantage of the benefits, bringing more federal dollars into California,” said Anthony Wright, executive director of the consumer group Health Access California.\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"OmrpQ79CAOg6jHOolJQ3xUHGfDKtvU9p\"]\u003c/p>\n\n",
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"excerpt": "In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14038\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-e1375404453328.jpg\">\u003cimg class=\"size-large wp-image-14038\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-620x356.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"356\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Anna Gorman\u003c/strong>, \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2014/02/california-bill-would-extend-health-coverage-to-all-residents/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.\u003c/p>\n\u003cp>The bill, \u003ca href=\"http://legiscan.com/CA/bill/SB1005/2013\" target=\"_blank\">SB 1005\u003c/a>, would extend state-funded Medi-Cal to low-income immigrants who, because they are in the country without permission, are now eligible only for emergency and pregnancy coverage. It would also create a marketplace similar to Covered California to offer insurance policies to higher income immigrants who lack legal status.\u003c/p>\n\u003caside class=\"pullquote alignleft\">It’s not clear how much the new coverage would cost or how the state would fund it.\u003c/aside>\n\u003cp>Sen. Ricardo Lara, a Democrat who represents Long Beach and southeast Los Angeles, announced the proposed legislation at a press conference Friday. He said immigrants contribute to the California economy and deserve to have access to health insurance.\u003c!--more-->\u003c/p>\n\u003cp>“While we’ve made enormous strides to reduce California’s uninsured population with the implementation of the Affordable Care Act, we won’t have a truly healthy state until everyone has access to quality, affordable coverage,” he said in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An estimated 2.3 to 2.6 million immigrants live in California illegally –- more than in any other state. About 1 million are believed to be uninsured, while many of the others purchase their own policies or are covered through employer plans.\u003c/p>\n\u003cp>Currently, those who are uninsured can receive medical care at community and free clinics and in some counties, through public hospitals and health facilities.\u003c/p>\n\u003cp>Ira Mehlman, spokesman for the Federation for American Immigration Reform, a group that opposes illegal immigration, said the proposed legislation is clearly an end-run around what Congress intended under the health law. But Mehlman said the effort didn’t surprise him: The proposal comes just months after the California legislature approved special driver’s licenses for those living here without legal permission.\u003c/p>\n\u003cp>“There isn’t anything [the California legislature] is not going to give people who are in the country illegally,” he said.\u003c/p>\n\u003cp>Most of the state’s Medi-Cal recipients receive services paid for by a combination of federal and state funds. The new proposal would be paid for entirely by the state.\u003c/p>\n\u003cp>Diana Dooley, secretary of the state’s Health and Human Services Agency, has said that California health officials are aware of the need to cover immigrants who lack legal status. But she said the priority for now is covering people who are eligible for coverage under the Affordable Care Act.\u003c/p>\n\u003cp>It’s not clear how much the new coverage would cost or how the state would fund it. That would depend on how many people came forward. Fear of deportation often keeps people from seeking public services, advocates for immigrants’ rights said.\u003c/p>\n\u003cp>These advocates and other activists argue that the legislation would lower health care spending in California by enabling immigrants to receive regular check-ups, reducing their reliance on emergency rooms.\u003c/p>\n\u003cp>They also argue that it could help the state by bringing more families of mixed immigration status out of the shadows.\u003c/p>\n\u003cp>“Opening the door to all Californians means it’s more likely that those already eligible take advantage of the benefits, bringing more federal dollars into California,” said Anthony Wright, executive director of the consumer group Health Access California.\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"OmrpQ79CAOg6jHOolJQ3xUHGfDKtvU9p\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Covered California's Outreach to Latinos Is Falling Short",
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"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\" wp-image-16988\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"CoveredCA_Spanish\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While Covered California's website is available in Spanish, the agency has a dramatic shortage of Spanish-speaking enrollment counselors. Many Spanish-speaking Californians say they prefer to enroll in person.\u003c/figcaption>\u003c/figure>\n\u003cp style=\"text-align: center\">[contextly_auto_sidebar id=\"40XDR90cUfTnil6sPWl2ZIij39yn5sBs\"]\u003c/p>\n\u003cp>California may be leading the nation in its aim to enroll Latinos into health care plans under the Affordable Care Act, but sign-ups are falling far short of the goal. The state's marketplace for health insurance, Covered California, is scrambling to fix problems with its marketing and outreach campaigns.\u003c/p>\n\u003cp>For starters, Spanish-speaking counselors are hard to come by. More of them are needed to address concerns of Latinos, who are wary of the health insurance system. Some are hesitant to sign up because they're afraid undocumented family members will be discovered and then deported. Others aren't sure it's worth the money.\u003c/p>\n\u003cp>People like Larissa Bobadilla are trying to convince them that it's okay.\u003c/p>\n\u003cp>“They trust me,” says Bobadilla, a health outreach worker and enrollment counselor. She started working in Los Angeles 16 years ago as a promotora, a health educator. Now, the children of people she helped more than a decade ago are coming to her to find out what's really going on with Obamacare. “The news gives a lot of information, (but) it confuses the people. They don’t know what is the truth.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many Latinos have never bought insurance before. So Bobadilla takes the time to explain what the benefits are and how they work, in their own language: Spanish.\u003c/p>\n\u003cp>Bobadilla is exactly the kind of person Covered California wants in the trenches. The trouble is, there aren't nearly enough people like her out there. The state wanted to have 20,000 certified counselors ready to go when plans first went on sale in October. Yet today, it has just 4,000.\u003c!--more-->\u003c/p>\n\u003cp>There are several reasons for the shortfall. Political wrangling at the federal level delayed the rollout of training programs. That meant there wasn't time to approve a Spanish curriculum or a Spanish certification test. So many qualified counselors like Larissa Bobadilla had to take their chances in English.\u003c/p>\n\u003cp>“I feeling so nervous, feeling so—frustration,” she says. “It's so hard when it’s in another language.”\u003c/p>\n\u003cp>She passed the test. But other promotoras in the community didn't, and they can’t help anybody until they do.\u003c/p>\n\u003cp>\u003cstrong>Compensation Too Low?\u003c/strong>\u003c/p>\n\u003cp>Money has been another problem. The state relies on community nonprofits to recruit and train enrollment counselors like Bobadilla. But the state only pays $58 for each person a counselor enrolls -- and then only after a customer pays the first month's premium. Many nonprofits say that’s not enough to cover the actual costs of training counselors and giving consumers all the help they need.\u003c/p>\n\u003cp>“It’s not just about enrolling people, you have to educate them,” Sonya Vasquez, policy director at Community Health Councils. “And then because they built that relationship with you, if there’s something that happens, they’re going to come back to you and none of that is actually getting paid for.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/135515601&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>The shortage of people power isn’t just limited to the streets. Covered California underestimated how many counselors it would need to staff its call centers. Many people who asked to speak to someone in Spanish got transferred to English-speaking agents. When there are too many calls, the system simply hangs up.\u003c/p>\n\u003cp>The website has had similar problems.\u003c/p>\n\u003cp>\"I visited the website, with my brother’s help, and we tried to enroll, but it didn’t work,” says Maria Aurelia, a teacher from San Pablo, east of San Francisco. She went to an enrollment event at her local library. “I prefer to sign up face-to-face. Fac-to-face, there’s better communication.”\u003c/p>\n\u003cp>All these steps require a lot of effort. So it should be no surprise that the number of Latinos who have actually signed up for a plan through Covered California is extremely low.\u003c/p>\n\u003cp>\u003cstrong>Suspend Advertising Campaign -- or Keep Going\u003c/strong>\u003c/p>\n\u003cp>State senator Norma Torres is exasperated. She says the economics of the system depend on Latinos, who, as a group, are younger and healthier than the population as whole. Their premiums will help keep costs down for everyone else. Torres is frustrated that her office has been flooded with calls from Latinos who want to sign up but can’t.\u003c/p>\n\u003cp>“What is the message they’ve received? Keep trying. Keep calling,” Torres said at Covered California’s January board meeting. “What business would say to consumers who want their product to keep trying? To not give up? We need to do better.”\u003c/p>\n\u003cp>She’s urging Covered California not to spend any more money on advertising until it improves its customer service operations. But executive director Peter Lee says he won't give up on marketing.\u003c/p>\n\u003cp>“We are not going to take our foot off the gas in raising awareness and getting people to knock on our door. It’s our job to make sure when you knock, we answer the door,” he says.\u003c/p>\n\u003cp>[contextly_sidebar id=\"81fd9fa21138ea944dc7810f459a7cc1\"]\u003c/p>\n\u003cp>But marketing experts say the disconnect between the hype and reality is yet another reason Latinos aren't signing up. People hear from their friends about bad experiences trying to use the system, but then they see TV commercials that say it's easy to enroll and affordable plans are within everyone's reach.\u003c/p>\n\u003cp>“It’s almost defrauding the consumer,” says Carlos Santiago of Hispanic market research firm Santiago Solutions Group in Los Angeles.\u003c/p>\n\u003cp>He says these ads further erode the trust of Latino communities.\u003c/p>\n\u003cp>“It’s building this greatness, greatness, greatness, greatness,” he says. “In fact, you go into doubt, your mind goes like but that’s not true, that’s not true. Why should I call?”\u003c/p>\n\u003cp>Santiago says affordability is the greatest hurdle. Despite the ads, people still don't understand that they may qualify for subsidies that will bring monthly payments down, or that they might be eligible for free coverage through the state's Medicaid program. But even then, there's still a big problem with price sensitivity.\u003c/p>\n\u003cp>Many Latinos grew up without health insurance, and haven't considered buying it before now. Santiago says paying a couple hundred dollars every month for an average plan, just to have peace of mind, is not a convincing value proposition.\u003c/p>\n\u003cp>“You go wait a minute, am I going to use this right away? How much do I need that security right now, this year when I have all these other realities in my life to fit in my budget,” he says.\u003c/p>\n\u003cp>The threat of tax penalties may push some people over the edge, but others will decide that paying a fine will be more cost effective. Santiago's research shows that only a quarter of Latinos are willing to pay more than $100 a month for insurance.\u003c/p>\n\u003cp>So even if Covered California manages to come up with a brilliant marketing campaign and hire an army of customer service agents, there's still a problem of price point.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cstrong>This is the second of two stories looking at Covered California's enrollment of Hispanics. The first story looked specifically at Covered California's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\">marketing campaign\u003c/a>.\u003c/strong>\u003c/em>\u003c/p>\n\n",
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"excerpt": "For starters, Spanish-speaking counselors are hard to come by. More of them are needed to address concerns of Latinos, who are wary of the health insurance system. Some are hesitant to sign up because they're afraid undocumented family members will be discovered and then deported. Others aren't sure it's worth the money.\r\n\r\nPeople like Larissa Bobadilla are trying to convince them that it's okay.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16988\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-e1388775098705.jpg\">\u003cimg class=\" wp-image-16988\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/CoveredCA_Spanish-640x480.jpg\" alt=\"CoveredCA_Spanish\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While Covered California's website is available in Spanish, the agency has a dramatic shortage of Spanish-speaking enrollment counselors. Many Spanish-speaking Californians say they prefer to enroll in person.\u003c/figcaption>\u003c/figure>\n\u003cp style=\"text-align: center\">[contextly_auto_sidebar id=\"40XDR90cUfTnil6sPWl2ZIij39yn5sBs\"]\u003c/p>\n\u003cp>California may be leading the nation in its aim to enroll Latinos into health care plans under the Affordable Care Act, but sign-ups are falling far short of the goal. The state's marketplace for health insurance, Covered California, is scrambling to fix problems with its marketing and outreach campaigns.\u003c/p>\n\u003cp>For starters, Spanish-speaking counselors are hard to come by. More of them are needed to address concerns of Latinos, who are wary of the health insurance system. Some are hesitant to sign up because they're afraid undocumented family members will be discovered and then deported. Others aren't sure it's worth the money.\u003c/p>\n\u003cp>People like Larissa Bobadilla are trying to convince them that it's okay.\u003c/p>\n\u003cp>“They trust me,” says Bobadilla, a health outreach worker and enrollment counselor. She started working in Los Angeles 16 years ago as a promotora, a health educator. Now, the children of people she helped more than a decade ago are coming to her to find out what's really going on with Obamacare. “The news gives a lot of information, (but) it confuses the people. They don’t know what is the truth.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many Latinos have never bought insurance before. So Bobadilla takes the time to explain what the benefits are and how they work, in their own language: Spanish.\u003c/p>\n\u003cp>Bobadilla is exactly the kind of person Covered California wants in the trenches. The trouble is, there aren't nearly enough people like her out there. The state wanted to have 20,000 certified counselors ready to go when plans first went on sale in October. Yet today, it has just 4,000.\u003c!--more-->\u003c/p>\n\u003cp>There are several reasons for the shortfall. Political wrangling at the federal level delayed the rollout of training programs. That meant there wasn't time to approve a Spanish curriculum or a Spanish certification test. So many qualified counselors like Larissa Bobadilla had to take their chances in English.\u003c/p>\n\u003cp>“I feeling so nervous, feeling so—frustration,” she says. “It's so hard when it’s in another language.”\u003c/p>\n\u003cp>She passed the test. But other promotoras in the community didn't, and they can’t help anybody until they do.\u003c/p>\n\u003cp>\u003cstrong>Compensation Too Low?\u003c/strong>\u003c/p>\n\u003cp>Money has been another problem. The state relies on community nonprofits to recruit and train enrollment counselors like Bobadilla. But the state only pays $58 for each person a counselor enrolls -- and then only after a customer pays the first month's premium. Many nonprofits say that’s not enough to cover the actual costs of training counselors and giving consumers all the help they need.\u003c/p>\n\u003cp>“It’s not just about enrolling people, you have to educate them,” Sonya Vasquez, policy director at Community Health Councils. “And then because they built that relationship with you, if there’s something that happens, they’re going to come back to you and none of that is actually getting paid for.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/135515601&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>The shortage of people power isn’t just limited to the streets. Covered California underestimated how many counselors it would need to staff its call centers. Many people who asked to speak to someone in Spanish got transferred to English-speaking agents. When there are too many calls, the system simply hangs up.\u003c/p>\n\u003cp>The website has had similar problems.\u003c/p>\n\u003cp>\"I visited the website, with my brother’s help, and we tried to enroll, but it didn’t work,” says Maria Aurelia, a teacher from San Pablo, east of San Francisco. She went to an enrollment event at her local library. “I prefer to sign up face-to-face. Fac-to-face, there’s better communication.”\u003c/p>\n\u003cp>All these steps require a lot of effort. So it should be no surprise that the number of Latinos who have actually signed up for a plan through Covered California is extremely low.\u003c/p>\n\u003cp>\u003cstrong>Suspend Advertising Campaign -- or Keep Going\u003c/strong>\u003c/p>\n\u003cp>State senator Norma Torres is exasperated. She says the economics of the system depend on Latinos, who, as a group, are younger and healthier than the population as whole. Their premiums will help keep costs down for everyone else. Torres is frustrated that her office has been flooded with calls from Latinos who want to sign up but can’t.\u003c/p>\n\u003cp>“What is the message they’ve received? Keep trying. Keep calling,” Torres said at Covered California’s January board meeting. “What business would say to consumers who want their product to keep trying? To not give up? We need to do better.”\u003c/p>\n\u003cp>She’s urging Covered California not to spend any more money on advertising until it improves its customer service operations. But executive director Peter Lee says he won't give up on marketing.\u003c/p>\n\u003cp>“We are not going to take our foot off the gas in raising awareness and getting people to knock on our door. It’s our job to make sure when you knock, we answer the door,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But marketing experts say the disconnect between the hype and reality is yet another reason Latinos aren't signing up. People hear from their friends about bad experiences trying to use the system, but then they see TV commercials that say it's easy to enroll and affordable plans are within everyone's reach.\u003c/p>\n\u003cp>“It’s almost defrauding the consumer,” says Carlos Santiago of Hispanic market research firm Santiago Solutions Group in Los Angeles.\u003c/p>\n\u003cp>He says these ads further erode the trust of Latino communities.\u003c/p>\n\u003cp>“It’s building this greatness, greatness, greatness, greatness,” he says. “In fact, you go into doubt, your mind goes like but that’s not true, that’s not true. Why should I call?”\u003c/p>\n\u003cp>Santiago says affordability is the greatest hurdle. Despite the ads, people still don't understand that they may qualify for subsidies that will bring monthly payments down, or that they might be eligible for free coverage through the state's Medicaid program. But even then, there's still a big problem with price sensitivity.\u003c/p>\n\u003cp>Many Latinos grew up without health insurance, and haven't considered buying it before now. Santiago says paying a couple hundred dollars every month for an average plan, just to have peace of mind, is not a convincing value proposition.\u003c/p>\n\u003cp>“You go wait a minute, am I going to use this right away? How much do I need that security right now, this year when I have all these other realities in my life to fit in my budget,” he says.\u003c/p>\n\u003cp>The threat of tax penalties may push some people over the edge, but others will decide that paying a fine will be more cost effective. Santiago's research shows that only a quarter of Latinos are willing to pay more than $100 a month for insurance.\u003c/p>\n\u003cp>So even if Covered California manages to come up with a brilliant marketing campaign and hire an army of customer service agents, there's still a problem of price point.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>This is the second of two stories looking at Covered California's enrollment of Hispanics. The first story looked specifically at Covered California's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\">marketing campaign\u003c/a>.\u003c/strong>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: No Job Loss from Soda Tax",
"title": "Study: No Job Loss from Soda Tax",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_17715\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Taxing sugar-sweetened beverages, such as soda, would have no negative effect on jobs, a \u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301630\" target=\"_blank\">new study \u003c/a>shows. In fact, there would be a small increase, researchers estimate.\u003c/p>\n\u003cp>A team led by Lisa Powell, an economist at the University of Illinois at Chicago, analyzed the effect of a 20 percent tax on sugar-swettened beverages. That works out to a little more than a penny-per-ounce. They looked at the impact in two states: Illinois and California.\u003c/p>\n\u003cp>\"Effectively we found that there was pretty much zero change in jobs, zero net effect,\" Powell told me in an interview. \u003c!--more-->\u003c/p>\n\u003cp>These findings are counter to what the beverage industry has long held as a jobs-killer. But Powell says this analysis looked beyond just the effects of less sugary-beverage consumption and to the broader economy. Powell says that while some jobs would indeed be lost, those losses would be offset by gains in other areas. In particular, she noted that consumers who reduced consumption of sugary-drinks would likely switch to other drinks, such as 100 percent fruit juice or diet sodas.\u003c/p>\n\u003cp>\"A truck driver may no longer be driving around sugar-sweetened beverages,\" she said, \"but he may be driving other goods.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The authors called the results of their study \"conservative\" in part because they did not estimate reduced health costs that would result from reduced consumption of sugary-beverages.\u003c/p>\n\u003cp>In a statement, the American Beverage Assocation disputed the findings. \"Americans have made it clear they don't support taxes and other restrictions on common grocery items, like soft drinks,\" the statement says. \"Soda taxes have unintended consequences on middle-class jobs and small businesses.\"\u003c/p>\n\u003cp>In 2012, voters in two California cities, Richmond and El Monte, turned down proposed soda taxes.\u003c/p>\n\u003cp>\u003cstrong>Warning Label Proposed\u003c/strong>\u003c/p>\n\u003cp>In other soda news, state Senator Bill Monning (D-Carmel) has introduced a bill that would make California the first state to require warning labels on sugary beverages. From the Associated Press:\u003c/p>\n\u003cblockquote>\u003cp>SB1000 would require the warning on the front of all beverage containers with added sweeteners that have 75 or more calories in every 12 ounces. The label would read: \"STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.\"\u003c/p>\u003c/blockquote>\n\u003cp>The measure is backed by the Latino Coalition for a Healthy California, the California Black Health Network and the \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2014/02/health-warnings-sugary-drinks-soda-cma.html?ana=RSS&s=article_search\" target=\"_blank\">California Medical Association\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"UTH78Q0tewpoxz1pE8rCs2YR4dqDNf4x\"]\u003c/p>\n\n",
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"excerpt": "A team led by Lisa Powell, an economist at the University of Illinois at Chicago, analyzed the effect of a 20 percent tax on sugar-swettened beverages. That works out to a little more than a penny-per-ounce. They looked at the impact in two states: Illinois and California.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17715\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\">\u003cimg class=\"size-full wp-image-17715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-400x250.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/02/RS7242_136799870-1-hpf-320x200.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Taxing sugar-sweetened beverages, such as soda, would have no negative effect on jobs, a \u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301630\" target=\"_blank\">new study \u003c/a>shows. In fact, there would be a small increase, researchers estimate.\u003c/p>\n\u003cp>A team led by Lisa Powell, an economist at the University of Illinois at Chicago, analyzed the effect of a 20 percent tax on sugar-swettened beverages. That works out to a little more than a penny-per-ounce. They looked at the impact in two states: Illinois and California.\u003c/p>\n\u003cp>\"Effectively we found that there was pretty much zero change in jobs, zero net effect,\" Powell told me in an interview. \u003c!--more-->\u003c/p>\n\u003cp>These findings are counter to what the beverage industry has long held as a jobs-killer. But Powell says this analysis looked beyond just the effects of less sugary-beverage consumption and to the broader economy. Powell says that while some jobs would indeed be lost, those losses would be offset by gains in other areas. In particular, she noted that consumers who reduced consumption of sugary-drinks would likely switch to other drinks, such as 100 percent fruit juice or diet sodas.\u003c/p>\n\u003cp>\"A truck driver may no longer be driving around sugar-sweetened beverages,\" she said, \"but he may be driving other goods.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The authors called the results of their study \"conservative\" in part because they did not estimate reduced health costs that would result from reduced consumption of sugary-beverages.\u003c/p>\n\u003cp>In a statement, the American Beverage Assocation disputed the findings. \"Americans have made it clear they don't support taxes and other restrictions on common grocery items, like soft drinks,\" the statement says. \"Soda taxes have unintended consequences on middle-class jobs and small businesses.\"\u003c/p>\n\u003cp>In 2012, voters in two California cities, Richmond and El Monte, turned down proposed soda taxes.\u003c/p>\n\u003cp>\u003cstrong>Warning Label Proposed\u003c/strong>\u003c/p>\n\u003cp>In other soda news, state Senator Bill Monning (D-Carmel) has introduced a bill that would make California the first state to require warning labels on sugary beverages. From the Associated Press:\u003c/p>\n\u003cblockquote>\u003cp>SB1000 would require the warning on the front of all beverage containers with added sweeteners that have 75 or more calories in every 12 ounces. The label would read: \"STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.\"\u003c/p>\u003c/blockquote>\n\u003cp>The measure is backed by the Latino Coalition for a Healthy California, the California Black Health Network and the \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2014/02/health-warnings-sugary-drinks-soda-cma.html?ana=RSS&s=article_search\" target=\"_blank\">California Medical Association\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"UTH78Q0tewpoxz1pE8rCs2YR4dqDNf4x\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_17619\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/pharmacy-2-e1392140738356.jpg\">\u003cimg class=\"size-large wp-image-17619\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/pharmacy-2-640x427.jpg\" alt=\"Clinical pharmacist Diana Arouchanova worked with patient Diana Freedman’s physician to switch one of the medications that helped lower her blood pressure (Heidi de Marco/KHN)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Clinical pharmacist Diana Arouchanova worked with patient Diana Freedman’s physician to switch one of the medications that helped lower her blood pressure (Heidi de Marco/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Anna Gorman,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/February/11/pharmacists-see-clinical-role-expand.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Jill Freedman felt like her heart was jumping out of her chest. She knew her blood pressure was too high and feared having a heart attack or a stroke.\u003c/p>\n\u003cp>\"I was freaking out,\" said Freedman, 55. \"You get very emotional when you think you could drop dead at any moment.\"\u003c/p>\n\u003cp>Her doctor doubled one of her medications, she said, but that only made her feel worse. So Freedman turned to the one person she knew she could count on -- her pharmacist.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"We are the most overeducated and underutilized healthcare professional in the U.S.\" \u003c/aside>\n\u003cp>\"It was Diana who figured out what the problem was,\" said Freedman, referring to her longtime pharmacist Diana Arouchanova. \"Had she not been on top of what I’m going through, God knows how many more weeks this could have potentially gone on.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Arouchanova, who owns Clinicare Pharmacy in Northridge, reviewed Freedman's medications and realized that her problem stemmed from the dangerous combination of two prescriptions. She got the physician to change the medications and started checking Freedman's blood pressure daily. Soon, it began to drop.\u003c!--more-->\u003c/p>\n\u003cp>Once limited to filling and dispensing drugs, pharmacists are increasingly providing direct care to patients. Across the country, they are working with doctors to give immunizations and help patients safely manage medications. In some places, they can even write prescriptions after a physician's diagnosis.\u003c/p>\n\u003cp>California is among the states to give pharmacists the greatest flexibility, thanks in part to a law that took effect this year. Other states, including New Mexico and North Carolina, have also allowed pharmacists to take on more clinical responsibilities.\u003c/p>\n\u003cp>It's all part of a push by druggists and pharmacies to take a greater role in guiding patients and promoting good health. One prominent example is CVS Caremark's recent announcement that it will stop selling tobacco products to help customers become healthier.\u003c/p>\n\u003cp>At the same time, health officials are looking for ways to ease the strain on overloaded doctors, improve care and contain costs. With millions of people gaining coverage under the nation's health law, experts say pharmacists can fill gaps in primary care and help avoid unnecessary hospital admissions.\u003c/p>\n\u003cp>Pharmacists, who are required to\u003cstrong> \u003c/strong>have a doctorate in pharmacy, say technicians can fill prescriptions and that their training and education can be put to better use.\u003c/p>\n\u003cp>\"We are the most overeducated and underutilized healthcare professional in the U.S.,\" said R. Pete Vanderveen, dean of the USC School of Pharmacy. \"It doesn't take eight years of education and a professional doctorate to fill a bottle with pills.\"\u003c/p>\n\u003cp>The new California law designates pharmacists as health care providers and allows them to give routine vaccinations and provide some travel and birth-control medications. The law also creates a new class of provider known as an \"advanced practice pharmacist.\" With additional training and experience, such as a residency program, advanced practice pharmacists will be able to collaborate with doctors in assessing and referring patients, starting and stopping medications and managing patients' diseases.\u003c/p>\n\u003cp>Some physicians, however, are wary of pharmacists doing too much on their own. The American Medical Association supports physician-led teams that include pharmacists, but opposes giving pharmacists prescription privileges without a doctor's supervision. The California Medical Association initially opposed the state law but withdrew the opposition after amendments were added, including one that limited the type of medications they could provide.\u003c/p>\n\u003cp>Pharmacist organizations are quick to point out they don't want to take over the physician's job.\u003c/p>\n\u003cp>\"We are not looking to become the primary care provider for all patients,\" said Stacie Maass, a senior vice president at the American Pharmacists Association. \"We want to be part of the team.\"\u003c/p>\n\u003cp>Research has shown that pairing pharmacists and physicians can save money and improve health outcomes. Other studies are under way.\u003c/p>\n\u003cp>Clinical pharmacist Michelle Lee is funded by a federal grant to the USC School of Pharmacy and AltaMed Health Services to determine whether pharmacists can help high-risk patients control chronic diseases take their medications as prescribed and avoid hospitalization.\u003c/p>\n\u003cp>On a recent day at an AltaMed clinic in Boyle Heights, a primarily Latino neighborhood in Los Angeles, Lee stopped the medications of a liver disease patient whose condition might have worsened if he took what a local hospital just prescribed him. Then she ordered another check of his liver.\u003c/p>\n\u003cp>Lee also saw 57-year-old Maria Flores, who has uncontrolled diabetes, noticing that both her blood sugar and her blood pressure were higher than normal.\u003c/p>\n\u003cp>\"Have you been under any stress?\" Lee asked through a Spanish-language translator.\u003c/p>\n\u003cp>The woman started to tear up. She responded that there had been a death in the family and that she hadn't been able to sleep or eat. Lee ordered a shot of insulin and adjusted her blood-pressure medication. She reminded Flores to check her blood sugar every day.\u003c/p>\n\u003cp>\"It's important for us to know if the insulin is at a good dose,\" she said. \"We might need to make adjustments.\"\u003c/p>\n\u003cp>As a student, Lee worked at Walgreens and customers frequently came in with questions. Lee said she wanted to do more for them. Now, Lee said she believes she is doing that.\u003c/p>\n\u003cp>\"It's a little role but I think it's making a big difference,\" she said.\u003c/p>\n\u003cp>Freedman appreciates the difference. She discovered Clinicare Pharmacy about seven years ago. In contrast to the chain drug store she'd been using, which she felt was impersonal, Arouchanova and her staff regularly called to see how she was feeling and to check on any side effects.\u003c/p>\n\u003cp>Now Arouchanova, 36, helps her track the more than a dozen medications she takes for hypertension, Crohn’s disease and ulcerative colitis.\u003c/p>\n\u003cp>Freedman stops by a couple times a week, sometimes just to say hello. She considers her pharmacist a friend and brings her birthday presents. \"I can walk in here any time of the day,\" she said. \"There is somebody who greets me with a smile.\"\u003c/p>\n\u003cp>Arouchanova, an Armenian immigrant with a bob of short blond hair, said she tries to go \"above and beyond the call of duty.\"\u003c/p>\n\u003cp>\"I take care of each of my patients as if they were my only patients,\" she said. That means working up to 12 hours a day and only seeing her young son briefly in the morning and evening.\u003c/p>\n\u003cp>One day a week, a physician, Hanriet Minasian, works out of an office in the pharmacy. She and Minasian have an agreement that allows Arouchanova to order labs and to start, stop and adjust medications. They refer patients to one another and together review their patients' charts.\u003c/p>\n\u003cp>Erika Pappas, 34, who lives in nearby Reseda, sees both Arouchanova and Minasian for her diabetes and hypertension.\u003c/p>\n\u003cp>\"I don't have to worry about my pharmacist or my doctor not being on the same page,\" she said during a recent visit. \"Everything is very clear.\"\u003c/p>\n\u003cp>Minasian said Arouchanova is another set of eyes on complex cases -- patients with multiple chronic diseases who receive numerous prescriptions.\u003c/p>\n\u003cp>\"It's like a checks and balances system,\" Minasian said. \"The more heads you put together, the better care we can provide for our patients.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"z7rb1W1ynPsKeajzYwtkWOoP3QcHE5NL\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17619\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/pharmacy-2-e1392140738356.jpg\">\u003cimg class=\"size-large wp-image-17619\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/pharmacy-2-640x427.jpg\" alt=\"Clinical pharmacist Diana Arouchanova worked with patient Diana Freedman’s physician to switch one of the medications that helped lower her blood pressure (Heidi de Marco/KHN)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Clinical pharmacist Diana Arouchanova worked with patient Diana Freedman’s physician to switch one of the medications that helped lower her blood pressure (Heidi de Marco/KHN)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Anna Gorman,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2014/February/11/pharmacists-see-clinical-role-expand.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Jill Freedman felt like her heart was jumping out of her chest. She knew her blood pressure was too high and feared having a heart attack or a stroke.\u003c/p>\n\u003cp>\"I was freaking out,\" said Freedman, 55. \"You get very emotional when you think you could drop dead at any moment.\"\u003c/p>\n\u003cp>Her doctor doubled one of her medications, she said, but that only made her feel worse. So Freedman turned to the one person she knew she could count on -- her pharmacist.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"We are the most overeducated and underutilized healthcare professional in the U.S.\" \u003c/aside>\n\u003cp>\"It was Diana who figured out what the problem was,\" said Freedman, referring to her longtime pharmacist Diana Arouchanova. \"Had she not been on top of what I’m going through, God knows how many more weeks this could have potentially gone on.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Arouchanova, who owns Clinicare Pharmacy in Northridge, reviewed Freedman's medications and realized that her problem stemmed from the dangerous combination of two prescriptions. She got the physician to change the medications and started checking Freedman's blood pressure daily. Soon, it began to drop.\u003c!--more-->\u003c/p>\n\u003cp>Once limited to filling and dispensing drugs, pharmacists are increasingly providing direct care to patients. Across the country, they are working with doctors to give immunizations and help patients safely manage medications. In some places, they can even write prescriptions after a physician's diagnosis.\u003c/p>\n\u003cp>California is among the states to give pharmacists the greatest flexibility, thanks in part to a law that took effect this year. Other states, including New Mexico and North Carolina, have also allowed pharmacists to take on more clinical responsibilities.\u003c/p>\n\u003cp>It's all part of a push by druggists and pharmacies to take a greater role in guiding patients and promoting good health. One prominent example is CVS Caremark's recent announcement that it will stop selling tobacco products to help customers become healthier.\u003c/p>\n\u003cp>At the same time, health officials are looking for ways to ease the strain on overloaded doctors, improve care and contain costs. With millions of people gaining coverage under the nation's health law, experts say pharmacists can fill gaps in primary care and help avoid unnecessary hospital admissions.\u003c/p>\n\u003cp>Pharmacists, who are required to\u003cstrong> \u003c/strong>have a doctorate in pharmacy, say technicians can fill prescriptions and that their training and education can be put to better use.\u003c/p>\n\u003cp>\"We are the most overeducated and underutilized healthcare professional in the U.S.,\" said R. Pete Vanderveen, dean of the USC School of Pharmacy. \"It doesn't take eight years of education and a professional doctorate to fill a bottle with pills.\"\u003c/p>\n\u003cp>The new California law designates pharmacists as health care providers and allows them to give routine vaccinations and provide some travel and birth-control medications. The law also creates a new class of provider known as an \"advanced practice pharmacist.\" With additional training and experience, such as a residency program, advanced practice pharmacists will be able to collaborate with doctors in assessing and referring patients, starting and stopping medications and managing patients' diseases.\u003c/p>\n\u003cp>Some physicians, however, are wary of pharmacists doing too much on their own. The American Medical Association supports physician-led teams that include pharmacists, but opposes giving pharmacists prescription privileges without a doctor's supervision. The California Medical Association initially opposed the state law but withdrew the opposition after amendments were added, including one that limited the type of medications they could provide.\u003c/p>\n\u003cp>Pharmacist organizations are quick to point out they don't want to take over the physician's job.\u003c/p>\n\u003cp>\"We are not looking to become the primary care provider for all patients,\" said Stacie Maass, a senior vice president at the American Pharmacists Association. \"We want to be part of the team.\"\u003c/p>\n\u003cp>Research has shown that pairing pharmacists and physicians can save money and improve health outcomes. Other studies are under way.\u003c/p>\n\u003cp>Clinical pharmacist Michelle Lee is funded by a federal grant to the USC School of Pharmacy and AltaMed Health Services to determine whether pharmacists can help high-risk patients control chronic diseases take their medications as prescribed and avoid hospitalization.\u003c/p>\n\u003cp>On a recent day at an AltaMed clinic in Boyle Heights, a primarily Latino neighborhood in Los Angeles, Lee stopped the medications of a liver disease patient whose condition might have worsened if he took what a local hospital just prescribed him. Then she ordered another check of his liver.\u003c/p>\n\u003cp>Lee also saw 57-year-old Maria Flores, who has uncontrolled diabetes, noticing that both her blood sugar and her blood pressure were higher than normal.\u003c/p>\n\u003cp>\"Have you been under any stress?\" Lee asked through a Spanish-language translator.\u003c/p>\n\u003cp>The woman started to tear up. She responded that there had been a death in the family and that she hadn't been able to sleep or eat. Lee ordered a shot of insulin and adjusted her blood-pressure medication. She reminded Flores to check her blood sugar every day.\u003c/p>\n\u003cp>\"It's important for us to know if the insulin is at a good dose,\" she said. \"We might need to make adjustments.\"\u003c/p>\n\u003cp>As a student, Lee worked at Walgreens and customers frequently came in with questions. Lee said she wanted to do more for them. Now, Lee said she believes she is doing that.\u003c/p>\n\u003cp>\"It's a little role but I think it's making a big difference,\" she said.\u003c/p>\n\u003cp>Freedman appreciates the difference. She discovered Clinicare Pharmacy about seven years ago. In contrast to the chain drug store she'd been using, which she felt was impersonal, Arouchanova and her staff regularly called to see how she was feeling and to check on any side effects.\u003c/p>\n\u003cp>Now Arouchanova, 36, helps her track the more than a dozen medications she takes for hypertension, Crohn’s disease and ulcerative colitis.\u003c/p>\n\u003cp>Freedman stops by a couple times a week, sometimes just to say hello. She considers her pharmacist a friend and brings her birthday presents. \"I can walk in here any time of the day,\" she said. \"There is somebody who greets me with a smile.\"\u003c/p>\n\u003cp>Arouchanova, an Armenian immigrant with a bob of short blond hair, said she tries to go \"above and beyond the call of duty.\"\u003c/p>\n\u003cp>\"I take care of each of my patients as if they were my only patients,\" she said. That means working up to 12 hours a day and only seeing her young son briefly in the morning and evening.\u003c/p>\n\u003cp>One day a week, a physician, Hanriet Minasian, works out of an office in the pharmacy. She and Minasian have an agreement that allows Arouchanova to order labs and to start, stop and adjust medications. They refer patients to one another and together review their patients' charts.\u003c/p>\n\u003cp>Erika Pappas, 34, who lives in nearby Reseda, sees both Arouchanova and Minasian for her diabetes and hypertension.\u003c/p>\n\u003cp>\"I don't have to worry about my pharmacist or my doctor not being on the same page,\" she said during a recent visit. \"Everything is very clear.\"\u003c/p>\n\u003cp>Minasian said Arouchanova is another set of eyes on complex cases -- patients with multiple chronic diseases who receive numerous prescriptions.\u003c/p>\n\u003cp>\"It's like a checks and balances system,\" Minasian said. \"The more heads you put together, the better care we can provide for our patients.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "New Health Plan for the Poor and Elderly Raises Questions",
"title": "New Health Plan for the Poor and Elderly Raises Questions",
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"content": "\u003cfigure id=\"attachment_17548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Christina-Kahn-e1391725977223.jpg\">\u003cimg class=\" wp-image-17548 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Christina-Kahn-e1391725977223-1024x768.jpg\" alt=\"Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors.\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>A new experiment in managing the health of older Californians is causing a lot of confusion among seniors. Letters have been hitting mailboxes around the state this week with information about the changes. It’s the second letter in a series of three -- the first went out in January -- and they have been inspiring a lot of calls to county health insurance counseling centers.\u003c/p>\n\u003cp>“Why do they keep doing this to us old people?” asks a woman named Andrea, a 72-year-old resident of San Carlos. She called San Mateo County's counseling office when she received her first letter, telling her she was going to be automatically enrolled in a new health plan -- one she’d never heard of and never intended to sign up for.\u003c/p>\n\u003cp>“We get used to one thing and now we have to do something else?\" she said. \"I've gotta call quick. Otherwise I'll get something, and maybe I don't want that.”\u003c/p>\n\u003cp>Christina Kahn, manager of the Health Insurance Counseling and Advocacy Program of San Mateo County, has been returning phone calls like Andrea’s to explain.\u003c!--more-->\u003c/p>\n\u003cp>The new health program is called \u003ca href=\"http://www.dhcs.ca.gov/Pages/DualsDemonstration.aspx\">Cal MediConnect\u003c/a>. It’s part of a national pilot project under the Affordable Care Act aimed at helping the country’s sickest patients get better care. More than 1 million people in the state currently receive health benefits from two government programs: Medi-Cal for people who are low income \u003cem>and \u003c/em>Medicare for people over 65 and the disabled. In policy circles, they're known as the \"dual eligibles.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/133583680&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>The new project streamlines the two plans into one for this population. It also incorporates community-based services and in-home services, all under one umbrella. Kahn says this should make it easier for seniors to use their benefits, and hopefully, save the state some money.\u003c/p>\n\u003cp>“But really the overall goal is to keep people at home,” she says, “and to prevent them from being admitted into a skilled nursing facility, which is really expensive for Medi-Cal to pay for.”\u003c/p>\n\u003cp>The goal is also to coordinate care better for this frail group. The new plans will pay care coordinators to help seniors get services from local nonprofits. It now covers the costs of installing a grab bar in a bathtub to prevent falls, for example, or a taxi to the doctor, so people don’t skip appointments because they can’t find a ride. Kahn says this will help keep people healthy and at home at a time when the aging population is outpacing the capacity of institutional care.\u003c/p>\n\u003cp>“We don’t have enough convalescent homes to take care of people in our county,” she says. “Real estate is really expensive, and it’s not easy for a skilled nursing facility to stay afloat.”\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>California is one of nine states that was approved by federal agencies to participate in the three-year pilot project. It’s one of the first to get started. Seven counties are affected. San Mateo, San Diego, San Bernardino and Riverside are sending letters now to people whose new plans will go into effect in April and May. Alameda and Los Angeles plans take effect in July, and Santa Clara will start next January. An eighth county, Orange, is on hold indefinitely.\u003c/p>\n\u003cp>Some advocates say the state is moving too fast, too soon.\u003c/p>\n\u003cp>“California’s demonstration has been the most controversial because it’s so much more ambitious,” says Kevin Prindiville, executive director of the National Senior Citizens Law Center, based in Oakland.\u003c/p>\n\u003cp>About half a million Californians will be transferred into the new test program, and he’s worried counseling centers won’t have enough resources to ensure a smooth transition.\u003c/p>\n\u003cp>“We don’t think there’s been enough federal money or enough state money or enough of a lead time to train those folks on what’s happening and for those agencies to get beefed up to answer the demand,” he says.\u003c/p>\n\u003cp>Kahn says people calling the San Mateo counseling office generally have two questions: “Providers. Are my providers covered? And then they’ll ask how to opt out.”\u003c/p>\n\u003cp>In the San Mateo plan, for example, some specialists at UC San Francisco aren’t covered. Kahn says rather than getting a chance to explain the virtues of the program, she’s mainly helping people like Andrea sidestep the automatic enrollment and keep their current plans.\u003c/p>\n\u003cp>“I know through Obama, everything’s changing,” she says. “But, when I’m offered basically what I had before, I figured it worked, so why change it?”\u003c/p>\n\u003cp>Kahn says it will take some time before seniors understand how the program might help them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you believe you are affected by the new Cal MediConnect program and have questions, call 800-434-0222 to be connected to the Health Insurance Counseling and Advocacy Program in your county.\u003c/em>\u003c/p>\n\n",
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"excerpt": "An experiment in managing the health of older Californians is causing a lot of confusion among seniors. Letters have been hitting mailboxes around the state this week with information about the changes. It’s the second letter in a series of three -- the first went out in January -- and they have been inspiring a lot of calls to county health insurance counseling centers.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Christina-Kahn-e1391725977223.jpg\">\u003cimg class=\" wp-image-17548 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/Christina-Kahn-e1391725977223-1024x768.jpg\" alt=\"Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors.\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christina Kahn, manager of the San Mateo Health Insurance Counseling and Advocacy Program, returns phone calls to local seniors. (April Dembosky/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>A new experiment in managing the health of older Californians is causing a lot of confusion among seniors. Letters have been hitting mailboxes around the state this week with information about the changes. It’s the second letter in a series of three -- the first went out in January -- and they have been inspiring a lot of calls to county health insurance counseling centers.\u003c/p>\n\u003cp>“Why do they keep doing this to us old people?” asks a woman named Andrea, a 72-year-old resident of San Carlos. She called San Mateo County's counseling office when she received her first letter, telling her she was going to be automatically enrolled in a new health plan -- one she’d never heard of and never intended to sign up for.\u003c/p>\n\u003cp>“We get used to one thing and now we have to do something else?\" she said. \"I've gotta call quick. Otherwise I'll get something, and maybe I don't want that.”\u003c/p>\n\u003cp>Christina Kahn, manager of the Health Insurance Counseling and Advocacy Program of San Mateo County, has been returning phone calls like Andrea’s to explain.\u003c!--more-->\u003c/p>\n\u003cp>The new health program is called \u003ca href=\"http://www.dhcs.ca.gov/Pages/DualsDemonstration.aspx\">Cal MediConnect\u003c/a>. It’s part of a national pilot project under the Affordable Care Act aimed at helping the country’s sickest patients get better care. More than 1 million people in the state currently receive health benefits from two government programs: Medi-Cal for people who are low income \u003cem>and \u003c/em>Medicare for people over 65 and the disabled. In policy circles, they're known as the \"dual eligibles.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Pharmacies Braced for Cuts to Their Medi-Cal Payments",
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"content": "\u003cfigure id=\"attachment_17523\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/97429646-e1391668167902.jpg\">\u003cimg class=\"size-large wp-image-17523\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/97429646-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images) \u003ccite>(Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pharmacies across the state are bracing for a blow to their revenues. Starting Friday, Medi-Cal --the state’s health coverage for low-income patients -- will start paying 10 percent less for filling certain prescriptions. Though the number of drugs affected is less than originally outlined, pharmacists are still worried.\u003c/p>\n\u003cp>Many of them say there is a misconception that they make loads of money selling drugs. But after they pay pharmaceutical companies for the medications they stock, there’s little profit left, they say. An additional cut could put them in the red on some drugs.\u003c/p>\n\u003cp>“The margin in drug products is roughly 2 to 4 percent,” says Jon Roth, CEO of the California Pharmacists’ Association. “If you’re looking at a 10 percent reduction, you’re immediately upside down and dispensing medication at a loss.”\u003c!--more-->\u003c/p>\n\u003cp>Some pharmacies said they would simply stop carrying certain drugs rather than take the hit. Advocates had worried that patients wouldn’t be able to get expensive medications for cancer, HIV, or mental health conditions.\u003c/p>\n\u003cp>So the state stepped in and created a \u003ca href=\"http://www.dhcs.ca.gov/services/Documents/AB_97%20Draft%20Exempted%20Drug%20List01142014.pdf\">list of 2,600 drugs \u003c/a>that are now exempt from the cuts - about 60 percent of all drugs reimbursed in a given month. However, the state still plans to \"clawback\" -- or retroactively collect -- payments on the remaining drugs dating back to June 2011, when the cuts were first signed into law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Roth says the exemptions make the cuts “much more palatable.”\u003c/p>\n\u003cp>But some small-town pharmacies say they will still be hurt by the remaining cuts and the clawbacks.\u003c/p>\n\u003cp>“It’s getting tighter and tighter,” says Nancy Dunckel, the owner of the Elmore Pharmacy in Red Bluff, 130 miles north of Sacramento.\u003c/p>\n\u003cp>She says independent shops like hers can’t offset losses the way large chain pharmacies like Walmart can.\u003c/p>\n\u003cp>“The pharmacy department is usually a loss leader for them. So they can survive on out-front items, whereas a pharmacy like mine can’t,” she says.\u003c/p>\n\u003cp>She’s afraid her employees will be the ones to suffer.\u003c/p>\n\u003cp>“I’ve been able to carry health (insurance) for them, they have 401(k)s and retirement plans, which most small businesses can’t,” she says. “And I’m not sure if they’re going to be able to carry that on.”\u003c/p>\n\u003cp>Dunckel has grown so frustrated with all the cuts and business changes, she’s decided to sell her pharmacy and move to Oregon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\n\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/133408548&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\n",
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"excerpt": "Pharmacies across the state are bracing for a blow to their revenues. Starting Friday, Medi-Cal --the state’s health coverage for low-income patients -- will start paying 10 percent less for filling certain prescriptions. Though the number of drugs affected is less than originally outlined, pharmacists are still worried.\r\n\r\nMany of them say there is a misconception that they make loads of money selling drugs. But after they pay pharmaceutical companies for the medications they stock, there’s little profit left, they say. An additional cut could put them in the red on some drugs.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Roth says the exemptions make the cuts “much more palatable.”\u003c/p>\n\u003cp>But some small-town pharmacies say they will still be hurt by the remaining cuts and the clawbacks.\u003c/p>\n\u003cp>“It’s getting tighter and tighter,” says Nancy Dunckel, the owner of the Elmore Pharmacy in Red Bluff, 130 miles north of Sacramento.\u003c/p>\n\u003cp>She says independent shops like hers can’t offset losses the way large chain pharmacies like Walmart can.\u003c/p>\n\u003cp>“The pharmacy department is usually a loss leader for them. So they can survive on out-front items, whereas a pharmacy like mine can’t,” she says.\u003c/p>\n\u003cp>She’s afraid her employees will be the ones to suffer.\u003c/p>\n\u003cp>“I’ve been able to carry health (insurance) for them, they have 401(k)s and retirement plans, which most small businesses can’t,” she says. “And I’m not sure if they’re going to be able to carry that on.”\u003c/p>\n\u003cp>Dunckel has grown so frustrated with all the cuts and business changes, she’s decided to sell her pharmacy and move to Oregon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\n\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/133408548&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
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},
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"id": "fresh-air",
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"hidden-brain": {
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"airtime": "SUN 7pm-8pm",
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
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"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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