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"disqusTitle": "In California, School Anti-Bullying Efforts Falling Short",
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"content": "\u003cfigure id=\"attachment_14548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14548 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/139712709-640x433.jpg\" alt=\"The California state auditor faulted both local entities and the state's oversight (Photo: Getty Images)\" width=\"640\" height=\"433\">\u003cfigcaption class=\"wp-caption-text\">A new report from the California state auditor faulted both local entities and the state's oversight in anti-bullying programs. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://www.edsource.org/today/author/jane-adams#.UhzwOBaBERk\" target=\"_blank\">\u003cstrong>By Jane Meredith Adams\u003c/strong>\u003c/a>, \u003ca href=\"http://www.edsource.org/today/2013/audit-says-school-bullying-prevention-efforts-falling-short/37495#.UhzhJhaBERk\" target=\"_blank\">EdSource Today\u003c/a>\u003c/p>\n\u003cp>Just as kids are heading back to classrooms, a new \u003ca href=\"http://www.auditor.ca.gov/pdfs/reports/2012-108.pdf\" target=\"_blank\">state audit\u003c/a> has found that most schools do not track whether their anti-bullying programs have made campuses any safer and that schools are inconsistent in how they record and resolve bullying incidents.\u003c/p>\n\u003cp>The California Department of Education has been insufficient in both oversight and guidance, the audit said. It further noted that the department went four years without noticing that it was not monitoring schools to ensure they were addressing student complaints, as required by law. At the same time, funding has been cut for statewide surveys on student safety, making it more difficult to determine students’ experiences with bullying.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The audit shows that passing laws isn’t enough. We need to implement them and ensure accountability at the district, county and statewide levels.”\u003c/aside>\n\u003cp>On the plus side, the audit did find that the vast majority of California schools have anti-bullying programs in place and have provided staff training in how to prevent bullying, discrimination, harassment and intimidation.\u003c/p>\n\u003cp>Still, one advocate said the audit confirms that much remains to be done to reduce the high levels of bullying in California schools.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The audit shows that passing laws isn’t enough –- we need to implement them and ensure accountability at the district, county and statewide levels,” said Jesse Melgar, with Equality California, a San Francisco-based advocacy group. “Now, California schools and the Department of Education have an opportunity to use the audit’s findings to review, update and enhance their policies to better protect our youth and ensure student success.”\u003c!--more-->\u003c/p>\n\u003cp>The California Department of Education disputed many of the audit’s finding, saying officials are committed to addressing bullying and keeping students safe.\u003c/p>\n\u003cp>“Although not mentioned in this report, California has made significant progress in addressing negative school behavior despite the impacts of ongoing budget cuts and staff reductions,” Chief Deputy Superintendent of Public Instruction Richard Zeiger said in a statement. “Nevertheless, CDE acknowledges the auditor’s concerns and will continue our work to build and reinforce a positive school climate throughout the state.”\u003c/p>\n\u003ch4>Bullying at school\u003c/h4>\n\u003cp>Some 28 percent of seventh graders in California \u003ca href=\"http://www.auditor.ca.gov/pdfs/reports/2012-108.pdf\" target=\"_blank\">reported \u003c/a>being harassed at school, and 22 percent of ninth-grade students reported that other students had spread rumors or lies about them online at least once over the previous 12-month period. The data come from the 2009-11 California Healthy Kids Survey. The report noted the link between bullying and several high-profile student suicides, including the 2010 suicide of 13-year-old Seth Walsh of Tehachapi, a victim of anti-gay bullying.\u003c/p>\n\u003cp>“He was only one of many young people who decided it was easier to commit suicide than to go to school the next day,” said Karyl Ketchum, co-chair of the School Compliance Task Force of the \u003ca href=\"http://ocequality.com/\" target=\"_blank\">Orange County Equality Coalition\u003c/a>, which monitors schools in Orange County for compliance with anti-bullying and discrimination laws.\u003c/p>\n\u003cp>“The local educational agencies are not following through with their requirements under the law and no one cares,” she said.\u003c/p>\n\u003cp>Auditors surveyed every school district, county office of education and charter school in the state –- nearly 2,000 in total. Of the nearly 1,400 entities that responded, 80 percent said they had adopted anti-bullying programs and policies. Some 55 percent said they did not formally evaluate the effectiveness of the programs.\u003c/p>\n\u003cp>In addition to the statewide survey, the auditors visited six schools in Los Angeles, Fresno and Sacramento. Those site visits raised concerns about whether schools were receiving sufficient guidance on how to document and resolve complaints. At the schools, auditors found that staff did not always document complaints, follow reporting requirements or record follow-ups on incidents.\u003c/p>\n\u003cp>Experts said that collecting accurate data was essential to ending what President Barack Obama \u003ca href=\"http://www.whitehouse.gov/blog/2012/04/20/ending-bullying-our-schools-communities\" target=\"_blank\">called\u003c/a> “the pain, agony, and loss caused by bullying in our schools and communities.”\u003c/p>\n\u003cp>“Most schools in the U.S. have no systematic ways of tracking reports, and in most situations, do not even follow their own policies or guidelines,” said Dorothy Espelage, co-chair of an American Educational Research Association task force on bullying that issued a \u003ca href=\"http://www.aera.net/newsroom/news/preventionofbullyingresearchreportandrecomm/tabid/14865/default.aspx\" target=\"_blank\">2013 report on the prevention of bullying in schools. \u003c/a>“As bullying legislation is often ‘unfunded’ mandates, there are no research monies to even track compliance of school districts.”\u003c/p>\n\u003ch4>State department criticized\u003c/h4>\n\u003cp>The audit was critical of the Department of Education, beginning with the department’s failure to detect that its Office of Equal Opportunity was not collecting data on bullying for several years. The department ultimately updated its internal program to collect the data on bullying in 2012, four school years after the state \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=00001-01000&file=234-234.5\" target=\"_blank\">Safe Place to Learn Act \u003c/a>mandated that the department provide oversight, the report noted.\u003c/p>\n\u003cp>The department was also chastised for failing to meet the 60-day legal requirement to resolve appeals in some cases, with 11 of the 18 appeals reviewed by the auditors running between one and 305 days late.\u003c/p>\n\u003cp>Also criticized was the department’s \u003ca href=\"http://www.californiahealthykids.org/index\" target=\"_blank\">website \u003c/a>of bullying resources for schools, with auditors determining that the site was cluttered with 10-year-old research, a dead link, and little information on current issues such as online bullying or bullying related to being perceived as gay or lesbian. In its survey, the audit found that more than half of the school districts, charter schools and county offices of education were unaware that the department even had resources to assist them in complying with laws to protect students from harassment and discrimination.\u003c/p>\n\u003cp>Zeiger, the state official, disputed that audit’s contention that the department was not a leader in protecting students.\u003c/p>\n\u003cp>“Protecting student safety and guarding against discrimination are top priorities at the California Department of Education,” he said, “and the department has been a leader in the prevention of bullying and assisting schools, parents and students in safety issues.”\u003c/p>\n\u003ch4>Conflict of interest in complaint process faulted\u003c/h4>\n\u003cp>The audit noted that schools are encouraged to use their own staff to resolve bullying complaints quickly, but that resolving complaints internally could lead to conflicts of interest. The audit cited two incidents in Sacramento City Unified School District where the administrator who was assigned to resolve a complaint of bullying, harassment, intimidation or discrimination was the same person named in the complaint for allegedly failing to take appropriate action to address the student incident. The audit did not provide details about the specific complaints.\u003c/p>\n\u003cp>Sacramento City will take immediate action to strengthen its anti-bullying efforts, said district spokesman Gabe Ross. He added that the district was the first in the area to implement a comprehensive anti-bullying policy and now has a full-time, grant-funded anti-bullying specialist at the district level.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Our schools are certainly safer for kids than they were before we began this work two years ago,” Ross said.\u003c/p>\n\n",
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"excerpt": "Just as kids are heading back to classrooms, a new state audit has found that most schools do not track whether their anti-bullying programs have made campuses any safer and that schools are inconsistent in how they record and resolve bullying incidents.\r\n\r\nThe California Department of Education has been insufficient in both oversight and guidance, the audit said. It further noted that the department went four years without noticing that it was not monitoring schools to ensure they were addressing student complaints, as required by law. At the same time, funding has been cut for statewide surveys on student safety, making it more difficult to determine students’ experiences with bullying.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14548\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14548 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/139712709-640x433.jpg\" alt=\"The California state auditor faulted both local entities and the state's oversight (Photo: Getty Images)\" width=\"640\" height=\"433\">\u003cfigcaption class=\"wp-caption-text\">A new report from the California state auditor faulted both local entities and the state's oversight in anti-bullying programs. (Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://www.edsource.org/today/author/jane-adams#.UhzwOBaBERk\" target=\"_blank\">\u003cstrong>By Jane Meredith Adams\u003c/strong>\u003c/a>, \u003ca href=\"http://www.edsource.org/today/2013/audit-says-school-bullying-prevention-efforts-falling-short/37495#.UhzhJhaBERk\" target=\"_blank\">EdSource Today\u003c/a>\u003c/p>\n\u003cp>Just as kids are heading back to classrooms, a new \u003ca href=\"http://www.auditor.ca.gov/pdfs/reports/2012-108.pdf\" target=\"_blank\">state audit\u003c/a> has found that most schools do not track whether their anti-bullying programs have made campuses any safer and that schools are inconsistent in how they record and resolve bullying incidents.\u003c/p>\n\u003cp>The California Department of Education has been insufficient in both oversight and guidance, the audit said. It further noted that the department went four years without noticing that it was not monitoring schools to ensure they were addressing student complaints, as required by law. At the same time, funding has been cut for statewide surveys on student safety, making it more difficult to determine students’ experiences with bullying.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“The audit shows that passing laws isn’t enough. We need to implement them and ensure accountability at the district, county and statewide levels.”\u003c/aside>\n\u003cp>On the plus side, the audit did find that the vast majority of California schools have anti-bullying programs in place and have provided staff training in how to prevent bullying, discrimination, harassment and intimidation.\u003c/p>\n\u003cp>Still, one advocate said the audit confirms that much remains to be done to reduce the high levels of bullying in California schools.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The audit shows that passing laws isn’t enough –- we need to implement them and ensure accountability at the district, county and statewide levels,” said Jesse Melgar, with Equality California, a San Francisco-based advocacy group. “Now, California schools and the Department of Education have an opportunity to use the audit’s findings to review, update and enhance their policies to better protect our youth and ensure student success.”\u003c!--more-->\u003c/p>\n\u003cp>The California Department of Education disputed many of the audit’s finding, saying officials are committed to addressing bullying and keeping students safe.\u003c/p>\n\u003cp>“Although not mentioned in this report, California has made significant progress in addressing negative school behavior despite the impacts of ongoing budget cuts and staff reductions,” Chief Deputy Superintendent of Public Instruction Richard Zeiger said in a statement. “Nevertheless, CDE acknowledges the auditor’s concerns and will continue our work to build and reinforce a positive school climate throughout the state.”\u003c/p>\n\u003ch4>Bullying at school\u003c/h4>\n\u003cp>Some 28 percent of seventh graders in California \u003ca href=\"http://www.auditor.ca.gov/pdfs/reports/2012-108.pdf\" target=\"_blank\">reported \u003c/a>being harassed at school, and 22 percent of ninth-grade students reported that other students had spread rumors or lies about them online at least once over the previous 12-month period. The data come from the 2009-11 California Healthy Kids Survey. The report noted the link between bullying and several high-profile student suicides, including the 2010 suicide of 13-year-old Seth Walsh of Tehachapi, a victim of anti-gay bullying.\u003c/p>\n\u003cp>“He was only one of many young people who decided it was easier to commit suicide than to go to school the next day,” said Karyl Ketchum, co-chair of the School Compliance Task Force of the \u003ca href=\"http://ocequality.com/\" target=\"_blank\">Orange County Equality Coalition\u003c/a>, which monitors schools in Orange County for compliance with anti-bullying and discrimination laws.\u003c/p>\n\u003cp>“The local educational agencies are not following through with their requirements under the law and no one cares,” she said.\u003c/p>\n\u003cp>Auditors surveyed every school district, county office of education and charter school in the state –- nearly 2,000 in total. Of the nearly 1,400 entities that responded, 80 percent said they had adopted anti-bullying programs and policies. Some 55 percent said they did not formally evaluate the effectiveness of the programs.\u003c/p>\n\u003cp>In addition to the statewide survey, the auditors visited six schools in Los Angeles, Fresno and Sacramento. Those site visits raised concerns about whether schools were receiving sufficient guidance on how to document and resolve complaints. At the schools, auditors found that staff did not always document complaints, follow reporting requirements or record follow-ups on incidents.\u003c/p>\n\u003cp>Experts said that collecting accurate data was essential to ending what President Barack Obama \u003ca href=\"http://www.whitehouse.gov/blog/2012/04/20/ending-bullying-our-schools-communities\" target=\"_blank\">called\u003c/a> “the pain, agony, and loss caused by bullying in our schools and communities.”\u003c/p>\n\u003cp>“Most schools in the U.S. have no systematic ways of tracking reports, and in most situations, do not even follow their own policies or guidelines,” said Dorothy Espelage, co-chair of an American Educational Research Association task force on bullying that issued a \u003ca href=\"http://www.aera.net/newsroom/news/preventionofbullyingresearchreportandrecomm/tabid/14865/default.aspx\" target=\"_blank\">2013 report on the prevention of bullying in schools. \u003c/a>“As bullying legislation is often ‘unfunded’ mandates, there are no research monies to even track compliance of school districts.”\u003c/p>\n\u003ch4>State department criticized\u003c/h4>\n\u003cp>The audit was critical of the Department of Education, beginning with the department’s failure to detect that its Office of Equal Opportunity was not collecting data on bullying for several years. The department ultimately updated its internal program to collect the data on bullying in 2012, four school years after the state \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=00001-01000&file=234-234.5\" target=\"_blank\">Safe Place to Learn Act \u003c/a>mandated that the department provide oversight, the report noted.\u003c/p>\n\u003cp>The department was also chastised for failing to meet the 60-day legal requirement to resolve appeals in some cases, with 11 of the 18 appeals reviewed by the auditors running between one and 305 days late.\u003c/p>\n\u003cp>Also criticized was the department’s \u003ca href=\"http://www.californiahealthykids.org/index\" target=\"_blank\">website \u003c/a>of bullying resources for schools, with auditors determining that the site was cluttered with 10-year-old research, a dead link, and little information on current issues such as online bullying or bullying related to being perceived as gay or lesbian. In its survey, the audit found that more than half of the school districts, charter schools and county offices of education were unaware that the department even had resources to assist them in complying with laws to protect students from harassment and discrimination.\u003c/p>\n\u003cp>Zeiger, the state official, disputed that audit’s contention that the department was not a leader in protecting students.\u003c/p>\n\u003cp>“Protecting student safety and guarding against discrimination are top priorities at the California Department of Education,” he said, “and the department has been a leader in the prevention of bullying and assisting schools, parents and students in safety issues.”\u003c/p>\n\u003ch4>Conflict of interest in complaint process faulted\u003c/h4>\n\u003cp>The audit noted that schools are encouraged to use their own staff to resolve bullying complaints quickly, but that resolving complaints internally could lead to conflicts of interest. The audit cited two incidents in Sacramento City Unified School District where the administrator who was assigned to resolve a complaint of bullying, harassment, intimidation or discrimination was the same person named in the complaint for allegedly failing to take appropriate action to address the student incident. The audit did not provide details about the specific complaints.\u003c/p>\n\u003cp>Sacramento City will take immediate action to strengthen its anti-bullying efforts, said district spokesman Gabe Ross. He added that the district was the first in the area to implement a comprehensive anti-bullying policy and now has a full-time, grant-funded anti-bullying specialist at the district level.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Our schools are certainly safer for kids than they were before we began this work two years ago,” Ross said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Supreme Court: Trained School Employees May Administer Insulin",
"title": "California Supreme Court: Trained School Employees May Administer Insulin",
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"content": "\u003cfigure id=\"attachment_14282\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14282\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/89468368-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By KQED News Staff and Wires\u003c/strong>\u003c/p>\n\u003cp>SACRAMENTO -- Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday.\u003c/p>\n\u003cp>The ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn't available.\"\u003c/aside>\n\u003cp>The Supreme Court ruled that \"state law in effect leaves to each student's physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons.\"\u003c/p>\n\u003cp>The decision supports a 2007 agreement between the state Department of Education and the American Diabetes Association, which addressed a shortage of nurses to attend to all diabetic students by allowing trained teachers and administrators to give the shots.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That agreement settled a class-action lawsuit in federal court, alleging the state's schools had failed to ensure diabetic students receive legally required health care services.\u003c!--more-->\u003c/p>\n\u003cp>Nurses' organizations sued to block the agreement, arguing that state law allows only nurses to administer prescription medication, including insulin. They said inappropriately administered shots could hurt students.\u003c/p>\n\u003cp>But parents and groups such as the American Diabetes Association said many school districts across the state are experiencing a shortage of licensed nurses, which could leave the children who cannot self-administer their shots at risk.\u003c/p>\n\u003cp>\"Students with diabetes will no longer be placed in situations that endanger their health, their safety and their access to educational opportunities,\" Dwight Holing with the American Diabetes Association told KQED. \"Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn't available,\" he added. \"Today, that ends.\"\u003c/p>\n\u003cp>There are an estimated 14,000 diabetic students in California public schools. The state has one nurse for every 2,200 students. Sixty-nine percent of California's schools have only a part-time nurse, and 26 percent have no nurse at all.\u003c/p>\n\u003cp>In a statement, the American Nurses Association said it was \"extremely disappointed\" with the decision and that it lowers the level of care children will receive at school. \"Moreover, the California Supreme Court has essentially decided that state heath care licensing laws meant to protect patients can be ignored to the detriment of vulnerable populations.\"\u003c/p>\n\u003cp>The Obama administration filed a brief in the case supporting the broader policy allowing school employees to administer the shots as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Ryder Diaz contributed to this report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "SACRAMENTO -- Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday.\r\n\r\nThe ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots.\r\n\r\nThe Supreme Court ruled that \"state law in effect leaves to each student's physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons.\"",
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"description": "SACRAMENTO -- Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday.\r\n\r\nThe ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots.\r\n\r\nThe Supreme Court ruled that "state law in effect leaves to each student's physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons."",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14282\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14282\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/89468368-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By KQED News Staff and Wires\u003c/strong>\u003c/p>\n\u003cp>SACRAMENTO -- Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday.\u003c/p>\n\u003cp>The ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn't available.\"\u003c/aside>\n\u003cp>The Supreme Court ruled that \"state law in effect leaves to each student's physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons.\"\u003c/p>\n\u003cp>The decision supports a 2007 agreement between the state Department of Education and the American Diabetes Association, which addressed a shortage of nurses to attend to all diabetic students by allowing trained teachers and administrators to give the shots.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That agreement settled a class-action lawsuit in federal court, alleging the state's schools had failed to ensure diabetic students receive legally required health care services.\u003c!--more-->\u003c/p>\n\u003cp>Nurses' organizations sued to block the agreement, arguing that state law allows only nurses to administer prescription medication, including insulin. They said inappropriately administered shots could hurt students.\u003c/p>\n\u003cp>But parents and groups such as the American Diabetes Association said many school districts across the state are experiencing a shortage of licensed nurses, which could leave the children who cannot self-administer their shots at risk.\u003c/p>\n\u003cp>\"Students with diabetes will no longer be placed in situations that endanger their health, their safety and their access to educational opportunities,\" Dwight Holing with the American Diabetes Association told KQED. \"Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn't available,\" he added. \"Today, that ends.\"\u003c/p>\n\u003cp>There are an estimated 14,000 diabetic students in California public schools. The state has one nurse for every 2,200 students. Sixty-nine percent of California's schools have only a part-time nurse, and 26 percent have no nurse at all.\u003c/p>\n\u003cp>In a statement, the American Nurses Association said it was \"extremely disappointed\" with the decision and that it lowers the level of care children will receive at school. \"Moreover, the California Supreme Court has essentially decided that state heath care licensing laws meant to protect patients can be ignored to the detriment of vulnerable populations.\"\u003c/p>\n\u003cp>The Obama administration filed a brief in the case supporting the broader policy allowing school employees to administer the shots as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Ryder Diaz contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Scott Detrow, KQED\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Update 1:05pm: \u003c/strong>Gov. Jerry Brown has signed AB 1266 into law.\u003c/p>\n\u003cp>\u003cstrong>Here's the original post:\u003c/strong>\u003c/p>\n\u003cp>A bill on Gov. Jerry Brown’s desk would allow transgender students to participate in sports and other activities as well as use facilities based on how they identify their gender, regardless of what sex they were born as. The governor has until Tuesday at midnight to sign or veto the bill.\u003c/p>\n\u003cp>The legislation,\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1266&search_keywords=\" target=\"_blank\"> AB 1266\u003c/a>, adds just four words to California law, but the Transgender Law Center’s legal director, Ilona Turner, calls it a major step toward acceptance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When transgender students are forced to participate in activities based on the sex that they were assigned that is not the sex they are living as, it outs them as transgender, for one thing,” she said, “and subjects them to all kinds of stigma and harassment from their peers.”\u003c/p>\n\u003cp>California’s education laws already ban gender-based discrimination, but outreach group Gender Spectrum’s director of education and training, Joel Baum, said the new measure would “give clear direction” to school administrators making decisions on a sensitive subject.\u003c!--more-->\u003c/p>\n\u003cp>Last month a transgender student in Arcadia \u003ca href=\"http://www.latimes.com/local/lanow/la-me-ln-arcadia-transgender-discrimination-20130724,0,6807708.story\" target=\"_blank\">won a federal complaint\u003c/a> because the school district did not allow him to use the boys' restrooms and locker rooms. Assemblymember Tom Ammiano (D-San Francisco) called on the governor to sign the bill.\u003c/p>\n\u003cp>“The gender identity of these kids needs to be respected and they shouldn’t have to sue to make it happen,” Ammiano said in a release.\u003c/p>\n\u003cp>Senate debate on AB 1266 earlier this summer highlighted some of the dynamics school districts are dealing with. Republican Senator Stephen Knight warned boys might use the law to compete in and dominate girls sports. “This doesn’t leave a loophole,” he said. “It leaves a cavernous hole that many kids will see. And if you think high school kids won’t do something like that, then a lot of you weren’t in high school very recently.”\u003c/p>\n\u003cp>“People just don’t pretend to be transgender,” countered Turner. “That simply doesn’t happen. Being transgender is not a popular thing. Transgender students face harassment, violence and just a great deal of bias from other students and the world. Nobody is going to intentionally take that on if they are not, in fact, transgender.”\u003c/p>\n\u003cp>While California often claims the mantle of being the first state to implement new laws or policies, this bill isn’t one of them. New Jersey law already addresses the issue, and six other states have regulations or guidance in place allowing transgender students or employees to choose which facilities they use.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measure passed both chambers on party-line votes. If the governor does not act, the bill will become law without his signature.\u003c/p>\n\n",
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"excerpt": "A bill on Gov. Jerry Brown’s desk would allow transgender students to participate in sports and other activities as well as use facilities based on how they identify their gender, regardless of what sex they were born as. The governor has until Tuesday to sign or veto the bill.\r\n\r\nThe legislation, AB 1266, adds just four words to California law, but the Transgender Law Center’s legal director, Ilona Turner, calls it a major step toward acceptance.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Scott Detrow, KQED\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Update 1:05pm: \u003c/strong>Gov. Jerry Brown has signed AB 1266 into law.\u003c/p>\n\u003cp>\u003cstrong>Here's the original post:\u003c/strong>\u003c/p>\n\u003cp>A bill on Gov. Jerry Brown’s desk would allow transgender students to participate in sports and other activities as well as use facilities based on how they identify their gender, regardless of what sex they were born as. The governor has until Tuesday at midnight to sign or veto the bill.\u003c/p>\n\u003cp>The legislation,\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1266&search_keywords=\" target=\"_blank\"> AB 1266\u003c/a>, adds just four words to California law, but the Transgender Law Center’s legal director, Ilona Turner, calls it a major step toward acceptance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When transgender students are forced to participate in activities based on the sex that they were assigned that is not the sex they are living as, it outs them as transgender, for one thing,” she said, “and subjects them to all kinds of stigma and harassment from their peers.”\u003c/p>\n\u003cp>California’s education laws already ban gender-based discrimination, but outreach group Gender Spectrum’s director of education and training, Joel Baum, said the new measure would “give clear direction” to school administrators making decisions on a sensitive subject.\u003c!--more-->\u003c/p>\n\u003cp>Last month a transgender student in Arcadia \u003ca href=\"http://www.latimes.com/local/lanow/la-me-ln-arcadia-transgender-discrimination-20130724,0,6807708.story\" target=\"_blank\">won a federal complaint\u003c/a> because the school district did not allow him to use the boys' restrooms and locker rooms. Assemblymember Tom Ammiano (D-San Francisco) called on the governor to sign the bill.\u003c/p>\n\u003cp>“The gender identity of these kids needs to be respected and they shouldn’t have to sue to make it happen,” Ammiano said in a release.\u003c/p>\n\u003cp>Senate debate on AB 1266 earlier this summer highlighted some of the dynamics school districts are dealing with. Republican Senator Stephen Knight warned boys might use the law to compete in and dominate girls sports. “This doesn’t leave a loophole,” he said. “It leaves a cavernous hole that many kids will see. And if you think high school kids won’t do something like that, then a lot of you weren’t in high school very recently.”\u003c/p>\n\u003cp>“People just don’t pretend to be transgender,” countered Turner. “That simply doesn’t happen. Being transgender is not a popular thing. Transgender students face harassment, violence and just a great deal of bias from other students and the world. Nobody is going to intentionally take that on if they are not, in fact, transgender.”\u003c/p>\n\u003cp>While California often claims the mantle of being the first state to implement new laws or policies, this bill isn’t one of them. New Jersey law already addresses the issue, and six other states have regulations or guidance in place allowing transgender students or employees to choose which facilities they use.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measure passed both chambers on party-line votes. If the governor does not act, the bill will become law without his signature.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Debate Over Role of Nurse Practitioners in Primary Care Responsibilities",
"title": "Debate Over Role of Nurse Practitioners in Primary Care Responsibilities",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14252\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14252\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS4667_WellnessCenter_ChrisRichard-scr-640x480.jpg\" alt=\"Pediatric Nurse Practitioner examines toddler. (Chris Richard/KQED)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">A pediatric nurse practitioner examines a toddler. (Chris Richard/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>An estimated 6 million Californians will be eligible for insurance under Obamacare -- about 5 million through the Covered California marketplace and more than a million people via the Medi-Cal expansion.\u003c/p>\n\u003cp>Yet, just 16 of California's 58 counties have enough primary care doctors\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\"> right now\u003c/a>. To try to improve access, California legislators are moving bills to expand \"scope of practice\" for such midlevel health providers as pharmacists and nurse practitioners. In general, such bills would allow certain health providers to practice more independently. Right now, in many cases, they must be overseen by physicians. More autonomy could open access for underserved groups.\u003c/p>\n\u003cp>But some of those ideas are being hotly debated in Sacramento.\u003c/p>\n\u003cp>The toughest scope-of-practice sell right now seems to be nurse practitioners. Earlier this week, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB491\" target=\"_blank\">SB 491,\u003c/a> which would expand nurse practitioner duties, failed to get out of committee. It will be up for a vote again next week. State Sen. Ed Hernandez (D-West Covina), an optometrist himself, joined \u003ca href=\"http://www.kqed.org/a/forum/R201308090900\">KQED Forum\u003c/a> Friday to discuss the bill. He said California needs to \"utilize providers within their training\" to help ease this \"huge access problem in primary care.\"\u003c!--more-->\u003c/p>\n\u003cp>California, as it turns out, is among only a \u003ca href=\"http://www.californiahealthline.org/insight/2013/california-behind-national-scopeofpractice-curve-according-to-nurse-practitioners\" target=\"_blank\">handful of states with the most restrictive policies\u003c/a> (see map) around nurse practitioners and patient care. Paul Phinney, a pediatrician and president of the California Medical Association, said \"allowing nurse practitioners to practice independently fragments care.\" He agreed there is tremendous primary care need, but said a better way to address the problem would be to \"have physicians and nurse practitioners work collaboratively in teams.\"\u003c/p>\n\u003cfigure id=\"attachment_14244\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.aanp.org/legislation-regulation/state-practice-environment\">\u003cimg class=\"size-medium wp-image-14244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/Screen-Shot-2013-08-09-at-12.20.25-PM-300x189.png\" alt=\"Map of state practice environment for nurse practitioners. California has some of the most restrictive policies. (Map: American Association of Nurse Practitioners)\" width=\"300\" height=\"189\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map of state practice environment for nurse practitioners. California has some of the most restrictive policies. (Map: American Association of Nurse Practitioners)\u003c/figcaption>\u003c/figure>\n\u003cp>Hernandez agreed a team approach is best, but pointed to many studies (he didn't say specifically, but \u003ca href=\"http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health/Recommendations.aspx\" target=\"_blank\">this one\u003c/a> from the Institute of Medicine is a good start) that have found nurse practitioners are \"just as qualified\" to provide safe primary care as physicians are. Right now, 17 states currently allow independent practice for nurse practitioners.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of course, that means 33 states do not allow fully independent practice, countered Phinney.\u003c/p>\n\u003cp>Debra Bakerjian, senior director of clinical education at the UC Davis School of Nursing, talked about structural barriers that further limit the practice of nurse practitioners. For example, Medi-Cal recipients face not only a primary care shortage but also a shortage of physicians who will accept Medi-Cal. Since nurse practitioners must be aligned with a physician, if the physician does not accept Medi-Cal, neither can the NP. With changes in regulations, like SB 491, \"We could expand and provide access to care to people who don't have it already,\" she explained.\u003c/p>\n\u003cp>Bakerjian stressed that NPs want to be part of a health care team, but argued that \"physicians should be required to be part of a team as well.\"\u003c/p>\n\u003cp>Forum is a call-in discussion program, and a call from a woman who identified herself as Aurora was especially pointed. She said that she is a psychiatric mental health nurse practitioner who works with severely mentally ill adults and children in an urban area.\u003c/p>\n\u003cp>We have a \"huge waiting list,\" she said, adding that severely mentally ill children might face a one-year wait to get into a clinic. \"We cannot get physicians to collaborate with us,\" Aurora said. \"Often there are no physicians available to do that.\"\u003c/p>\n\u003cp>SB 493 -- which would permit more practice options for pharmacists -- has already passed out of committee. A third scope-of-practice bill, also by Hernandez, would \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB492\" target=\"_blank\">permit optometrists\u003c/a> to diagnose and treat more conditions. Like the NP bill, it will be heard next week as well.\u003c/p>\n\u003cp>Still, California Healthline reported that California, a trendsetter in so many ways, is \u003ca href=\"http://www.californiahealthline.org/insight/2013/california-behind-national-scopeofpractice-curve-according-to-nurse-practitioners\" target=\"_blank\">behind the curve\u003c/a> on the scope-of-practice issue for nurse practitioners, according to Tay Kopanos of the American Association of Nurse Practitioners:\u003c/p>\n\u003cblockquote>\u003cp>\"In Oregon, a nurse practitioner can manage care completely from diagnosis to prescribing treatment, but step over the border into California and barriers are thrown up that prevent care,\" Kopanos said. \"We are concerned that when legislators begin setting up state-based requirements for team care, they might be shortchanging everyone by requiring a physician to be the head of every team.\"\u003c/p>\n\u003cp>\"We're not sure that's the best way to do it,\" Kopanos said. \"We can see circumstances in many states from Kentucky to California, where having somebody other than a physician -- maybe a nurse practitioner or maybe some other provider -- heading teams in underserved areas would be best for patients.\"\u003c/p>\n\u003cp>\"That's what we think should be the driving force behind states' decisions -- what's best for patients,\" Kopanos said.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the Forum discussion:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201308090900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201308090900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "An estimated 6 million Californians will be eligible for insurance under Obamacare -- about 5 million through the Covered California marketplace and more than a million people via the Medi-Cal expansion.\r\n\r\nYet, just 16 of California's 58 counties have enough primary care doctors right now. To try to improve access, California legislators are moving bills to expand \"scope-of-practice\" for such mid-level health providers as pharmacists and nurse practitioners.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14252\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14252\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS4667_WellnessCenter_ChrisRichard-scr-640x480.jpg\" alt=\"Pediatric Nurse Practitioner examines toddler. (Chris Richard/KQED)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">A pediatric nurse practitioner examines a toddler. (Chris Richard/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>An estimated 6 million Californians will be eligible for insurance under Obamacare -- about 5 million through the Covered California marketplace and more than a million people via the Medi-Cal expansion.\u003c/p>\n\u003cp>Yet, just 16 of California's 58 counties have enough primary care doctors\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\"> right now\u003c/a>. To try to improve access, California legislators are moving bills to expand \"scope of practice\" for such midlevel health providers as pharmacists and nurse practitioners. In general, such bills would allow certain health providers to practice more independently. Right now, in many cases, they must be overseen by physicians. More autonomy could open access for underserved groups.\u003c/p>\n\u003cp>But some of those ideas are being hotly debated in Sacramento.\u003c/p>\n\u003cp>The toughest scope-of-practice sell right now seems to be nurse practitioners. Earlier this week, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB491\" target=\"_blank\">SB 491,\u003c/a> which would expand nurse practitioner duties, failed to get out of committee. It will be up for a vote again next week. State Sen. Ed Hernandez (D-West Covina), an optometrist himself, joined \u003ca href=\"http://www.kqed.org/a/forum/R201308090900\">KQED Forum\u003c/a> Friday to discuss the bill. He said California needs to \"utilize providers within their training\" to help ease this \"huge access problem in primary care.\"\u003c!--more-->\u003c/p>\n\u003cp>California, as it turns out, is among only a \u003ca href=\"http://www.californiahealthline.org/insight/2013/california-behind-national-scopeofpractice-curve-according-to-nurse-practitioners\" target=\"_blank\">handful of states with the most restrictive policies\u003c/a> (see map) around nurse practitioners and patient care. Paul Phinney, a pediatrician and president of the California Medical Association, said \"allowing nurse practitioners to practice independently fragments care.\" He agreed there is tremendous primary care need, but said a better way to address the problem would be to \"have physicians and nurse practitioners work collaboratively in teams.\"\u003c/p>\n\u003cfigure id=\"attachment_14244\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.aanp.org/legislation-regulation/state-practice-environment\">\u003cimg class=\"size-medium wp-image-14244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/Screen-Shot-2013-08-09-at-12.20.25-PM-300x189.png\" alt=\"Map of state practice environment for nurse practitioners. California has some of the most restrictive policies. (Map: American Association of Nurse Practitioners)\" width=\"300\" height=\"189\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map of state practice environment for nurse practitioners. California has some of the most restrictive policies. (Map: American Association of Nurse Practitioners)\u003c/figcaption>\u003c/figure>\n\u003cp>Hernandez agreed a team approach is best, but pointed to many studies (he didn't say specifically, but \u003ca href=\"http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health/Recommendations.aspx\" target=\"_blank\">this one\u003c/a> from the Institute of Medicine is a good start) that have found nurse practitioners are \"just as qualified\" to provide safe primary care as physicians are. Right now, 17 states currently allow independent practice for nurse practitioners.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of course, that means 33 states do not allow fully independent practice, countered Phinney.\u003c/p>\n\u003cp>Debra Bakerjian, senior director of clinical education at the UC Davis School of Nursing, talked about structural barriers that further limit the practice of nurse practitioners. For example, Medi-Cal recipients face not only a primary care shortage but also a shortage of physicians who will accept Medi-Cal. Since nurse practitioners must be aligned with a physician, if the physician does not accept Medi-Cal, neither can the NP. With changes in regulations, like SB 491, \"We could expand and provide access to care to people who don't have it already,\" she explained.\u003c/p>\n\u003cp>Bakerjian stressed that NPs want to be part of a health care team, but argued that \"physicians should be required to be part of a team as well.\"\u003c/p>\n\u003cp>Forum is a call-in discussion program, and a call from a woman who identified herself as Aurora was especially pointed. She said that she is a psychiatric mental health nurse practitioner who works with severely mentally ill adults and children in an urban area.\u003c/p>\n\u003cp>We have a \"huge waiting list,\" she said, adding that severely mentally ill children might face a one-year wait to get into a clinic. \"We cannot get physicians to collaborate with us,\" Aurora said. \"Often there are no physicians available to do that.\"\u003c/p>\n\u003cp>SB 493 -- which would permit more practice options for pharmacists -- has already passed out of committee. A third scope-of-practice bill, also by Hernandez, would \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB492\" target=\"_blank\">permit optometrists\u003c/a> to diagnose and treat more conditions. Like the NP bill, it will be heard next week as well.\u003c/p>\n\u003cp>Still, California Healthline reported that California, a trendsetter in so many ways, is \u003ca href=\"http://www.californiahealthline.org/insight/2013/california-behind-national-scopeofpractice-curve-according-to-nurse-practitioners\" target=\"_blank\">behind the curve\u003c/a> on the scope-of-practice issue for nurse practitioners, according to Tay Kopanos of the American Association of Nurse Practitioners:\u003c/p>\n\u003cblockquote>\u003cp>\"In Oregon, a nurse practitioner can manage care completely from diagnosis to prescribing treatment, but step over the border into California and barriers are thrown up that prevent care,\" Kopanos said. \"We are concerned that when legislators begin setting up state-based requirements for team care, they might be shortchanging everyone by requiring a physician to be the head of every team.\"\u003c/p>\n\u003cp>\"We're not sure that's the best way to do it,\" Kopanos said. \"We can see circumstances in many states from Kentucky to California, where having somebody other than a physician -- maybe a nurse practitioner or maybe some other provider -- heading teams in underserved areas would be best for patients.\"\u003c/p>\n\u003cp>\"That's what we think should be the driving force behind states' decisions -- what's best for patients,\" Kopanos said.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the Forum discussion:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201308090900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201308090900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cutting Down on Cancer Overdiagnosis: National Panel Weighs In",
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"content": "\u003cfigure id=\"attachment_13901\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://www.flickr.com/photos/78147607@N00/5436471236/in/photolist-9hpkuG-9xNuXm-9xKwS6-9xNuGy-9xKwK2-9xNuPm-9xKwFa-9xNuTL-dRanE5-4uDMsi-dRbiVo\">\u003cimg class=\"size-medium wp-image-13901\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/5436471236_a64b2a0245_b-300x299.jpg\" alt='Ductal carcinoma in situ seen under a microscope. While doctors also call it Stage 0 Breast Cancer, in an article Monday, doctors argue it should no longer be labelled \"cancer.\" (Ed Euthman/Flickr)' width=\"300\" height=\"299\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ductal carcinoma in situ as seen under a microscope. Doctors also call D.C.I.S. \"Stage 0 Breast Cancer.\" But in an article Monday, a panel of national scientists argue it should no longer be labelled \"cancer.\" (Ed Euthman/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>What power does a word have? If the word is “cancer,” for most people it packs a wallop of emotion ranging from general anxiety to abject terror. For the last 30 years, a large industry has grown and developed with a focus on awareness and screening. The goals were laudable: get screened; catch cancer early; early diagnosis means patients dodge a death sentence.\u003c/p>\n\u003cp>There’s just one problem. It’s not working. This notion of screening was dependent upon the understanding of cancer 30 years ago: that cancer started from a tiny seed and steadily grew and spread until – without treatment – it killed the patient.\u003c/p>\n\u003cp>But today scientists know that not all cancers behave this way. Some are fast-growing, some may grow slowly, but progressively. But others are “indolent,” so slow-growing, they will never cause the patient harm.\u003c/p>\n\u003cp>So what certain cancer screening tests have wrought (think \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\">mammography\u003c/a>, \u003ca href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\">PSA tests\u003c/a>) is a dramatic increase in diagnosis of early-stage disease without a corresponding decline in death rates from cancer or diagnosis of late-stage disease. Many of these early stage patients are likely \"overdiagnosed\" and then \"overtreated\" -- for cancers that may never have grown and spread.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We terrify (women) with D.C.I.S. thinking they have cancer. We could wait six months to see if something changes without making people hysterical.”\u003c/aside>\n\u003cp>Against this backdrop, the National Cancer Institute called together a group of nationally recognized cancer doctors and researchers to review the evidence on overdiagnosis. In a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1722196\" target=\"_blank\">Viewpoint\u003c/a> published Monday in JAMA, the panel calls for major changes in the way the medical world classifies and thinks of “cancer” and the way screening programs are designed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This article is really critical for laying the ground work for introducing what I hope will be groundbreaking changes in screening and prevention,” said lead author Dr. Laura Esserman, director of the breast care center at UC San Francisco.\u003c!--more-->\u003c/p>\n\u003cp>Esserman and her colleagues say the improved understanding of the behavior of various cancers provides an opportunity “to refocus screening on reducing disease mortality and lower the burden of cancer screening and treatments.”\u003c/p>\n\u003cp>\u003cstrong>Reserve the word “cancer” for cancers\u003c/strong>\u003c/p>\n\u003cp>For starters, the writers encourage saving the word “cancer” for those tumors with a “reasonable likelihood of lethal progression if left untreated.”\u003c/p>\n\u003cp>They call for dropping the word \"cancer\" from pre-cancerous conditions. The panel calls out two conditions specifically: prostatic intraephithelial neoplasia, currently classified as prostate cancer and D.C.I.S. -- ductal carcinoma in situ -- currently classified as breast cancer.\u003c/p>\n\u003cp>“We terrify (women) with D.C.I.S. thinking they have cancer,” Esserman says, adding that in many cases, “We could wait six months to see if something changes without making people hysterical.”\u003c/p>\n\u003cp>The panel also calls for the development of highly specialized diagnostic tests to identify these low risk tumors. Many \u003ca href=\"http://www.oncotypedx.com\">biotech companies\u003c/a> are already at work on these kinds of molecular diagnostic tools. It's part of the personalized medicine approach to treatment.\u003c/p>\n\u003cp>\u003cstrong>\"We need a 21st century definition of cancer\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Otis Brawley, chief medical office of the American Cancer Society, said he was “largely in agreement” with the panel’s recommendations. In our call, he gave me a short biology lesson on medical science’s understanding of cancer, explaining that back in the 1840s Rudolf Virchow, a German pathologist, used an early microscope and identified cancer cells. Virchow then drew pictures that “profile what we use 160 years later” to diagnose cancer, Brawley says. He explained what while many other areas of medicine have advanced, our definitions of cancer still rely on what Virchow defined 160 years ago. (If you're as startled by this news as I was, check out Brawley’s \u003ca href=\"http://www.tedmed.com/talks/show?id=7295\">TedMed Talk\u003c/a>.)\u003c/p>\n\u003cp>Brawley credited a colleague who likened the way doctors classify cancers today to “’racial profiling’ -- something that 160 years ago looked like it would kill you.”\u003c/p>\n\u003cp>“We need a 21\u003csup>st\u003c/sup> century definition of cancer,” Brawley said. “It is my belief that papers like this are going to motivate people” to address problems in classifying cancers. The easiest way to get around the problem, he said -- in reference to ductal carcinoma in situ in particular -- is to “remove the word carcinoma.\"\u003c/p>\n\u003cp>Despite Esserman's desire to avoid what she called the \"rancorous debate\" that's been going on around cancer screening and detection, that debate is likely to continue.\u003c/p>\n\u003cp>Dr. Larry Norton, director of the breast center at New York's Memorial Sloan-Kettering Cancer Center \u003ca href=\"http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment/?emc=eta1&_r=1\" target=\"_blank\">told the New York Times\u003c/a> that simply changing names doesn't solve the bigger problem that the technology isn't there yet to prove which cases of D.C.I.S. will grow and which ones won't. “I wish we knew that. We don’t have very accurate ways of looking at tissue and looking at tumors under the microscope and knowing with great certainty that it is a slow-growing cancer,” he told the Times.\u003c/p>\n\u003cp>\u003cstrong>Next steps\u003c/strong>\u003c/p>\n\u003cp>Writer and journalist Shannon Brownlee who literally \u003ca href=\"http://www.tedmed.com/talks/show?id=7295\">wrote the book\u003c/a> on overtreatment said she was “delighted” by the Viewpoint. She believes the next step is for medical groups such as the American Society of Clinical Oncology and the American College of Obstetricians and Gynecologists to rethink their own guidelines on screening and treatment. By moving beyond a belief that screening is the best way to attack cancer, she says, the recommendations “free us up intellectually to reduce deaths from cancer.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Viewpoint writers call for an effort across medical disciplines, including pathology, surgery, imaging as well as advocates “to revise the taxonomy of lesions now called cancer.” They also call for the creations of \"observational registries\" to generate data so patients with conditions that are unlikely to become cancer can confidently select less invasive treatment options.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13901\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://www.flickr.com/photos/78147607@N00/5436471236/in/photolist-9hpkuG-9xNuXm-9xKwS6-9xNuGy-9xKwK2-9xNuPm-9xKwFa-9xNuTL-dRanE5-4uDMsi-dRbiVo\">\u003cimg class=\"size-medium wp-image-13901\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/5436471236_a64b2a0245_b-300x299.jpg\" alt='Ductal carcinoma in situ seen under a microscope. While doctors also call it Stage 0 Breast Cancer, in an article Monday, doctors argue it should no longer be labelled \"cancer.\" (Ed Euthman/Flickr)' width=\"300\" height=\"299\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ductal carcinoma in situ as seen under a microscope. Doctors also call D.C.I.S. \"Stage 0 Breast Cancer.\" But in an article Monday, a panel of national scientists argue it should no longer be labelled \"cancer.\" (Ed Euthman/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>What power does a word have? If the word is “cancer,” for most people it packs a wallop of emotion ranging from general anxiety to abject terror. For the last 30 years, a large industry has grown and developed with a focus on awareness and screening. The goals were laudable: get screened; catch cancer early; early diagnosis means patients dodge a death sentence.\u003c/p>\n\u003cp>There’s just one problem. It’s not working. This notion of screening was dependent upon the understanding of cancer 30 years ago: that cancer started from a tiny seed and steadily grew and spread until – without treatment – it killed the patient.\u003c/p>\n\u003cp>But today scientists know that not all cancers behave this way. Some are fast-growing, some may grow slowly, but progressively. But others are “indolent,” so slow-growing, they will never cause the patient harm.\u003c/p>\n\u003cp>So what certain cancer screening tests have wrought (think \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\">mammography\u003c/a>, \u003ca href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\">PSA tests\u003c/a>) is a dramatic increase in diagnosis of early-stage disease without a corresponding decline in death rates from cancer or diagnosis of late-stage disease. Many of these early stage patients are likely \"overdiagnosed\" and then \"overtreated\" -- for cancers that may never have grown and spread.\u003c/p>\n\u003caside class=\"pullquote alignright\">“We terrify (women) with D.C.I.S. thinking they have cancer. We could wait six months to see if something changes without making people hysterical.”\u003c/aside>\n\u003cp>Against this backdrop, the National Cancer Institute called together a group of nationally recognized cancer doctors and researchers to review the evidence on overdiagnosis. In a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1722196\" target=\"_blank\">Viewpoint\u003c/a> published Monday in JAMA, the panel calls for major changes in the way the medical world classifies and thinks of “cancer” and the way screening programs are designed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This article is really critical for laying the ground work for introducing what I hope will be groundbreaking changes in screening and prevention,” said lead author Dr. Laura Esserman, director of the breast care center at UC San Francisco.\u003c!--more-->\u003c/p>\n\u003cp>Esserman and her colleagues say the improved understanding of the behavior of various cancers provides an opportunity “to refocus screening on reducing disease mortality and lower the burden of cancer screening and treatments.”\u003c/p>\n\u003cp>\u003cstrong>Reserve the word “cancer” for cancers\u003c/strong>\u003c/p>\n\u003cp>For starters, the writers encourage saving the word “cancer” for those tumors with a “reasonable likelihood of lethal progression if left untreated.”\u003c/p>\n\u003cp>They call for dropping the word \"cancer\" from pre-cancerous conditions. The panel calls out two conditions specifically: prostatic intraephithelial neoplasia, currently classified as prostate cancer and D.C.I.S. -- ductal carcinoma in situ -- currently classified as breast cancer.\u003c/p>\n\u003cp>“We terrify (women) with D.C.I.S. thinking they have cancer,” Esserman says, adding that in many cases, “We could wait six months to see if something changes without making people hysterical.”\u003c/p>\n\u003cp>The panel also calls for the development of highly specialized diagnostic tests to identify these low risk tumors. Many \u003ca href=\"http://www.oncotypedx.com\">biotech companies\u003c/a> are already at work on these kinds of molecular diagnostic tools. It's part of the personalized medicine approach to treatment.\u003c/p>\n\u003cp>\u003cstrong>\"We need a 21st century definition of cancer\"\u003c/strong>\u003c/p>\n\u003cp>Dr. Otis Brawley, chief medical office of the American Cancer Society, said he was “largely in agreement” with the panel’s recommendations. In our call, he gave me a short biology lesson on medical science’s understanding of cancer, explaining that back in the 1840s Rudolf Virchow, a German pathologist, used an early microscope and identified cancer cells. Virchow then drew pictures that “profile what we use 160 years later” to diagnose cancer, Brawley says. He explained what while many other areas of medicine have advanced, our definitions of cancer still rely on what Virchow defined 160 years ago. (If you're as startled by this news as I was, check out Brawley’s \u003ca href=\"http://www.tedmed.com/talks/show?id=7295\">TedMed Talk\u003c/a>.)\u003c/p>\n\u003cp>Brawley credited a colleague who likened the way doctors classify cancers today to “’racial profiling’ -- something that 160 years ago looked like it would kill you.”\u003c/p>\n\u003cp>“We need a 21\u003csup>st\u003c/sup> century definition of cancer,” Brawley said. “It is my belief that papers like this are going to motivate people” to address problems in classifying cancers. The easiest way to get around the problem, he said -- in reference to ductal carcinoma in situ in particular -- is to “remove the word carcinoma.\"\u003c/p>\n\u003cp>Despite Esserman's desire to avoid what she called the \"rancorous debate\" that's been going on around cancer screening and detection, that debate is likely to continue.\u003c/p>\n\u003cp>Dr. Larry Norton, director of the breast center at New York's Memorial Sloan-Kettering Cancer Center \u003ca href=\"http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment/?emc=eta1&_r=1\" target=\"_blank\">told the New York Times\u003c/a> that simply changing names doesn't solve the bigger problem that the technology isn't there yet to prove which cases of D.C.I.S. will grow and which ones won't. “I wish we knew that. We don’t have very accurate ways of looking at tissue and looking at tumors under the microscope and knowing with great certainty that it is a slow-growing cancer,” he told the Times.\u003c/p>\n\u003cp>\u003cstrong>Next steps\u003c/strong>\u003c/p>\n\u003cp>Writer and journalist Shannon Brownlee who literally \u003ca href=\"http://www.tedmed.com/talks/show?id=7295\">wrote the book\u003c/a> on overtreatment said she was “delighted” by the Viewpoint. She believes the next step is for medical groups such as the American Society of Clinical Oncology and the American College of Obstetricians and Gynecologists to rethink their own guidelines on screening and treatment. By moving beyond a belief that screening is the best way to attack cancer, she says, the recommendations “free us up intellectually to reduce deaths from cancer.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Viewpoint writers call for an effort across medical disciplines, including pathology, surgery, imaging as well as advocates “to revise the taxonomy of lesions now called cancer.” They also call for the creations of \"observational registries\" to generate data so patients with conditions that are unlikely to become cancer can confidently select less invasive treatment options.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mental Health Funds Well-Spent or Wasted? Prop. 63 Authors Divided",
"title": "Mental Health Funds Well-Spent or Wasted? Prop. 63 Authors Divided",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>By Elaine Korry, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13769\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13769\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS5694_Korry-Prop-63-art-therapy-Daniels-Place-scr-620x465.jpg\" alt=\"Young people with mental health needs find help through art therapy at Daniel's Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)\" width=\"620\" height=\"465\">\u003cfigcaption class=\"wp-caption-text\">Young people with mental health needs find help through art therapy at Daniel's Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Remember Proposition 63? The voter initiative known as the Mental Health Services Act was approved in 2004. It imposed a 1 percent surtax on income over $1 million to fund services for Californians with a serious mental illness. Now, nine years later, the state auditor is about to release a long-awaited report, detailing how nearly $9 billion in taxpayer money raised by Prop. 63 has been spent. Whether that money has been spent wisely is being hotly debated, and even the bill's co-authors are divided.\u003c/p>\n\u003cp>“What did they do with the money? Where has all the money gone? We would like to know,” said Rose King, one of the initiative’s original co-authors. Lawmakers requested the audit after whistle-blowers including King complained that the funds were being misused.\u003c/p>\n\u003cp>As written, nearly three-quarters of the money raised by Prop 63 was slated to fund services for people already diagnosed with a severe mental illness. Twenty percent was reserved for prevention and early intervention strategies. The remaining funds would go to oversight, administration, and innovations.\u003c!--more-->\u003c/p>\n\u003cp>Instead, King, who has battled for years to get mental health services for members of her own family, charges that voters who approved Prop. 63 have been duped. “It is a model of discrimination and waste,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The other co-author of Prop. 63, Rusty Selix, also welcomes the audit, but for a different reason. “We think that the audit will affirm that 99 percent of the money has gone exactly where it should go,” said Selix, who heads the state Council of Community Mental Health Agencies. He says Prop. 63 is funding a continuum of care for the very people who need coordinated services most.\u003c/p>\n\u003cp>Not so, according to Peter Mantas, the former chairman of the Contra Costa County Mental Health Commission, whose own family was ravaged by mental illness. Mantas’ son, who was diagnosed with paranoid schizophrenia, took his own mother’s life during a schizophrenic break.\u003c/p>\n\u003cp>In the aftermath of that tragedy, Mantas says he witnessed first-hand a fragmented system that allows people with severe disorders to cycle through emergency rooms over and over until the unthinkable happens “They wind up getting jailed, not taking medication, continuing the downward spiral, and society pays a very hefty fine for that, beyond the emotional toll,” said Mantas.\u003c/p>\n\u003cp>According to Mantas, Proposition 63 should be revamping mental health care from the ground up to make the most vulnerable people with severe illness the priority. Instead, Mantas wound up quitting the county commission in frustration after two years, charging that too much money was being funneled into what he calls “little feel-good programs,” that don’t impact the entire system.\u003c/p>\n\u003cp>Yet supporters of these programs say they are the very kind of services that might have helped Mantas’ son before it was too late.\u003c/p>\n\u003cp>They cite examples such as Daniel’s Place, a comfortable drop-in center in Santa Monica, where young people who are troubled can come, whether diagnosed with a mental disorder or not. Some of the clients receive traditional case management; others come for support groups, or non-traditional services such as art therapy, drama therapy or even a popular drumming group.\u003c/p>\n\u003cp>Program manager Emily James says Daniel’s Place is a low-barrier environment by design. “It’s a lot easier to start talking to a young person about coming to an art group than saying, ‘Come in and see our psychiatrist and get on psychotropic medications.’ That’s just not something that a lot of people want to do,” said James.\u003c/p>\n\u003cp>Prop. 63 also pays for peer advocates at Daniel’s Place, such as Duane Lynch, who has received mental health services himself. “There’s someone around their age, someone who understands what they’re going through because they lived through the same thing,” said Lynch. He says some young clients can connect better with a peer advocate than a professional therapist because the two have had a shared experience.\u003c/p>\n\u003cp>Daniel’s Place is all about building relationships to catch mental illness early, when it’s more easily treated. Prop. 63 co-author Rusty Selix says early intervention has to be a big part of any mental health strategy. He understands the frustration of family members who have dealt with a loved one’s long-term illness, but he says to criticize Prop. 63 is misdirected. “They’re looking at the way Prop. 63 money is being spent, and that’s not where the problem is,” says Selix. “The problem is we don’t have the other money that we used to have. That’s why [Prop 63] hasn’t achieved its goals.”\u003c/p>\n\u003cp>According to Selix, Prop. 63 money, about $1 billion per year, was intended to supplement an existing $2 billion state mental health budget. Instead, he says, the recession prompted Sacramento to slash the existing budget almost in half. The new funds from Prop. 63 have barely filled the gap.\u003c/p>\n\u003cp>UCLA psychiatrist Joel Braslow says Prop. 63 averted what would have been an even worse collapse in public mental health. “Most people are not being adequately cared for that have severe mental illness,” said Braslow, a historian of public mental health systems. “What Prop. 63 has done is at least allowed for better care than would have been possible otherwise,” he said.\u003c/p>\n\u003cp>According to Braslow, the feud over Prop. 63 spending misses the point. He says, both sides are correct: better services are needed for severe mental illness -- and for prevention and early intervention strategies. “Actually I think it would be more useful to turn it around and say, ‘Why aren’t we providing more resources?’”\u003c/p>\n\u003cp>The state audit, scheduled to be released next month, may answer some questions about how Prop. 63 funds are being allocated. But Braslow says no matter what it shows, mental illness will remain a neglected social problem until Californians get real about what it costs to adequately care for people who can’t take care of themselves.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201307220850a.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201307220850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Remember Proposition 63? The voter initiative known as the Mental Health Services Act was approved in 2004. It imposed a 1% surtax on income over $1 million to fund services for Californians with a serious mental illness. Nine years later, the state auditor is about to release a long-awaited report, detailing how nearly $9 billion in taxpayer money raised by Prop 63 has been spent.\r\n\r\n“What did they do with the money? Where has all the money gone? We would like to know,” said Rose King, one of the initiative’s original co-authors. Lawmakers requested the audit after whistle-blowers including King complained that the funds were being misused.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Elaine Korry, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13769\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13769\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS5694_Korry-Prop-63-art-therapy-Daniels-Place-scr-620x465.jpg\" alt=\"Young people with mental health needs find help through art therapy at Daniel's Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)\" width=\"620\" height=\"465\">\u003cfigcaption class=\"wp-caption-text\">Young people with mental health needs find help through art therapy at Daniel's Place, a drop-in center in Santa Monica. (Elaine Korry/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Remember Proposition 63? The voter initiative known as the Mental Health Services Act was approved in 2004. It imposed a 1 percent surtax on income over $1 million to fund services for Californians with a serious mental illness. Now, nine years later, the state auditor is about to release a long-awaited report, detailing how nearly $9 billion in taxpayer money raised by Prop. 63 has been spent. Whether that money has been spent wisely is being hotly debated, and even the bill's co-authors are divided.\u003c/p>\n\u003cp>“What did they do with the money? Where has all the money gone? We would like to know,” said Rose King, one of the initiative’s original co-authors. Lawmakers requested the audit after whistle-blowers including King complained that the funds were being misused.\u003c/p>\n\u003cp>As written, nearly three-quarters of the money raised by Prop 63 was slated to fund services for people already diagnosed with a severe mental illness. Twenty percent was reserved for prevention and early intervention strategies. The remaining funds would go to oversight, administration, and innovations.\u003c!--more-->\u003c/p>\n\u003cp>Instead, King, who has battled for years to get mental health services for members of her own family, charges that voters who approved Prop. 63 have been duped. “It is a model of discrimination and waste,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The other co-author of Prop. 63, Rusty Selix, also welcomes the audit, but for a different reason. “We think that the audit will affirm that 99 percent of the money has gone exactly where it should go,” said Selix, who heads the state Council of Community Mental Health Agencies. He says Prop. 63 is funding a continuum of care for the very people who need coordinated services most.\u003c/p>\n\u003cp>Not so, according to Peter Mantas, the former chairman of the Contra Costa County Mental Health Commission, whose own family was ravaged by mental illness. Mantas’ son, who was diagnosed with paranoid schizophrenia, took his own mother’s life during a schizophrenic break.\u003c/p>\n\u003cp>In the aftermath of that tragedy, Mantas says he witnessed first-hand a fragmented system that allows people with severe disorders to cycle through emergency rooms over and over until the unthinkable happens “They wind up getting jailed, not taking medication, continuing the downward spiral, and society pays a very hefty fine for that, beyond the emotional toll,” said Mantas.\u003c/p>\n\u003cp>According to Mantas, Proposition 63 should be revamping mental health care from the ground up to make the most vulnerable people with severe illness the priority. Instead, Mantas wound up quitting the county commission in frustration after two years, charging that too much money was being funneled into what he calls “little feel-good programs,” that don’t impact the entire system.\u003c/p>\n\u003cp>Yet supporters of these programs say they are the very kind of services that might have helped Mantas’ son before it was too late.\u003c/p>\n\u003cp>They cite examples such as Daniel’s Place, a comfortable drop-in center in Santa Monica, where young people who are troubled can come, whether diagnosed with a mental disorder or not. Some of the clients receive traditional case management; others come for support groups, or non-traditional services such as art therapy, drama therapy or even a popular drumming group.\u003c/p>\n\u003cp>Program manager Emily James says Daniel’s Place is a low-barrier environment by design. “It’s a lot easier to start talking to a young person about coming to an art group than saying, ‘Come in and see our psychiatrist and get on psychotropic medications.’ That’s just not something that a lot of people want to do,” said James.\u003c/p>\n\u003cp>Prop. 63 also pays for peer advocates at Daniel’s Place, such as Duane Lynch, who has received mental health services himself. “There’s someone around their age, someone who understands what they’re going through because they lived through the same thing,” said Lynch. He says some young clients can connect better with a peer advocate than a professional therapist because the two have had a shared experience.\u003c/p>\n\u003cp>Daniel’s Place is all about building relationships to catch mental illness early, when it’s more easily treated. Prop. 63 co-author Rusty Selix says early intervention has to be a big part of any mental health strategy. He understands the frustration of family members who have dealt with a loved one’s long-term illness, but he says to criticize Prop. 63 is misdirected. “They’re looking at the way Prop. 63 money is being spent, and that’s not where the problem is,” says Selix. “The problem is we don’t have the other money that we used to have. That’s why [Prop 63] hasn’t achieved its goals.”\u003c/p>\n\u003cp>According to Selix, Prop. 63 money, about $1 billion per year, was intended to supplement an existing $2 billion state mental health budget. Instead, he says, the recession prompted Sacramento to slash the existing budget almost in half. The new funds from Prop. 63 have barely filled the gap.\u003c/p>\n\u003cp>UCLA psychiatrist Joel Braslow says Prop. 63 averted what would have been an even worse collapse in public mental health. “Most people are not being adequately cared for that have severe mental illness,” said Braslow, a historian of public mental health systems. “What Prop. 63 has done is at least allowed for better care than would have been possible otherwise,” he said.\u003c/p>\n\u003cp>According to Braslow, the feud over Prop. 63 spending misses the point. He says, both sides are correct: better services are needed for severe mental illness -- and for prevention and early intervention strategies. “Actually I think it would be more useful to turn it around and say, ‘Why aren’t we providing more resources?’”\u003c/p>\n\u003cp>The state audit, scheduled to be released next month, may answer some questions about how Prop. 63 funds are being allocated. But Braslow says no matter what it shows, mental illness will remain a neglected social problem until Californians get real about what it costs to adequately care for people who can’t take care of themselves.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201307220850a.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201307220850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How to Better Protect Farmworkers from Pesticides? Bilingual Labels",
"title": "How to Better Protect Farmworkers from Pesticides? Bilingual Labels",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Dan Charles,\u003ca href=\"http://www.npr.org/blogs/thesalt/2013/07/17/203015727/how-to-better-protect-farm-workers-from-pesticides-use-spanish\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13748\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13748\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS407_farmlabor20120427-scr-620x339.jpg\" alt=\"(Sandy Huffaker/Getty Images)\" width=\"620\" height=\"339\">\u003cfigcaption class=\"wp-caption-text\">(Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Advocates for farmworkers, especially those who grow America's leafy greens and fresh vegetables, are \u003ca href=\"http://farmworkerjustice.org/press/new-farmworker-justice-report-profiles-dangers-pesticide-poisoning-offers-recommendations-epa\" target=\"_blank\">pushing\u003c/a> the government to do more to protect those workers from exposure to pesticides.\u003c/p>\n\u003cp>A 20-year-old regulation — the \u003ca href=\"http://www.epa.gov/agriculture/twor.html\" target=\"_blank\">Worker Protection Standard\u003c/a> — is supposed to prevent harmful pesticide exposures on the farm. But activist groups like Farmworker Justice say it falls short, and the Environmental Protection Agency is currently working on a \u003ca href=\"http://yosemite.epa.gov/opei/rulegate.nsf/byRIN/2070-AJ22\">new version\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Pesticides carry warning labels that spell out health risks and how workers should protect themselves — but those labels are usually in English.\u003c/aside>\n\u003cp>A new \u003ca href=\"http://farmworkerjustice.org/sites/default/files/aExposed%20and%20Ignored%20by%20Farmworker%20Justice%20singles%20compressed.pdf\">report\u003c/a> from Farmworker Justice points out that under the current rules, farmworkers don't get nearly as much information about hazardous chemicals they may encounter as, say, factory workers. (Industrial workers are covered by different regulations, issued by the Occupational Safety and Health Administration.)\u003c/p>\n\u003cp>And then there's the barrier of language. Pesticides carry warning labels that spell out health risks and how workers should protect themselves — but those labels are usually in English. More than 80 percent of the workers in the \"salad bowls\" of Salinas, Calif., or Yuma, Ariz., are Hispanic. Many have difficulty communicating in English.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Farmworkers \"are frustrated about their lack of knowledge about these chemicals,\" says Virginia Ruiz, director of Occupational and Environmental Health at Farmworker Justice. Her group, along with many others, submitted formal \u003ca href=\"http://www.regulations.gov/contentStreamer?objectId=0900006480eb5cf5&disposition=attachment&contentType=pdf\">comments\u003c/a> to the EPA arguing that \"without bilingual labeling, today's Spanish-speaking agricultural workforce is at great risk for pesticide exposure.\"\u003c/p>\n\u003cp>Pesticide companies appear to be split on the issue. One industry trade association, Responsible Industry for a Sound Environment, has \u003ca href=\"http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2011-0014-0206\">opposed\u003c/a> bilingual labels, arguing that Spanish translations were unnecessary and would make labels more cumbersome to design. The agricultural chemical company Syngenta, on the other hand, \u003ca href=\"http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2011-0014-0223\">endorsed\u003c/a> the idea.\u003c/p>\n\u003cp>The proposed regulations face a long road before they'd ever take effect. Once the EPA finishes its draft, the document has to go through a review by the White House before it is even released for public comment. It could be years before the regulations are final.\u003c/p>\n\u003cp>In the meantime, though, some activist groups (including Farmworker Justice and Oxfam America\u003c/p>\n\u003cp>) have joined forces with food companies (Costco!) to attack the problem on their own, through a new \u003ca href=\"http://www.equitablefood.net/\">Equitable Food Initiative\u003c/a>. The initiative is based on the idea that giving farmworkers more power, responsibility and money will lead to better, higher-quality food production.\u003c/p>\n\u003cp>The initiative has drawn up standards that (among many other things) are supposed to reduce the use of pesticides and share information — in any language — about how to handle them safely. On each farm, a worker-manager team is responsible for meeting the standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The whole point is to get the team on-site to own this obligation,\" says Peter O'Driscoll, the initiative's project manager, who works with Oxfam America.\u003c/p>\n\n",
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"excerpt": "The Obama administration is counting on Latinos to help make the Affordable Care Act a success, but there may be troubles ahead: Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.\r\n\r\n“Even with the federal grants given out, it does not nearly cover the populations we have to reach and the amount of work we have to do,” says Lori Baptista, director of policy at the Tiburcio Vasquez Health Center Inc. in Hayward, California. The center sees 14,000 patients and clients each year; 78 percent are Latino, and 70 percent do not speak English as a first language.\r\n",
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"description": "The Obama administration is counting on Latinos to help make the Affordable Care Act a success, but there may be troubles ahead: Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.\r\n\r\n“Even with the federal grants given out, it does not nearly cover the populations we have to reach and the amount of work we have to do,” says Lori Baptista, director of policy at the Tiburcio Vasquez Health Center Inc. in Hayward, California. The center sees 14,000 patients and clients each year; 78 percent are Latino, and 70 percent do not speak English as a first language.\r\n",
"title": "How to Better Protect Farmworkers from Pesticides? Bilingual Labels | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Dan Charles,\u003ca href=\"http://www.npr.org/blogs/thesalt/2013/07/17/203015727/how-to-better-protect-farm-workers-from-pesticides-use-spanish\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13748\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13748\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS407_farmlabor20120427-scr-620x339.jpg\" alt=\"(Sandy Huffaker/Getty Images)\" width=\"620\" height=\"339\">\u003cfigcaption class=\"wp-caption-text\">(Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Advocates for farmworkers, especially those who grow America's leafy greens and fresh vegetables, are \u003ca href=\"http://farmworkerjustice.org/press/new-farmworker-justice-report-profiles-dangers-pesticide-poisoning-offers-recommendations-epa\" target=\"_blank\">pushing\u003c/a> the government to do more to protect those workers from exposure to pesticides.\u003c/p>\n\u003cp>A 20-year-old regulation — the \u003ca href=\"http://www.epa.gov/agriculture/twor.html\" target=\"_blank\">Worker Protection Standard\u003c/a> — is supposed to prevent harmful pesticide exposures on the farm. But activist groups like Farmworker Justice say it falls short, and the Environmental Protection Agency is currently working on a \u003ca href=\"http://yosemite.epa.gov/opei/rulegate.nsf/byRIN/2070-AJ22\">new version\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Pesticides carry warning labels that spell out health risks and how workers should protect themselves — but those labels are usually in English.\u003c/aside>\n\u003cp>A new \u003ca href=\"http://farmworkerjustice.org/sites/default/files/aExposed%20and%20Ignored%20by%20Farmworker%20Justice%20singles%20compressed.pdf\">report\u003c/a> from Farmworker Justice points out that under the current rules, farmworkers don't get nearly as much information about hazardous chemicals they may encounter as, say, factory workers. (Industrial workers are covered by different regulations, issued by the Occupational Safety and Health Administration.)\u003c/p>\n\u003cp>And then there's the barrier of language. Pesticides carry warning labels that spell out health risks and how workers should protect themselves — but those labels are usually in English. More than 80 percent of the workers in the \"salad bowls\" of Salinas, Calif., or Yuma, Ariz., are Hispanic. Many have difficulty communicating in English.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Farmworkers \"are frustrated about their lack of knowledge about these chemicals,\" says Virginia Ruiz, director of Occupational and Environmental Health at Farmworker Justice. Her group, along with many others, submitted formal \u003ca href=\"http://www.regulations.gov/contentStreamer?objectId=0900006480eb5cf5&disposition=attachment&contentType=pdf\">comments\u003c/a> to the EPA arguing that \"without bilingual labeling, today's Spanish-speaking agricultural workforce is at great risk for pesticide exposure.\"\u003c/p>\n\u003cp>Pesticide companies appear to be split on the issue. One industry trade association, Responsible Industry for a Sound Environment, has \u003ca href=\"http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2011-0014-0206\">opposed\u003c/a> bilingual labels, arguing that Spanish translations were unnecessary and would make labels more cumbersome to design. The agricultural chemical company Syngenta, on the other hand, \u003ca href=\"http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2011-0014-0223\">endorsed\u003c/a> the idea.\u003c/p>\n\u003cp>The proposed regulations face a long road before they'd ever take effect. Once the EPA finishes its draft, the document has to go through a review by the White House before it is even released for public comment. It could be years before the regulations are final.\u003c/p>\n\u003cp>In the meantime, though, some activist groups (including Farmworker Justice and Oxfam America\u003c/p>\n\u003cp>) have joined forces with food companies (Costco!) to attack the problem on their own, through a new \u003ca href=\"http://www.equitablefood.net/\">Equitable Food Initiative\u003c/a>. The initiative is based on the idea that giving farmworkers more power, responsibility and money will lead to better, higher-quality food production.\u003c/p>\n\u003cp>The initiative has drawn up standards that (among many other things) are supposed to reduce the use of pesticides and share information — in any language — about how to handle them safely. On each farm, a worker-manager team is responsible for meeting the standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The whole point is to get the team on-site to own this obligation,\" says Peter O'Driscoll, the initiative's project manager, who works with Oxfam America.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Where California Stands in Mental Health Needs and Services",
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"content": "\u003cfigure id=\"attachment_13688\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/93587218@N00/25840514/in/photolist-3hru7-3hru5-9aQE1-3hru6-3hrNZ-2Y453-3hrNX-3hs7T-3hs7P-3hs7R-3hrP1-3hrNY-3hs7Q-3hrP3-3hrP2-3hs7S-3hs7U-3hsmb-3hsm9-3hsma-8s3Xb5-66oLS7-7HCMm-mMfbc-5RunBD-bVCerP-2PW8Wr-2Q1AKw-2Q1Ayq-2PWb7v-2Q1zgQ-2PWa2x-2PW9CR-2Q1Aif-2Q1AQC-2Q1BjG-2Q1B2G-2Q1AuA-2Q1zLh-2PWb2M-2PW9yn-2PW9n6-2Q1AqN-2PWajV-2Q1A4d-2PW9gB-2Q1B7Y-2PW9QZ-2PW9bg-2PWaSi-2PW96V\">\u003cimg class=\"size-large wp-image-13688\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/Fresno-620x368.jpg\" alt=\"The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)\" width=\"620\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Two new assessments released Wednesday gave an overview of mental health in California – from suicide rates to access to care to the supply of mental health professionals.\u003c/p>\n\u003cp>While there are bright spots, they provide a pretty sobering view. The first, \u003ca href=\"http://www.chcf.org/publications/2013/07/mental-health-california\" target=\"_blank\">Mental Health Care in California: Painting A Picture\u003c/a>, details that nearly 1 in 6 adults in the state has \"a mental health need\" and 1 in 20 has a serious mental illness. The rate in children is even higher: 1 in 13.\u003c/p>\n\u003cp>And too many people are not getting treatment. According to the analysis, half of adults and two-thirds of adolescents with a mental heath illness do not receive treatment. A big contributing factor is likely the state of the mental health workforce in California which is quantified in both the first report and \u003ca href=\"http://www.chcf.org/publications/2013/07/complex-case-mental-health\" target=\"_blank\">the second\u003c/a>. Both analyses are from the California HealthCare Foundation. They describe a varied and fragmented delivery and financing system in the state.\u003c/p>\n\u003cp>Steve Schilling knows the issue all too well. He's CEO of Clinica Sierra Vista which has multiple health centers in southern San Joaquin Valley. He said \"scarcity\" would be a better word than \"variation\" when it came to describing mental health services. In the CHCF analysis, the San Joaquin Valley fell well below a state average for all mental health professions. The Inland Empire also fared poorly. \"I really think we have a non-system of behavioral health in California,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>California has a layer-upon-layer system of mental health funding that can vary dramatically according to what county you live in, or where you seek care. This year's state budget brought \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/06/11/budget-deal-restores-some-health-programs-while-slashing-others/\" target=\"_blank\">a ray of good news\u003c/a> with a boost of $140 million in funds. But county funding has long been determined by an arcane formula. CHCF's researchers noted that \"(w)hile no current analysis comparing county's total per capital mental health program revenues and expenditures is publicly available, it is widely assumed that the amounts vary greatly between counties.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Then there's federal funds. Because Clinica Sierra Vista is a federally-qualified health center, or FQHC, it is constrained by federal rules as to who can provide services. This is an issue because California's mental health workforce has a different composition from that of the U.S. as a whole. In particular, California has more Marriage and Family Therapists, or MFTs, than the U.S. But, in general, MFTs are barred from billing Medi-Cal or Medicare, so, essentially, barred from serving those patients.\u003c/p>\n\u003cp>These reports come at a critical time -- as the state is preparing for the full implementation of the federal health law on Jan. 1 and the tens -- or hundreds -- of thousands of newly insured people seeking access to care.\u003c/p>\n\u003cp>\"The challenge is going to be ... do we have the manpower and the capacity within the system to meet everyone's needs,\" said Dr. Neal Adams with the California Institute for Mental Health, one of the co-authors of the Painting a Picture study.\u003c/p>\n\u003cp>A big uncertainty, Adams noted, is \u003ca href=\"http://www.samhsa.gov/healthreform/parity/\" target=\"_blank\">a 2008 law\u003c/a> requiring parity between mental health services and medical/surgical services. While the law specifically covered group health plans only, the Centers for Medicare and Medicaid Services (CMS) has yet to issue regulations to put the law into effect. The Affordable Care Act and the benefits package in Covered California, the health care marketplace being set up by the state to comply with the ACA, both mention parity. But, \"absent guidelines,\" Adams says, \"I'm worried there will be continued problems with access.\"\u003c/p>\n\u003cp>He pointed out that Proposition 63, passed by the voters in 2004, was intended to provide state funding to community-based mental health services. But while revenue from this so-called \"millionaires' tax\" -- since it created a 1 percent tax on personal income in excess of $1 million -- has flowed, alternative state funding to mental health services was cut in the wake of the economic downturn.\u003c/p>\n\u003cp>Still, the upcoming expansion of insurance under the ACA -- both through the new marketplace and the expansion of Medi-Cal will bring new dollars to health care overall. Adams is optimistic that \"we're going to see more people come into the system with benefits and better ability to pay for services.\"\u003c/p>\n\u003cp>While Rusty Selix, executive director of California Council of Community Mental Health Agencies, argued that better outpatient mental health programs are sorely needed, the ACA's new funding should make a difference.\u003c/p>\n\u003cp>\"Mental health has always been under-funded,\" he observed. Under Obamacare, \"there will be funding.\"\u003c/p>\n\u003cp>Learn More:\u003c/p>\n\u003cp>\u003ca href=\"http://www.kqed.org/a/forum/R201307170930\" target=\"_blank\">\u003cstrong>Higher Mental Illness Rates Among Low-Income Californians\u003c/strong>\u003c/a> (KQED Forum):\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Two new assessments released Wednesday gave an overview of mental health in California – from suicide rates to access to care to the supply mental health professionals. \r\n\r\nWhile there are bright spots, they provide a pretty sobering view. The first, Mental Health Care in California: Painting A Picture, details that nearly 1 in 6 adults in the state has \"a mental health need\" and 1 in 20 has a serious mental illness. The rate in children is even higher: 1 in 13.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13688\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/93587218@N00/25840514/in/photolist-3hru7-3hru5-9aQE1-3hru6-3hrNZ-2Y453-3hrNX-3hs7T-3hs7P-3hs7R-3hrP1-3hrNY-3hs7Q-3hrP3-3hrP2-3hs7S-3hs7U-3hsmb-3hsm9-3hsma-8s3Xb5-66oLS7-7HCMm-mMfbc-5RunBD-bVCerP-2PW8Wr-2Q1AKw-2Q1Ayq-2PWb7v-2Q1zgQ-2PWa2x-2PW9CR-2Q1Aif-2Q1AQC-2Q1BjG-2Q1B2G-2Q1AuA-2Q1zLh-2PWb2M-2PW9yn-2PW9n6-2Q1AqN-2PWajV-2Q1A4d-2PW9gB-2Q1B7Y-2PW9QZ-2PW9bg-2PWaSi-2PW96V\">\u003cimg class=\"size-large wp-image-13688\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/Fresno-620x368.jpg\" alt=\"The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)\" width=\"620\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The San Joaquin Valley has rates of mental health professionals far below state average. (Melissa Wiese/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Two new assessments released Wednesday gave an overview of mental health in California – from suicide rates to access to care to the supply of mental health professionals.\u003c/p>\n\u003cp>While there are bright spots, they provide a pretty sobering view. The first, \u003ca href=\"http://www.chcf.org/publications/2013/07/mental-health-california\" target=\"_blank\">Mental Health Care in California: Painting A Picture\u003c/a>, details that nearly 1 in 6 adults in the state has \"a mental health need\" and 1 in 20 has a serious mental illness. The rate in children is even higher: 1 in 13.\u003c/p>\n\u003cp>And too many people are not getting treatment. According to the analysis, half of adults and two-thirds of adolescents with a mental heath illness do not receive treatment. A big contributing factor is likely the state of the mental health workforce in California which is quantified in both the first report and \u003ca href=\"http://www.chcf.org/publications/2013/07/complex-case-mental-health\" target=\"_blank\">the second\u003c/a>. Both analyses are from the California HealthCare Foundation. They describe a varied and fragmented delivery and financing system in the state.\u003c/p>\n\u003cp>Steve Schilling knows the issue all too well. He's CEO of Clinica Sierra Vista which has multiple health centers in southern San Joaquin Valley. He said \"scarcity\" would be a better word than \"variation\" when it came to describing mental health services. In the CHCF analysis, the San Joaquin Valley fell well below a state average for all mental health professions. The Inland Empire also fared poorly. \"I really think we have a non-system of behavioral health in California,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>California has a layer-upon-layer system of mental health funding that can vary dramatically according to what county you live in, or where you seek care. This year's state budget brought \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/06/11/budget-deal-restores-some-health-programs-while-slashing-others/\" target=\"_blank\">a ray of good news\u003c/a> with a boost of $140 million in funds. But county funding has long been determined by an arcane formula. CHCF's researchers noted that \"(w)hile no current analysis comparing county's total per capital mental health program revenues and expenditures is publicly available, it is widely assumed that the amounts vary greatly between counties.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Then there's federal funds. Because Clinica Sierra Vista is a federally-qualified health center, or FQHC, it is constrained by federal rules as to who can provide services. This is an issue because California's mental health workforce has a different composition from that of the U.S. as a whole. In particular, California has more Marriage and Family Therapists, or MFTs, than the U.S. But, in general, MFTs are barred from billing Medi-Cal or Medicare, so, essentially, barred from serving those patients.\u003c/p>\n\u003cp>These reports come at a critical time -- as the state is preparing for the full implementation of the federal health law on Jan. 1 and the tens -- or hundreds -- of thousands of newly insured people seeking access to care.\u003c/p>\n\u003cp>\"The challenge is going to be ... do we have the manpower and the capacity within the system to meet everyone's needs,\" said Dr. Neal Adams with the California Institute for Mental Health, one of the co-authors of the Painting a Picture study.\u003c/p>\n\u003cp>A big uncertainty, Adams noted, is \u003ca href=\"http://www.samhsa.gov/healthreform/parity/\" target=\"_blank\">a 2008 law\u003c/a> requiring parity between mental health services and medical/surgical services. While the law specifically covered group health plans only, the Centers for Medicare and Medicaid Services (CMS) has yet to issue regulations to put the law into effect. The Affordable Care Act and the benefits package in Covered California, the health care marketplace being set up by the state to comply with the ACA, both mention parity. But, \"absent guidelines,\" Adams says, \"I'm worried there will be continued problems with access.\"\u003c/p>\n\u003cp>He pointed out that Proposition 63, passed by the voters in 2004, was intended to provide state funding to community-based mental health services. But while revenue from this so-called \"millionaires' tax\" -- since it created a 1 percent tax on personal income in excess of $1 million -- has flowed, alternative state funding to mental health services was cut in the wake of the economic downturn.\u003c/p>\n\u003cp>Still, the upcoming expansion of insurance under the ACA -- both through the new marketplace and the expansion of Medi-Cal will bring new dollars to health care overall. Adams is optimistic that \"we're going to see more people come into the system with benefits and better ability to pay for services.\"\u003c/p>\n\u003cp>While Rusty Selix, executive director of California Council of Community Mental Health Agencies, argued that better outpatient mental health programs are sorely needed, the ACA's new funding should make a difference.\u003c/p>\n\u003cp>\"Mental health has always been under-funded,\" he observed. Under Obamacare, \"there will be funding.\"\u003c/p>\n\u003cp>Learn More:\u003c/p>\n\u003cp>\u003ca href=\"http://www.kqed.org/a/forum/R201307170930\" target=\"_blank\">\u003cstrong>Higher Mental Illness Rates Among Low-Income Californians\u003c/strong>\u003c/a> (KQED Forum):\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drink Up: Schools Must Provide More Water During Meals",
"title": "Drink Up: Schools Must Provide More Water During Meals",
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"content": "\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong> \u003ca href=\"http://www.edsource.org/today/2013/drink-up-schools-required-to-expand-water-service-during-meals/34876#.UeADaxbKaSA\" target=\"_blank\">EdSource Today\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13644\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-13644\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/Fort-Bragg-HS-water-station-300x254.jpg\" alt=\"A student fills a reusable water bottle at a hydration station at Fort Bragg High School. (Jennifer McClendon/Network for a Healthy California)\" width=\"300\" height=\"254\">\u003cfigcaption class=\"wp-caption-text\">Hydration stations like this one at Fort Bragg High School are popular with students. (Jennifer McClendon/Network for a Healthy California)\u003c/figcaption>\u003c/figure>\n\u003cp>Let them drink water.\u003c/p>\n\u003cp>That’s the message of a new federal regulation that requires schools to expand free water service for students at meals, beginning this September.\u003c/p>\n\u003cp>As a drink with zero calories, low cost and near-ubiquitous availability, water would seem an obvious choice for a school beverage, given the epidemic of obesity among California children. But making drinking water available in cafeterias has been a challenge for some schools, despite state and federal laws requiring that they do so at lunch. This new \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_interimfinal.pdf\" target=\"_blank\">regulation\u003c/a>, from the U.S. Department of Agriculture, for the first time requires free drinking water at breakfast -- and is the latest legal prod in the effort to bring water instead of sugary drinks into the mouths of students.\u003c/p>\n\u003cp>“This regulation is one more push toward raising awareness,” said Karla Hampton, co-author of the 2012 \u003ca href=\"http://waterinschools.org/pdfs/FulfillingThePromiseOfFreeWater2012.pdf\" target=\"_blank\">policy brief\u003c/a> “Fulfilling the Promise of Free Water in K-12 Schools,” produced by researchers at UCSF and two advocacy groups.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next step, she acknowledged, is to persuade reluctant students to give tap water a chance. “When it’s not just coming out of a dirty old fountain, when you have ice cubes, water containers and clean water in schools, they like it,” she said.\u003c/p>\n\u003cp>\u003cstrong>Dry campuses\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>Meeting the legal requirement could be as simple as providing pitchers of water and cups in the cafeteria, or as advanced as installing high-tech “hydration stations” that provide chilled, filtered water, as several school districts have already done.\u003c/p>\n\u003cp>Still, one in four California schools surveyed in 2011 did not provide free, clean water to students in places where food was served, according to a UCSF \u003ca href=\"http://waterinschools.org/pdfs/Patel_2011_EncouragingWaterInSchoolsAndChildCareSettings.pdf\" target=\"_blank\">study\u003c/a>. School staff cited a number of causes, including lack of awareness of legislation, a dearth of functional water fountains, and concern about the cost of making water available in cafeterias.\u003c/p>\n\u003cp>“It’s a challenge,” Hampton said. “Someone is coming in telling you to change your routine. ‘How much is this going to cost? Where do we get these hydration stations?’”\u003c/p>\n\u003cp>Recent \u003ca href=\"http://www.leginfo.ca.gov/pub/09-10/bill/sen/sb_1401-1450/sb_1413_bill_20100930_chaptered.html\" target=\"_blank\">state\u003c/a> and \u003ca href=\"http://www.gpo.gov/fdsys/pkg/PLAW-111publ296/pdf/PLAW-111publ296.pdf\" target=\"_blank\">federal\u003c/a> laws require schools to provide free drinking water where lunch is served. But the state law does not include enforcement mechanisms to make sure campuses comply. The federal law requires the California Department of Education to audit districts –- but not every school. Starting this year, audits will be conducted once every three years, up from every five years.\u003c/p>\n\u003cp>“It’s really in the hands of school districts, schools, teachers, parents and students” to prod schools to provide water at meal service, said Quang Dang, senior attorney at ChangeLab Solutions. Free, fresh water at meals is just a start, he said. “There could be stronger regulations to make water available to kids throughout the school day.”\u003c/p>\n\u003cp>Cafeteria beverages have included milk and juice offered at free or reduced price through the National School Lunch Program, with soda and sports drinks available for sale in vending machines. Those high-calorie sugary drinks will be eliminated from school vending machines by 2014-15, according to the new U.S.D.A. regulations, and advocates hope the change will spur schools to make cold water an appealing option for students.\u003c/p>\n\u003cp>\u003cstrong>Confusion, concern\u003c/strong>\u003c/p>\n\u003cp>Yet the question of how to provide free drinking water in cafeterias has generated concern and confusion in some districts, starting with the role of the school water fountain, said Dr. Anisha Patel, UCSF pediatrics professor and an expert on water in California schools. Because water fountains have long been the sole source of drinking water for students, some administrators believed fountains would come under scrutiny, a disheartening prospect in schools that struggle with aging plumbing infrastructure and cutbacks in custodial service. In a 2009 \u003ca href=\"http://www.waterinschools.org/pdfs/waterwoes.pdf\" target=\"_blank\">survey\u003c/a> of students in 23 schools, 70 percent said that the water fountains at their school looked “disgusting” and dispensed water that looked “gross,” according to the nonprofit Northcoast Nutrition and Fitness Collaborative. But improving water fountains is not the focus of the laws, unless they are located in cafeterias, and most of them are not.\u003c/p>\n\u003cp>Some school staff were also under the erroneous impression that the National School Lunch Program, which encourages children to drink milk, prohibited offering free drinking water next to milk.\u003c/p>\n\u003cdiv>\n\u003cp>And then there’s the lurking question in some districts of whether \u003ca href=\"http://water.epa.gov/drink/local/ca.cfm\" target=\"_blank\">tap water is safe\u003c/a>. Elevated lead levels were found in drinking water at some schools in Los Angeles during a 2008 \u003ca href=\"http://www.nbclosangeles.com/School_Water_Investigation.html\" target=\"_blank\">investigation\u003c/a>, and schools in the Central Valley struggle with water supplies contaminated with nitrates and arsenic.\u003c/p>\n\u003c/div>\n\u003cp>The Roseville City School District is an example of a straightforward approach to providing water in cafeterias. “We just put an Igloo (water dispenser) out there and some cups and put home-type filters on faucets to take out the minerals,” said Rene Yamashiro, food service director for the district and legislative chair for the California School Nutrition Association.\u003c/p>\n\u003ch4>Cold and ‘cool’\u003c/h4>\n\u003cp>Schools in Eureka, Del Norte and Mendocino counties have taken a marketing approach, working to entice students by providing spiffy water stations that attach to the wall and dispense jets of cold water into reusable water bottles. “The latest and greatest thing that everybody wants is a hydration station,” said Tarney Sheldon, with the Ukiah-based North Coast Opportunities.\u003c/p>\n\u003cp dir=\"ltr\">The sleek hydration stations, or at least clean water fountains, when coupled with basic information about the health and environmental benefits of drinking water, encourage students to drink more water, said Jennifer McClendon, of Network for a Healthy California, part of the state Department of Public Health. In a June survey of 1,500 students in Humboldt, Mendocino, Sonoma and Del Norte counties McClendon found that students drank more tap water, and felt more positively about tap water, in schools that had improved the way water was delivered, compared to students at schools that had made no improvements to their water delivery systems. (Complete survey data have not yet been released.)\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp dir=\"ltr\">“By updating the drinking fountains, schools are making the water cool in temperature, but also ‘cool,’” McClendon said. “They are changing the perception that drinking fountains are dirty and gross. Now they’re new and innovative.”\u003c/p>\n\n",
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"excerpt": "Let them drink water.\r\n\r\nThat’s the message of a new federal regulation that requires schools to expand free water service for students at meals, beginning this September.\r\n\r\nAs a drink with zero calories, low cost and near-ubiquitous availability, water would seem an obvious choice for a school beverage, given the epidemic of obesity among California children. But making drinking water available in cafeterias has been a challenge for some schools, despite state and federal laws requiring that they do so at lunch. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong> \u003ca href=\"http://www.edsource.org/today/2013/drink-up-schools-required-to-expand-water-service-during-meals/34876#.UeADaxbKaSA\" target=\"_blank\">EdSource Today\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13644\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-13644\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/Fort-Bragg-HS-water-station-300x254.jpg\" alt=\"A student fills a reusable water bottle at a hydration station at Fort Bragg High School. (Jennifer McClendon/Network for a Healthy California)\" width=\"300\" height=\"254\">\u003cfigcaption class=\"wp-caption-text\">Hydration stations like this one at Fort Bragg High School are popular with students. (Jennifer McClendon/Network for a Healthy California)\u003c/figcaption>\u003c/figure>\n\u003cp>Let them drink water.\u003c/p>\n\u003cp>That’s the message of a new federal regulation that requires schools to expand free water service for students at meals, beginning this September.\u003c/p>\n\u003cp>As a drink with zero calories, low cost and near-ubiquitous availability, water would seem an obvious choice for a school beverage, given the epidemic of obesity among California children. But making drinking water available in cafeterias has been a challenge for some schools, despite state and federal laws requiring that they do so at lunch. This new \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_interimfinal.pdf\" target=\"_blank\">regulation\u003c/a>, from the U.S. Department of Agriculture, for the first time requires free drinking water at breakfast -- and is the latest legal prod in the effort to bring water instead of sugary drinks into the mouths of students.\u003c/p>\n\u003cp>“This regulation is one more push toward raising awareness,” said Karla Hampton, co-author of the 2012 \u003ca href=\"http://waterinschools.org/pdfs/FulfillingThePromiseOfFreeWater2012.pdf\" target=\"_blank\">policy brief\u003c/a> “Fulfilling the Promise of Free Water in K-12 Schools,” produced by researchers at UCSF and two advocacy groups.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next step, she acknowledged, is to persuade reluctant students to give tap water a chance. “When it’s not just coming out of a dirty old fountain, when you have ice cubes, water containers and clean water in schools, they like it,” she said.\u003c/p>\n\u003cp>\u003cstrong>Dry campuses\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>Meeting the legal requirement could be as simple as providing pitchers of water and cups in the cafeteria, or as advanced as installing high-tech “hydration stations” that provide chilled, filtered water, as several school districts have already done.\u003c/p>\n\u003cp>Still, one in four California schools surveyed in 2011 did not provide free, clean water to students in places where food was served, according to a UCSF \u003ca href=\"http://waterinschools.org/pdfs/Patel_2011_EncouragingWaterInSchoolsAndChildCareSettings.pdf\" target=\"_blank\">study\u003c/a>. School staff cited a number of causes, including lack of awareness of legislation, a dearth of functional water fountains, and concern about the cost of making water available in cafeterias.\u003c/p>\n\u003cp>“It’s a challenge,” Hampton said. “Someone is coming in telling you to change your routine. ‘How much is this going to cost? Where do we get these hydration stations?’”\u003c/p>\n\u003cp>Recent \u003ca href=\"http://www.leginfo.ca.gov/pub/09-10/bill/sen/sb_1401-1450/sb_1413_bill_20100930_chaptered.html\" target=\"_blank\">state\u003c/a> and \u003ca href=\"http://www.gpo.gov/fdsys/pkg/PLAW-111publ296/pdf/PLAW-111publ296.pdf\" target=\"_blank\">federal\u003c/a> laws require schools to provide free drinking water where lunch is served. But the state law does not include enforcement mechanisms to make sure campuses comply. The federal law requires the California Department of Education to audit districts –- but not every school. Starting this year, audits will be conducted once every three years, up from every five years.\u003c/p>\n\u003cp>“It’s really in the hands of school districts, schools, teachers, parents and students” to prod schools to provide water at meal service, said Quang Dang, senior attorney at ChangeLab Solutions. Free, fresh water at meals is just a start, he said. “There could be stronger regulations to make water available to kids throughout the school day.”\u003c/p>\n\u003cp>Cafeteria beverages have included milk and juice offered at free or reduced price through the National School Lunch Program, with soda and sports drinks available for sale in vending machines. Those high-calorie sugary drinks will be eliminated from school vending machines by 2014-15, according to the new U.S.D.A. regulations, and advocates hope the change will spur schools to make cold water an appealing option for students.\u003c/p>\n\u003cp>\u003cstrong>Confusion, concern\u003c/strong>\u003c/p>\n\u003cp>Yet the question of how to provide free drinking water in cafeterias has generated concern and confusion in some districts, starting with the role of the school water fountain, said Dr. Anisha Patel, UCSF pediatrics professor and an expert on water in California schools. Because water fountains have long been the sole source of drinking water for students, some administrators believed fountains would come under scrutiny, a disheartening prospect in schools that struggle with aging plumbing infrastructure and cutbacks in custodial service. In a 2009 \u003ca href=\"http://www.waterinschools.org/pdfs/waterwoes.pdf\" target=\"_blank\">survey\u003c/a> of students in 23 schools, 70 percent said that the water fountains at their school looked “disgusting” and dispensed water that looked “gross,” according to the nonprofit Northcoast Nutrition and Fitness Collaborative. But improving water fountains is not the focus of the laws, unless they are located in cafeterias, and most of them are not.\u003c/p>\n\u003cp>Some school staff were also under the erroneous impression that the National School Lunch Program, which encourages children to drink milk, prohibited offering free drinking water next to milk.\u003c/p>\n\u003cdiv>\n\u003cp>And then there’s the lurking question in some districts of whether \u003ca href=\"http://water.epa.gov/drink/local/ca.cfm\" target=\"_blank\">tap water is safe\u003c/a>. Elevated lead levels were found in drinking water at some schools in Los Angeles during a 2008 \u003ca href=\"http://www.nbclosangeles.com/School_Water_Investigation.html\" target=\"_blank\">investigation\u003c/a>, and schools in the Central Valley struggle with water supplies contaminated with nitrates and arsenic.\u003c/p>\n\u003c/div>\n\u003cp>The Roseville City School District is an example of a straightforward approach to providing water in cafeterias. “We just put an Igloo (water dispenser) out there and some cups and put home-type filters on faucets to take out the minerals,” said Rene Yamashiro, food service director for the district and legislative chair for the California School Nutrition Association.\u003c/p>\n\u003ch4>Cold and ‘cool’\u003c/h4>\n\u003cp>Schools in Eureka, Del Norte and Mendocino counties have taken a marketing approach, working to entice students by providing spiffy water stations that attach to the wall and dispense jets of cold water into reusable water bottles. “The latest and greatest thing that everybody wants is a hydration station,” said Tarney Sheldon, with the Ukiah-based North Coast Opportunities.\u003c/p>\n\u003cp dir=\"ltr\">The sleek hydration stations, or at least clean water fountains, when coupled with basic information about the health and environmental benefits of drinking water, encourage students to drink more water, said Jennifer McClendon, of Network for a Healthy California, part of the state Department of Public Health. In a June survey of 1,500 students in Humboldt, Mendocino, Sonoma and Del Norte counties McClendon found that students drank more tap water, and felt more positively about tap water, in schools that had improved the way water was delivered, compared to students at schools that had made no improvements to their water delivery systems. (Complete survey data have not yet been released.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp dir=\"ltr\">“By updating the drinking fountains, schools are making the water cool in temperature, but also ‘cool,’” McClendon said. “They are changing the perception that drinking fountains are dirty and gross. Now they’re new and innovative.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Elaine Korry, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13585\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-13585\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/ops-shield-1-300x169.jpg\" alt=\"(Monica Lam/Center for Investigative Reporting)\" width=\"300\" height=\"169\">\u003cfigcaption class=\"wp-caption-text\">(Monica Lam/Center for Investigative Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>A state audit has found widespread safety problems at five residential centers for people with severe developmental disorders. It documents years of failures by the state Office of Protective Services, which is charged with resident safety at the centers.\u003c/p>\n\u003cp>The 76-page audit was requested by lawmakers following allegations of sexual molestation and physical assaults that had gone unpunished by the Office of Protective Services. OPS is the in-house oversight agency of the state Department of Developmental Services, which cares for 1,700 people with cerebral palsy, mental retardation and severe autism. In a telephone conference call, disability rights advocate Greg deGiere said the audit vindicates years of media investigations and family complaints.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We're talking about serial rapes, torture with tasers, at least one apparent homicide.\"\u003c/aside>\n\u003cp>\"This audit is a scathing, devastating indictment of the state's mismanagement of the developmental center residents' safety,\" said disability rights advocate Greg deGiere in a conference call. \"Both the Department of Developmental Services and the Department of Public Health have failed to do their jobs and still are failing to do them adequately.\"\u003c!--more-->\u003c/p>\n\u003cp>The auditors cited poor quality investigations, outdated reporting policies and high staff turnover which had put residents' safety at risk. The audit focused on 48 incidents of alleged abuse, and found failures of oversight in every case. \"We're talking about serial rapes, torture with tasers, at least one apparent homicide,\" deGiere said. \"This is serious stuff, people who are locked away in these places.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>State lawmakers demanded the audit last year after a \u003ca href=\"http://californiawatch.org/broken-shield\" target=\"_blank\">series of reports\u003c/a> from KQED and the Center for Investigative Reporting. As CIR \u003ca href=\"http://cironline.org/reports/california-auditor-developmental-center-police-failed-protect-patients-4954\" target=\"_blank\">reported Tuesday\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>CIR, through its California Watch project, detailed that dozens of women were sexually assaulted inside state centers, but police investigators didn’t order “rape kits” to collect evidence, a standard law enforcement tool. Police waited so long to investigate one sexual assault that the staff janitor accused of rape fled the country. The police force’s inaction also allowed abusive caregivers to continue molesting patients – even after the department had evidence that could have stopped future assaults.\u003c/p>\n\u003cp>The Office of Protective Services’ records indicate the force sent 82 patient abuse cases to district attorneys for possible prosecution. However, auditors determined much of the data on the entire caseload was \"not sufficiently reliable for the purposes of this audit” to verify that number.\u003c/p>\u003c/blockquote>\n\u003cp>The Office of Protective Services blamed understaffing and excessive overtime for the lapses documented by the auditor. It accepted all the recommendations for faster, more thorough reporting of safety incidents in the future.\u003c/p>\n\u003cp>\u003cstrong>Learn more: \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.californiareport.org/archive/R201202241630/b\" target=\"_blank\">Suspicious Deaths Unsolved at Developmental Centers\u003c/a> (The California Report)\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Elaine Korry, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13585\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-13585\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/ops-shield-1-300x169.jpg\" alt=\"(Monica Lam/Center for Investigative Reporting)\" width=\"300\" height=\"169\">\u003cfigcaption class=\"wp-caption-text\">(Monica Lam/Center for Investigative Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>A state audit has found widespread safety problems at five residential centers for people with severe developmental disorders. It documents years of failures by the state Office of Protective Services, which is charged with resident safety at the centers.\u003c/p>\n\u003cp>The 76-page audit was requested by lawmakers following allegations of sexual molestation and physical assaults that had gone unpunished by the Office of Protective Services. OPS is the in-house oversight agency of the state Department of Developmental Services, which cares for 1,700 people with cerebral palsy, mental retardation and severe autism. In a telephone conference call, disability rights advocate Greg deGiere said the audit vindicates years of media investigations and family complaints.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We're talking about serial rapes, torture with tasers, at least one apparent homicide.\"\u003c/aside>\n\u003cp>\"This audit is a scathing, devastating indictment of the state's mismanagement of the developmental center residents' safety,\" said disability rights advocate Greg deGiere in a conference call. \"Both the Department of Developmental Services and the Department of Public Health have failed to do their jobs and still are failing to do them adequately.\"\u003c!--more-->\u003c/p>\n\u003cp>The auditors cited poor quality investigations, outdated reporting policies and high staff turnover which had put residents' safety at risk. The audit focused on 48 incidents of alleged abuse, and found failures of oversight in every case. \"We're talking about serial rapes, torture with tasers, at least one apparent homicide,\" deGiere said. \"This is serious stuff, people who are locked away in these places.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>State lawmakers demanded the audit last year after a \u003ca href=\"http://californiawatch.org/broken-shield\" target=\"_blank\">series of reports\u003c/a> from KQED and the Center for Investigative Reporting. As CIR \u003ca href=\"http://cironline.org/reports/california-auditor-developmental-center-police-failed-protect-patients-4954\" target=\"_blank\">reported Tuesday\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>CIR, through its California Watch project, detailed that dozens of women were sexually assaulted inside state centers, but police investigators didn’t order “rape kits” to collect evidence, a standard law enforcement tool. Police waited so long to investigate one sexual assault that the staff janitor accused of rape fled the country. The police force’s inaction also allowed abusive caregivers to continue molesting patients – even after the department had evidence that could have stopped future assaults.\u003c/p>\n\u003cp>The Office of Protective Services’ records indicate the force sent 82 patient abuse cases to district attorneys for possible prosecution. However, auditors determined much of the data on the entire caseload was \"not sufficiently reliable for the purposes of this audit” to verify that number.\u003c/p>\u003c/blockquote>\n\u003cp>The Office of Protective Services blamed understaffing and excessive overtime for the lapses documented by the auditor. It accepted all the recommendations for faster, more thorough reporting of safety incidents in the future.\u003c/p>\n\u003cp>\u003cstrong>Learn more: \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.californiareport.org/archive/R201202241630/b\" target=\"_blank\">Suspicious Deaths Unsolved at Developmental Centers\u003c/a> (The California Report)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Scott Detrow\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13518\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/36918612@N00/2638175536/in/photolist-528kF7-2BqCz-5xsQnV-htkC8-9X5QWJ-eapkfY-eaiFrX-eaiF82-eapkrQ-eapkmj-6wdGPC-6W8eqC-4ZYayq-4ZTWEi-4ZTWAD-4ZU7G6-esgBZN-7x1gPw-6sjgMg-7fxKc-bP7DHt-noicq-8efdEi-8eitv5-8eiw3w-8eixnY-8efg1F-8effUR-8efbTX-8efef6-8efe74-8efgY4-axp3Ak-6CY8hF-8fJsfT-4Yggbv-59tQdA-bADdAX-5ceuVw-6zhqMV-an5Cxz-6bA1MG-8izUrc-LDZw-7cvjq-qb2jy-ayMr98-cVwRrj-9peHfY-7oV2q8-9LbLum\">\u003cimg class=\"size-large wp-image-13518\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/2638175536_3065ca2b22_b-620x412.jpg\" alt=\"These dogs appear to meet the state standard. (Bettnet/Flickr)\" width=\"620\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">These dogs appear to meet the bill's standard. (Bettnet/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>July 4 is a pretty big day for patriotism, parades and, yes, hot dogs. All across the country, people are grilling them, boiling them -- even scarfing them down in \u003ca href=\"http://www.nathansfamous.com/index.php/hot-dog-eating-contest\" target=\"_blank\">competitive eating contests\u003c/a>.\u003c/p>\n\u003cp>But what, exactly, makes a hot dog a hot dog? California legislators are seeking to define it. To see how that idea is playing in the field, I headed over to Dave’s Dogs, a cart that's a couple blocks from the state Capitol in Sacramento.\u003c/p>\n\u003cp>Vendor Amy Frey typically sells 30 to 50 dogs a day. “I have sweet relish, red caramelized onions, raw onions, sauerkraut and jalapeno peppers,” Frey said. “Ketchup, mustard, mayonnaise. Lots of mustard choices.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"... frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst ...\" -- AB 1252\u003c/aside>\n\u003cp>\"But what’s below all those toppings? The Legislature, via \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1251-1300/ab_1252_bill_20130222_introduced.htm\" target=\"_blank\">a bill\u003c/a> that passed the Assembly earlier this year and is now in a Senate committee, has a pretty specific definition: “a whole, cured, cooked sausage that is skinless or stuffed in casing, that may be known as a frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst, and that may be served in a bun or roll.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“That sounds about right,” said Frey after hearing the legislative definition. “That’s pretty much what we do. So they want to tell us we are what we are.”\u003c!--more-->\u003c/p>\n\u003cp>To be fair, the hot dog definition is just three lines in the midst of a larger omnibus bill filled with relatively minor technical changes to California’s food codes. A group representing local health inspectors, the California Conference of Directors of Environmental Health, is pushing for the definition. The whole point, they say, is to define hot dogs as precooked or cured so that street vendors who reheat them are held to different health standards than restaurants.\u003c/p>\n\u003cp>“We have been finding that local jurisdictions have somewhat confused the issue,” explained CCDEH executive director Justin Malan. “If true hot dogs are fully cooked or cured, they can be reheated or cooked on those rollers.” Raw sausages like bratwurst, on the other hand, would still be held to a higher sanitary standard. Malan conceded “there’s some sort of joking around the issue,” but said the hot dog definition would move California toward a national model for health code standards.\u003c/p>\n\u003cp>Dave’s Dogs customers aren’t so sure about all the alternate names in the bill, though. “I used to live around Chicago, so (I’ve heard of) Vienna beef,\" said a customer named Robin, who only gave her first name. \"But we always called them hot dogs. That was just it.”\u003c/p>\n\u003cp>Sean Foley wasn’t quite sure how to define a hot dog. “A hot dog to me is not a sausage, but an Oscar-Meyer-wiener-type of thing. That’s always been a hot dog to me.” As for the nine other names in the Assembly definition? “If a hot dog is encompassing that, that, to me, is morphing on the name,” he said.\u003c/p>\n\u003cp>Amy Frey thought it over, and said nobody ever asks her for anything but a \"hot dog.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“None of the above,” she said. “But I did have a guy who used to drive by and yell, ‘Hi, Weenie Lady!’ at me.\"\u003c/p>\n\n",
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"excerpt": "If you’re hungry for a hot dog in Sacramento, head to Dave’s Dogs, a cart a couple blocks from the state capitol. Vendor Amy Frey typically sells 30 to 50 dogs a day. “I have sweet relish, red caramelized onions, raw onions, sauerkraut, and jalapeno peppers,” Frey said. “Ketchup, mustard, mayonnaise. Lots of mustard choices.”\r\n\r\nBut what’s below all those toppings? What makes a hot dog a hot dog? A bill that passed the Assembly earlier this year, AB 1252, has a pretty specific definition: “a whole, cured, cooked sausage that is skinless or stuffed in casing, that may be known as a frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst, and that may be served in a bun or roll.\" ",
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"description": "If you’re hungry for a hot dog in Sacramento, head to Dave’s Dogs, a cart a couple blocks from the state capitol. Vendor Amy Frey typically sells 30 to 50 dogs a day. “I have sweet relish, red caramelized onions, raw onions, sauerkraut, and jalapeno peppers,” Frey said. “Ketchup, mustard, mayonnaise. Lots of mustard choices.”\r\n\r\nBut what’s below all those toppings? What makes a hot dog a hot dog? A bill that passed the Assembly earlier this year, AB 1252, has a pretty specific definition: “a whole, cured, cooked sausage that is skinless or stuffed in casing, that may be known as a frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst, and that may be served in a bun or roll." ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Scott Detrow\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_13518\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/36918612@N00/2638175536/in/photolist-528kF7-2BqCz-5xsQnV-htkC8-9X5QWJ-eapkfY-eaiFrX-eaiF82-eapkrQ-eapkmj-6wdGPC-6W8eqC-4ZYayq-4ZTWEi-4ZTWAD-4ZU7G6-esgBZN-7x1gPw-6sjgMg-7fxKc-bP7DHt-noicq-8efdEi-8eitv5-8eiw3w-8eixnY-8efg1F-8effUR-8efbTX-8efef6-8efe74-8efgY4-axp3Ak-6CY8hF-8fJsfT-4Yggbv-59tQdA-bADdAX-5ceuVw-6zhqMV-an5Cxz-6bA1MG-8izUrc-LDZw-7cvjq-qb2jy-ayMr98-cVwRrj-9peHfY-7oV2q8-9LbLum\">\u003cimg class=\"size-large wp-image-13518\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/2638175536_3065ca2b22_b-620x412.jpg\" alt=\"These dogs appear to meet the state standard. (Bettnet/Flickr)\" width=\"620\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">These dogs appear to meet the bill's standard. (Bettnet/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>July 4 is a pretty big day for patriotism, parades and, yes, hot dogs. All across the country, people are grilling them, boiling them -- even scarfing them down in \u003ca href=\"http://www.nathansfamous.com/index.php/hot-dog-eating-contest\" target=\"_blank\">competitive eating contests\u003c/a>.\u003c/p>\n\u003cp>But what, exactly, makes a hot dog a hot dog? California legislators are seeking to define it. To see how that idea is playing in the field, I headed over to Dave’s Dogs, a cart that's a couple blocks from the state Capitol in Sacramento.\u003c/p>\n\u003cp>Vendor Amy Frey typically sells 30 to 50 dogs a day. “I have sweet relish, red caramelized onions, raw onions, sauerkraut and jalapeno peppers,” Frey said. “Ketchup, mustard, mayonnaise. Lots of mustard choices.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"... frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst ...\" -- AB 1252\u003c/aside>\n\u003cp>\"But what’s below all those toppings? The Legislature, via \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/asm/ab_1251-1300/ab_1252_bill_20130222_introduced.htm\" target=\"_blank\">a bill\u003c/a> that passed the Assembly earlier this year and is now in a Senate committee, has a pretty specific definition: “a whole, cured, cooked sausage that is skinless or stuffed in casing, that may be known as a frankfurter, frank, furter, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst, and that may be served in a bun or roll.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That sounds about right,” said Frey after hearing the legislative definition. “That’s pretty much what we do. So they want to tell us we are what we are.”\u003c!--more-->\u003c/p>\n\u003cp>To be fair, the hot dog definition is just three lines in the midst of a larger omnibus bill filled with relatively minor technical changes to California’s food codes. A group representing local health inspectors, the California Conference of Directors of Environmental Health, is pushing for the definition. The whole point, they say, is to define hot dogs as precooked or cured so that street vendors who reheat them are held to different health standards than restaurants.\u003c/p>\n\u003cp>“We have been finding that local jurisdictions have somewhat confused the issue,” explained CCDEH executive director Justin Malan. “If true hot dogs are fully cooked or cured, they can be reheated or cooked on those rollers.” Raw sausages like bratwurst, on the other hand, would still be held to a higher sanitary standard. Malan conceded “there’s some sort of joking around the issue,” but said the hot dog definition would move California toward a national model for health code standards.\u003c/p>\n\u003cp>Dave’s Dogs customers aren’t so sure about all the alternate names in the bill, though. “I used to live around Chicago, so (I’ve heard of) Vienna beef,\" said a customer named Robin, who only gave her first name. \"But we always called them hot dogs. That was just it.”\u003c/p>\n\u003cp>Sean Foley wasn’t quite sure how to define a hot dog. “A hot dog to me is not a sausage, but an Oscar-Meyer-wiener-type of thing. That’s always been a hot dog to me.” As for the nine other names in the Assembly definition? “If a hot dog is encompassing that, that, to me, is morphing on the name,” he said.\u003c/p>\n\u003cp>Amy Frey thought it over, and said nobody ever asks her for anything but a \"hot dog.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“None of the above,” she said. “But I did have a guy who used to drive by and yell, ‘Hi, Weenie Lady!’ at me.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State to Transfer Inmates from Prisons Plagued by Valley Fever",
"title": "State to Transfer Inmates from Prisons Plagued by Valley Fever",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>By Julie Small, KPCC\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12470\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-300x200.jpg\" alt=\"Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\" width=\"300\" height=\"200\">\u003cfigcaption class=\"wp-caption-text\">Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Two Central Valley prisons are plagued with Valley Fever, and now California officials have agreed to transfer thousands of inmates. The action comes a week after a federal court moved to enforce a new prison medical policy. That policy bars the state from housing inmates who are susceptible to the fungal disease in the prisons where Valley Fever is most prevalent.\u003c/p>\n\u003cp>Joyce Hayhoe, a spokeswoman for the federal receiver in charge of prison medical care, says Pleasant Valley and Avenal State prisons in the Central Valley are the prison system’s hotspots. “The overwhelming majority of cases of people coming down with Valley Fever originate from those two facilities,\" Hayhoe said.\u003c/p>\n\u003cp>Eighteen inmates have died from Valley Fever in the last many months, and hundreds more have suffered from its flu-like symptoms.\u003c/p>\n\u003cp>Earlier this year the federal receiver directed the state to transfer more than 2,500 inmates at the two prisons who are known to be susceptible to the disease. Those susceptible include medically high-risk inmates, such as people undergoing chemotherapy, and all African-American and Filipino prisoners. “The whole point of our directive was to prevent serious illness and death,” Hayhoe said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The receiver issued his directive in April, a few months after court experts concluded in a report that prison officials’ efforts to control the spread of Valley Fever by treating the soil on prison grounds had failed.\u003c/p>\n\u003cp>But it took a federal court order in June to get California’s Department of Corrections and Rehabilitation to comply.\u003c/p>\n\u003cp>This move come against the backdrop of a second federal court order to reduce the prison population by 10,000 inmates by the end of the year. As part of that effort, the Corrections Department is preparing to begin transfers of 1,700 acutely ill inmates to a new prison medical facility that has just opened in Stockton. At the opening ceremony last week, Corrections Secretary Jeff Beard said having to orchestrate thousands more transfers at the same time, “makes the situation extremely complex.”\u003c/p>\n\u003cp>Beard said the receiver’s medical directive forces him to shift thousands of inmates into other facilities that don’t necessarily have room. Beard emphasized a need to be \"careful and thoughtful\" about next steps \"because the last thing we want to do is to destabilize other institutions and then cause other problems.”\u003c/p>\n\u003cp>The Department has already transferred 560 of the highest risk inmates from Avenal and Pleasant Valley prisons since Jan. 1.\u003c/p>\n\u003cp>Beard said it would be more prudent to wait to hear from experts at the federal Centers for Disease Control who toured the facilities a month ago -- before moving thousands more inmates.\u003c/p>\n\u003cp>Valley Fever is a fungal infection also called Coccidioidomycosis that can cause flu-like symptoms. It is not contagious. People contract it by inhaling airborne spores dislodged from the soil. California’s Central Valley has the highest rates of the disease in the state while the rate inside Pleasant Valley and Avenal prisons is even higher.\u003c/p>\n\u003cp>According to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/valley-fever-cases-skyrocketing-says-cdc/\" target=\"_blank\">a CDC report in March\u003c/a>, Valley Fever cases are skyrocketing. Between 1998 and 2011 more than 110,000 cases were reported and about a third of those cases were in California.\u003c/p>\n\u003cp>California prisons officials have been grappling with Valley Fever since 2006. That's when California’s Department of Health Care Services found that inmates with compromised immune systems were especially vulnerable. They also found that certain racial groups are more susceptible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Corrections Department had previously restricted inmates who suffer from severe HIV infections from the two prisons and barred inmates with chronic lung diseases that require the use of oxygen tanks.\u003c/p>\n\n",
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"excerpt": "California officials agreed to transfer thousands of inmates from two Central Valley prisons plagued with Valley Fever. The move comes a week after a federal court moved to enforce a new prison medical policy that bars the state from housing inmates who are susceptible to the fungal disease in the prisons where it’s most prevalent.\r\n\r\nJoyce Hayhoe, a spokeswoman for the federal receiver in charge of prison medical care says Pleasant Valley and Avenal State prisons in the Central Valley are the prisons system’s hotspots:",
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"description": "California officials agreed to transfer thousands of inmates from two Central Valley prisons plagued with Valley Fever. The move comes a week after a federal court moved to enforce a new prison medical policy that bars the state from housing inmates who are susceptible to the fungal disease in the prisons where it’s most prevalent.\r\n\r\nJoyce Hayhoe, a spokeswoman for the federal receiver in charge of prison medical care says Pleasant Valley and Avenal State prisons in the Central Valley are the prisons system’s hotspots:",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Julie Small, KPCC\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12470\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-12470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-300x200.jpg\" alt=\"Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\" width=\"300\" height=\"200\">\u003cfigcaption class=\"wp-caption-text\">Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Two Central Valley prisons are plagued with Valley Fever, and now California officials have agreed to transfer thousands of inmates. The action comes a week after a federal court moved to enforce a new prison medical policy. That policy bars the state from housing inmates who are susceptible to the fungal disease in the prisons where Valley Fever is most prevalent.\u003c/p>\n\u003cp>Joyce Hayhoe, a spokeswoman for the federal receiver in charge of prison medical care, says Pleasant Valley and Avenal State prisons in the Central Valley are the prison system’s hotspots. “The overwhelming majority of cases of people coming down with Valley Fever originate from those two facilities,\" Hayhoe said.\u003c/p>\n\u003cp>Eighteen inmates have died from Valley Fever in the last many months, and hundreds more have suffered from its flu-like symptoms.\u003c/p>\n\u003cp>Earlier this year the federal receiver directed the state to transfer more than 2,500 inmates at the two prisons who are known to be susceptible to the disease. Those susceptible include medically high-risk inmates, such as people undergoing chemotherapy, and all African-American and Filipino prisoners. “The whole point of our directive was to prevent serious illness and death,” Hayhoe 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>The receiver issued his directive in April, a few months after court experts concluded in a report that prison officials’ efforts to control the spread of Valley Fever by treating the soil on prison grounds had failed.\u003c/p>\n\u003cp>But it took a federal court order in June to get California’s Department of Corrections and Rehabilitation to comply.\u003c/p>\n\u003cp>This move come against the backdrop of a second federal court order to reduce the prison population by 10,000 inmates by the end of the year. As part of that effort, the Corrections Department is preparing to begin transfers of 1,700 acutely ill inmates to a new prison medical facility that has just opened in Stockton. At the opening ceremony last week, Corrections Secretary Jeff Beard said having to orchestrate thousands more transfers at the same time, “makes the situation extremely complex.”\u003c/p>\n\u003cp>Beard said the receiver’s medical directive forces him to shift thousands of inmates into other facilities that don’t necessarily have room. Beard emphasized a need to be \"careful and thoughtful\" about next steps \"because the last thing we want to do is to destabilize other institutions and then cause other problems.”\u003c/p>\n\u003cp>The Department has already transferred 560 of the highest risk inmates from Avenal and Pleasant Valley prisons since Jan. 1.\u003c/p>\n\u003cp>Beard said it would be more prudent to wait to hear from experts at the federal Centers for Disease Control who toured the facilities a month ago -- before moving thousands more inmates.\u003c/p>\n\u003cp>Valley Fever is a fungal infection also called Coccidioidomycosis that can cause flu-like symptoms. It is not contagious. People contract it by inhaling airborne spores dislodged from the soil. California’s Central Valley has the highest rates of the disease in the state while the rate inside Pleasant Valley and Avenal prisons is even higher.\u003c/p>\n\u003cp>According to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/valley-fever-cases-skyrocketing-says-cdc/\" target=\"_blank\">a CDC report in March\u003c/a>, Valley Fever cases are skyrocketing. Between 1998 and 2011 more than 110,000 cases were reported and about a third of those cases were in California.\u003c/p>\n\u003cp>California prisons officials have been grappling with Valley Fever since 2006. That's when California’s Department of Health Care Services found that inmates with compromised immune systems were especially vulnerable. They also found that certain racial groups are more susceptible.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Corrections Department had previously restricted inmates who suffer from severe HIV infections from the two prisons and barred inmates with chronic lung diseases that require the use of oxygen tanks.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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