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"disqusTitle": "California's Tobacco Tax: Campaign Funds For & Against Prop. 29",
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"content": "\u003cfigure id=\"attachment_6321\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/cigarette.jpg\">\u003cimg class=\"size-medium wp-image-6321\" title=\"If Proposition 29 passes the taxes on a pack of cigarettes would rise to $1.87. (Flickr/Fried Dough)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/cigarette-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If Proposition 29 passes the taxes on a pack of cigarettes would rise to $1.87. (Flickr/Fried Dough)\u003c/figcaption>\u003c/figure>\n\u003cp>Voters in California are deciding today whether to \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">boost the sales tax on a pack of cigarettes\u003c/a> by a dollar.\u003c/p>\n\u003cp>Many bucks have been poured into the campaign from both sides. Still \u003ca href=\"http://maplight.org/california/proposition/2012/june/prop-29/funding\" target=\"_blank\">these graphics\u003c/a> from the nonprofit \u003ca href=\"http://maplight.org/\" target=\"_blank\">MapLight.org\u003c/a> (drawing on data from \u003ca href=\"http://cal-access.sos.ca.gov/Campaign/Measures/Detail.aspx?id=1324462&session=2011\" target=\"_blank\">the California Secretary of State\u003c/a>) suggest the contributions have been a bit lopsided.\u003c/p>\n\u003cp>Those supporting the tax - including New York Mayor Michael Bloomberg and Laurene Powell Jobs - have gathered up $12.3 million:\u003c/p>\n\u003cfigure id=\"attachment_6316\" class=\"wp-caption aligncenter\" style=\"max-width: 470px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Yes-on-Prop-29.png\">\u003cimg class=\"size-full wp-image-6316\" title=\"Funding for Yes on Prop 29 (Maplight.org)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Yes-on-Prop-29.png\" alt=\"\" width=\"470\" height=\"502\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29.png 470w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29-400x427.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29-320x342.png 320w\" sizes=\"(max-width: 470px) 100vw, 470px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Funding for Yes on Prop 29 (MapLight.org)\u003c/figcaption>\u003c/figure>\n\u003cp>Those fighting the tax rounded up a smokin' $46.8 million:\u003c/p>\n\u003cfigure id=\"attachment_6317\" class=\"wp-caption aligncenter\" style=\"max-width: 465px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/No-on-Prop-29.png\">\u003cimg class=\"size-full wp-image-6317\" title=\"Funding for No on Prop 29 (MapLight.org)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/No-on-Prop-29.png\" alt=\"\" width=\"465\" height=\"502\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29.png 465w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29-400x432.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29-320x345.png 320w\" sizes=\"(max-width: 465px) 100vw, 465px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Funding for No on Prop 29 (MapLight.org)\u003c/figcaption>\u003c/figure>\n\u003cp>This morning \u003ca href=\"http://www.forbes.com/sites/kerryadolan/2012/06/05/billionaires-including-mike-bloomberg-vs-big-tobacco-in-california-ballot-measure-to-boost-cigarette-tax/\" target=\"_blank\">Forbes distilled the issue to Billionaries V. Big Tobacco\u003c/a>, and gave some background on the backers from both side.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>\u003ca href=\"http://www.ocregister.com/news/percent-357151-poll-voters.html%20\" target=\"_blank\">Two recent polls \u003c/a>reported that the tax measure was leading with a slight margin .\u003c/p>\n\u003cp>Bloomberg, who is worth \u003ca href=\"http://www.forbes.com/profile/michael-bloomberg/%20\" target=\"_blank\">$22 billion\u003c/a>, has developed the reputation of a nanny mayor, after \u003ca href=\"http://www.forbes.com/sites/calebmelby/2012/05/31/before-the-ban-on-sugary-drinks-7-other-controversial-mayor-bloomberg-initiatives/%20\" target=\"_blank\">banning smoking in public places in New York City \u003c/a>in February 2011 and banning trans-fats in 2006. Last week the mayor took some heat for a proposal to ban the sale of large-sized sugary drinks.\u003c/p>\n\u003cp>Both Bloomberg and Jacobs, worth \u003ca href=\"http://www.forbes.com/profile/irwin-jacobs/%20\" target=\"_blank\">$1.4 billion as of March\u003c/a> this year, have signed on to Bill Gates’ and Warren Buffett’s Giving Pledge, in which the very wealthy agree to give away at least half their fortunes. In his letter explaining why he signed the pledge, Bloomberg singles out anti-tobacco issues as an area of interest: “For instance, with private funding, we can prevent tens of millions of premature deaths caused by tobacco-related diseases and traffic accidents -just two areas where my foundation has been active.”\u003c/p>\n\u003cp>What’s fascinating is the national involvement in this state ballot measure. As Kelly Phillips Erb \u003ca href=\"http://www.forbes.com/sites/kellyphillipserb/2012/06/02/california-cigarette-tax-battle-attracts-money-and-attention-from-big-tobacco-bloomberg-and-armstrong/\" target=\"_blank\">points out\u003c/a>, California is a such a huge state that with its 40 million people, it ranks as one of the largest markets for cigarettes.\u003c/p>\u003c/blockquote>\n\u003cp>Sarah Varney \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/21/proposition-29-first-cigarette-tax-increase-in-13-years-yes-or-no/\" target=\"_blank\">wrote on this blog \u003c/a>that it would be the first tax hike on cigarettes in the state in 13 years:\u003c/p>\n\u003cblockquote>\u003cp>California voters are schizophrenic when it comes to regulating smoking. Polls show broad support for bans on smoking on sidewalks and public parks. Some cities have even outlawed smoking in apartment buildings.\u003c/p>\n\u003cp>But in 2006, the state’s voters rejected a ballot measure to hike cigarette taxes. While California was once the most aggressive state in taxing cigarettes, the tax rate here is lower than that of 32 other states. At 87 cents a pack, California’s cigarette taxes are 60 cents lower than the national average.\u003c/p>\n\u003cp>Proposition 29 — on the ballot June 5 — would change that. It would raise the tax on cigarettes to almost $2 a pack.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Here's \u003ca href=\"http://blogs.kqed.org/lowdown/2012/05/25/whosmokes/#more-2169\">more information about who smokes in the state of California\u003c/a> at KQED's News Ed Project \u003ca href=\"http://blogs.kqed.org/lowdown/\">The Lowdown\u003c/a>.\u003c/p>\n\n",
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"description": "Voters in California are deciding today whether to boost the sales tax on a pack of cigarettes by a dollar. Many bucks have been poured into the campaign from both sides. Still these graphics from the nonprofit MapLight.org (drawing on data from the California Secretary of State) suggest the contributions have been a bit lopsided.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6321\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/cigarette.jpg\">\u003cimg class=\"size-medium wp-image-6321\" title=\"If Proposition 29 passes the taxes on a pack of cigarettes would rise to $1.87. (Flickr/Fried Dough)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/cigarette-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If Proposition 29 passes the taxes on a pack of cigarettes would rise to $1.87. (Flickr/Fried Dough)\u003c/figcaption>\u003c/figure>\n\u003cp>Voters in California are deciding today whether to \u003ca href=\"http://www.sos.ca.gov/elections/ballot-measures/qualified-ballot-measures.htm\" target=\"_blank\">boost the sales tax on a pack of cigarettes\u003c/a> by a dollar.\u003c/p>\n\u003cp>Many bucks have been poured into the campaign from both sides. Still \u003ca href=\"http://maplight.org/california/proposition/2012/june/prop-29/funding\" target=\"_blank\">these graphics\u003c/a> from the nonprofit \u003ca href=\"http://maplight.org/\" target=\"_blank\">MapLight.org\u003c/a> (drawing on data from \u003ca href=\"http://cal-access.sos.ca.gov/Campaign/Measures/Detail.aspx?id=1324462&session=2011\" target=\"_blank\">the California Secretary of State\u003c/a>) suggest the contributions have been a bit lopsided.\u003c/p>\n\u003cp>Those supporting the tax - including New York Mayor Michael Bloomberg and Laurene Powell Jobs - have gathered up $12.3 million:\u003c/p>\n\u003cfigure id=\"attachment_6316\" class=\"wp-caption aligncenter\" style=\"max-width: 470px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Yes-on-Prop-29.png\">\u003cimg class=\"size-full wp-image-6316\" title=\"Funding for Yes on Prop 29 (Maplight.org)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Yes-on-Prop-29.png\" alt=\"\" width=\"470\" height=\"502\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29.png 470w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29-400x427.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/Yes-on-Prop-29-320x342.png 320w\" sizes=\"(max-width: 470px) 100vw, 470px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Funding for Yes on Prop 29 (MapLight.org)\u003c/figcaption>\u003c/figure>\n\u003cp>Those fighting the tax rounded up a smokin' $46.8 million:\u003c/p>\n\u003cfigure id=\"attachment_6317\" class=\"wp-caption aligncenter\" style=\"max-width: 465px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/No-on-Prop-29.png\">\u003cimg class=\"size-full wp-image-6317\" title=\"Funding for No on Prop 29 (MapLight.org)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/No-on-Prop-29.png\" alt=\"\" width=\"465\" height=\"502\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29.png 465w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29-400x432.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/No-on-Prop-29-320x345.png 320w\" sizes=\"(max-width: 465px) 100vw, 465px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Funding for No on Prop 29 (MapLight.org)\u003c/figcaption>\u003c/figure>\n\u003cp>This morning \u003ca href=\"http://www.forbes.com/sites/kerryadolan/2012/06/05/billionaires-including-mike-bloomberg-vs-big-tobacco-in-california-ballot-measure-to-boost-cigarette-tax/\" target=\"_blank\">Forbes distilled the issue to Billionaries V. Big Tobacco\u003c/a>, and gave some background on the backers from both side.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>\u003ca href=\"http://www.ocregister.com/news/percent-357151-poll-voters.html%20\" target=\"_blank\">Two recent polls \u003c/a>reported that the tax measure was leading with a slight margin .\u003c/p>\n\u003cp>Bloomberg, who is worth \u003ca href=\"http://www.forbes.com/profile/michael-bloomberg/%20\" target=\"_blank\">$22 billion\u003c/a>, has developed the reputation of a nanny mayor, after \u003ca href=\"http://www.forbes.com/sites/calebmelby/2012/05/31/before-the-ban-on-sugary-drinks-7-other-controversial-mayor-bloomberg-initiatives/%20\" target=\"_blank\">banning smoking in public places in New York City \u003c/a>in February 2011 and banning trans-fats in 2006. Last week the mayor took some heat for a proposal to ban the sale of large-sized sugary drinks.\u003c/p>\n\u003cp>Both Bloomberg and Jacobs, worth \u003ca href=\"http://www.forbes.com/profile/irwin-jacobs/%20\" target=\"_blank\">$1.4 billion as of March\u003c/a> this year, have signed on to Bill Gates’ and Warren Buffett’s Giving Pledge, in which the very wealthy agree to give away at least half their fortunes. In his letter explaining why he signed the pledge, Bloomberg singles out anti-tobacco issues as an area of interest: “For instance, with private funding, we can prevent tens of millions of premature deaths caused by tobacco-related diseases and traffic accidents -just two areas where my foundation has been active.”\u003c/p>\n\u003cp>What’s fascinating is the national involvement in this state ballot measure. As Kelly Phillips Erb \u003ca href=\"http://www.forbes.com/sites/kellyphillipserb/2012/06/02/california-cigarette-tax-battle-attracts-money-and-attention-from-big-tobacco-bloomberg-and-armstrong/\" target=\"_blank\">points out\u003c/a>, California is a such a huge state that with its 40 million people, it ranks as one of the largest markets for cigarettes.\u003c/p>\u003c/blockquote>\n\u003cp>Sarah Varney \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/21/proposition-29-first-cigarette-tax-increase-in-13-years-yes-or-no/\" target=\"_blank\">wrote on this blog \u003c/a>that it would be the first tax hike on cigarettes in the state in 13 years:\u003c/p>\n\u003cblockquote>\u003cp>California voters are schizophrenic when it comes to regulating smoking. Polls show broad support for bans on smoking on sidewalks and public parks. Some cities have even outlawed smoking in apartment buildings.\u003c/p>\n\u003cp>But in 2006, the state’s voters rejected a ballot measure to hike cigarette taxes. While California was once the most aggressive state in taxing cigarettes, the tax rate here is lower than that of 32 other states. At 87 cents a pack, California’s cigarette taxes are 60 cents lower than the national average.\u003c/p>\n\u003cp>Proposition 29 — on the ballot June 5 — would change that. It would raise the tax on cigarettes to almost $2 a pack.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Here's \u003ca href=\"http://blogs.kqed.org/lowdown/2012/05/25/whosmokes/#more-2169\">more information about who smokes in the state of California\u003c/a> at KQED's News Ed Project \u003ca href=\"http://blogs.kqed.org/lowdown/\">The Lowdown\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "One in Ten California Veterans are Uninsured",
"title": "One in Ten California Veterans are Uninsured",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_6305\" class=\"wp-caption alignleft\" style=\"max-width: 190px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/vet.jpg\">\u003cimg class=\"size-full wp-image-6305\" title=\"One in ten California veterans lack health insurance. (Robert Wood Johnson Foundation)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/vet.jpg\" alt=\"\" width=\"190\" height=\"152\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">One in ten California veterans lack health insurance. (Robert Wood Johnson Foundation)\u003c/figcaption>\u003c/figure>\n\u003cp>Ten percent of California veterans don't have health insurance or don't use \u003ca href=\"http://www.va.gov/\">Veterans Affairs\u003c/a> (V.A.) care. That's just slightly below the 10.3 percent rate among veterans around the country.\u003c/p>\n\u003cp>That's according to a \u003ca href=\"http://www.rwjf.org/coverage/product.jsp?id=74428\">report\u003c/a> by the \u003ca href=\"http://www.urban.org/\">Urban Institute\u003c/a>. Co-author\u003ca href=\"http://www.urban.org/expert.cfm?ID=JenniferMHaley\"> Jennifer Haley\u003c/a> says there are 108,000 uninsured vets in the state, second only to the number in Texas.\u003c/p>\n\u003cp>\"In our study someone is uninsured if they don’t have any of the types of insurance coverage you’d think of for general population and they also don’t report using V.A. care,\" says Haley.\u003c/p>\n\u003cp>Haley used data from the \u003ca href=\"http://www.census.gov/acs/www/about_the_survey/american_community_survey/\">2010 American Community Survey\u003c/a> to look at the rates among non-elderly vets, ages 19-64. She says disproportionate numbers of the uninsured were also unemployed and unmarried.\u003c!--more-->\u003c/p>\n\u003cp>All of them reported big gaps in accessing health services compared to their insured counterparts. 41.2 percent of the uninsured reported unmet medical needs in the past 12 months as opposed to 12.7 percent of vets with insurance. And 33.7 percent of vets without health insurance said they were delaying care due to cost, compared to 8.4 percent of those with insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.swords-to-plowshares.org/about/staff-and-board/\">Amy Fairweather\u003c/a> director of policy with the San Francisco veterans advocacy group \u003ca href=\"http://www.swords-to-plowshares.org/\">Swords to Plowshares\u003c/a> says people often incorrectly assume that veterans automatically have health insurance through the V.A.\u003c/p>\n\u003cp>“They have to prove eligibility,\" she says. Certain service distinctions automatically qualify you, she says, as does having a service connected illness. There is also a poverty means test, and certain treatments require co-pays.\u003c/p>\n\u003cp>Fairweather says because veterans are overrepresented in the homeless population in San Francisco \"it comes as no surprise that there are so many veterans who are completely uninsured... except for the really community based system of care which is overburdened and can’t meet everyones needs.”\u003c/p>\n\u003cp>Still, she is quick to point out that for \u003ca href=\"http://www.blogs.va.gov/VAntage/586/busting-myths-about-va-health-care/\">those who do have access\u003c/a> in Northern California, the VA hospitals are excellent and are often connected with first class teaching hospitals.\u003c/p>\n\u003cp>\"They’re very good with PTSD,\" Fairweather says. \"They’re very good with Agent Orange for older veterans, because that’s been their area of expertise. They obviously have to catch up with women and some other things.\"\u003c/p>\n\u003cp>But she says it can be difficult to get in the door. Fairweather says the \u003ca href=\"http://www.benefits.va.gov/oakland/\">Oakland Veterans Benefit Administration\u003c/a>, which determines eligibility has 34,000 claims backlogged.\u003c/p>\n\u003cp>\"Claims are taking a year to two years for the initial walk through,\" she says. \"A lot of the initial decisions are appealable so that takes going through the system again.\"\u003c/p>\n\u003cp>But the Urban Institute report did find that in California - and around the country - veterans are uninsured at lower rates than the general population. Among the non-elderly, \u003ca href=\"http://aspe.hhs.gov/health/reports/2011/CPSHealthIns2011/ib.shtml\">about 18 percent of the general population was without insurance in 2010\u003c/a>.\u003c/p>\n\u003cp>As with \u003ca href=\"http://en.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States\">the general figure\u003c/a>, where veterans live does seems to play a role in insurance status. The report found uninsurance rates among veterans fluctuated across states, from 4.3 percent in Massachusetts to 17.3 percent in Montana.\u003c/p>\n\u003cp>The Urban Institute's Jennifer Haley says they were interested in what caused the state variation, and tried controlling for factors like differences in veterans' incomes.\u003c/p>\n\u003cp>\"But even when we controlled for that, the state differences didn’t go away,\" she says. \"It could be due of Medicaid enrollment differences or other state policy differences but we didn’t look in depth at that.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was funded by the \u003ca href=\"http://www.rwjf.org/\">Robert Wood Johnson Foundation\u003c/a>.\u003c/p>\n\n",
"disqusIdentifier": "6292 http://blogs.kqed.org/stateofhealth/?p=6292",
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"description": "Ten percent of California veterans don't have health insurance or don't use Veterans Affairs (V.A.) care. That's just slightly below the 10.3 percent rate among veterans around the country. That's according to a report by the Urban Institute. Co-author Jennifer Haley says there are 108,000 uninsured vets in the state, second only to the number",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6305\" class=\"wp-caption alignleft\" style=\"max-width: 190px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/vet.jpg\">\u003cimg class=\"size-full wp-image-6305\" title=\"One in ten California veterans lack health insurance. (Robert Wood Johnson Foundation)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/vet.jpg\" alt=\"\" width=\"190\" height=\"152\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">One in ten California veterans lack health insurance. (Robert Wood Johnson Foundation)\u003c/figcaption>\u003c/figure>\n\u003cp>Ten percent of California veterans don't have health insurance or don't use \u003ca href=\"http://www.va.gov/\">Veterans Affairs\u003c/a> (V.A.) care. That's just slightly below the 10.3 percent rate among veterans around the country.\u003c/p>\n\u003cp>That's according to a \u003ca href=\"http://www.rwjf.org/coverage/product.jsp?id=74428\">report\u003c/a> by the \u003ca href=\"http://www.urban.org/\">Urban Institute\u003c/a>. Co-author\u003ca href=\"http://www.urban.org/expert.cfm?ID=JenniferMHaley\"> Jennifer Haley\u003c/a> says there are 108,000 uninsured vets in the state, second only to the number in Texas.\u003c/p>\n\u003cp>\"In our study someone is uninsured if they don’t have any of the types of insurance coverage you’d think of for general population and they also don’t report using V.A. care,\" says Haley.\u003c/p>\n\u003cp>Haley used data from the \u003ca href=\"http://www.census.gov/acs/www/about_the_survey/american_community_survey/\">2010 American Community Survey\u003c/a> to look at the rates among non-elderly vets, ages 19-64. She says disproportionate numbers of the uninsured were also unemployed and unmarried.\u003c!--more-->\u003c/p>\n\u003cp>All of them reported big gaps in accessing health services compared to their insured counterparts. 41.2 percent of the uninsured reported unmet medical needs in the past 12 months as opposed to 12.7 percent of vets with insurance. And 33.7 percent of vets without health insurance said they were delaying care due to cost, compared to 8.4 percent of those with insurance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.swords-to-plowshares.org/about/staff-and-board/\">Amy Fairweather\u003c/a> director of policy with the San Francisco veterans advocacy group \u003ca href=\"http://www.swords-to-plowshares.org/\">Swords to Plowshares\u003c/a> says people often incorrectly assume that veterans automatically have health insurance through the V.A.\u003c/p>\n\u003cp>“They have to prove eligibility,\" she says. Certain service distinctions automatically qualify you, she says, as does having a service connected illness. There is also a poverty means test, and certain treatments require co-pays.\u003c/p>\n\u003cp>Fairweather says because veterans are overrepresented in the homeless population in San Francisco \"it comes as no surprise that there are so many veterans who are completely uninsured... except for the really community based system of care which is overburdened and can’t meet everyones needs.”\u003c/p>\n\u003cp>Still, she is quick to point out that for \u003ca href=\"http://www.blogs.va.gov/VAntage/586/busting-myths-about-va-health-care/\">those who do have access\u003c/a> in Northern California, the VA hospitals are excellent and are often connected with first class teaching hospitals.\u003c/p>\n\u003cp>\"They’re very good with PTSD,\" Fairweather says. \"They’re very good with Agent Orange for older veterans, because that’s been their area of expertise. They obviously have to catch up with women and some other things.\"\u003c/p>\n\u003cp>But she says it can be difficult to get in the door. Fairweather says the \u003ca href=\"http://www.benefits.va.gov/oakland/\">Oakland Veterans Benefit Administration\u003c/a>, which determines eligibility has 34,000 claims backlogged.\u003c/p>\n\u003cp>\"Claims are taking a year to two years for the initial walk through,\" she says. \"A lot of the initial decisions are appealable so that takes going through the system again.\"\u003c/p>\n\u003cp>But the Urban Institute report did find that in California - and around the country - veterans are uninsured at lower rates than the general population. Among the non-elderly, \u003ca href=\"http://aspe.hhs.gov/health/reports/2011/CPSHealthIns2011/ib.shtml\">about 18 percent of the general population was without insurance in 2010\u003c/a>.\u003c/p>\n\u003cp>As with \u003ca href=\"http://en.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States\">the general figure\u003c/a>, where veterans live does seems to play a role in insurance status. The report found uninsurance rates among veterans fluctuated across states, from 4.3 percent in Massachusetts to 17.3 percent in Montana.\u003c/p>\n\u003cp>The Urban Institute's Jennifer Haley says they were interested in what caused the state variation, and tried controlling for factors like differences in veterans' incomes.\u003c/p>\n\u003cp>\"But even when we controlled for that, the state differences didn’t go away,\" she says. \"It could be due of Medicaid enrollment differences or other state policy differences but we didn’t look in depth at that.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was funded by the \u003ca href=\"http://www.rwjf.org/\">Robert Wood Johnson Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "As Patients' Records Go Digital, Theft And Hacking Problems Grow ",
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"content": "\u003cp>By \u003ca href=\"http://www.kaiserhealthnews.org/\">David Schultz, Kaiser Health News\u003c/a>\u003c/p>\n\u003cdiv>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/hackhack.jpg\">\u003cimg class=\"alignleft size-full wp-image-6313\" title=\"California has had three of the ten most significant health data breaches since 2009. (Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/hackhack.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/a>As more doctors and hospitals go digital with medical records, the size and frequency of data breaches are alarming privacy advocates and public health officials.\u003c/p>\n\u003cp>Three of the ten largest health data breaches have occurred in California. The \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\">U.S. Department of Health and Human Resources\u003c/a> started tracking the break-ins in 2009.\u003c/p>\n\u003cp>Keeping records secure is a challenge that doctors, public health officials and federal regulators are just beginning to grasp. And, as two recent incidents at Howard University Hospital show, inadequate data security can affect huge numbers of people.\u003c!--more-->\u003c/p>\n\u003cp>On May 14, federal prosecutors \u003ca href=\"http://dl.dropbox.com/u/37285095/Napper%20Information.pdf\" target=\"_blank\">charged\u003c/a> one of the hospital's medical technicians with violating the Health Insurance Portability and Accountability Act, or HIPAA. Prosecutors say that over a 17-month period Laurie Napper used her position at the hospital to gain access to patients' names, addresses and Medicare numbers in order to sell their information. A plea hearing has been set for June 12; Napper's attorney declined comment.\u003c/p>\n\u003cp>Just a few weeks earlier, the hospital \u003ca href=\"http://huhealthcare.com/healthcare/hospital/data-breach/FAQ\" target=\"_blank\">notified\u003c/a> more than 34,000 patients that their medical data had been compromised. A contractor working with the hospital had downloaded the patients' files onto a personal laptop, which was stolen from the contractor's car. The data on the laptop was password-protected but unencrypted, which means anyone who guessed the password could have accessed the patient files without a randomly generated key. According to a hospital press release, those files included names, addresses, and Social Security numbers -- and, in a few cases, \"diagnosis-related information.\"\u003c/p>\n\u003cp>Ronald J. Harris, Howard University's top spokesman, said in an e-mail that the two incidents are unrelated, but declined to answer further questions. In its press release about the stolen laptop, the hospital said it will set new requirements for all laptops used by contractors and those issued to hospital personnel to help protect data.\u003c/p>\n\u003cp>Still it could have been worse. Much worse.\u003c/p>\n\u003cp>Just days after Howard University contacted its patients about the stolen laptop, the Utah Department of Health \u003ca href=\"http://www.health.utah.gov/databreach/\" target=\"_blank\">announced\u003c/a> that hackers based in Eastern Europe had broken into one of its servers and stolen personal medical information for almost 800,000 people -- more than one of every four residents of the state.\u003c/p>\n\u003cp>And last November, TRICARE, which handles health insurance for the military, \u003ca href=\"http://www.tricare.mil/breach/old.htm\" target=\"_blank\">announced\u003c/a> that a trove of its backup computer tapes had been stolen from one of its contractors in Virginia. The tapes contained names, Social Security numbers, home addresses and, in some cases, clinical notes and lab test results for nearly 5 million patients, making it the largest medical data breach since the Department of Health and Human Services began tracking incidents two and a half years ago.\u003c/p>\n\u003cp>As recently as five years ago, it's possible no one outside Howard University would have known about the incidents there. But, \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/index.html\" target=\"_blank\">new reporting rules\u003c/a> adopted as part of the 2009 stimulus act insure the public knows far more about medical data breaches than in the past. When a breach occurs that affects 500 or more patients, health care providers now must notify not only HHS, but also the media.\u003c/p>\n\u003cp>Deven McGraw, director of the health privacy project at the \u003ca href=\"https://www.cdt.org/\" target=\"_blank\">Center for Democracy & Technology\u003c/a>, a Washington-based Internet advocacy group, said the number of incidents is growing with the increased use of digital health records. The health care industry, she added, has been slow to respond.\u003c/p>\n\u003cp>\"Many financial companies have used encryption for years and they probably wonder what the heck is going on with the health care industry,\" McGraw said. \"It's much cheaper to deploy safeguards than to suffer a breach.\"\u003c/p>\n\u003cp>This growing problem puts HHS in a tough spot. It is pushing hospitals and doctors to adopt electronic health records, but it's also responsible for punishing health care providers who fail to properly secure their patients' records.\u003c/p>\n\u003cp>\"Mistakes happen, incidents happen, corners get cut from time to time,\" said Susan McAndrew, deputy director for health information policy at HHS's Office of Civil Rights. \"That's where we come in.\"\u003c/p>\n\u003cp>\u003cstrong>What Is A Data Breach?\u003c/strong>\u003c/p>\n\u003cp>While a medical data breach can lead to everything from identity theft to billing fraud to blackmail, some breaches ultimately have little consequence on the patients affected. When a medical data breach occurs, it simply means that patient information was, at some point in time, unsecured. For example, in the incident with the Howard University contractor, it's unlikely the person who stole the laptop out of the contractor’s car knew -- or cared -- that there was medical data on it.\u003c/p>\n\u003cp>According to an \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\" target=\"_blank\">HHS database\u003c/a>, more than 40 percent of medical data breaches in the past two and a half years involved portable media devices such as laptops or hard drives. McGraw said many of these incidents were entirely avoidable.\u003c/p>\n\u003cp>\"We have technology that can help save us when we're all too human,\" she said.\u003c/p>\n\u003cp>Cloud storage, password protection and encryption are all measures health care providers could be taking to make portable electronic health records more secure, McGraw said.\u003c/p>\n\u003cp>Another thing that might make health care providers tighten their security is the potential of facing hefty fines if their patients' data are breached. However, until very recently, providers haven't had to worry much about this.\u003c/p>\n\u003cp>Since the enactment of HIPAA in 2003 until late last year, there were more than 22,000 complaints about violations of the law's privacy rule. HHS issued a monetary penalty only once, according to a \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/compliancerept.pdf\" target=\"_blank\">report\u003c/a> it gave to Congress. Though the department has the power to issue subpoenas when enforcing HIPAA, it has only used that power twice since 2003.\u003c/p>\n\u003cp>\"The industry is very interested and responsive to correct the mistakes that they make and improve their privacy policies,\" McAndrew said, \"so it's not necessary for us to resort to these types of penalties.\"\u003c/p>\n\u003cp>\u003cstrong>Senate Grilling\u003c/strong>\u003c/p>\n\u003cp>HHS was criticized for lax enforcement at a \u003ca href=\"http://www.judiciary.senate.gov/hearings/hearing.cfm?id=9b6937d5e931a0b792d258d9b332c04d\" target=\"_blank\">Senate hearing\u003c/a> in November. In the six months that followed, the department \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/pcsurgery_agreement.html\" target=\"_blank\">reached settlements\u003c/a> in several HIPAA cases with \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/bcbstagrmnt.html\" target=\"_blank\">penalties totaling more than $1.5 million\u003c/a>.\u003c/p>\n\u003cp>McGraw said HHS was losing credibility on the enforcement issue, so she's pleased by the department's rapid response to its Senate grilling.\u003c/p>\n\u003cp>But, she said, federal regulators can only do so much. While the benefits of electronic health records far outweigh the risks, McGraw said, those risks can only be mitigated -- not eliminated.\u003c/p>\n\u003cp>\"No matter how good you make the technology,\" McGraw said, \"we'll never get the risk down to zero. But we can do a lot better than we have been doing.\"\u003c/p>\n\u003cp>\u003cstrong>Largest Data Breaches\u003c/strong>\u003c/p>\n\u003cp>Since 2009, federal law has required health care providers to report to the Department of Health and Human Services and the news media all data breaches affecting 500 patients or more. These are the top 10 largest medical data breaches since then:\u003c/p>\n\u003ctable width=\"620\">\n\u003ctbody>\n\u003ctr>\n\u003ctd>Health Care Provider\u003c/td>\n\u003ctd>State\u003c/td>\n\u003ctd>Patients Affected\u003c/td>\n\u003ctd>Type of Breach\u003c/td>\n\u003ctd>Date\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>TRICARE\u003c/td>\n\u003ctd>Virginia\u003c/td>\n\u003ctd>4,901,432\u003c/td>\n\u003ctd>Loss of backup tapes\u003c/td>\n\u003ctd>Sept. 13, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Health Net, Inc.\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>1,900,000\u003c/td>\n\u003ctd>Unknown\u003c/td>\n\u003ctd>Jan. 21, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>North Bronx Healthcare Network\u003c/td>\n\u003ctd>New York\u003c/td>\n\u003ctd>1,700,000\u003c/td>\n\u003ctd>Electronic medical record theft\u003c/td>\n\u003ctd>Dec. 23, 2010\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>AvMed, Inc.\u003c/td>\n\u003ctd>Florida\u003c/td>\n\u003ctd>1,220,000\u003c/td>\n\u003ctd>Laptop theft\u003c/td>\n\u003ctd>Dec. 10, 2009\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>The Nemours Foundation\u003c/td>\n\u003ctd>Florida\u003c/td>\n\u003ctd>1,055,489\u003c/td>\n\u003ctd>Loss of backup tapes\u003c/td>\n\u003ctd>Aug. 10, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Blue Cross Blue Shield of Tennessee\u003c/td>\n\u003ctd>Tennessee\u003c/td>\n\u003ctd>1,023,209\u003c/td>\n\u003ctd>Hard drive theft\u003c/td>\n\u003ctd>Oct. 2, 2009\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Sutter Medical Foundation\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>943,434\u003c/td>\n\u003ctd>Desktop computer theft\u003c/td>\n\u003ctd>Oct. 15, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>South Shore Hospital\u003c/td>\n\u003ctd>Massachusetts\u003c/td>\n\u003ctd>800,000\u003c/td>\n\u003ctd>Loss of portable electronic device\u003c/td>\n\u003ctd>Feb. 26, 2010\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Utah Department of Health\u003c/td>\n\u003ctd>Utah\u003c/td>\n\u003ctd>780,000\u003c/td>\n\u003ctd>Hacking\u003c/td>\n\u003ctd>March 10, 2012 to April 2, 2012\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Eisenhower Medical Center\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>514,330\u003c/td>\n\u003ctd>Computer theft\u003c/td>\n\u003ctd>11-Mar-11\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd colspan=\"4\">Source: \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\" target=\"_blank\">U.S. Department of Health and Human Resources\u003c/a>.\u003c/td>\n\u003c/tr>\n\u003c/tbody>\n\u003c/table>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By \u003ca href=\"http://www.kaiserhealthnews.org/\">David Schultz, Kaiser Health News\u003c/a>\u003c/p>\n\u003cdiv>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/hackhack.jpg\">\u003cimg class=\"alignleft size-full wp-image-6313\" title=\"California has had three of the ten most significant health data breaches since 2009. (Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/hackhack.jpg\" alt=\"\" width=\"300\" height=\"199\">\u003c/a>As more doctors and hospitals go digital with medical records, the size and frequency of data breaches are alarming privacy advocates and public health officials.\u003c/p>\n\u003cp>Three of the ten largest health data breaches have occurred in California. The \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\">U.S. Department of Health and Human Resources\u003c/a> started tracking the break-ins in 2009.\u003c/p>\n\u003cp>Keeping records secure is a challenge that doctors, public health officials and federal regulators are just beginning to grasp. And, as two recent incidents at Howard University Hospital show, inadequate data security can affect huge numbers of people.\u003c!--more-->\u003c/p>\n\u003cp>On May 14, federal prosecutors \u003ca href=\"http://dl.dropbox.com/u/37285095/Napper%20Information.pdf\" target=\"_blank\">charged\u003c/a> one of the hospital's medical technicians with violating the Health Insurance Portability and Accountability Act, or HIPAA. Prosecutors say that over a 17-month period Laurie Napper used her position at the hospital to gain access to patients' names, addresses and Medicare numbers in order to sell their information. A plea hearing has been set for June 12; Napper's attorney declined comment.\u003c/p>\n\u003cp>Just a few weeks earlier, the hospital \u003ca href=\"http://huhealthcare.com/healthcare/hospital/data-breach/FAQ\" target=\"_blank\">notified\u003c/a> more than 34,000 patients that their medical data had been compromised. A contractor working with the hospital had downloaded the patients' files onto a personal laptop, which was stolen from the contractor's car. The data on the laptop was password-protected but unencrypted, which means anyone who guessed the password could have accessed the patient files without a randomly generated key. According to a hospital press release, those files included names, addresses, and Social Security numbers -- and, in a few cases, \"diagnosis-related information.\"\u003c/p>\n\u003cp>Ronald J. Harris, Howard University's top spokesman, said in an e-mail that the two incidents are unrelated, but declined to answer further questions. In its press release about the stolen laptop, the hospital said it will set new requirements for all laptops used by contractors and those issued to hospital personnel to help protect data.\u003c/p>\n\u003cp>Still it could have been worse. Much worse.\u003c/p>\n\u003cp>Just days after Howard University contacted its patients about the stolen laptop, the Utah Department of Health \u003ca href=\"http://www.health.utah.gov/databreach/\" target=\"_blank\">announced\u003c/a> that hackers based in Eastern Europe had broken into one of its servers and stolen personal medical information for almost 800,000 people -- more than one of every four residents of the state.\u003c/p>\n\u003cp>And last November, TRICARE, which handles health insurance for the military, \u003ca href=\"http://www.tricare.mil/breach/old.htm\" target=\"_blank\">announced\u003c/a> that a trove of its backup computer tapes had been stolen from one of its contractors in Virginia. The tapes contained names, Social Security numbers, home addresses and, in some cases, clinical notes and lab test results for nearly 5 million patients, making it the largest medical data breach since the Department of Health and Human Services began tracking incidents two and a half years ago.\u003c/p>\n\u003cp>As recently as five years ago, it's possible no one outside Howard University would have known about the incidents there. But, \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/index.html\" target=\"_blank\">new reporting rules\u003c/a> adopted as part of the 2009 stimulus act insure the public knows far more about medical data breaches than in the past. When a breach occurs that affects 500 or more patients, health care providers now must notify not only HHS, but also the media.\u003c/p>\n\u003cp>Deven McGraw, director of the health privacy project at the \u003ca href=\"https://www.cdt.org/\" target=\"_blank\">Center for Democracy & Technology\u003c/a>, a Washington-based Internet advocacy group, said the number of incidents is growing with the increased use of digital health records. The health care industry, she added, has been slow to respond.\u003c/p>\n\u003cp>\"Many financial companies have used encryption for years and they probably wonder what the heck is going on with the health care industry,\" McGraw said. \"It's much cheaper to deploy safeguards than to suffer a breach.\"\u003c/p>\n\u003cp>This growing problem puts HHS in a tough spot. It is pushing hospitals and doctors to adopt electronic health records, but it's also responsible for punishing health care providers who fail to properly secure their patients' records.\u003c/p>\n\u003cp>\"Mistakes happen, incidents happen, corners get cut from time to time,\" said Susan McAndrew, deputy director for health information policy at HHS's Office of Civil Rights. \"That's where we come in.\"\u003c/p>\n\u003cp>\u003cstrong>What Is A Data Breach?\u003c/strong>\u003c/p>\n\u003cp>While a medical data breach can lead to everything from identity theft to billing fraud to blackmail, some breaches ultimately have little consequence on the patients affected. When a medical data breach occurs, it simply means that patient information was, at some point in time, unsecured. For example, in the incident with the Howard University contractor, it's unlikely the person who stole the laptop out of the contractor’s car knew -- or cared -- that there was medical data on it.\u003c/p>\n\u003cp>According to an \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\" target=\"_blank\">HHS database\u003c/a>, more than 40 percent of medical data breaches in the past two and a half years involved portable media devices such as laptops or hard drives. McGraw said many of these incidents were entirely avoidable.\u003c/p>\n\u003cp>\"We have technology that can help save us when we're all too human,\" she said.\u003c/p>\n\u003cp>Cloud storage, password protection and encryption are all measures health care providers could be taking to make portable electronic health records more secure, McGraw said.\u003c/p>\n\u003cp>Another thing that might make health care providers tighten their security is the potential of facing hefty fines if their patients' data are breached. However, until very recently, providers haven't had to worry much about this.\u003c/p>\n\u003cp>Since the enactment of HIPAA in 2003 until late last year, there were more than 22,000 complaints about violations of the law's privacy rule. HHS issued a monetary penalty only once, according to a \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/compliancerept.pdf\" target=\"_blank\">report\u003c/a> it gave to Congress. Though the department has the power to issue subpoenas when enforcing HIPAA, it has only used that power twice since 2003.\u003c/p>\n\u003cp>\"The industry is very interested and responsive to correct the mistakes that they make and improve their privacy policies,\" McAndrew said, \"so it's not necessary for us to resort to these types of penalties.\"\u003c/p>\n\u003cp>\u003cstrong>Senate Grilling\u003c/strong>\u003c/p>\n\u003cp>HHS was criticized for lax enforcement at a \u003ca href=\"http://www.judiciary.senate.gov/hearings/hearing.cfm?id=9b6937d5e931a0b792d258d9b332c04d\" target=\"_blank\">Senate hearing\u003c/a> in November. In the six months that followed, the department \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/pcsurgery_agreement.html\" target=\"_blank\">reached settlements\u003c/a> in several HIPAA cases with \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/bcbstagrmnt.html\" target=\"_blank\">penalties totaling more than $1.5 million\u003c/a>.\u003c/p>\n\u003cp>McGraw said HHS was losing credibility on the enforcement issue, so she's pleased by the department's rapid response to its Senate grilling.\u003c/p>\n\u003cp>But, she said, federal regulators can only do so much. While the benefits of electronic health records far outweigh the risks, McGraw said, those risks can only be mitigated -- not eliminated.\u003c/p>\n\u003cp>\"No matter how good you make the technology,\" McGraw said, \"we'll never get the risk down to zero. But we can do a lot better than we have been doing.\"\u003c/p>\n\u003cp>\u003cstrong>Largest Data Breaches\u003c/strong>\u003c/p>\n\u003cp>Since 2009, federal law has required health care providers to report to the Department of Health and Human Services and the news media all data breaches affecting 500 patients or more. These are the top 10 largest medical data breaches since then:\u003c/p>\n\u003ctable width=\"620\">\n\u003ctbody>\n\u003ctr>\n\u003ctd>Health Care Provider\u003c/td>\n\u003ctd>State\u003c/td>\n\u003ctd>Patients Affected\u003c/td>\n\u003ctd>Type of Breach\u003c/td>\n\u003ctd>Date\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>TRICARE\u003c/td>\n\u003ctd>Virginia\u003c/td>\n\u003ctd>4,901,432\u003c/td>\n\u003ctd>Loss of backup tapes\u003c/td>\n\u003ctd>Sept. 13, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Health Net, Inc.\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>1,900,000\u003c/td>\n\u003ctd>Unknown\u003c/td>\n\u003ctd>Jan. 21, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>North Bronx Healthcare Network\u003c/td>\n\u003ctd>New York\u003c/td>\n\u003ctd>1,700,000\u003c/td>\n\u003ctd>Electronic medical record theft\u003c/td>\n\u003ctd>Dec. 23, 2010\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>AvMed, Inc.\u003c/td>\n\u003ctd>Florida\u003c/td>\n\u003ctd>1,220,000\u003c/td>\n\u003ctd>Laptop theft\u003c/td>\n\u003ctd>Dec. 10, 2009\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>The Nemours Foundation\u003c/td>\n\u003ctd>Florida\u003c/td>\n\u003ctd>1,055,489\u003c/td>\n\u003ctd>Loss of backup tapes\u003c/td>\n\u003ctd>Aug. 10, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Blue Cross Blue Shield of Tennessee\u003c/td>\n\u003ctd>Tennessee\u003c/td>\n\u003ctd>1,023,209\u003c/td>\n\u003ctd>Hard drive theft\u003c/td>\n\u003ctd>Oct. 2, 2009\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Sutter Medical Foundation\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>943,434\u003c/td>\n\u003ctd>Desktop computer theft\u003c/td>\n\u003ctd>Oct. 15, 2011\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>South Shore Hospital\u003c/td>\n\u003ctd>Massachusetts\u003c/td>\n\u003ctd>800,000\u003c/td>\n\u003ctd>Loss of portable electronic device\u003c/td>\n\u003ctd>Feb. 26, 2010\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Utah Department of Health\u003c/td>\n\u003ctd>Utah\u003c/td>\n\u003ctd>780,000\u003c/td>\n\u003ctd>Hacking\u003c/td>\n\u003ctd>March 10, 2012 to April 2, 2012\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd>Eisenhower Medical Center\u003c/td>\n\u003ctd>California\u003c/td>\n\u003ctd>514,330\u003c/td>\n\u003ctd>Computer theft\u003c/td>\n\u003ctd>11-Mar-11\u003c/td>\n\u003c/tr>\n\u003ctr>\n\u003ctd colspan=\"4\">Source: \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html\" target=\"_blank\">U.S. Department of Health and Human Resources\u003c/a>.\u003c/td>\n\u003c/tr>\n\u003c/tbody>\n\u003c/table>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Confusion for Parents, Providers over Sign Up for Dental Managed Care",
"title": "Confusion for Parents, Providers over Sign Up for Dental Managed Care",
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"content": "\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca title=\"http://centerforhealthreporting.org/blog/how-–-and-why-–-do-some-parents-choose-dental-managed-care-their-kids-confusion-reigns909\" href=\"http://centerforhealthreporting.org/blog/how-%E2%80%93-and-why-%E2%80%93-do-some-parents-choose-dental-managed-care-their-kids-confusion-reigns909\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6234\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/ItzelGarcia_LaurenWhaley.jpg\">\u003cimg class=\"size-medium wp-image-6234\" title=\"(Photo: Lauren Whaley)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/ItzelGarcia_LaurenWhaley-300x198.jpg\" alt=\"(Photo: Lauren Whaley)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Itzel Garcia's mother says she doesn't know how her daughter was switched from her dentist to a dental managed care plan. (Photo: Lauren M. Whaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Fact:\u003c/strong> Dental managed care for poor kids in Los Angeles County has a disappointing record: Fewer than one in four LA County children on Medi-Cal managed care saw a dentist last year.\u003c/p>\n\u003cp>\u003cstrong>Fact:\u003c/strong> Dental managed care is voluntary in Los Angeles County and parents must actively sign their kids up for the program. If they don’t, children default into the traditional “fee-for-service” system.\u003c/p>\n\u003cp>\u003cstrong>Question:\u003c/strong> Given that this poor-performing program is voluntary, how did 154,000 kids get on it in the first place? And why do they stay?\u003c/p>\n\u003cp>There’s a lot of confusion related to getting on -- and staying on -- Medi-Cal dental managed care in Los Angeles County, where parents have a choice.\u003ca title=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" href=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" target=\"_blank\"> In Sacramento County\u003c/a>, the only other county in the state that offers Medi-Cal dental managed care, the program is mandatory.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Sometimes patients will get switched to different offices without their knowledge.”\u003c/aside>\n\u003cp>Several dentists, children’s advocates and parents told me that dental plans play a role in signing patients up for their services. They said some plan representatives set up shop just outside federal \u003ca title=\"http://www.fns.usda.gov/wic/aboutwic/\" href=\"http://www.fns.usda.gov/wic/aboutwic/\" target=\"_blank\">WIC Program \u003c/a>offices. Some, they said, go to pediatricians’ offices and health clinics, some visit school fairs and Medi-Cal offices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->“The plans come to them,” said Scott Jacks, a pediatric dentist and founder of \u003ca title=\"http://www.childrensdentalgroup.com/\" href=\"http://www.childrensdentalgroup.com/\" target=\"_blank\">Children’s Dental Group\u003c/a>, which operates four offices in Los Angeles County that see thousands of patients annually. “They’ll put tables in medical offices and they will promise these patients the moon and everything and they’ll sign up.”\u003c/p>\n\u003cp>Parents often don’t know what they’re getting into when they sign up, said Arlene Glube, the director of Southern California operations for the nonprofit \u003ca title=\"http://www.centerfororalhealth.org/\" href=\"http://www.centerfororalhealth.org/\" target=\"_blank\">Center for Oral Health\u003c/a>.\u003c/p>\n\u003cp>“There is a lot of salesmanship involved: ‘Sign up for ours! Sign up for ours!’” she said. “Our experience really tells us they’re not well enough educated at the time of signing up for a plan to understand how to utilize it and when to utilize it.”\u003c/p>\n\u003cp>(Side note, if this is really happening, why are the clinics, medical offices and schools allowing it? Are they confused, too?)\u003c/p>\n\u003cp>Officials at the California's \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>, which administers Medi-Cal, said they have investigated complaints about plans visiting medical and WIC offices. “DHCS has heard such complaints, but upon investigation, has been unable to corroborate that this was occurring,” said spokesman Norman Williams. “This is a practice that DHCS does not allow.”\u003c/p>\n\u003cp>Enrollment, he said, must be facilitated by a “non-biased entity.”\u003c/p>\n\u003cp>Once children are signed up, the confusion can continue.\u003c/p>\n\u003cp>So reports Isabel Lopez, the mother of 7-year-old Itzel Garcia, the little girl I profiled recently in a story about \u003ca title=\"http://centerforhealthreporting.org/article/managed-care-leaves-many-la-county-children-desperate-dental-care901\" href=\"http://centerforhealthreporting.org/article/managed-care-leaves-many-la-county-children-desperate-dental-care901\" target=\"_blank\">Medi-Cal dental managed care\u003c/a>. The first grader waited for four months in pain for a referral to a specialist that never came.\u003c/p>\n\u003cp>Lopez doesn’t remember how she put her daughter on managed care in the first place, but she does know this: Itzel initially was assigned to the Health Net plan and saw a Health Net dentist. But when Lopez took Itzel back to the dentist, she was told her daughter couldn’t be seen.\u003c/p>\n\u003cp>Itzel, she had been told, was no longer in Health Net. Somehow, she had been switched to Access Dental.\u003c/p>\n\u003cp>“I don’t know how it happened,” Lopez said.\u003c/p>\n\u003cp>This occurs frequently, said Grace Hardy, dental director of\u003ca title=\"http://www.nevhc.org/\" href=\"http://www.nevhc.org/\" target=\"_blank\"> Northeast Valley Health Corporation\u003c/a>, a community health center that operates dental clinics in Sun Valley and San Fernando.\u003c/p>\n\u003cp>“Sometimes patients will get switched to different offices without their knowledge,” she said. “They’ll come in and they’re not on the roster anymore. The patient doesn’t know what happened.” More often than not, neither does the clinic.\u003c/p>\n\u003cp>About a year ago, DHCS witnessed a spike in the number of complaints from Medi-Cal recipients who said they had been switched, Williams said. The department investigated and found that representatives hired by one plan to sign members up were falsifying applications. This was happening because they were paid for the number of people they signed up for the plan, Williams said.\u003c/p>\n\u003cp>“The plan dismissed these employees and DHCS has received no further complaints,” he said.\u003c/p>\n\u003cp>Hardy’s health center used to allow a dental plan to visit the clinics to speak to patients without insurance.\u003c/p>\n\u003cp>“They’ll approach people on fee-for-service and have them sign up for their (managed care) program,” she said. “They don’t tell them that once you sign up for our program, you might be assigned to another office.”\u003c/p>\n\u003cp>That plan is no longer welcome, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We stopped having those representatives altogether,” she said. “It was causing more conflicts than anything.”\u003c/p>\n\n",
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"excerpt": "Fact: Dental managed care for poor kids in Los Angeles County has a disappointing record: Fewer than one in four LA County children on Medi-Cal managed care saw a dentist last year.\r\n\r\nFact: Dental managed care is voluntary in Los Angeles County and parents must actively sign their kids up for the program. If they don’t, children default into the traditional “fee-for-service” system.\r\n\r\nQuestion mark: Given that this poor-performing program is voluntary, how did 154,000 kids get on it in the first place? And why do they stay?",
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"description": "Fact: Dental managed care for poor kids in Los Angeles County has a disappointing record: Fewer than one in four LA County children on Medi-Cal managed care saw a dentist last year.\r\n\r\nFact: Dental managed care is voluntary in Los Angeles County and parents must actively sign their kids up for the program. If they don’t, children default into the traditional “fee-for-service” system.\r\n\r\nQuestion mark: Given that this poor-performing program is voluntary, how did 154,000 kids get on it in the first place? And why do they stay?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca title=\"http://centerforhealthreporting.org/blog/how-–-and-why-–-do-some-parents-choose-dental-managed-care-their-kids-confusion-reigns909\" href=\"http://centerforhealthreporting.org/blog/how-%E2%80%93-and-why-%E2%80%93-do-some-parents-choose-dental-managed-care-their-kids-confusion-reigns909\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6234\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/ItzelGarcia_LaurenWhaley.jpg\">\u003cimg class=\"size-medium wp-image-6234\" title=\"(Photo: Lauren Whaley)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/ItzelGarcia_LaurenWhaley-300x198.jpg\" alt=\"(Photo: Lauren Whaley)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Itzel Garcia's mother says she doesn't know how her daughter was switched from her dentist to a dental managed care plan. (Photo: Lauren M. Whaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Fact:\u003c/strong> Dental managed care for poor kids in Los Angeles County has a disappointing record: Fewer than one in four LA County children on Medi-Cal managed care saw a dentist last year.\u003c/p>\n\u003cp>\u003cstrong>Fact:\u003c/strong> Dental managed care is voluntary in Los Angeles County and parents must actively sign their kids up for the program. If they don’t, children default into the traditional “fee-for-service” system.\u003c/p>\n\u003cp>\u003cstrong>Question:\u003c/strong> Given that this poor-performing program is voluntary, how did 154,000 kids get on it in the first place? And why do they stay?\u003c/p>\n\u003cp>There’s a lot of confusion related to getting on -- and staying on -- Medi-Cal dental managed care in Los Angeles County, where parents have a choice.\u003ca title=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" href=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" target=\"_blank\"> In Sacramento County\u003c/a>, the only other county in the state that offers Medi-Cal dental managed care, the program is mandatory.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Sometimes patients will get switched to different offices without their knowledge.”\u003c/aside>\n\u003cp>Several dentists, children’s advocates and parents told me that dental plans play a role in signing patients up for their services. They said some plan representatives set up shop just outside federal \u003ca title=\"http://www.fns.usda.gov/wic/aboutwic/\" href=\"http://www.fns.usda.gov/wic/aboutwic/\" target=\"_blank\">WIC Program \u003c/a>offices. Some, they said, go to pediatricians’ offices and health clinics, some visit school fairs and Medi-Cal offices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->“The plans come to them,” said Scott Jacks, a pediatric dentist and founder of \u003ca title=\"http://www.childrensdentalgroup.com/\" href=\"http://www.childrensdentalgroup.com/\" target=\"_blank\">Children’s Dental Group\u003c/a>, which operates four offices in Los Angeles County that see thousands of patients annually. “They’ll put tables in medical offices and they will promise these patients the moon and everything and they’ll sign up.”\u003c/p>\n\u003cp>Parents often don’t know what they’re getting into when they sign up, said Arlene Glube, the director of Southern California operations for the nonprofit \u003ca title=\"http://www.centerfororalhealth.org/\" href=\"http://www.centerfororalhealth.org/\" target=\"_blank\">Center for Oral Health\u003c/a>.\u003c/p>\n\u003cp>“There is a lot of salesmanship involved: ‘Sign up for ours! Sign up for ours!’” she said. “Our experience really tells us they’re not well enough educated at the time of signing up for a plan to understand how to utilize it and when to utilize it.”\u003c/p>\n\u003cp>(Side note, if this is really happening, why are the clinics, medical offices and schools allowing it? Are they confused, too?)\u003c/p>\n\u003cp>Officials at the California's \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>, which administers Medi-Cal, said they have investigated complaints about plans visiting medical and WIC offices. “DHCS has heard such complaints, but upon investigation, has been unable to corroborate that this was occurring,” said spokesman Norman Williams. “This is a practice that DHCS does not allow.”\u003c/p>\n\u003cp>Enrollment, he said, must be facilitated by a “non-biased entity.”\u003c/p>\n\u003cp>Once children are signed up, the confusion can continue.\u003c/p>\n\u003cp>So reports Isabel Lopez, the mother of 7-year-old Itzel Garcia, the little girl I profiled recently in a story about \u003ca title=\"http://centerforhealthreporting.org/article/managed-care-leaves-many-la-county-children-desperate-dental-care901\" href=\"http://centerforhealthreporting.org/article/managed-care-leaves-many-la-county-children-desperate-dental-care901\" target=\"_blank\">Medi-Cal dental managed care\u003c/a>. The first grader waited for four months in pain for a referral to a specialist that never came.\u003c/p>\n\u003cp>Lopez doesn’t remember how she put her daughter on managed care in the first place, but she does know this: Itzel initially was assigned to the Health Net plan and saw a Health Net dentist. But when Lopez took Itzel back to the dentist, she was told her daughter couldn’t be seen.\u003c/p>\n\u003cp>Itzel, she had been told, was no longer in Health Net. Somehow, she had been switched to Access Dental.\u003c/p>\n\u003cp>“I don’t know how it happened,” Lopez said.\u003c/p>\n\u003cp>This occurs frequently, said Grace Hardy, dental director of\u003ca title=\"http://www.nevhc.org/\" href=\"http://www.nevhc.org/\" target=\"_blank\"> Northeast Valley Health Corporation\u003c/a>, a community health center that operates dental clinics in Sun Valley and San Fernando.\u003c/p>\n\u003cp>“Sometimes patients will get switched to different offices without their knowledge,” she said. “They’ll come in and they’re not on the roster anymore. The patient doesn’t know what happened.” More often than not, neither does the clinic.\u003c/p>\n\u003cp>About a year ago, DHCS witnessed a spike in the number of complaints from Medi-Cal recipients who said they had been switched, Williams said. The department investigated and found that representatives hired by one plan to sign members up were falsifying applications. This was happening because they were paid for the number of people they signed up for the plan, Williams said.\u003c/p>\n\u003cp>“The plan dismissed these employees and DHCS has received no further complaints,” he said.\u003c/p>\n\u003cp>Hardy’s health center used to allow a dental plan to visit the clinics to speak to patients without insurance.\u003c/p>\n\u003cp>“They’ll approach people on fee-for-service and have them sign up for their (managed care) program,” she said. “They don’t tell them that once you sign up for our program, you might be assigned to another office.”\u003c/p>\n\u003cp>That plan is no longer welcome, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We stopped having those representatives altogether,” she said. “It was causing more conflicts than anything.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Health Care Jobs: How Healthy?",
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"content": "\u003cfigure id=\"attachment_6155\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/PatientMoved_05252012_MilitaryHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-6155\" title=\"(US Navy: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/PatientMoved_05252012_MilitaryHealth_Flickr-300x232.jpg\" alt=\"(US Navy: Flickr)\" width=\"300\" height=\"232\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Hospital team moves patient from one bed to another. (U.S. Navy: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California stands to reap tens of thousands of jobs because of the federal health care overhaul -- according to a new \u003ca title=\"BACEI Report\" href=\"http://www.bayareaeconomy.org/media/files/pdf/AffordableCareActWeb.pdf\" target=\"_blank\">report \u003c/a>[PDF] by the\u003ca title=\"http://www.bayareaeconomy.org/\" href=\"http://www.bayareaeconomy.org/\" target=\"_blank\"> Bay Area Council Economic Institute \u003c/a>(BACEI).\u003c/p>\n\u003cp>Researchers compared the state’s 2010 workforce to what it might have been if the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act\u003c/a> had been fully implemented in that year. They concluded that once the ACA is fully in place in 2014 almost 99,000 new jobs will be created as a result of the law, most of them in Southern California. The Sacramento Valley will see the largest increase rate: a 1.3 percent boost in job opportunities.\u003c/p>\n\u003cp>But ironically, health care jobs are not always healthy for the worker. Odd hours, ergonomics, and environmental factors contribute to specific risks for hospital and clinic workers.\u003c/p>\n\u003cp>By its nature health care is a 24-hour enterprise. \u003ca title=\"http://hospitalmedicine.ucsf.edu/facstaff/catherinelau.html\" href=\"http://hospitalmedicine.ucsf.edu/facstaff/catherinelau.html\" target=\"_blank\">Dr. Catherine Lau\u003c/a> works nights almost exclusively as director of Nighttime Hospitalist Service at the UC San Francisco Medical Center. In an interview Lau said that while she appreciates the quiet, it can be \"a little disorienting\" to work at night in a windowless space. Shift-working nurses show higher rates of \u003ca title=\"breast cancer risk\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22473669\" target=\"_blank\">breast cancer,\u003c/a> obesity and \u003ca title=\"type 2 diabetes risk\" href=\"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001141\" target=\"_blank\">type 2 diabetes\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Nurses, physical therapists, and other health care workers push, pull, reach, bend, lift, and carry – and too often from positions and postures that challenge good body mechanics. Nursing aides, orderlies, and attendants are \u003ca title=\"injury risk\" href=\"http://hchcw.org/9-reasons-to-care/the-most-dangerous-job-in-the-nation\" target=\"_blank\">four times more likely\u003c/a> to be injured on the job than the average worker in the United States. The \u003ca title=\"http://www.aroundthecapitol.com/Bills/AB_1136/20112012/\" href=\"http://www.aroundthecapitol.com/Bills/AB_1136/20112012/\" target=\"_blank\">California Safe Patient Handling Act\u003c/a> regulates the lifting and transfer of hospital patients, however, it has been in effect less than year – not long enough to measure improvements.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hospital air exposes patients and staff to potentially hundreds of toxins including formaldehyde from out-gassing building materials, medical waste and cleaning products. In a 2009 survey by the \u003ca title=\"Center for Health Design\" href=\"http://www.healthdesign.org/\" target=\"_blank\">Center for Health Design\u003c/a>, two-thirds of providers in both hospitals and ambulatory care centers called indoor air quality “a major problem.” In fact, it was singled out as the most urgent design problem. Hospitals will always have bad smells, but Lau said in her current hospital \"the air quality in general is pretty good\" though some floors are better than others.\u003c/p>\n\u003cp>Employee \u003ca title=\"SEIU\" href=\"http://www.seiu.org/a/members/safety-and-health.php\" target=\"_blank\">unions\u003c/a>, healthcare systems and regional organizations are working toward healthier health care environments across the state. California-based Dignity Health and Kaiser Permanente are part of the \u003ca title=\"HHI\" href=\"http://healthierhospitals.org/about-hhi/who-we-are\" target=\"_blank\">Healthier Hospitals Initiative\u003c/a>, a project sponsored in part by \u003ca title=\"Health Care Without Harm\" href=\"http://www.noharm.org/\" target=\"_blank\">Health Care Without Harm\u003c/a>, an international advocacy organization promoting sustainable healthcare.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>With the state unemployment rate hovering around 11 percent, the Employment Development Department has projected that healthcare jobs will grow 24 percent by 2018. The Affordable Care Act was not designed to be an economic stimulus bill, but the BACEI report calls the ACA an “economic boon” -- albeit with some known risks to workers -- for California.\u003c/p>\n\n",
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"excerpt": "California stands to reap tens of thousands of jobs because of the federal health care overhaul -- according to a new report [PDF] by the Bay Area Council Economic Institute (BACEI).\r\n\r\nResearchers compared the state’s 2010 workforce to what it might have been if the Affordable Care Act had been fully implemented in that year. They concluded that once the ACA is fully in place in 2014 almost 99,000 new jobs will be created as a result of the law, most of them in Southern California. The Sacramento Valley will see the largest increase rate: a 1.3 percent boost in job opportunities.",
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"description": "California stands to reap tens of thousands of jobs because of the federal health care overhaul -- according to a new report by the Bay Area Council Economic Institute (BACEI).\r\n\r\nResearchers compared the state’s 2010 workforce to what it might have been if the Affordable Care Act had been fully implemented in that year. They concluded that once the ACA is fully in place in 2014 almost 99,000 new jobs will be created as a result of the law, most of them in Southern California. The Sacramento Valley will see the largest increase rate: a 1.3 percent boost in job opportunities.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6155\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/PatientMoved_05252012_MilitaryHealth_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-6155\" title=\"(US Navy: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/PatientMoved_05252012_MilitaryHealth_Flickr-300x232.jpg\" alt=\"(US Navy: Flickr)\" width=\"300\" height=\"232\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Hospital team moves patient from one bed to another. (U.S. Navy: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California stands to reap tens of thousands of jobs because of the federal health care overhaul -- according to a new \u003ca title=\"BACEI Report\" href=\"http://www.bayareaeconomy.org/media/files/pdf/AffordableCareActWeb.pdf\" target=\"_blank\">report \u003c/a>[PDF] by the\u003ca title=\"http://www.bayareaeconomy.org/\" href=\"http://www.bayareaeconomy.org/\" target=\"_blank\"> Bay Area Council Economic Institute \u003c/a>(BACEI).\u003c/p>\n\u003cp>Researchers compared the state’s 2010 workforce to what it might have been if the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act\u003c/a> had been fully implemented in that year. They concluded that once the ACA is fully in place in 2014 almost 99,000 new jobs will be created as a result of the law, most of them in Southern California. The Sacramento Valley will see the largest increase rate: a 1.3 percent boost in job opportunities.\u003c/p>\n\u003cp>But ironically, health care jobs are not always healthy for the worker. Odd hours, ergonomics, and environmental factors contribute to specific risks for hospital and clinic workers.\u003c/p>\n\u003cp>By its nature health care is a 24-hour enterprise. \u003ca title=\"http://hospitalmedicine.ucsf.edu/facstaff/catherinelau.html\" href=\"http://hospitalmedicine.ucsf.edu/facstaff/catherinelau.html\" target=\"_blank\">Dr. Catherine Lau\u003c/a> works nights almost exclusively as director of Nighttime Hospitalist Service at the UC San Francisco Medical Center. In an interview Lau said that while she appreciates the quiet, it can be \"a little disorienting\" to work at night in a windowless space. Shift-working nurses show higher rates of \u003ca title=\"breast cancer risk\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22473669\" target=\"_blank\">breast cancer,\u003c/a> obesity and \u003ca title=\"type 2 diabetes risk\" href=\"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001141\" target=\"_blank\">type 2 diabetes\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Nurses, physical therapists, and other health care workers push, pull, reach, bend, lift, and carry – and too often from positions and postures that challenge good body mechanics. Nursing aides, orderlies, and attendants are \u003ca title=\"injury risk\" href=\"http://hchcw.org/9-reasons-to-care/the-most-dangerous-job-in-the-nation\" target=\"_blank\">four times more likely\u003c/a> to be injured on the job than the average worker in the United States. The \u003ca title=\"http://www.aroundthecapitol.com/Bills/AB_1136/20112012/\" href=\"http://www.aroundthecapitol.com/Bills/AB_1136/20112012/\" target=\"_blank\">California Safe Patient Handling Act\u003c/a> regulates the lifting and transfer of hospital patients, however, it has been in effect less than year – not long enough to measure improvements.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hospital air exposes patients and staff to potentially hundreds of toxins including formaldehyde from out-gassing building materials, medical waste and cleaning products. In a 2009 survey by the \u003ca title=\"Center for Health Design\" href=\"http://www.healthdesign.org/\" target=\"_blank\">Center for Health Design\u003c/a>, two-thirds of providers in both hospitals and ambulatory care centers called indoor air quality “a major problem.” In fact, it was singled out as the most urgent design problem. Hospitals will always have bad smells, but Lau said in her current hospital \"the air quality in general is pretty good\" though some floors are better than others.\u003c/p>\n\u003cp>Employee \u003ca title=\"SEIU\" href=\"http://www.seiu.org/a/members/safety-and-health.php\" target=\"_blank\">unions\u003c/a>, healthcare systems and regional organizations are working toward healthier health care environments across the state. California-based Dignity Health and Kaiser Permanente are part of the \u003ca title=\"HHI\" href=\"http://healthierhospitals.org/about-hhi/who-we-are\" target=\"_blank\">Healthier Hospitals Initiative\u003c/a>, a project sponsored in part by \u003ca title=\"Health Care Without Harm\" href=\"http://www.noharm.org/\" target=\"_blank\">Health Care Without Harm\u003c/a>, an international advocacy organization promoting sustainable healthcare.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>With the state unemployment rate hovering around 11 percent, the Employment Development Department has projected that healthcare jobs will grow 24 percent by 2018. The Affordable Care Act was not designed to be an economic stimulus bill, but the BACEI report calls the ACA an “economic boon” -- albeit with some known risks to workers -- for California.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "From Healthy Families to Medi-Cal: Kids' Health Care Access in Jeopardy",
"title": "From Healthy Families to Medi-Cal: Kids' Health Care Access in Jeopardy",
"headTitle": "State of Health | KQED News",
"content": "\u003cdiv>\n\u003cp>By \u003ca title=\"http://californiawatch.org/user/stephanie-snyder\" href=\"http://californiawatch.org/user/stephanie-snyder\" target=\"_blank\">Stephanie Snyder\u003c/a>, \u003ca title=\"http://californiawatch.org/dailyreport/kids-access-health-care-concern-under-browns-budget-16301\" href=\"http://californiawatch.org/dailyreport/kids-access-health-care-concern-under-browns-budget-16301\" target=\"_blank\">California Watch\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/black-african-american-doctor-health-hospital.jpg\">\u003cimg class=\"alignleft size-medium wp-image-6170\" title=\"black african american doctor he\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/black-african-american-doctor-health-hospital-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>Low-income children in rural California are in danger of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.\u003c/p>\n\u003cp>The governor is proposing to transfer nearly 900,000 children enrolled in \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families,\u003c/a> the state’s Children’s Health Insurance Program, to \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/pages/default.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/default.aspx\" target=\"_blank\">Medi-Cal\u003c/a> – a program aimed at serving the state’s poorest families, seniors and disabled residents.\u003c/p>\n\u003cp>One major concern is that many doctors who accept children in the Healthy Families program do not accept Medi-Cal, because of Medi-Cal’s lower reimbursement rates.\u003c/p>\n\u003cp>While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could make it tough for families in rural areas to find doctors who accept Medi-Cal.\u003c/p>\n\u003cp>“In the more rural areas or outlying areas, there would be quite a loss or quite a strain,” said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the \u003ca href=\"http://www.aap.org/\" target=\"_blank\">American Academy of Pediatrics\u003c/a>. “Access to care would be a huge issue.”\u003c!--more-->\u003c/p>\n\u003cp>And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they do not already serve Medi-Cal patients, Cohen said.\u003c/p>\n\u003cp>The governor’s \u003ca href=\"http://www.ebudget.ca.gov/Revised/BudgetSummary/BSS/BSS.html\">proposal\u003c/a> requires doctors to accept Medi-Cal’s monthly reimbursement – an average cut of nearly 20 percent over Healthy Families rates. Doctors currently receive a monthly average of $103 per patient in Healthy Families, but Medi-Cal pays $84 on average per patient.\u003c/p>\n\u003cp>A survey referenced by the Legislative Analyst’s Office asked pediatricians who now provide care to Healthy Families patients, but not Medi-Cal patients, if they would be willing to make the switch. The February \u003ca href=\"http://www.lao.ca.gov/analysis/2012/health/healthy-families-021712.aspx\">report\u003c/a> said 29 percent would not accept Medi-Cal and 46 percent were not sure.\u003c/p>\n\u003cp>Anthony Wright, executive director of \u003ca href=\"http://www.health-access.org/\">Health Access California\u003c/a>, an advocacy group, said there likely would be a disruption of care for Healthy Families patients in rural areas when their doctors face the decision of whether they can accept a smaller payment.\u003c/p>\n\u003cp>“People have doctors, they have networks of physicians, children are getting care as we speak,” Wright said. “Will they have access to the same physicians if they’re in the middle of treatment?”\u003c/p>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a27/\" href=\"http://asmdc.org/members/a27/\" target=\"_blank\">Assemblyman Bill Monning\u003c/a>, D-Monterey, said the health department addressed questions about access to care during last week's budget subcommittee meetings.\u003c/p>\n\u003cp>“We already face shortages in rural areas of providers – not only in primary care, but specialty services and providers,” says Monning, who serves on the health subcommittee. “We have to be very cautious that we don’t maneuver ourselves out of access for families. … You can’t move children who are currently in Healthy Families to an environment where there aren’t providers that accept Medi-Cal.”\u003c/p>\n\u003cp>“There’s no program that isn’t facing cuts or reductions and yet when you look in the area of health and human services we have to be mindful of the imminent consequences,” Monning continued.\u003cstrong> \u003c/strong>“We understand the need to achieve savings, but at what cost?”\u003c/p>\n\u003cp>Legislators hope to find some middle ground on the issue of children's health care and last week, the Senate budget subcommittee on health voted to support an alternative plan. The Assembly budget subcommittee is expected to follow suit, Monning said.\u003c/p>\n\u003cp>Opponents to the governor’s proposal say the state should make the transition more slowly, instead of all it once. They suggest first transferring to Medi-Cal only the 186,000 Healthy Families patients from families earning less than 133 percent of the federal poverty level.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>The proposal to move all 878,000 patients enrolled in Healthy Families to Medi-Cal creates several administrative concerns by transitioning too many kids too quickly, said Cohen, the San Diego pediatrician.\u003c/p>\n\u003cp>“We don’t think that the state has the capacity to smoothly transfer all of the patients at once,” Cohen said. “The only one that’s not in agreement is the governor’s office.”\u003c/p>\n\u003cp>But there would be some benefits to combining the programs, he said.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Medi-Cal patients are treated with a “richer benefits plan,” Cohen said. Unlike the Healthy Families program, children would have greater access to free vaccinations and speech and developmental treatment, Cohen said.\u003c/p>\n\u003cp>Access to care is a concern with such a large potential transition of patients, said Wright, of Health Access. But transitioning a smaller number of children to Medi-Cal would help “work out some kinks.”\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Low-income children in rural California are in danger of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.\r\n\r\nThe governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the state’s Children’s Health Insurance Program, to Medi-Cal – a program aimed at serving the state’s poorest families, seniors and disabled residents.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cp>By \u003ca title=\"http://californiawatch.org/user/stephanie-snyder\" href=\"http://californiawatch.org/user/stephanie-snyder\" target=\"_blank\">Stephanie Snyder\u003c/a>, \u003ca title=\"http://californiawatch.org/dailyreport/kids-access-health-care-concern-under-browns-budget-16301\" href=\"http://californiawatch.org/dailyreport/kids-access-health-care-concern-under-browns-budget-16301\" target=\"_blank\">California Watch\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/black-african-american-doctor-health-hospital.jpg\">\u003cimg class=\"alignleft size-medium wp-image-6170\" title=\"black african american doctor he\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/black-african-american-doctor-health-hospital-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>Low-income children in rural California are in danger of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.\u003c/p>\n\u003cp>The governor is proposing to transfer nearly 900,000 children enrolled in \u003ca title=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" href=\"http://www.healthyfamilies.ca.gov/Home/default.aspx\" target=\"_blank\">Healthy Families,\u003c/a> the state’s Children’s Health Insurance Program, to \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/pages/default.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/default.aspx\" target=\"_blank\">Medi-Cal\u003c/a> – a program aimed at serving the state’s poorest families, seniors and disabled residents.\u003c/p>\n\u003cp>One major concern is that many doctors who accept children in the Healthy Families program do not accept Medi-Cal, because of Medi-Cal’s lower reimbursement rates.\u003c/p>\n\u003cp>While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could make it tough for families in rural areas to find doctors who accept Medi-Cal.\u003c/p>\n\u003cp>“In the more rural areas or outlying areas, there would be quite a loss or quite a strain,” said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the \u003ca href=\"http://www.aap.org/\" target=\"_blank\">American Academy of Pediatrics\u003c/a>. “Access to care would be a huge issue.”\u003c!--more-->\u003c/p>\n\u003cp>And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they do not already serve Medi-Cal patients, Cohen said.\u003c/p>\n\u003cp>The governor’s \u003ca href=\"http://www.ebudget.ca.gov/Revised/BudgetSummary/BSS/BSS.html\">proposal\u003c/a> requires doctors to accept Medi-Cal’s monthly reimbursement – an average cut of nearly 20 percent over Healthy Families rates. Doctors currently receive a monthly average of $103 per patient in Healthy Families, but Medi-Cal pays $84 on average per patient.\u003c/p>\n\u003cp>A survey referenced by the Legislative Analyst’s Office asked pediatricians who now provide care to Healthy Families patients, but not Medi-Cal patients, if they would be willing to make the switch. The February \u003ca href=\"http://www.lao.ca.gov/analysis/2012/health/healthy-families-021712.aspx\">report\u003c/a> said 29 percent would not accept Medi-Cal and 46 percent were not sure.\u003c/p>\n\u003cp>Anthony Wright, executive director of \u003ca href=\"http://www.health-access.org/\">Health Access California\u003c/a>, an advocacy group, said there likely would be a disruption of care for Healthy Families patients in rural areas when their doctors face the decision of whether they can accept a smaller payment.\u003c/p>\n\u003cp>“People have doctors, they have networks of physicians, children are getting care as we speak,” Wright said. “Will they have access to the same physicians if they’re in the middle of treatment?”\u003c/p>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a27/\" href=\"http://asmdc.org/members/a27/\" target=\"_blank\">Assemblyman Bill Monning\u003c/a>, D-Monterey, said the health department addressed questions about access to care during last week's budget subcommittee meetings.\u003c/p>\n\u003cp>“We already face shortages in rural areas of providers – not only in primary care, but specialty services and providers,” says Monning, who serves on the health subcommittee. “We have to be very cautious that we don’t maneuver ourselves out of access for families. … You can’t move children who are currently in Healthy Families to an environment where there aren’t providers that accept Medi-Cal.”\u003c/p>\n\u003cp>“There’s no program that isn’t facing cuts or reductions and yet when you look in the area of health and human services we have to be mindful of the imminent consequences,” Monning continued.\u003cstrong> \u003c/strong>“We understand the need to achieve savings, but at what cost?”\u003c/p>\n\u003cp>Legislators hope to find some middle ground on the issue of children's health care and last week, the Senate budget subcommittee on health voted to support an alternative plan. The Assembly budget subcommittee is expected to follow suit, Monning said.\u003c/p>\n\u003cp>Opponents to the governor’s proposal say the state should make the transition more slowly, instead of all it once. They suggest first transferring to Medi-Cal only the 186,000 Healthy Families patients from families earning less than 133 percent of the federal poverty level.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>The proposal to move all 878,000 patients enrolled in Healthy Families to Medi-Cal creates several administrative concerns by transitioning too many kids too quickly, said Cohen, the San Diego pediatrician.\u003c/p>\n\u003cp>“We don’t think that the state has the capacity to smoothly transfer all of the patients at once,” Cohen said. “The only one that’s not in agreement is the governor’s office.”\u003c/p>\n\u003cp>But there would be some benefits to combining the programs, he said.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Medi-Cal patients are treated with a “richer benefits plan,” Cohen said. Unlike the Healthy Families program, children would have greater access to free vaccinations and speech and developmental treatment, Cohen said.\u003c/p>\n\u003cp>Access to care is a concern with such a large potential transition of patients, said Wright, of Health Access. But transitioning a smaller number of children to Medi-Cal would help “work out some kinks.”\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "No Death Panel Debate--Mass. Senate OKs \"Palliative Care Awareness\"",
"title": "No Death Panel Debate--Mass. Senate OKs \"Palliative Care Awareness\"",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>By Martha Bebinger\u003c/strong>,\u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/mass-senate-skirts-end-of-life-counseling-controversy/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/mass-senate-skirts-end-of-life-counseling-controversy/\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6113\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Hands_RyanWilcox_Flickr_12082011.jpg\">\u003cimg class=\"size-medium wp-image-6113\" title=\"(Ryan Wilcox: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Hands_RyanWilcox_Flickr_12082011-300x200.jpg\" alt=\"(Ryan Wilcox: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Wilcox: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's been almost three years since Sarah Palin claimed that end-of-life care options could turn into \u003ca title=\"https://www.facebook.com/note.php?note_id=113851103434\" href=\"https://www.facebook.com/note.php?note_id=113851103434\" target=\"_blank\">death panels\u003c/a>.\u003c/p>\n\u003cp>But last week, with no discussion, legislators avoided a minefield that exploded repeatedly during the national health care debate. With a quick call of the ayes and nays, the Massachusetts Senate approved Amendment no. 121, “Palliative Care Awareness.\" It requires that physicians and nurses in Massachusetts must talk to terminally ill patients about their end of life options, their risks and benefits and how best to manage their symptoms and pain.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Senate Republican leaders confirm that they have no objections ... and it's also supported by one of the state’s leading right-to-life groups.\u003c/aside>\n\u003cp>In 2006, Massachusetts passed statewide health insurance reform which requires nearly every resident to carry health insurance. It's considered a model to the feds' \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act. \u003c/a>\u003c/p>\n\u003cp>Since then, Massachusetts has been implementing its plan. Counseling advocates say they won’t let Palin’s interpretation of end-of-life care derail their mission.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The national controversy about death panels — what AARP called lies about death panels — is completely misguided,” said \u003ca title=\"http://www.bidmc.org/CentersandDepartments/Departments/EthicsSupportService/OurEthicsSupportTeam.aspx\" href=\"http://www.bidmc.org/CentersandDepartments/Departments/EthicsSupportService/OurEthicsSupportTeam.aspx\" target=\"_blank\">Dr. Lachlan Forrow\u003c/a>, who directs ethics and palliative care programs at Beth Israel Deaconess Medical Center. “In Massachusetts we can unite and show how to do it right.”\u003c!--more-->\u003c/p>\n\u003cp>Forrow chaired an expert panel on end-of-life care that wrapped up last year. The Senate amendment is a first step toward filling the panel’s recommendations. Forrow says there’s widespread agreement in Massachusetts that to make sure patients get the care they want they must be informed about their options.\u003c/p>\n\u003cp>To prolong life “as long it might work in the ICU might be a choice,” says Forrow. Other patients might say “I want to be at home with my family, as comfortable as possible. People need the full range of choices. That needs to be documented if they (the patients) have preferences, and it has to be respected absolutely all the time.”\u003c/p>\n\u003cp>The next step, Forrow says, must be to train hospital and home care staff about how to follow a patient’s wishes.\u003c/p>\n\u003cp>Senate Republican leaders confirm that they have no objections to this amendment and it's also supported by one of the state’s leading right-to-life groups, the \u003ca title=\"http://www.mafamily.org/\" href=\"http://www.mafamily.org/\" target=\"_blank\">Massachusetts Family Institute\u003c/a>.\u003c/p>\n\u003cp>New York requires hospitals and physicians to offer information and counseling about palliative care to terminally ill patients. The\u003ca title=\"http://www.nhpco.org/templates/1/homepage.cfm\" href=\"http://www.nhpco.org/templates/1/homepage.cfm\" target=\"_blank\"> National Hospice and Palliative Care Organization\u003c/a> says several bills that would establish end-of-life counseling funded by Medicare or Social Security are pending on Capitol Hill but that state action is very unusual.\u003c/p>\n\u003cp>Such broad support for end-of-life discussions with doctors begs the question: Why is reception for this issue so different in the Bay State?\u003c/p>\n\u003cp>“People in Massachusetts are smarter than everywhere else,” said Sen. Richard Moore, laughing. Moore sponsored the end-of-life counseling amendment. “No, seriously, we approached this in the right way, bringing in people who had experience with it.”\u003c/p>\n\u003cp>The point, Moore said, was “not to demonize anybody in the process, and I think that’s a big part of it.”\u003c/p>\n\u003cp>Moore stresses that the state would not require that patients make end-of-life plans or even have the conversation if they don’t want to.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This issue is only in the Senate health care costs bill right now. House leaders declined to say if they would support such an amendment when the House takes up its version of the health care cost legislation.\u003c/p>\n\n",
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"excerpt": "It's been almost three years since Sarah Palin claimed that end-of-life care options could turn into death panels.\r\n\r\nBut last week, with no debate, legislators avoided a minefield that exploded repeatedly during the national health care debate. With a quick call of the ayes and nays, the Massachusetts Senate approved Amendment no. 121, “Palliative Care Awareness.\" It requires that physicians and nurses in Massachusetts must talk to terminally ill patients about their end of life options, their risks and benefits and how best to manage their symptoms and pain.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Martha Bebinger\u003c/strong>,\u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/mass-senate-skirts-end-of-life-counseling-controversy/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/mass-senate-skirts-end-of-life-counseling-controversy/\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6113\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Hands_RyanWilcox_Flickr_12082011.jpg\">\u003cimg class=\"size-medium wp-image-6113\" title=\"(Ryan Wilcox: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Hands_RyanWilcox_Flickr_12082011-300x200.jpg\" alt=\"(Ryan Wilcox: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ryan Wilcox: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>It's been almost three years since Sarah Palin claimed that end-of-life care options could turn into \u003ca title=\"https://www.facebook.com/note.php?note_id=113851103434\" href=\"https://www.facebook.com/note.php?note_id=113851103434\" target=\"_blank\">death panels\u003c/a>.\u003c/p>\n\u003cp>But last week, with no discussion, legislators avoided a minefield that exploded repeatedly during the national health care debate. With a quick call of the ayes and nays, the Massachusetts Senate approved Amendment no. 121, “Palliative Care Awareness.\" It requires that physicians and nurses in Massachusetts must talk to terminally ill patients about their end of life options, their risks and benefits and how best to manage their symptoms and pain.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Senate Republican leaders confirm that they have no objections ... and it's also supported by one of the state’s leading right-to-life groups.\u003c/aside>\n\u003cp>In 2006, Massachusetts passed statewide health insurance reform which requires nearly every resident to carry health insurance. It's considered a model to the feds' \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act. \u003c/a>\u003c/p>\n\u003cp>Since then, Massachusetts has been implementing its plan. Counseling advocates say they won’t let Palin’s interpretation of end-of-life care derail their mission.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The national controversy about death panels — what AARP called lies about death panels — is completely misguided,” said \u003ca title=\"http://www.bidmc.org/CentersandDepartments/Departments/EthicsSupportService/OurEthicsSupportTeam.aspx\" href=\"http://www.bidmc.org/CentersandDepartments/Departments/EthicsSupportService/OurEthicsSupportTeam.aspx\" target=\"_blank\">Dr. Lachlan Forrow\u003c/a>, who directs ethics and palliative care programs at Beth Israel Deaconess Medical Center. “In Massachusetts we can unite and show how to do it right.”\u003c!--more-->\u003c/p>\n\u003cp>Forrow chaired an expert panel on end-of-life care that wrapped up last year. The Senate amendment is a first step toward filling the panel’s recommendations. Forrow says there’s widespread agreement in Massachusetts that to make sure patients get the care they want they must be informed about their options.\u003c/p>\n\u003cp>To prolong life “as long it might work in the ICU might be a choice,” says Forrow. Other patients might say “I want to be at home with my family, as comfortable as possible. People need the full range of choices. That needs to be documented if they (the patients) have preferences, and it has to be respected absolutely all the time.”\u003c/p>\n\u003cp>The next step, Forrow says, must be to train hospital and home care staff about how to follow a patient’s wishes.\u003c/p>\n\u003cp>Senate Republican leaders confirm that they have no objections to this amendment and it's also supported by one of the state’s leading right-to-life groups, the \u003ca title=\"http://www.mafamily.org/\" href=\"http://www.mafamily.org/\" target=\"_blank\">Massachusetts Family Institute\u003c/a>.\u003c/p>\n\u003cp>New York requires hospitals and physicians to offer information and counseling about palliative care to terminally ill patients. The\u003ca title=\"http://www.nhpco.org/templates/1/homepage.cfm\" href=\"http://www.nhpco.org/templates/1/homepage.cfm\" target=\"_blank\"> National Hospice and Palliative Care Organization\u003c/a> says several bills that would establish end-of-life counseling funded by Medicare or Social Security are pending on Capitol Hill but that state action is very unusual.\u003c/p>\n\u003cp>Such broad support for end-of-life discussions with doctors begs the question: Why is reception for this issue so different in the Bay State?\u003c/p>\n\u003cp>“People in Massachusetts are smarter than everywhere else,” said Sen. Richard Moore, laughing. Moore sponsored the end-of-life counseling amendment. “No, seriously, we approached this in the right way, bringing in people who had experience with it.”\u003c/p>\n\u003cp>The point, Moore said, was “not to demonize anybody in the process, and I think that’s a big part of it.”\u003c/p>\n\u003cp>Moore stresses that the state would not require that patients make end-of-life plans or even have the conversation if they don’t want to.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This issue is only in the Senate health care costs bill right now. House leaders declined to say if they would support such an amendment when the House takes up its version of the health care cost legislation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By David Gorn, \u003ca title=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" href=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6090\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\">\u003cimg class=\"size-full wp-image-6090\" title=\"(Photo: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\" alt=\"(Photo: Kaiser Health News)\" width=\"300\" height=\"215\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Community-Based Adult Services\u003c/a> program grew out of a lawsuit challenging the state's proposal and replaces the \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Adult Day Health Care\u003c/a> program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\u003c/p>\n\u003cp>\"The original budget for ADHC was $170 million, and the current CBAS budget is\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I guess I just don't understand why we had to go through all of this.\"\u003c/aside>\n\u003cp>$155 million,\" said Lydia Missaelides, executive director of the \u003ca title=\"http://www.caads.org/index.html\" href=\"http://www.caads.org/index.html\" target=\"_blank\">California Association of Adult Day Services\u003c/a>. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of course, that doesn't count the expense of legal battles, or the daunting number of man hours spent designing and implementing a new system, not to mention the constant arguing and debating over more than a year, she said. Missaelides sighed at the idea of it.\u003c!--more-->\u003c/p>\n\u003cp>\"I guess I just don't understand,\" she said, \"why we had to go through all of this.\"\u003c/p>\n\u003cp>The ADHC-to-CBAS metamorphosis -- which began in budget proposals more than a year ago -- sparked legislation, multiple hearings at the Capitol and a lengthy lawsuit.\u003c/p>\n\u003cp>\"We are in the process of implementing a legal settlement of substantial scope, and we are starting an entirely new program -- two very costly activities,\" said Norman Williams, deputy director of public affairs at the \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>. \"Because of this, in subsequent years we expect additional savings to be realized.\"\u003c/p>\n\u003cp>The state's costs related to the lawsuit and settlement are separate from CBAS expenditures.\u003c/p>\n\u003cp>\u003cstrong>Process Slowing Down\u003c/strong>\u003c/p>\n\u003cp>DHCS recently announced it would phase in its new adult day health program, rather than implement it all at once on July 1. The shift involves several complicated steps: determining eligibility for 40,000 frail and elderly patients across the state, moving 80 percent of them to managed care plans and converting existing centers to not-for-profit status. The state recently adjusted its timetable and built in a three-month cushion to ease the transition.\u003c/p>\n\u003cp>State officials said 31 of the 253 adult day health care centers in California will make the switch in July, while the bulk of the centers now are eyeing an Oct. 1 deadline.\u003c/p>\n\u003cp>The extra time was necessary, health officials said, to work out a number of crucial details. For instance, the state requires any for-profit adult day health care center to switch to not-for-profit status to qualify as a Community-Based Adult Services center. But here we are -- just about a month to the July 1 deadline and the state has not yet issued guidelines for that requirement.\u003c/p>\n\u003cp>In addition:\u003c/p>\n\u003cul>\n\u003cli>Rates still need to be worked out for health plans\u003c/li>\n\u003cli>Questions remain about what will happen if the for-profits can't make the switch\u003c/li>\n\u003cli>And what about patient eligibility denials?\u003c/li>\n\u003c/ul>\n\u003cp>Appeals to denials will be heard starting next week. The Adult Day Health Care Association recently announced that it will file an appeal to reverse the state's 10 percent provider rate cut. Meanwhile, two more ADHC centers recently closed.\u003c/p>\n\u003cp>The good news for adult day health care beneficiaries is that state officials agreed to spend more on the new program. In the May budget revision, the CBAS budget was raised to $156 million for the next year.\u003c/p>\n\u003cp>Missaelides said state officials clearly have been listening to stakeholders' concerns these days, as evidenced by the decision to delay implementation for most of the centers, with the new phase-in approach.\u003c/p>\n\u003cp>The relative handful of CBAS centers that will lead the way with a July 1 implementation date were selected because they are all \u003ca title=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" href=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" target=\"_blank\">County Organized Health Systems\u003c/a>, according to Jane Ogle, deputy director of the Department of Health Care Services.\u003c/p>\n\u003cp>\"We picked the COHS counties first because the beneficiaries are already members of the plan and don't have to make a plan selection,\" Ogle said. \"This eliminates one step in the process.\"\u003c/p>\n\u003cp>In the rest of the counties, a big step in the process will be enrollment into Medi-Cal managed care plans. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In those counties where beneficiaries have to make a choice,\" Ogle said, \"we will wait until October, to give them plenty of time to make that selection.\"\u003c/p>\n\n",
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"excerpt": "After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\r\n\r\nThe Community-Based Adult Services program grew out of a lawsuit challenging the state's proposal and replaces the Adult Day Health Care program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\r\n\r\n\"The original budget for ADHC was $170 million, and the current CBAS budget is $155 million,\" said Lydia Missaelides, executive director of the California Association of Adult Day Services. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By David Gorn, \u003ca title=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" href=\"http://www.californiahealthline.org/features/2012/costs-in-new-adult-day-program-almost-same-as-old-one.aspx#\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_6090\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\">\u003cimg class=\"size-full wp-image-6090\" title=\"(Photo: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/SeniorWalking_KaiserHealthNews.jpg\" alt=\"(Photo: Kaiser Health News)\" width=\"300\" height=\"215\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>After more than a year of battling over eliminating and then restructuring adult day health care coverage for Medi-Cal beneficiaries, California's budget for delivering that care is similar to what it was before all the haggling started.\u003c/p>\n\u003cp>The \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Community-Based Adult Services\u003c/a> program grew out of a lawsuit challenging the state's proposal and replaces the \u003ca title=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/ADHC/ADHC.aspx\" target=\"_blank\">Adult Day Health Care\u003c/a> program. CBAS will provide services to 80 percent of previous ADHC beneficiaries and is funded at a similar level to the original program.\u003c/p>\n\u003cp>\"The original budget for ADHC was $170 million, and the current CBAS budget is\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I guess I just don't understand why we had to go through all of this.\"\u003c/aside>\n\u003cp>$155 million,\" said Lydia Missaelides, executive director of the \u003ca title=\"http://www.caads.org/index.html\" href=\"http://www.caads.org/index.html\" target=\"_blank\">California Association of Adult Day Services\u003c/a>. \"That means you're looking at roughly the same cost to provide the same services to 80% of the beneficiaries.\"\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 doesn't count the expense of legal battles, or the daunting number of man hours spent designing and implementing a new system, not to mention the constant arguing and debating over more than a year, she said. Missaelides sighed at the idea of it.\u003c!--more-->\u003c/p>\n\u003cp>\"I guess I just don't understand,\" she said, \"why we had to go through all of this.\"\u003c/p>\n\u003cp>The ADHC-to-CBAS metamorphosis -- which began in budget proposals more than a year ago -- sparked legislation, multiple hearings at the Capitol and a lengthy lawsuit.\u003c/p>\n\u003cp>\"We are in the process of implementing a legal settlement of substantial scope, and we are starting an entirely new program -- two very costly activities,\" said Norman Williams, deputy director of public affairs at the \u003ca title=\"http://www.dhcs.ca.gov/Pages/default.aspx\" href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">Department of Health Care Services\u003c/a>. \"Because of this, in subsequent years we expect additional savings to be realized.\"\u003c/p>\n\u003cp>The state's costs related to the lawsuit and settlement are separate from CBAS expenditures.\u003c/p>\n\u003cp>\u003cstrong>Process Slowing Down\u003c/strong>\u003c/p>\n\u003cp>DHCS recently announced it would phase in its new adult day health program, rather than implement it all at once on July 1. The shift involves several complicated steps: determining eligibility for 40,000 frail and elderly patients across the state, moving 80 percent of them to managed care plans and converting existing centers to not-for-profit status. The state recently adjusted its timetable and built in a three-month cushion to ease the transition.\u003c/p>\n\u003cp>State officials said 31 of the 253 adult day health care centers in California will make the switch in July, while the bulk of the centers now are eyeing an Oct. 1 deadline.\u003c/p>\n\u003cp>The extra time was necessary, health officials said, to work out a number of crucial details. For instance, the state requires any for-profit adult day health care center to switch to not-for-profit status to qualify as a Community-Based Adult Services center. But here we are -- just about a month to the July 1 deadline and the state has not yet issued guidelines for that requirement.\u003c/p>\n\u003cp>In addition:\u003c/p>\n\u003cul>\n\u003cli>Rates still need to be worked out for health plans\u003c/li>\n\u003cli>Questions remain about what will happen if the for-profits can't make the switch\u003c/li>\n\u003cli>And what about patient eligibility denials?\u003c/li>\n\u003c/ul>\n\u003cp>Appeals to denials will be heard starting next week. The Adult Day Health Care Association recently announced that it will file an appeal to reverse the state's 10 percent provider rate cut. Meanwhile, two more ADHC centers recently closed.\u003c/p>\n\u003cp>The good news for adult day health care beneficiaries is that state officials agreed to spend more on the new program. In the May budget revision, the CBAS budget was raised to $156 million for the next year.\u003c/p>\n\u003cp>Missaelides said state officials clearly have been listening to stakeholders' concerns these days, as evidenced by the decision to delay implementation for most of the centers, with the new phase-in approach.\u003c/p>\n\u003cp>The relative handful of CBAS centers that will lead the way with a July 1 implementation date were selected because they are all \u003ca title=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" href=\"http://www.chcf.org/publications/2000/03/medical-managed-care\" target=\"_blank\">County Organized Health Systems\u003c/a>, according to Jane Ogle, deputy director of the Department of Health Care Services.\u003c/p>\n\u003cp>\"We picked the COHS counties first because the beneficiaries are already members of the plan and don't have to make a plan selection,\" Ogle said. \"This eliminates one step in the process.\"\u003c/p>\n\u003cp>In the rest of the counties, a big step in the process will be enrollment into Medi-Cal managed care plans. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In those counties where beneficiaries have to make a choice,\" Ogle said, \"we will wait until October, to give them plenty of time to make that selection.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Perhaps the Most Vulnerable ... Budget Cuts Hit Mentally Ill Especially Hard",
"title": "Perhaps the Most Vulnerable ... Budget Cuts Hit Mentally Ill Especially Hard",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_6073\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Screen-Shot-2012-05-24-at-1.44.14-PM.png\">\u003cimg class=\"size-medium wp-image-6073\" title=\"(Lauren Whaley: CHCF Center for Health Reporting)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Screen-Shot-2012-05-24-at-1.44.14-PM-300x179.png\" alt=\"(Lauren Whaley: CHCF Center for Health Reporting)\" width=\"300\" height=\"179\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lauren Whaley: CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>In a series they're calling \"Mental Breakdown\" the \u003ca title=\"http://localsearch.modbee.com/sp?aff=1100&keywords=mental+breakdown&x=0&y=0\" href=\"http://localsearch.modbee.com/sp?aff=1100&keywords=mental+breakdown&x=0&y=0\" target=\"_blank\">Modesto Bee\u003c/a> collaborated with the \u003ca title=\"http://centerforhealthreporting.org/project/mental-breakdown-state-county-cuts-devastate-mentally-ill\" href=\"http://centerforhealthreporting.org/project/mental-breakdown-state-county-cuts-devastate-mentally-ill\" target=\"_blank\">Center for Health Reporting\u003c/a> in a sobering look at how state and county cuts are devastating county mental health departments -- by focusing close to home in the Central Valley's Stanislaus County. Modesto is the county seat of Stanislaus.\u003c/p>\n\u003cp>Reporters describe people with mental illness who should be in state mental hospitals instead\u003ca title=\"http://centerforhealthreporting.org/article/mentally-ill-languish-jails-due-budget-cuts-lack-beds893\" href=\"http://centerforhealthreporting.org/article/mentally-ill-languish-jails-due-budget-cuts-lack-beds893\" target=\"_blank\"> spend weeks in local jails\u003c/a>, waiting for beds. \u003ca title=\"http://www.modbee.com/2012/05/19/2207051/hospital-emergency-feeling-the.html\" href=\"http://www.modbee.com/2012/05/19/2207051/hospital-emergency-feeling-the.html\" target=\"_blank\">Hospital emergency rooms\u003c/a> have seen a dramatic increase in mentally ill patients. In all likelihood, counties across California are feeling the same impact.\u003c/p>\n\u003cp>But the series also speaks of hope. With the right treatment, even people with the most serious mental illnesses can do well -- as this short video between father and daughter attests:\u003c/p>\n\u003cp>[youtube http://player.vimeo.com/video/42419594?title=0&byline=0&portrait=0&color=ffffff]\u003c/p>\n\u003cp>You can read more about Matt Freitas and the work he does in his clinic \u003ca title=\"http://centerforhealthreporting.org/article/shining-light-modesto899\" href=\"http://centerforhealthreporting.org/article/shining-light-modesto899\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "In a series they're calling \"Mental Breakdown\" the Modesto Bee has collaborated with the Center for Health Reporting in a sobering look at how state and county cuts are devastating county mental health departments. They zeroed in on the Central Valley's Stanislaus County.\r\n\r\nReporters describe people with mental illness who should be in state mental hospitals instead spend weeks in local jails, waiting for beds. Hospital emergency rooms have seen a dramatic increase in mentally ill patients. In all likelihood, counties across California are feeling the same impact.",
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"description": "In a series they're calling "Mental Breakdown" the Modesto Bee has collaborated with the Center for Health Reporting in a sobering look at how state and county cuts are devastating county mental health departments. They zeroed in on the Central Valley's Stanislaus County.\r\n\r\nReporters describe people with mental illness who should be in state mental hospitals instead spend weeks in local jails, waiting for beds. Hospital emergency rooms have seen a dramatic increase in mentally ill patients. In all likelihood, counties across California are feeling the same impact.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6073\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Screen-Shot-2012-05-24-at-1.44.14-PM.png\">\u003cimg class=\"size-medium wp-image-6073\" title=\"(Lauren Whaley: CHCF Center for Health Reporting)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Screen-Shot-2012-05-24-at-1.44.14-PM-300x179.png\" alt=\"(Lauren Whaley: CHCF Center for Health Reporting)\" width=\"300\" height=\"179\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Lauren Whaley: CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>In a series they're calling \"Mental Breakdown\" the \u003ca title=\"http://localsearch.modbee.com/sp?aff=1100&keywords=mental+breakdown&x=0&y=0\" href=\"http://localsearch.modbee.com/sp?aff=1100&keywords=mental+breakdown&x=0&y=0\" target=\"_blank\">Modesto Bee\u003c/a> collaborated with the \u003ca title=\"http://centerforhealthreporting.org/project/mental-breakdown-state-county-cuts-devastate-mentally-ill\" href=\"http://centerforhealthreporting.org/project/mental-breakdown-state-county-cuts-devastate-mentally-ill\" target=\"_blank\">Center for Health Reporting\u003c/a> in a sobering look at how state and county cuts are devastating county mental health departments -- by focusing close to home in the Central Valley's Stanislaus County. Modesto is the county seat of Stanislaus.\u003c/p>\n\u003cp>Reporters describe people with mental illness who should be in state mental hospitals instead\u003ca title=\"http://centerforhealthreporting.org/article/mentally-ill-languish-jails-due-budget-cuts-lack-beds893\" href=\"http://centerforhealthreporting.org/article/mentally-ill-languish-jails-due-budget-cuts-lack-beds893\" target=\"_blank\"> spend weeks in local jails\u003c/a>, waiting for beds. \u003ca title=\"http://www.modbee.com/2012/05/19/2207051/hospital-emergency-feeling-the.html\" href=\"http://www.modbee.com/2012/05/19/2207051/hospital-emergency-feeling-the.html\" target=\"_blank\">Hospital emergency rooms\u003c/a> have seen a dramatic increase in mentally ill patients. In all likelihood, counties across California are feeling the same impact.\u003c/p>\n\u003cp>But the series also speaks of hope. With the right treatment, even people with the most serious mental illnesses can do well -- as this short video between father and daughter attests:\u003c/p>\n\u003cp>\u003c/p>\u003cp>null\u003c/p>\u003cp>\u003c/p>\n\u003cp>You can read more about Matt Freitas and the work he does in his clinic \u003ca title=\"http://centerforhealthreporting.org/article/shining-light-modesto899\" href=\"http://centerforhealthreporting.org/article/shining-light-modesto899\" target=\"_blank\">here\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "PSA Debate on Morning TV: American Cancer Society vs. Basketball Coach",
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"content": "\u003cp>The debate about the U.S. Preventative Services Task Force giving the \u003ca title=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\" href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\" target=\"_blank\">PSA test a \"D\" rating\u003c/a> was all over the morning talk shows today. But perhaps the most interesting debate happened during a commercial break. While this clip did not air, CBS fortunately recorded it.\u003c/p>\n\u003cp>Watch as\u003ca title=\"http://pressroom.cancer.org/index.php?s=18&item=40\" href=\"http://pressroom.cancer.org/index.php?s=18&item=40\" target=\"_blank\"> Dr. Otis Brawley\u003c/a>, Chief Medical Officer of the American Cancer Society, and former basketball coach \u003ca title=\"http://www.espnmediazone3.com/us/2009/11/17/phelps_digger/\" href=\"http://www.espnmediazone3.com/us/2009/11/17/phelps_digger/\" target=\"_blank\">Digger Phelps\u003c/a>, who has had surgery for prostate cancer clearly articulate the two opposing poles of the PSA test.\u003c/p>\n\u003cp>\u003cobject width=\"425\" height=\"279\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"src\" value=\"http://cnettv.cnet.com/av/video/cbsnews/atlantis2/cbsnews_player_embed.swf\">\u003cparam name=\"allowfullscreen\" value=\"true\">\u003cparam name=\"allowscriptaccess\" value=\"always\">\u003cparam name=\"flashvars\" value=\"si=254&contentValue=50125119&shareUrl=http://www.cbsnews.com/video/watch/?id=7409376n\">\u003cembed width=\"425\" height=\"279\" type=\"application/x-shockwave-flash\" src=\"http://cnettv.cnet.com/av/video/cbsnews/atlantis2/cbsnews_player_embed.swf\" allowfullscreen=\"true\" allowscriptaccess=\"always\" flashvars=\"si=254&contentValue=50125119&shareUrl=http://www.cbsnews.com/video/watch/?id=7409376n\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>Hat/Tip to \u003ca title=\"http://www.healthnewsreview.org/2012/05/reactions-to-uspstf-prostate-cancer-screening-recommendations/\" href=\"http://www.healthnewsreview.org/2012/05/reactions-to-uspstf-prostate-cancer-screening-recommendations/\" target=\"_blank\">HealthNewsReview \u003c/a>for blogging the video.\u003c/p>\n\u003cp>Near the end, Phelps passionately argues against \"watchful waiting,\" saying the idea of having cancer is too frightening to postpone treatment. Brawley starts to make the case for informed consent, but doesn't have time to finish in this clip.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But this is exactly the paradox of going ahead and doing the test. Brawley estimates \u003ca title=\"http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says?ps=sh_sthdl\" target=\"_blank\">a million men\u003c/a> have been needlessly cured of their prostate cancer-- a disease men are significantly more likely to die \u003cem>with\u003c/em> and not \u003cem>from\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This is what's behind the \u003ca title=\"http://www.ahrq.gov/clinic/uspstfix.htm\" href=\"http://www.ahrq.gov/clinic/uspstfix.htm\" target=\"_blank\">U.S. Preventive Services Task Force\u003c/a> recommendation: if you can't live with doing nothing in the face of a prostate cancer diagnosis, then don't have the PSA test in the first place. You are more likely to be harmed by the treatment--the harms range from incontinence, impotence and death.\u003c/p>\n\n",
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"excerpt": "The debate about the U.S. Preventative Services Task Force giving the PSA test a \"D\" rating was all over the morning talk shows today. But perhaps the most interesting debate happened during a commercial break. While this clip did not air, CBS fortunately recorded it.\r\n\r\nWatch as Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society, and former basketball coach Digger Phelps, who has had surgery for prostate cancer clearly articulate the two opposing poles of the PSA test.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The debate about the U.S. Preventative Services Task Force giving the \u003ca title=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\" href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-stop-doing-the-psa-test-now/\" target=\"_blank\">PSA test a \"D\" rating\u003c/a> was all over the morning talk shows today. But perhaps the most interesting debate happened during a commercial break. While this clip did not air, CBS fortunately recorded it.\u003c/p>\n\u003cp>Watch as\u003ca title=\"http://pressroom.cancer.org/index.php?s=18&item=40\" href=\"http://pressroom.cancer.org/index.php?s=18&item=40\" target=\"_blank\"> Dr. Otis Brawley\u003c/a>, Chief Medical Officer of the American Cancer Society, and former basketball coach \u003ca title=\"http://www.espnmediazone3.com/us/2009/11/17/phelps_digger/\" href=\"http://www.espnmediazone3.com/us/2009/11/17/phelps_digger/\" target=\"_blank\">Digger Phelps\u003c/a>, who has had surgery for prostate cancer clearly articulate the two opposing poles of the PSA test.\u003c/p>\n\u003cp>\u003cobject width=\"425\" height=\"279\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"src\" value=\"http://cnettv.cnet.com/av/video/cbsnews/atlantis2/cbsnews_player_embed.swf\">\u003cparam name=\"allowfullscreen\" value=\"true\">\u003cparam name=\"allowscriptaccess\" value=\"always\">\u003cparam name=\"flashvars\" value=\"si=254&contentValue=50125119&shareUrl=http://www.cbsnews.com/video/watch/?id=7409376n\">\u003cembed width=\"425\" height=\"279\" type=\"application/x-shockwave-flash\" src=\"http://cnettv.cnet.com/av/video/cbsnews/atlantis2/cbsnews_player_embed.swf\" allowfullscreen=\"true\" allowscriptaccess=\"always\" flashvars=\"si=254&contentValue=50125119&shareUrl=http://www.cbsnews.com/video/watch/?id=7409376n\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>Hat/Tip to \u003ca title=\"http://www.healthnewsreview.org/2012/05/reactions-to-uspstf-prostate-cancer-screening-recommendations/\" href=\"http://www.healthnewsreview.org/2012/05/reactions-to-uspstf-prostate-cancer-screening-recommendations/\" target=\"_blank\">HealthNewsReview \u003c/a>for blogging the video.\u003c/p>\n\u003cp>Near the end, Phelps passionately argues against \"watchful waiting,\" saying the idea of having cancer is too frightening to postpone treatment. Brawley starts to make the case for informed consent, but doesn't have time to finish in this clip.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But this is exactly the paradox of going ahead and doing the test. Brawley estimates \u003ca title=\"http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says?ps=sh_sthdl\" target=\"_blank\">a million men\u003c/a> have been needlessly cured of their prostate cancer-- a disease men are significantly more likely to die \u003cem>with\u003c/em> and not \u003cem>from\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This is what's behind the \u003ca title=\"http://www.ahrq.gov/clinic/uspstfix.htm\" href=\"http://www.ahrq.gov/clinic/uspstfix.htm\" target=\"_blank\">U.S. Preventive Services Task Force\u003c/a> recommendation: if you can't live with doing nothing in the face of a prostate cancer diagnosis, then don't have the PSA test in the first place. You are more likely to be harmed by the treatment--the harms range from incontinence, impotence and death.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bill Would Make Vaccine \"Opt-Out\" A Little Tougher",
"title": "Bill Would Make Vaccine \"Opt-Out\" A Little Tougher",
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"content": "\u003cfigure id=\"attachment_5990\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Vaccination-Large-Jeff-J-Mitchell-Getty.jpg\">\u003cimg class=\"size-medium wp-image-5990\" title=\"(Jeff J. Mitchell: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Vaccination-Large-Jeff-J-Mitchell-Getty-300x192.jpg\" alt=\"(Jeff J. Mitchell: Getty Images)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jeff J. Mitchell: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California is one of \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">20 states \u003c/a>that allows parents to “opt out” of vaccines for their children simply by signing a form. It's called a \"personal belief exemption.\" But \u003ca title=\"http://www.aroundthecapitol.com/Bills/AB_2109/20112012/\" href=\"http://www.aroundthecapitol.com/Bills/AB_2109/20112012/\" target=\"_blank\">AB 2109\u003c/a> would change that. The bill has cleared the Assembly and is starting its path through Senate committees.\u003c/p>\n\u003cp>If the bill becomes law, parents who wish to refuse vaccines would first need to receive counseling from a licensed health professional about the risks and benefits of skipping immunizations for their children.\u003c/p>\n\u003cp>Vaccination rates in California have been dropping in recent years, worrying public health officials. Ten infants died in a whooping cough outbreak in 2009.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"This is not about taking away the rights of parents to make decisions.\"\u003c/aside>\n\u003cp>\"Democratic \u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> wrote the bill. He’s also a pediatrician and says parents’ decision not to vaccinate their own child puts others at risk too.\u003c/p>\n\u003cp>Very young children, infants may be too young to be immunized,\" he told me in a recent interview. \"People with cancer and on chemotherapy, people with HIV or AIDS ... they cannot receive immunizations.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Republican \u003ca title=\"http://arc.asm.ca.gov/member/3/\" href=\"http://arc.asm.ca.gov/member/3/\" target=\"_blank\">Assemblyman Dan Logue\u003c/a> co-chairs the Assembly’s Health Committee. He opposes the bill – but not for medical reasons.\u003c/p>\n\u003cp>“What we do now in California is we tell you how much salt to put on your food, what kind of light bulb you should screw in your lamp,\" he says. \"The people of California are fed up with a state government that thinks it can run our lives better than they can, and enough is enough.”\u003c/p>\n\u003cp>But Pan counters the nanny-state argument. \"This is not about taking away the rights of parents to make decisions. Parents are still free to make these decisions. But it's also the role of government to protect the public, that's why we have a police force, to protect us from criminals,\" he says. \"We have diseases out there that can kill people ... and vaccinations are one of the most effective and cost-effective means of protecting the public from infectious disease.\"\u003c/p>\n\u003cp>Statewide,\u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/2010KindergartenAssessmentReport.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2010KindergartenAssessmentReport.pdf\" target=\"_blank\"> just slightly over 90 percent \u003c/a>of all children entering kindergarten have received all required vaccinations, but that rate varies dramatically by county. Public health officials worry when the overall vaccination rate drops below 90 percent, but 95 percent is much better to protect everyone against measles -- which is highly contagious.\u003c/p>\n\u003cp>California counties with the lowest rates of vaccinations include Nevada, Mariposa, Tuolumne and Humboldt, all between 73 and 76 percent. Marin County's rate is just under 83 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill is currently in the Senate Rules committee and is expected to be heard in the Senate Health committee in the next few weeks.\u003c/p>\n\n",
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"excerpt": "California is one of 20 states that allows parents to “opt out” of vaccines for their children simply by signing a form. AB 2109 would change that. The bill has cleared the Assembly and is starting its path through Senate committees. If the bill becomes law, parents would first need to receive counseling from a licensed health professional about the risks and benefits of skipping immunizations for their children.\r\n\r\nVaccination rates in California have been dropping in recent years, worrying public health officials. Ten infants died in a whooping cough outbreak in 2009.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5990\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Vaccination-Large-Jeff-J-Mitchell-Getty.jpg\">\u003cimg class=\"size-medium wp-image-5990\" title=\"(Jeff J. Mitchell: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/Vaccination-Large-Jeff-J-Mitchell-Getty-300x192.jpg\" alt=\"(Jeff J. Mitchell: Getty Images)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jeff J. Mitchell: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California is one of \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">20 states \u003c/a>that allows parents to “opt out” of vaccines for their children simply by signing a form. It's called a \"personal belief exemption.\" But \u003ca title=\"http://www.aroundthecapitol.com/Bills/AB_2109/20112012/\" href=\"http://www.aroundthecapitol.com/Bills/AB_2109/20112012/\" target=\"_blank\">AB 2109\u003c/a> would change that. The bill has cleared the Assembly and is starting its path through Senate committees.\u003c/p>\n\u003cp>If the bill becomes law, parents who wish to refuse vaccines would first need to receive counseling from a licensed health professional about the risks and benefits of skipping immunizations for their children.\u003c/p>\n\u003cp>Vaccination rates in California have been dropping in recent years, worrying public health officials. Ten infants died in a whooping cough outbreak in 2009.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"This is not about taking away the rights of parents to make decisions.\"\u003c/aside>\n\u003cp>\"Democratic \u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> wrote the bill. He’s also a pediatrician and says parents’ decision not to vaccinate their own child puts others at risk too.\u003c/p>\n\u003cp>Very young children, infants may be too young to be immunized,\" he told me in a recent interview. \"People with cancer and on chemotherapy, people with HIV or AIDS ... they cannot receive immunizations.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Republican \u003ca title=\"http://arc.asm.ca.gov/member/3/\" href=\"http://arc.asm.ca.gov/member/3/\" target=\"_blank\">Assemblyman Dan Logue\u003c/a> co-chairs the Assembly’s Health Committee. He opposes the bill – but not for medical reasons.\u003c/p>\n\u003cp>“What we do now in California is we tell you how much salt to put on your food, what kind of light bulb you should screw in your lamp,\" he says. \"The people of California are fed up with a state government that thinks it can run our lives better than they can, and enough is enough.”\u003c/p>\n\u003cp>But Pan counters the nanny-state argument. \"This is not about taking away the rights of parents to make decisions. Parents are still free to make these decisions. But it's also the role of government to protect the public, that's why we have a police force, to protect us from criminals,\" he says. \"We have diseases out there that can kill people ... and vaccinations are one of the most effective and cost-effective means of protecting the public from infectious disease.\"\u003c/p>\n\u003cp>Statewide,\u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/2010KindergartenAssessmentReport.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2010KindergartenAssessmentReport.pdf\" target=\"_blank\"> just slightly over 90 percent \u003c/a>of all children entering kindergarten have received all required vaccinations, but that rate varies dramatically by county. Public health officials worry when the overall vaccination rate drops below 90 percent, but 95 percent is much better to protect everyone against measles -- which is highly contagious.\u003c/p>\n\u003cp>California counties with the lowest rates of vaccinations include Nevada, Mariposa, Tuolumne and Humboldt, all between 73 and 76 percent. Marin County's rate is just under 83 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill is currently in the Senate Rules committee and is expected to be heard in the Senate Health committee in the next few weeks.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Poll: What's It's Like To Be Sick In America",
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"content": "\u003cp>\u003cstrong>By Richard Knox and Joe Neel, NPR News and\u003c/strong>\u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/poll-what-its-like-to-be-sick-in-america/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/poll-what-its-like-to-be-sick-in-america/\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we’d ask Americans who actually use the health system quite a bit how they view the quality of care and its cost.\u003c/p>\n\u003cp>Most surveys don’t break it down this way.\u003c/p>\n\u003cfigure id=\"attachment_5958\" class=\"wp-caption alignleft\" style=\"max-width: 310px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/KHNcharts.png\">\u003cimg class=\"size-full wp-image-5958\" title=\"Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. Credit: Alyson Hurt/Nelson Hsu, NPR\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/KHNcharts.png\" alt=\"Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. Credit: Alyson Hurt/Nelson Hsu, NPR\" width=\"310\" height=\"595\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. (Image: Alyson Hurt/Nelson Hsu, NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>When the results came back, we found that people who have a serious medical condition or who’ve been in the hospital in the past year tended to have more concerns about costs and quality than people who aren’t sick. No big surprise there.\u003c/p>\n\u003cp>But what was notable: 3 of 4 people who were sick said cost is a very serious problem, and half said quality is a very serious problem.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nearly half of those with recent serious illness say they felt burdened by what they had to pay out of their own pocket for care.\u003c/p>\n\u003cp>The recently ill are more likely to say the cost and quality of care have worsened over the past five years, compared to people who weren’t sick.\u003c/p>\n\u003cp>Among people who’ve recently required a lot of care, significant proportions say their treatment was poorly managed, with nearly a third complaining of poor communication among their caregivers. One in eight believe they got the wrong diagnosis, treatment or test.\u003c!--more-->\u003c/p>\n\u003cp>Those findings led us to investigate the problems people are having, both in our poll and in a series of stories on the radio and the Web we’re calling “\u003ca title=\"http://www.npr.org/blogs/health/2012/05/21/153028362/your-stories-of-being-sick-inside-the-u-s-health-care-system\" href=\"http://www.npr.org/blogs/health/2012/05/21/153028362/your-stories-of-being-sick-inside-the-u-s-health-care-system\" target=\"_blank\">Sick in America\u003c/a>.”\u003c/p>\n\u003cp>The poll, a joint venture of NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health, is one of very few focusing on people who’ve actually been seriously ill, injured or hospitalized in the past year.\u003c/p>\n\u003cp>“This poll listens to the voices of the sick,” says Robert Blendon of Harvard. “That provides a good barometer of what’s happening in health care in America.”\u003c/p>\n\u003cp>The poll randomly surveyed 1,508 adults across the nation. A little more than a quarter of them had a serious illness, injury or disability requiring “a lot of medical care,” or overnight hospitalization within the past 12 months.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you want to dive deeper, here’s a \u003ca title=\"http://www.npr.org/documents/2012/may/poll/summary.pdf\" href=\"http://www.npr.org/documents/2012/may/poll/summary.pdf\" target=\"_blank\">summary of the poll findings\u003c/a>, plus the\u003ca title=\"http://www.npr.org/documents/2012/may/poll/topline.pdf\" href=\"http://www.npr.org/documents/2012/may/poll/topline.pdf\" target=\"_blank\"> topline data and charts\u003c/a>.\u003c/p>\n\n",
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"excerpt": "In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we’d ask Americans who actually use the health system quite a bit how they view the quality of care and its cost.\r\n\r\nMost surveys don’t break it down this way.\r\nWhen the results came back, we found that people who have a serious medical condition or who’ve been in the hospital in the past year tended to have more concerns about costs and quality than people who aren’t sick. No big surprise there.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Richard Knox and Joe Neel, NPR News and\u003c/strong>\u003ca title=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/poll-what-its-like-to-be-sick-in-america/\" href=\"http://capsules.kaiserhealthnews.org/index.php/2012/05/poll-what-its-like-to-be-sick-in-america/\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we’d ask Americans who actually use the health system quite a bit how they view the quality of care and its cost.\u003c/p>\n\u003cp>Most surveys don’t break it down this way.\u003c/p>\n\u003cfigure id=\"attachment_5958\" class=\"wp-caption alignleft\" style=\"max-width: 310px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/KHNcharts.png\">\u003cimg class=\"size-full wp-image-5958\" title=\"Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. Credit: Alyson Hurt/Nelson Hsu, NPR\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/KHNcharts.png\" alt=\"Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. Credit: Alyson Hurt/Nelson Hsu, NPR\" width=\"310\" height=\"595\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Poll. (Image: Alyson Hurt/Nelson Hsu, NPR)\u003c/figcaption>\u003c/figure>\n\u003cp>When the results came back, we found that people who have a serious medical condition or who’ve been in the hospital in the past year tended to have more concerns about costs and quality than people who aren’t sick. No big surprise there.\u003c/p>\n\u003cp>But what was notable: 3 of 4 people who were sick said cost is a very serious problem, and half said quality is a very serious problem.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nearly half of those with recent serious illness say they felt burdened by what they had to pay out of their own pocket for care.\u003c/p>\n\u003cp>The recently ill are more likely to say the cost and quality of care have worsened over the past five years, compared to people who weren’t sick.\u003c/p>\n\u003cp>Among people who’ve recently required a lot of care, significant proportions say their treatment was poorly managed, with nearly a third complaining of poor communication among their caregivers. One in eight believe they got the wrong diagnosis, treatment or test.\u003c!--more-->\u003c/p>\n\u003cp>Those findings led us to investigate the problems people are having, both in our poll and in a series of stories on the radio and the Web we’re calling “\u003ca title=\"http://www.npr.org/blogs/health/2012/05/21/153028362/your-stories-of-being-sick-inside-the-u-s-health-care-system\" href=\"http://www.npr.org/blogs/health/2012/05/21/153028362/your-stories-of-being-sick-inside-the-u-s-health-care-system\" target=\"_blank\">Sick in America\u003c/a>.”\u003c/p>\n\u003cp>The poll, a joint venture of NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health, is one of very few focusing on people who’ve actually been seriously ill, injured or hospitalized in the past year.\u003c/p>\n\u003cp>“This poll listens to the voices of the sick,” says Robert Blendon of Harvard. “That provides a good barometer of what’s happening in health care in America.”\u003c/p>\n\u003cp>The poll randomly surveyed 1,508 adults across the nation. A little more than a quarter of them had a serious illness, injury or disability requiring “a lot of medical care,” or overnight hospitalization within the past 12 months.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you want to dive deeper, here’s a \u003ca title=\"http://www.npr.org/documents/2012/may/poll/summary.pdf\" href=\"http://www.npr.org/documents/2012/may/poll/summary.pdf\" target=\"_blank\">summary of the poll findings\u003c/a>, plus the\u003ca title=\"http://www.npr.org/documents/2012/may/poll/topline.pdf\" href=\"http://www.npr.org/documents/2012/may/poll/topline.pdf\" target=\"_blank\"> topline data and charts\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
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"meta": {
"site": "radio",
"source": "WNYC"
},
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"hyphenacion": {
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"order": 15
},
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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},
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"id": "latino-usa",
"title": "Latino USA",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
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"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"meta": {
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},
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"rss": "https://rss.art19.com/masters-of-scale"
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},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
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},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
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"officialWebsiteLink": "/perspectives/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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"rss": "https://feeds.npr.org/510289/podcast.xml"
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