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"content": "\u003cfigure id=\"attachment_21794\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/v1ctor/10871254373/in/photolist-7xnQUz-4VVzWz-duRtoY-dteyRf-dtenzF-6onXMj-51knzJ-Q7qvr-51knpN-51gbqX-cBgG4U-53ybQU-CDq9F-hyE2be-25tH2r-6oiMk6-6oiM3g-6onXGL-5zr3ZY-6onXW9-9kVf2j-6oiMcc-53yc11-dHqMtG-cBgFKq-9kSbEZ-a3Qrfu-cBgFCW-cBgFyS-b8pMUx-aBgDAQ-53yc8S-EjCFC-7Vh97k-7Vhboa-7VkmkG-7VkjAo-6onY61-6onXyd-f1H9qJ-6onXuN-6oiLNF-25tDrw-L6Gwo-4bu3uW-4z8pLs-3mkAZ1-6DyhnP-5UDiQq-PiQgG\">\u003cimg class=\"size-large wp-image-21794\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/10871254373_07e4989b3c_k-640x424.jpg\" alt=\"(Victor/via Flickr)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Test strips -- the white strip in the photo above -- vary dramatically both in cash price and in insurance coverage. (Victor/via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Since early this summer, KQED and our partners, KPCC and ClearHealthCosts.com, have been crowdsourcing the costs of common health care procedures.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Every time someone moves to a new insurer, the pricing will be very different on test strips. Nobody is going to send you a breakdown.' \u003c/aside>\n\u003cp>If you're one of the 29 million people in America who has diabetes, we're turning now to you. We know that many people with diabetes must check their blood sugar, also called glucose, level several times a day.\u003c/p>\n\u003cp>For those of you who don't have diabetes, the reason for frequent checking is because in diabetes, sugar can build up in the bloodstream because the body is not able to process it. That can be dangerous. Depending on the severity of the disease, many people with diabetes must check their glucose level several times a day to make sure it is neither dangerously high nor dangerously low.\u003c/p>\n\u003cp>To \u003ca title=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" href=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html\" target=\"_blank\">check their blood sugar\u003c/a>, people with diabetes have a glucose meter. Each time they test their blood, a test strip is inserted into the meter. Then they use a special needle to prick a finger and place a drop of blood on a test strip. The meter displays the result.\u003c!--more-->\u003c/p>\n\u003cp>A single strip is not so much money, but testing day in, day out, the money adds up. In addition, like everything else in health care, different insurers cover different brands at different quantities and different co-pays or co-insurance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If you rely on our [health care] system,\" said Amy Tenderich, \u003ca title=\"http://www.diabetesmine.com/about\" href=\"http://www.diabetesmine.com/about\" target=\"_blank\">founder and editor of DiabetesMine.com,\u003c/a> a diabetes news, advocacy and community website, \"it's a major thorn in your side, because you have no way of knowing what the real costs are or how anything is calculated.\"\u003c/p>\n\u003cp>Tenderich knows the issue of test strips well. She was diagnosed with Type 1 diabetes in 2003.\u003c/p>\n\u003cp>Early last year, it looked like there was a glimmer of hope in the expense around test strips. Medicare instituted a \u003ca title=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" href=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" target=\"_blank\">competitive bidding process\u003c/a>. That brought the price of test strips down some, but may have created a ripple effect where other private insurers are clamping down on both quantity and variety of strips they cover. (Many in the diabetes community have also sharply criticized the move because they say the lower-cost strips are \u003ca title=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" href=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" target=\"_blank\">often less accurate\u003c/a>.)\u003c/p>\n\u003cp>Yes, you can\u003ca title=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" href=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" target=\"_blank\"> search online\u003c/a> and find the cash price for test strips pretty easily. But the variety can be confounding! First in quantity: boxes of 100, boxes of 50, a\u003ca title=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" href=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" target=\"_blank\"> box of 5\u003c/a>1.\u003c/p>\n\u003cp>Then there's price -- two brands I found were $17.17 for 100 count; another box of 50 was $33.79.\u003c/p>\n\u003cp>But cash prices found online are of little help to the millions of Americans who are insured and are restricted to what their insurer covers, both in brand and in quantity. The quantity is strips-per-some-arbitrary-unit-of-time. Maybe it's strips per day or per month, or 60 days, or 90 days.\u003c/p>\n\u003cp>It all depends on what contracts the insurance company has made with test strip manufacturers. Remember that those contracts are sealed; You can't compare insurer to insurer.\u003c/p>\n\u003cp>\"Every time someone moves to a new insurer,\" Tenderich says, \"the pricing will be very different on the drugs I'm taking and the test strips as well. Nobody is going to send you a breakdown. You have no way of knowing how they're calculated.\"\u003c/p>\n\u003cp>That's where PriceCheck comes in.\u003c/p>\n\u003cp>If you have diabetes and you test your blood sugar regularly, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">please visit PriceCheck\u003c/a> and submit what you paid and what your insurer paid. In addition, please share the specifics of your own insurance -- how many strips a day (or month) your insurer covers and exactly what your co-pay or co-insurance is on test strips. We want to know the limitations of your insurance. Since people with Type 2 diabetes may face strict restrictions on the number of strips they can use, we're also asking people to let us know if they have Type 1 or Type 2 diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California -- \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share your costs!\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If you rely on our [health care] system,\" said Amy Tenderich, \u003ca title=\"http://www.diabetesmine.com/about\" href=\"http://www.diabetesmine.com/about\" target=\"_blank\">founder and editor of DiabetesMine.com,\u003c/a> a diabetes news, advocacy and community website, \"it's a major thorn in your side, because you have no way of knowing what the real costs are or how anything is calculated.\"\u003c/p>\n\u003cp>Tenderich knows the issue of test strips well. She was diagnosed with Type 1 diabetes in 2003.\u003c/p>\n\u003cp>Early last year, it looked like there was a glimmer of hope in the expense around test strips. Medicare instituted a \u003ca title=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" href=\"http://www.medicare.gov/coverage/blood-sugar-test-strips.html\" target=\"_blank\">competitive bidding process\u003c/a>. That brought the price of test strips down some, but may have created a ripple effect where other private insurers are clamping down on both quantity and variety of strips they cover. (Many in the diabetes community have also sharply criticized the move because they say the lower-cost strips are \u003ca title=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" href=\"http://asweetlife.org/riva/blogs/diabetes-management-blogs/the-diabetes-test-strips-crisis-how-cutting-costs-is-robbing-your-health/33603/\" target=\"_blank\">often less accurate\u003c/a>.)\u003c/p>\n\u003cp>Yes, you can\u003ca title=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" href=\"https://www.google.com/search?client=safari&rls=en&q=cost+of+diabetes+test+strips&ie=UTF-8&oe=UTF-8&gws_rd=ssl#q=cost+of+diabetes+test+strips&rls=en&tbm=shop\" target=\"_blank\"> search online\u003c/a> and find the cash price for test strips pretty easily. But the variety can be confounding! First in quantity: boxes of 100, boxes of 50, a\u003ca title=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" href=\"http://www.totaldiabetessupply.com/glucose-test-strips/accu-chek-compact-glucose-test-strips-51.html?gdftrk=gdfV21446_a_7c1042_a_7c8455_a_7c7553747419&gclid=Cj0KEQjwnZShBRDfxqzr55rcyMEBEiQA1iRNPw_sUeHZuZeniGl06tQlgAqH5E0Y2yN4XctiOKSKV9YaAsZP8P8HAQ\" target=\"_blank\"> box of 5\u003c/a>1.\u003c/p>\n\u003cp>Then there's price -- two brands I found were $17.17 for 100 count; another box of 50 was $33.79.\u003c/p>\n\u003cp>But cash prices found online are of little help to the millions of Americans who are insured and are restricted to what their insurer covers, both in brand and in quantity. The quantity is strips-per-some-arbitrary-unit-of-time. Maybe it's strips per day or per month, or 60 days, or 90 days.\u003c/p>\n\u003cp>It all depends on what contracts the insurance company has made with test strip manufacturers. Remember that those contracts are sealed; You can't compare insurer to insurer.\u003c/p>\n\u003cp>\"Every time someone moves to a new insurer,\" Tenderich says, \"the pricing will be very different on the drugs I'm taking and the test strips as well. Nobody is going to send you a breakdown. You have no way of knowing how they're calculated.\"\u003c/p>\n\u003cp>That's where PriceCheck comes in.\u003c/p>\n\u003cp>If you have diabetes and you test your blood sugar regularly, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">please visit PriceCheck\u003c/a> and submit what you paid and what your insurer paid. In addition, please share the specifics of your own insurance -- how many strips a day (or month) your insurer covers and exactly what your co-pay or co-insurance is on test strips. We want to know the limitations of your insurance. Since people with Type 2 diabetes may face strict restrictions on the number of strips they can use, we're also asking people to let us know if they have Type 1 or Type 2 diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California -- \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share your costs!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>[vimeo 106451486 w=630 h=350]\u003c/p>\n\u003cp>Effective this week, Medi-Cal now covers a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/15/autism-benefit-finally-a-reality-for-children-on-medi-cal/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/15/autism-benefit-finally-a-reality-for-children-on-medi-cal/\" target=\"_blank\">key autism therapy\u003c/a>, and some 12,000 kids stand to benefit statewide. One of the children who will benefit is Timothy Wilson, a bubbly 6-year-old who will now be able to get Applied Behavior Analysis (ABA) through Medi-Cal, the state's insurance program for people who are low income. ABA is the clinical standard of care for autism.\u003c/p>\n\u003cp>Timothy was 2 when he was diagnosed with autism spectrum disorder. “He didn’t say mama, didn’t say dada,” says his mother, Jazzmon Wilson. He threw tantrums and hardly made eye contact. “You just see all your dreams go by the wayside.\"\u003c/p>\n\u003cp>The Wilsons enrolled him in the Regional Center of the East Bay, where children under 3 receive state-funded services. He began ABA therapy, which breaks down everyday skills into bite-sized, learnable portions, then uses repetition, memorization and rewards to reinforce or discourage behaviors. Parents learn to lead their child in the therapy as well. In the video, Jazzmon works with Timothy -- or Bubba as she calls him. Seeing him now, it's hard to believe how affected he was at a younger age.\u003c!--more-->\u003c/p>\n\u003cfigure id=\"attachment_148089\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/files/2014/09/Yes-Board.png\">\u003cimg class=\"size-medium wp-image-148089\" src=\"http://ww2.kqed.org/news/files/2014/09/Yes-Board-640x360.png\" alt=\"Jazzmon praises Timothy during an Applied Behavioral Analysis session.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon praises Timothy during an applied behavior analysis session. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In therapy, Timothy first learned to point, and eventually to say, “I want.” He started to make swift progress.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“You’re celebrating things others take for granted,\" Jazzmon says, including little things like simply knowing when her son wants some juice. \"ABA gives back the typical experiences (that) you dreamed of when your child was born.\"\u003c/p>\n\u003cp>“I felt like the door was cracked for hope,” says Jazzmon. “I thought autism was a death sentence -- we’re not going to go anywhere, do anything -- but this therapy gives you your life back.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'When I first heard about (the new Medi-Cal coverage) I thought to myself: my child is going to have a life. He’s going to be able to get a job.'\u003c/aside>\n\u003cp>Then the family moved to the Sacramento area and found themselves in a Catch-22. Because Timothy had made so much progress, he was disqualified from further therapy. State-funded regional centers must triage, taking only the more severe cases of developmental disability, so Timothy was turned away from Alta California Regional Center. School districts also provide therapy for autism, but Timothy was turned away there as well.\u003c/p>\n\u003cp>Without insurance and unable to afford private ABA, Timothy went without therapy. Jazzmon made a decision. “I need to fight back -- he’s losing years,\" she recalls thinking.\u003c/p>\n\u003cp>\u003ca href=\"http://www.sacbee.com/2014/09/09/6692301/early-treatment-may-decrease-autism.html\" target=\"_blank\">A growing body of evidence suggests\u003c/a> that early intervention is key. With therapy, \u003ca href=\"http://www.nytimes.com/2014/08/03/magazine/the-kids-who-beat-autism.html?module=Search&mabReward=relbias%3Aw%2C%7B%222%22%3A%22RI%3A12%22%7D&_r=1\" target=\"_blank\">some children stop showing signs of autism altogether\u003c/a>.\u003c/p>\n\u003cp>Fearing they would lose the progress they’d made, the family sued the school district and won a legal settlement that provided for Timothy’s ABA for the past year.\u003c/p>\n\u003cp>Meanwhile, advocates had been lobbying the state and federal government to make ABA a covered benefit under Medi-Cal. Under\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" target=\"_blank\"> new federal rules\u003c/a>, that coverage is now reality.\u003c/p>\n\u003cp>“When I first heard about [the Medi-Cal coverage], I thought to myself, 'My child is going to have a life. He’s going to be able to get a job. Maybe he’ll even move out of my house one day and have a family,” said Jazzmon.\u003c/p>\n\u003cfigure id=\"attachment_148098\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/files/2014/09/bubba-mall3.png\">\u003cimg class=\"size-medium wp-image-148098\" src=\"http://ww2.kqed.org/news/files/2014/09/bubba-mall3-640x360.png\" alt=\"ABA therapy has helped Timothy with social issues tied to autism spectrum disorder.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">ABA therapy has helped Timothy with social issues tied to autism spectrum disorder. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Today, Timothy looks like a pretty typical 6-year-old, at least at first glance. He loves seaweed chips, dinosaurs, his mommy and Mario Bros. But he still has some work to do to be able to interact with kids his age, says Jazzmon.\u003c/p>\n\u003cp>“Playing Superman or Spiderman, it takes a lot of imagination and sophistication,\" she says. \"A kid that doesn’t know how to do that becomes isolated.”\u003c/p>\n\u003cp>Timothy gets anxious around other kids, and doesn’t know how to strike up a conversation or sustain one. “Self-esteem is so important at this age,” says Jazzmon.\u003c/p>\n\u003cp>“My hope is one day he’ll have friends. I know he can learn that with A.B.A,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn of California Healthline contributed to the reporting of this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Effective this week, Medi-Cal now covers a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/15/autism-benefit-finally-a-reality-for-children-on-medi-cal/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/15/autism-benefit-finally-a-reality-for-children-on-medi-cal/\" target=\"_blank\">key autism therapy\u003c/a>, and some 12,000 kids stand to benefit statewide. One of the children who will benefit is Timothy Wilson, a bubbly 6-year-old who will now be able to get Applied Behavior Analysis (ABA) through Medi-Cal, the state's insurance program for people who are low income. ABA is the clinical standard of care for autism.\u003c/p>\n\u003cp>Timothy was 2 when he was diagnosed with autism spectrum disorder. “He didn’t say mama, didn’t say dada,” says his mother, Jazzmon Wilson. He threw tantrums and hardly made eye contact. “You just see all your dreams go by the wayside.\"\u003c/p>\n\u003cp>The Wilsons enrolled him in the Regional Center of the East Bay, where children under 3 receive state-funded services. He began ABA therapy, which breaks down everyday skills into bite-sized, learnable portions, then uses repetition, memorization and rewards to reinforce or discourage behaviors. Parents learn to lead their child in the therapy as well. In the video, Jazzmon works with Timothy -- or Bubba as she calls him. Seeing him now, it's hard to believe how affected he was at a younger age.\u003c!--more-->\u003c/p>\n\u003cfigure id=\"attachment_148089\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/files/2014/09/Yes-Board.png\">\u003cimg class=\"size-medium wp-image-148089\" src=\"http://ww2.kqed.org/news/files/2014/09/Yes-Board-640x360.png\" alt=\"Jazzmon praises Timothy during an Applied Behavioral Analysis session.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jazzmon praises Timothy during an applied behavior analysis session. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>In therapy, Timothy first learned to point, and eventually to say, “I want.” He started to make swift progress.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“You’re celebrating things others take for granted,\" Jazzmon says, including little things like simply knowing when her son wants some juice. \"ABA gives back the typical experiences (that) you dreamed of when your child was born.\"\u003c/p>\n\u003cp>“I felt like the door was cracked for hope,” says Jazzmon. “I thought autism was a death sentence -- we’re not going to go anywhere, do anything -- but this therapy gives you your life back.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">'When I first heard about (the new Medi-Cal coverage) I thought to myself: my child is going to have a life. He’s going to be able to get a job.'\u003c/aside>\n\u003cp>Then the family moved to the Sacramento area and found themselves in a Catch-22. Because Timothy had made so much progress, he was disqualified from further therapy. State-funded regional centers must triage, taking only the more severe cases of developmental disability, so Timothy was turned away from Alta California Regional Center. School districts also provide therapy for autism, but Timothy was turned away there as well.\u003c/p>\n\u003cp>Without insurance and unable to afford private ABA, Timothy went without therapy. Jazzmon made a decision. “I need to fight back -- he’s losing years,\" she recalls thinking.\u003c/p>\n\u003cp>\u003ca href=\"http://www.sacbee.com/2014/09/09/6692301/early-treatment-may-decrease-autism.html\" target=\"_blank\">A growing body of evidence suggests\u003c/a> that early intervention is key. With therapy, \u003ca href=\"http://www.nytimes.com/2014/08/03/magazine/the-kids-who-beat-autism.html?module=Search&mabReward=relbias%3Aw%2C%7B%222%22%3A%22RI%3A12%22%7D&_r=1\" target=\"_blank\">some children stop showing signs of autism altogether\u003c/a>.\u003c/p>\n\u003cp>Fearing they would lose the progress they’d made, the family sued the school district and won a legal settlement that provided for Timothy’s ABA for the past year.\u003c/p>\n\u003cp>Meanwhile, advocates had been lobbying the state and federal government to make ABA a covered benefit under Medi-Cal. Under\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" target=\"_blank\"> new federal rules\u003c/a>, that coverage is now reality.\u003c/p>\n\u003cp>“When I first heard about [the Medi-Cal coverage], I thought to myself, 'My child is going to have a life. He’s going to be able to get a job. Maybe he’ll even move out of my house one day and have a family,” said Jazzmon.\u003c/p>\n\u003cfigure id=\"attachment_148098\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/files/2014/09/bubba-mall3.png\">\u003cimg class=\"size-medium wp-image-148098\" src=\"http://ww2.kqed.org/news/files/2014/09/bubba-mall3-640x360.png\" alt=\"ABA therapy has helped Timothy with social issues tied to autism spectrum disorder.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">ABA therapy has helped Timothy with social issues tied to autism spectrum disorder. (Jeremy Raff/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Today, Timothy looks like a pretty typical 6-year-old, at least at first glance. He loves seaweed chips, dinosaurs, his mommy and Mario Bros. But he still has some work to do to be able to interact with kids his age, says Jazzmon.\u003c/p>\n\u003cp>“Playing Superman or Spiderman, it takes a lot of imagination and sophistication,\" she says. \"A kid that doesn’t know how to do that becomes isolated.”\u003c/p>\n\u003cp>Timothy gets anxious around other kids, and doesn’t know how to strike up a conversation or sustain one. “Self-esteem is so important at this age,” says Jazzmon.\u003c/p>\n\u003cp>“My hope is one day he’ll have friends. I know he can learn that with A.B.A,” she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn of California Healthline contributed to the reporting of this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_21642\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hankzby/2346334452/in/photolist-63LgLe-9x2t1S-63QvZU-hupmxC-4yah92-bCkeua-aF4nGK-5WNAjf-7a4T2e-4zkzuh-xFWZ6-bCkgmF-drmDCx-9wYsLx-9x2sTA-9x2teE-9wYhit-e4cWxN-e47fJi-CPD4-9wYsDB-5bE76S-e4d17U-e47mve-e4cVnQ-e4cYtd-e47iNg-e47hxM-e47jyR-e4cVKy-e47mT6-e47jWB-e47kKP-e47kjn-e4cZHW-moUE-n79pfx-7a5FcV-79Nvk2-79Nva8-79NtVz-79Skgw-79SmcL-79Nvtk-79Nu7x-79Ntxa-7a9r1J-bpqkoj-bCkg1R-drn6pU\">\u003cimg class=\"size-large wp-image-21642\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/2346334452_f5e85a3e82_o-copy-640x361.jpg\" alt=\"Students at Sproul Plaza, UC Berkeley. (Henry Zbyszynski/Flickr)\" width=\"640\" height=\"361\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Students at Sproul Plaza, UC Berkeley. In the last six years, the number of students seeking health at counseling centers has increased 37 percent across the UC system. (Henry Zbyszynski/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/168470037&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Students throughout the University of California system are having trouble accessing mental health care, and health services directors are raising alarms that increased staffing and funding could be warranted to meet demand.\u003c/p>\n\u003cp>“The increased need for mental health services on our campuses is outstripping our ability to provide those services,” said Dr. John Stobo, senior vice president for health sciences and services for the University of California. “It is a major problem. It’s not only a problem for UC, this is a national issue.”\u003c/p>\n\u003cp>In the last six years, the number of students seeking help at university counseling centers has increased 37 percent, according to data presented at UC Regents board meeting on Thursday.\u003c/p>\n\u003cp>“This is real. Students are having difficulty accessing mental health services on campus,” said Dr. Gina Fleming, medical director for the UC Self-Insured Health Plans. “They’re waiting longer to get an appointment. They’re having fewer appointments within the course of therapy, and more are needing to be referred off campus.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Wait times for regular appointments have been four weeks, or more in some cases. A typical student who calls in complaining of mild anxiety and procrastination in the first few weeks of the semester could be waiting until finals for therapy to begin in earnest.\u003c/p>\n\u003cp>“What might have started as a routine procrastination intervention may now be a crisis in full bloom,” said Elizabeth Gong-Guy, executive director of Counseling and Psychological Services at UCLA.\u003c/p>\n\u003cp>“Increasingly, we find that many of the students who make their way to our counseling centers are seasoned perfectionists who’ve driven themselves to unsustainable positions in which their lives lack any semblance of balance or self-compassion. These are students with eating disorders, crippling obsessive-compulsive disorders, cutting histories, addictions, and illicit stimulant abuse.”\u003c/p>\n\u003cp>She says more students are seeking help now because of awareness campaigns that helped reduced stigma around mental health issues. Those campaigns were funded through a $6.8 million grant the university received under Proposition 63, a voter-approved ballot measure that raised taxes on the wealthiest Californians to provide funds for the state’s public mental health system.\u003c/p>\n\u003cp>But that funding to the university ends this year, and health services directors worry they do not have enough money to hire the staff needed to keep up with unabated demand.\u003c/p>\n\u003cp>Gong-Guy said the UCLA counseling center treated 8,500 students last year – that amounts to 21 percent of the student population and a 23 percent increase over the year before.\u003c/p>\n\u003cp>System-wide, 25 percent of students who receive services at campus counseling centers are on psychotropic medications.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This increased utilization is now seriously limiting access to timely treatment that’s needed to support student success,” she said.\u003cbr>\nThe UC Regents asked the health services committee to bring a list of potential solutions to the next board meeting in November.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21642\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hankzby/2346334452/in/photolist-63LgLe-9x2t1S-63QvZU-hupmxC-4yah92-bCkeua-aF4nGK-5WNAjf-7a4T2e-4zkzuh-xFWZ6-bCkgmF-drmDCx-9wYsLx-9x2sTA-9x2teE-9wYhit-e4cWxN-e47fJi-CPD4-9wYsDB-5bE76S-e4d17U-e47mve-e4cVnQ-e4cYtd-e47iNg-e47hxM-e47jyR-e4cVKy-e47mT6-e47jWB-e47kKP-e47kjn-e4cZHW-moUE-n79pfx-7a5FcV-79Nvk2-79Nva8-79NtVz-79Skgw-79SmcL-79Nvtk-79Nu7x-79Ntxa-7a9r1J-bpqkoj-bCkg1R-drn6pU\">\u003cimg class=\"size-large wp-image-21642\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/2346334452_f5e85a3e82_o-copy-640x361.jpg\" alt=\"Students at Sproul Plaza, UC Berkeley. (Henry Zbyszynski/Flickr)\" width=\"640\" height=\"361\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Students at Sproul Plaza, UC Berkeley. In the last six years, the number of students seeking health at counseling centers has increased 37 percent across the UC system. (Henry Zbyszynski/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/168470037&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Students throughout the University of California system are having trouble accessing mental health care, and health services directors are raising alarms that increased staffing and funding could be warranted to meet demand.\u003c/p>\n\u003cp>“The increased need for mental health services on our campuses is outstripping our ability to provide those services,” said Dr. John Stobo, senior vice president for health sciences and services for the University of California. “It is a major problem. It’s not only a problem for UC, this is a national issue.”\u003c/p>\n\u003cp>In the last six years, the number of students seeking help at university counseling centers has increased 37 percent, according to data presented at UC Regents board meeting on Thursday.\u003c/p>\n\u003cp>“This is real. Students are having difficulty accessing mental health services on campus,” said Dr. Gina Fleming, medical director for the UC Self-Insured Health Plans. “They’re waiting longer to get an appointment. They’re having fewer appointments within the course of therapy, and more are needing to be referred off campus.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Wait times for regular appointments have been four weeks, or more in some cases. A typical student who calls in complaining of mild anxiety and procrastination in the first few weeks of the semester could be waiting until finals for therapy to begin in earnest.\u003c/p>\n\u003cp>“What might have started as a routine procrastination intervention may now be a crisis in full bloom,” said Elizabeth Gong-Guy, executive director of Counseling and Psychological Services at UCLA.\u003c/p>\n\u003cp>“Increasingly, we find that many of the students who make their way to our counseling centers are seasoned perfectionists who’ve driven themselves to unsustainable positions in which their lives lack any semblance of balance or self-compassion. These are students with eating disorders, crippling obsessive-compulsive disorders, cutting histories, addictions, and illicit stimulant abuse.”\u003c/p>\n\u003cp>She says more students are seeking help now because of awareness campaigns that helped reduced stigma around mental health issues. Those campaigns were funded through a $6.8 million grant the university received under Proposition 63, a voter-approved ballot measure that raised taxes on the wealthiest Californians to provide funds for the state’s public mental health system.\u003c/p>\n\u003cp>But that funding to the university ends this year, and health services directors worry they do not have enough money to hire the staff needed to keep up with unabated demand.\u003c/p>\n\u003cp>Gong-Guy said the UCLA counseling center treated 8,500 students last year – that amounts to 21 percent of the student population and a 23 percent increase over the year before.\u003c/p>\n\u003cp>System-wide, 25 percent of students who receive services at campus counseling centers are on psychotropic medications.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This increased utilization is now seriously limiting access to timely treatment that’s needed to support student success,” she said.\u003cbr>\nThe UC Regents asked the health services committee to bring a list of potential solutions to the next board meeting in November.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "SF Supervisor Proposes Funding Better Access to HIV Preventive Drug",
"title": "SF Supervisor Proposes Funding Better Access to HIV Preventive Drug",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5765\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/TruvadaBottle_05102012_JustinSullivan_GettyImages-e1411097604408.jpg\">\u003cimg class=\"wp-image-5765 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/TruvadaBottle_05102012_JustinSullivan_GettyImages-620x427.jpg\" alt=\"The FDA panel approved Truvada, an antiretroviral drug for use by healthy people to prevent HIV infection. (Justin Sullivan: Getty Images)\" width=\"620\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Truvada is a drug approved by the FDA to prevent infection with HIV. (Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Heather Boerner\u003c/strong>\u003c/p>\n\u003cp>San Francisco Supervisor David Campos announced Thursday that he would introduce a supplemental budget request at the Board of Supervisors meeting Tuesday for $807,000 to help bring a treatment to prevent HIV infection to those who could benefit from it. The treatment, pre-exposure prophylaxis or PrEP, consists of taking Truvada, an antiretroviral drug, every day. If the request is approved, San Francisco will follow the state of Washington in providing drug assistance for PrEP.\u003c/p>\n\u003cp>The goal is to dramatically reduce the number of new HIV infections. \u003cspan style=\"color: #000000\">Dr. Robert Grant, a professor at UCSF’s Gladstone Institute and a lead researcher in determining the efficacy of Truvada in preventing HIV infection, said at a hearing at City Hall Thursday that informal estimates suggest that if just 6,000 San Franciscans at high risk for HIV infection were to take Truvada, the number of new infections in the city might drop from about 400 a year to 50.\u003c/span>.\u003c/p>\n\u003cp>Today, fewer than 1,000 San Franciscans are taking Truvada for HIV prevention.\u003c!--more-->\u003c/p>\n\u003cp>“We have a very audacious goal, but we think we can hit it -- getting to zero,” said Dr. Susan Philip, director of STD Prevention and Control Services at the San Francisco Department of Public Health. “Zero new HIV infections. Zero HIV deaths. And zero HIV stigma.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Food and Drug Administration approved Truvada for PrEP in 2012. The drug is more than 90 percent effective at preventing HIV infection. But critics worry that use of Truvada may lead to reckless sexual behavior and continued spread of the virus.\u003c/p>\n\u003cp>But Grant's continuing research on Truvada has shown no new infections in people who take the pill daily. What’s more, Grant told the assembled audience that those who need PrEP most are seeking it out and taking it.\u003c/p>\n\u003cp>“There’s been some fear that PrEP would release a storm of sexuality, where people will have more partners,” he said. “What we’ve found is that the opposite is true. Those who take PrEP become more mindful of their sexual goals. They become more talkative with their partners about HIV risks and other (sexually transmitted illnesses).”\u003c/p>\n\u003cp>But while PrEP seems effective, only 2,319 people received prescriptions of Truvada for PrEP nationwide between 2012 and 2013, according to data from Gilead Sciences, which makes the drug. Grant said that a “tipping point” came in late 2013, where more people began to know about and request Truvada for PrEP, but that’s still a far cry from the 500,000 Americans that the Centers for Disease Control say could benefit from the prevention method.\u003c/p>\n\u003cp>Some of that disconnect may be due to cost. A year of Truvada runs about $13,000 without insurance. While Medi-Cal, Healthy San Francisco, and the majority of private insurers cover Truvada for PrEP, many people at highest risk for HIV —- young African American men who have sex with men, transgender women, sex workers, straight women and gay men in long-term relationships with HIV-positive partners, or gay men who are dating or in open relationships —- often have no insurance or have opted for insurance with high deductibles or scant drug coverage, putting a Truvada prescription out of reach for many.\u003c/p>\n\u003cp>Erik Gibb said he considers himself to be a “lucky guy” when it comes to PrEP, even though his health plan includes a $3,000 deductible and a $3,600-a-year copay for his Truvada prescription. Another speaker, Eric Norman, said he and his partner, an HIV-positive man, once had a scare, and Norman was worried he had contracted HIV. He was able to get a combination of stronger antiretroviral drugs which successfully prevented infection. He wanted to start on PrEP, but didn't have insurance and could not afford the medication.\u003c/p>\n\u003cp>“So I went back to this relationship, and I was happy in it,” he said. “But I was still living with the fear of infection and the risk that I was going to become HIV positive.”\u003c/p>\n\u003cp>Under Campos' proposal, about $500,000 would go toward drug copay assistance.The rest would pay for hiring and training community navigators, who can help those in need of Truvada navigate the insurance system and get the treatment fully covered.\u003c/p>\n\u003cp>Supervisor Scott Weiner, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/17/san-francisco-supervisor-announces-hes-taking-aids-preventive-drug-prep-truvada/\" target=\"_blank\">who announced Wednesday\u003c/a> that he’s one of the 1,000 San Franciscans taking Truvada for PrEP, said that access to PrEP shouldn’t be limited just to those who have access to good insurance.\u003c/p>\n\u003cp>Before the hearing Thursday morning, Campos led an assembly on the steps of City Hall in a moment of silence for all those lost to the virus.\u003c/p>\n\u003cp>“We owe it to them,” he said, “to make sure no one else gets infected.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Heather Boerner is a San Francisco-based healthcare journalist and author of\u003ca title=\"Positively Negative\" href=\"http://www.amazon.com/Positively-Negative-Pregnancy-Sciences-Surprising-ebook/dp/B00LUABTAO\" target=\"_blank\"> Positively Negative: Love, Pregnancy, and Science’s Surprising Victory Over HIV\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5765\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/TruvadaBottle_05102012_JustinSullivan_GettyImages-e1411097604408.jpg\">\u003cimg class=\"wp-image-5765 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/TruvadaBottle_05102012_JustinSullivan_GettyImages-620x427.jpg\" alt=\"The FDA panel approved Truvada, an antiretroviral drug for use by healthy people to prevent HIV infection. (Justin Sullivan: Getty Images)\" width=\"620\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Truvada is a drug approved by the FDA to prevent infection with HIV. (Justin Sullivan: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Heather Boerner\u003c/strong>\u003c/p>\n\u003cp>San Francisco Supervisor David Campos announced Thursday that he would introduce a supplemental budget request at the Board of Supervisors meeting Tuesday for $807,000 to help bring a treatment to prevent HIV infection to those who could benefit from it. The treatment, pre-exposure prophylaxis or PrEP, consists of taking Truvada, an antiretroviral drug, every day. If the request is approved, San Francisco will follow the state of Washington in providing drug assistance for PrEP.\u003c/p>\n\u003cp>The goal is to dramatically reduce the number of new HIV infections. \u003cspan style=\"color: #000000\">Dr. Robert Grant, a professor at UCSF’s Gladstone Institute and a lead researcher in determining the efficacy of Truvada in preventing HIV infection, said at a hearing at City Hall Thursday that informal estimates suggest that if just 6,000 San Franciscans at high risk for HIV infection were to take Truvada, the number of new infections in the city might drop from about 400 a year to 50.\u003c/span>.\u003c/p>\n\u003cp>Today, fewer than 1,000 San Franciscans are taking Truvada for HIV prevention.\u003c!--more-->\u003c/p>\n\u003cp>“We have a very audacious goal, but we think we can hit it -- getting to zero,” said Dr. Susan Philip, director of STD Prevention and Control Services at the San Francisco Department of Public Health. “Zero new HIV infections. Zero HIV deaths. And zero HIV stigma.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Food and Drug Administration approved Truvada for PrEP in 2012. The drug is more than 90 percent effective at preventing HIV infection. But critics worry that use of Truvada may lead to reckless sexual behavior and continued spread of the virus.\u003c/p>\n\u003cp>But Grant's continuing research on Truvada has shown no new infections in people who take the pill daily. What’s more, Grant told the assembled audience that those who need PrEP most are seeking it out and taking it.\u003c/p>\n\u003cp>“There’s been some fear that PrEP would release a storm of sexuality, where people will have more partners,” he said. “What we’ve found is that the opposite is true. Those who take PrEP become more mindful of their sexual goals. They become more talkative with their partners about HIV risks and other (sexually transmitted illnesses).”\u003c/p>\n\u003cp>But while PrEP seems effective, only 2,319 people received prescriptions of Truvada for PrEP nationwide between 2012 and 2013, according to data from Gilead Sciences, which makes the drug. Grant said that a “tipping point” came in late 2013, where more people began to know about and request Truvada for PrEP, but that’s still a far cry from the 500,000 Americans that the Centers for Disease Control say could benefit from the prevention method.\u003c/p>\n\u003cp>Some of that disconnect may be due to cost. A year of Truvada runs about $13,000 without insurance. While Medi-Cal, Healthy San Francisco, and the majority of private insurers cover Truvada for PrEP, many people at highest risk for HIV —- young African American men who have sex with men, transgender women, sex workers, straight women and gay men in long-term relationships with HIV-positive partners, or gay men who are dating or in open relationships —- often have no insurance or have opted for insurance with high deductibles or scant drug coverage, putting a Truvada prescription out of reach for many.\u003c/p>\n\u003cp>Erik Gibb said he considers himself to be a “lucky guy” when it comes to PrEP, even though his health plan includes a $3,000 deductible and a $3,600-a-year copay for his Truvada prescription. Another speaker, Eric Norman, said he and his partner, an HIV-positive man, once had a scare, and Norman was worried he had contracted HIV. He was able to get a combination of stronger antiretroviral drugs which successfully prevented infection. He wanted to start on PrEP, but didn't have insurance and could not afford the medication.\u003c/p>\n\u003cp>“So I went back to this relationship, and I was happy in it,” he said. “But I was still living with the fear of infection and the risk that I was going to become HIV positive.”\u003c/p>\n\u003cp>Under Campos' proposal, about $500,000 would go toward drug copay assistance.The rest would pay for hiring and training community navigators, who can help those in need of Truvada navigate the insurance system and get the treatment fully covered.\u003c/p>\n\u003cp>Supervisor Scott Weiner, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/17/san-francisco-supervisor-announces-hes-taking-aids-preventive-drug-prep-truvada/\" target=\"_blank\">who announced Wednesday\u003c/a> that he’s one of the 1,000 San Franciscans taking Truvada for PrEP, said that access to PrEP shouldn’t be limited just to those who have access to good insurance.\u003c/p>\n\u003cp>Before the hearing Thursday morning, Campos led an assembly on the steps of City Hall in a moment of silence for all those lost to the virus.\u003c/p>\n\u003cp>“We owe it to them,” he said, “to make sure no one else gets infected.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Heather Boerner is a San Francisco-based healthcare journalist and author of\u003ca title=\"Positively Negative\" href=\"http://www.amazon.com/Positively-Negative-Pregnancy-Sciences-Surprising-ebook/dp/B00LUABTAO\" target=\"_blank\"> Positively Negative: Love, Pregnancy, and Science’s Surprising Victory Over HIV\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Kaiser Agrees to Pay $4 Million Fine Over Mental Health Care",
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"content": "\u003cfigure id=\"attachment_20683\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167143743&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.\u003c/p>\n\u003cp>The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.\u003c/p>\n\u003cp>Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case.\u003c!--more-->\u003c/p>\n\u003cp>“It’s an admission by Kaiser that it has knowingly violated California mental health laws and shortchanged its patients,” said Clement Papazian, a social worker at Kaiser’s Oakland Medical Center. It’s “a vindication of what Kaiser mental health clinicians have been saying for years.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Papazian was one of several Kaiser clinicians lined up to testify in the hearings, slated to run through early October. The clinicians\u003ca title=\"Therapists, Patients Criticize Kaiser Over Delays\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\" rel=\"noopener\"> have complained \u003c/a>that they weren’t able to offer individual therapy appointments in a timely manner to patients with severe depression, anxiety and other conditions, sometimes leading to wait times of up to four weeks or more between appointments. Others say patients were directed to group therapy, even in cases where the patient wasn’t receptive to group therapy and requested individual care.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents mental health professionals at Kaiser, argued that \u003ca title=\"Patients, Therapists Allege Long Wait Times at Kaiser\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/21/kaiser-therapists-patients-allege-long-waits-for-mental-health-care/\" target=\"_blank\" rel=\"noopener\">these wait times\u003c/a> and policies led to tragic outcomes, even suicide, in some cases.\u003c/p>\n\u003cp>“Kaiser simply does not staff its psychiatry departments with enough psychologists, therapists and social workers to handle the caseload,” said Sal Rosselli, the union’s president, adding that the caseload is only increasing as more and more people sign up for Kaiser’s coverage under the Affordable Care Act.\u003c/p>\n\u003cp>Kaiser issued a lengthy statement saying that even though it agreed to pay the fine, it still disagreed with the penalty and believed it had not violated regulations around timely access.\u003c/p>\n\u003cp>The health plan vowed to make statewide improvements, including more convenient appointment times and locations, and adding more individual therapy. It says that over the years, it has been “continually analyzing our staffing levels throughout our care delivery system, and hiring appropriate mental health providers to meet growth in membership and our members’ needs.”\u003c/p>\n\u003cp>The state’s Department of Managed Health Care says it is currently conducting a follow-up survey of Kaiser’s mental health systems, to be completed this fall. Any remaining deficiencies will be addressed through corrective action plans, penalties or even the installation of a monitor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I am committed to protecting California’s health plan enrollees and ensuring they get timely access to all medically necessary health and mental health care services,” said Shelley Rouillard, the department director, “and will continue to aggressively monitor and take action against health plans that violate the law.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20683\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20683\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg\" alt=\"Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)\" width=\"640\" height=\"528\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z.jpg 640w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-400x330.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2014/08/5371998566_179533eed7_z-320x264.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"20\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/167143743&color=ff5500&inverse=false&auto_play=false&show_user=true\">\u003c/iframe>\u003c/p>\n\u003cp>Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.\u003c/p>\n\u003cp>The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.\u003c/p>\n\u003cp>Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case.\u003c!--more-->\u003c/p>\n\u003cp>“It’s an admission by Kaiser that it has knowingly violated California mental health laws and shortchanged its patients,” said Clement Papazian, a social worker at Kaiser’s Oakland Medical Center. It’s “a vindication of what Kaiser mental health clinicians have been saying for years.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Papazian was one of several Kaiser clinicians lined up to testify in the hearings, slated to run through early October. The clinicians\u003ca title=\"Therapists, Patients Criticize Kaiser Over Delays\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\" rel=\"noopener\"> have complained \u003c/a>that they weren’t able to offer individual therapy appointments in a timely manner to patients with severe depression, anxiety and other conditions, sometimes leading to wait times of up to four weeks or more between appointments. Others say patients were directed to group therapy, even in cases where the patient wasn’t receptive to group therapy and requested individual care.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents mental health professionals at Kaiser, argued that \u003ca title=\"Patients, Therapists Allege Long Wait Times at Kaiser\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/21/kaiser-therapists-patients-allege-long-waits-for-mental-health-care/\" target=\"_blank\" rel=\"noopener\">these wait times\u003c/a> and policies led to tragic outcomes, even suicide, in some cases.\u003c/p>\n\u003cp>“Kaiser simply does not staff its psychiatry departments with enough psychologists, therapists and social workers to handle the caseload,” said Sal Rosselli, the union’s president, adding that the caseload is only increasing as more and more people sign up for Kaiser’s coverage under the Affordable Care Act.\u003c/p>\n\u003cp>Kaiser issued a lengthy statement saying that even though it agreed to pay the fine, it still disagreed with the penalty and believed it had not violated regulations around timely access.\u003c/p>\n\u003cp>The health plan vowed to make statewide improvements, including more convenient appointment times and locations, and adding more individual therapy. It says that over the years, it has been “continually analyzing our staffing levels throughout our care delivery system, and hiring appropriate mental health providers to meet growth in membership and our members’ needs.”\u003c/p>\n\u003cp>The state’s Department of Managed Health Care says it is currently conducting a follow-up survey of Kaiser’s mental health systems, to be completed this fall. Any remaining deficiencies will be addressed through corrective action plans, penalties or even the installation of a monitor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I am committed to protecting California’s health plan enrollees and ensuring they get timely access to all medically necessary health and mental health care services,” said Shelley Rouillard, the department director, “and will continue to aggressively monitor and take action against health plans that violate the law.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Details of Autism Benefits -- Like Provider Rates -- Coming After Rollout",
"title": "Details of Autism Benefits -- Like Provider Rates -- Coming After Rollout",
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"content": "\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/capitol-desk/2014/9/autism-details-to-come-after-rollout\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>At the first stakeholder meeting last week to review California's new autism Medi-Cal coverage, state health officials said many details have yet to be worked out. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003ca title=\"Long-Sought Autism Treatment Now Covered by Medi-Cal\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/long-fought-autism-therapy-a-medi-cal-benefit-state-says/\" target=\"_blank\">New benefits, which include coverage of applied behavior analysis\u003c/a> -- also known as ABA therapy -- begin next week.\u003c/p>\n\u003cp>Department of Health Care Services officials said many details -- including the crucial figure of what the reimbursement rates will be -- still need to be worked out. Rates will be discussed at the next stakeholder meeting Oct. 16, officials said.\u003c!--more-->\u003c/p>\n\u003cp>The department still is on schedule to submit an autism coverage state plan amendment to the Centers for Medicare & Medicaid Services by Sept. 30, officials said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We will talk about rates later. We will have a separate session on rate setting,\" said Sarah Brooks, branch chief of the Medi-Cal managed care division at DHCS. \"We are working with different ABA providers so health plans can build their networks. We will be working with them to make sure we have proper network adequacy.\"\u003c/p>\n\u003cp>According to Laurie Weaver, chief of the benefits division at DHCS, the new benefit will cover the broad area of behavior health treatment, which includes ABA therapy as one type of treatment, but the department first will focus on ABA, since it's at the heart of the new benefit.\u003c/p>\n\u003cp>\"The state plan amendment will address ABA first, and we'll go from there,\" she said.\u003c/p>\n\u003cp>According to Abbie Totten, director of state programs for the California Association of Health Plans, it's unusual to launch a benefit before setting up the network.\u003c/p>\n\u003cp>\"You have to understand,\" Totten said to stakeholders at Thursday's meeting, \"we are implementing this benefit in a backwards manner. Usually when you implement a benefit you have time … you can develop all of those pieces, and we are not being provided that opportunity in this case.\"\u003c/p>\n\u003cp>The health plans will work with the state to implement the benefit as best they can -- but right now, she said, people will need to bear with the process, which may be rocky and a little confusing at first.\u003c/p>\n\u003cp>\"We have no rates, we have no idea what payment looks like, we have no idea what licensing or provider criteria will look like,\" Totten said.\u003c/p>\n\u003cp>\"So, just as a caution, we will work together on this. We are committed with the department to make this work, but we don't even have a [state plan amendment] that's approved yet,\" she said. \"We're going to do our best and try to make sure the providers are reimbursed properly.\"\u003c/p>\n\u003cp>\"This is day one,\" said Rene Mollow, deputy director of health care benefits and eligibility at DHCS.\u003c/p>\n\u003cp>\"You can look at this and say, 'Oh no, there's so much to do,' \" Mollow said. \"Or rather you can say, 'Wow, look at what we're doing here.' \"\u003c/p>\n\u003cp>Mollow said the department is committed to implementing the benefit with full involvement of stakeholders -- and that lengthens the process somewhat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are just starting down this pathway, and we know there will be improvements and there will be efforts to inform what the state of California will be doing,\" she said. \"It's a process. I would look at it as: day one. Woo-hoo!\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17935\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-e1393616709383.jpg\">\u003cimg class=\"size-large wp-image-17935\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/02/186380264-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"California Healthline\" href=\"http://www.californiahealthline.org/capitol-desk/2014/9/autism-details-to-come-after-rollout\" target=\"_blank\">CaliforniaHealthline\u003c/a>\u003c/p>\n\u003cp>At the first stakeholder meeting last week to review California's new autism Medi-Cal coverage, state health officials said many details have yet to be worked out. Medi-Cal is California's Medicaid program.\u003c/p>\n\u003cp>\u003ca title=\"Long-Sought Autism Treatment Now Covered by Medi-Cal\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/long-fought-autism-therapy-a-medi-cal-benefit-state-says/\" target=\"_blank\">New benefits, which include coverage of applied behavior analysis\u003c/a> -- also known as ABA therapy -- begin next week.\u003c/p>\n\u003cp>Department of Health Care Services officials said many details -- including the crucial figure of what the reimbursement rates will be -- still need to be worked out. Rates will be discussed at the next stakeholder meeting Oct. 16, officials said.\u003c!--more-->\u003c/p>\n\u003cp>The department still is on schedule to submit an autism coverage state plan amendment to the Centers for Medicare & Medicaid Services by Sept. 30, officials said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We will talk about rates later. We will have a separate session on rate setting,\" said Sarah Brooks, branch chief of the Medi-Cal managed care division at DHCS. \"We are working with different ABA providers so health plans can build their networks. We will be working with them to make sure we have proper network adequacy.\"\u003c/p>\n\u003cp>According to Laurie Weaver, chief of the benefits division at DHCS, the new benefit will cover the broad area of behavior health treatment, which includes ABA therapy as one type of treatment, but the department first will focus on ABA, since it's at the heart of the new benefit.\u003c/p>\n\u003cp>\"The state plan amendment will address ABA first, and we'll go from there,\" she said.\u003c/p>\n\u003cp>According to Abbie Totten, director of state programs for the California Association of Health Plans, it's unusual to launch a benefit before setting up the network.\u003c/p>\n\u003cp>\"You have to understand,\" Totten said to stakeholders at Thursday's meeting, \"we are implementing this benefit in a backwards manner. Usually when you implement a benefit you have time … you can develop all of those pieces, and we are not being provided that opportunity in this case.\"\u003c/p>\n\u003cp>The health plans will work with the state to implement the benefit as best they can -- but right now, she said, people will need to bear with the process, which may be rocky and a little confusing at first.\u003c/p>\n\u003cp>\"We have no rates, we have no idea what payment looks like, we have no idea what licensing or provider criteria will look like,\" Totten said.\u003c/p>\n\u003cp>\"So, just as a caution, we will work together on this. We are committed with the department to make this work, but we don't even have a [state plan amendment] that's approved yet,\" she said. \"We're going to do our best and try to make sure the providers are reimbursed properly.\"\u003c/p>\n\u003cp>\"This is day one,\" said Rene Mollow, deputy director of health care benefits and eligibility at DHCS.\u003c/p>\n\u003cp>\"You can look at this and say, 'Oh no, there's so much to do,' \" Mollow said. \"Or rather you can say, 'Wow, look at what we're doing here.' \"\u003c/p>\n\u003cp>Mollow said the department is committed to implementing the benefit with full involvement of stakeholders -- and that lengthens the process somewhat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are just starting down this pathway, and we know there will be improvements and there will be efforts to inform what the state of California will be doing,\" she said. \"It's a process. I would look at it as: day one. Woo-hoo!\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Watsonville Nursing Home Lawsuit May Drive Effort to Reduce Overmedication",
"title": "Watsonville Nursing Home Lawsuit May Drive Effort to Reduce Overmedication",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21306\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/137165920-e1410035335722.jpg\">\u003cimg class=\"size-large wp-image-21306\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/137165920-640x429.jpg\" alt=\" (Philippe Hugue/AFP/Getty Images)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Philippe Hugue/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Ina Jaffe,\u003c/strong>\u003ca href=\"http://www.npr.org/blogs/health/2014/09/05/346137537/feds-hope-hitting-nursing-homes-in-the-wallet-will-cut-overmedication\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>A federal lawsuit against two Watsonville nursing homes may offer a new approach to dealing with the persistent problem of such facilities overmedicating their residents.\u003c/p>\n\u003cp>\u003ca title=\"U.S. v. the Arba group, et al.\" href=\"https://s3.amazonaws.com/s3.documentcloud.org/documents/1284195/united-states-v-the-arba-group-et-al-complaint.pdf\" target=\"_blank\">The lawsuit\u003c/a> details multiple cases when the government says these drugs were inappropriately administered to patients. Watsonville is northeast of Monterey, in Santa Cruz County.\u003c/p>\n\u003cp>For instance when an 86-year-old man identified in the lawsuit as Patient 1 was admitted to Country Villa Watsonville West, he could speak clearly and walked in under his own power. Within days the facility began giving him Haldol and Risperdal, drugs used to treat schizophrenia and bipolar disorder, and he became bedridden, stopped eating and developed bedsores and infections.\u003c!--more-->\u003c/p>\n\u003cp>\"Within days he declined precipitously, to the point where he was read his last rites in the hospital,\" says Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform who represented the man and his family in a private suit that was settled out of court.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"He subsequently recovered,\" says Chicotel, \"but all this had been done without his family's knowledge, without his informed consent, without real good clinical indications for the use of the drug.\"\u003c/p>\n\u003cp>Antipsychotics like Risperdal and Haldol come with so-called black box warnings that say they could hasten death in elderly patients or people with dementia. Nevertheless, about a fifth of nursing home patients nationwide are prescribed antipsychotic drugs.\u003c/p>\n\u003cp>The U.S. attorney for Northern California declined to comment on the lawsuit, but it claims that the two nursing homes provided \"grossly inadequate, materially substandard and/or worthless services.\" Meanwhile, the nursing homes received about $20 million from Medicare and Medicaid for those services. So now the government wants its money back, and then some.\u003c/p>\n\u003cp>\"Under the False Claims Act, the government can ask for triple damages,\" explains Kelly Bagby, a senior attorney with the AARP Foundation. The nursing homes also could be fined, she says, for each incidence of filing a false report.\u003c/p>\n\u003cp>\"So every time they submitted a form that said, 'Here is Mrs. Jones' needs' and Mrs. Jones' needs were different than that, each one of those forms is a violation,\" says Bagby.\u003c/p>\n\u003cp>In a statement, the companies that own the two nursing homes called the charges \"untrue and without merit.\" They also filed their own lawsuit blaming the company they hired to manage the two facilities.\u003c/p>\n\u003cp>Deborah Pacyna, public affairs director for the California Association of Health Facilities, says that in the past couple years the federal government, in partnership with organizations like hers, has succeeded in \u003ca title=\"CMS nursing home report 2013\" href=\"http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf#page=171\" target=\"_blank\">reducing the use of antipsychotic drugs\u003c/a> in nursing homes.\u003c/p>\n\u003cp>\"But a lot of the regulators, a lot of our critics seem to be ignoring the fact that antipsychotics are being widely prescribed to patients who have dementia \u003ca title=\"Medicare Nursing Home Compendium\" href=\"http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf#page=190\" target=\"_blank\">who are living at home\u003c/a>, who are in the hospital or who are in assisted living settings,\" Pacyna says. \"Skilled nursing (homes) represents a fraction of those that have been impacted by this practice, yet we remain the focus.\"\u003c/p>\n\u003cp>Bagby, the AARP attorney, would like to maintain that focus, and thinks this lawsuit can help do that. \"If you're going to hit their bottom line, that's really where you change behavior.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bagby adds that with antipsychotic drugs still so widely prescribed for nursing home residents, there's the potential for more cases like this one across the country.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21306\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/137165920-e1410035335722.jpg\">\u003cimg class=\"size-large wp-image-21306\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/137165920-640x429.jpg\" alt=\" (Philippe Hugue/AFP/Getty Images)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Philippe Hugue/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Ina Jaffe,\u003c/strong>\u003ca href=\"http://www.npr.org/blogs/health/2014/09/05/346137537/feds-hope-hitting-nursing-homes-in-the-wallet-will-cut-overmedication\" target=\"_blank\"> NPR\u003c/a>\u003c/p>\n\u003cp>A federal lawsuit against two Watsonville nursing homes may offer a new approach to dealing with the persistent problem of such facilities overmedicating their residents.\u003c/p>\n\u003cp>\u003ca title=\"U.S. v. the Arba group, et al.\" href=\"https://s3.amazonaws.com/s3.documentcloud.org/documents/1284195/united-states-v-the-arba-group-et-al-complaint.pdf\" target=\"_blank\">The lawsuit\u003c/a> details multiple cases when the government says these drugs were inappropriately administered to patients. Watsonville is northeast of Monterey, in Santa Cruz County.\u003c/p>\n\u003cp>For instance when an 86-year-old man identified in the lawsuit as Patient 1 was admitted to Country Villa Watsonville West, he could speak clearly and walked in under his own power. Within days the facility began giving him Haldol and Risperdal, drugs used to treat schizophrenia and bipolar disorder, and he became bedridden, stopped eating and developed bedsores and infections.\u003c!--more-->\u003c/p>\n\u003cp>\"Within days he declined precipitously, to the point where he was read his last rites in the hospital,\" says Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform who represented the man and his family in a private suit that was settled out of court.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"He subsequently recovered,\" says Chicotel, \"but all this had been done without his family's knowledge, without his informed consent, without real good clinical indications for the use of the drug.\"\u003c/p>\n\u003cp>Antipsychotics like Risperdal and Haldol come with so-called black box warnings that say they could hasten death in elderly patients or people with dementia. Nevertheless, about a fifth of nursing home patients nationwide are prescribed antipsychotic drugs.\u003c/p>\n\u003cp>The U.S. attorney for Northern California declined to comment on the lawsuit, but it claims that the two nursing homes provided \"grossly inadequate, materially substandard and/or worthless services.\" Meanwhile, the nursing homes received about $20 million from Medicare and Medicaid for those services. So now the government wants its money back, and then some.\u003c/p>\n\u003cp>\"Under the False Claims Act, the government can ask for triple damages,\" explains Kelly Bagby, a senior attorney with the AARP Foundation. The nursing homes also could be fined, she says, for each incidence of filing a false report.\u003c/p>\n\u003cp>\"So every time they submitted a form that said, 'Here is Mrs. Jones' needs' and Mrs. Jones' needs were different than that, each one of those forms is a violation,\" says Bagby.\u003c/p>\n\u003cp>In a statement, the companies that own the two nursing homes called the charges \"untrue and without merit.\" They also filed their own lawsuit blaming the company they hired to manage the two facilities.\u003c/p>\n\u003cp>Deborah Pacyna, public affairs director for the California Association of Health Facilities, says that in the past couple years the federal government, in partnership with organizations like hers, has succeeded in \u003ca title=\"CMS nursing home report 2013\" href=\"http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf#page=171\" target=\"_blank\">reducing the use of antipsychotic drugs\u003c/a> in nursing homes.\u003c/p>\n\u003cp>\"But a lot of the regulators, a lot of our critics seem to be ignoring the fact that antipsychotics are being widely prescribed to patients who have dementia \u003ca title=\"Medicare Nursing Home Compendium\" href=\"http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf#page=190\" target=\"_blank\">who are living at home\u003c/a>, who are in the hospital or who are in assisted living settings,\" Pacyna says. \"Skilled nursing (homes) represents a fraction of those that have been impacted by this practice, yet we remain the focus.\"\u003c/p>\n\u003cp>Bagby, the AARP attorney, would like to maintain that focus, and thinks this lawsuit can help do that. \"If you're going to hit their bottom line, that's really where you change behavior.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bagby adds that with antipsychotic drugs still so widely prescribed for nursing home residents, there's the potential for more cases like this one across the country.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Are Double Mastectomy Rates Driven by 'Pink-Ribbon Culture Fearmongering'?",
"title": "Are Double Mastectomy Rates Driven by 'Pink-Ribbon Culture Fearmongering'?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_21230\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/176984427-e1409872053493.jpg\">\u003cimg class=\"wp-image-21230 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/176984427-640x418.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"418\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">'The pink ribbon is arguably the most successful marketing tool of the 20th century.' -- Karuna Jaggar, Breast Cancer Action (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>You may have read the other day about the big Stanford study on double mastectomies. Researchers looked at outcomes for every women in California diagnosed with early-stage breast cancer from 1998 to 2011 -- -- all 189,734 of them -- and found, surprisingly, that removing both breasts \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/02/stanford-study-double-mastectomies-dont-increase-breast-cancer-survival-rate/\" target=\"_blank\">doesn't increase breast cancer survival rate\u003c/a>.\u003c/p>\n\u003cp>From \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/02/stanford-study-double-mastectomies-dont-increase-breast-cancer-survival-rate/\" target=\"_blank\">NPR\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Women who had breast-conserving surgery had an 83.2 percent survival rate at 10 years, compared with 81.2 percent for those who had a double mastectomy.\u003c/p>\n\u003cp>“What it means is that women should be aware that if they choose double mastectomy, the chances are that it won’t cause them to live any longer than if they had chosen something else,” said Stanford professor Allison Kurian, lead author of the study.\u003c/p>\u003c/blockquote>\n\u003cp>Perhaps even more surprising than the lack of evidence to recommend double mastectomies is the discovery that, from 1998 to 2011, the procedure had risen among the large population studied from 2 percent to 12 percent. And for women under 40, the rate increased from 3.6 percent to a whopping 33 percent, \"even though most of them had stage zero or stage one cancer, a very early, very treatable form,\" NPR reports.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>On \u003ca href=\"http://www.kqed.org/a/forum/R201409040900\" target=\"_blank\">KQED radio's\u003cem> Forum\u003c/em> today\u003c/a>, host Michael Krasny discussed the research with two of the study's authors, a breast surgeon, and a leading advocate for women living with breast cancer. One of the obvious questions that arose:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Why are so many women opting for this more aggressive treatment?\u003c/p>\n\u003caside class=\"pullquote alignleft\">I would argue that pink-ribbon culture and marketing plays a very important role in this discussion because the dominant mainstream breast cancer movement ... is driven, arguably, by fearmongering.\"\n\u003cp>--Karuna Jagger, Breast Cancer Action\u003c/p>\u003c/aside>\n\u003cp>\"It’s been perplexing for people to try to understand why that is,\" said Stanford professor Allison Kurian, the study's lead author, who said no data had emerged over the time period studied to suggest a survival benefit from double mastectomies.\u003c/p>\n\u003cp>\"Many different explanations have been suggested, some of it relating to new sensitive diagnostic tests that might find more cancers or other findings that might prompt surgery,\" she said. \"And others potentially related to some new techniques of breast reconstruction that might encourage bilateral surgery for purposes of symmetry.\"\u003c/p>\n\u003cp>Scarlett Lin Gomez, senior author of the study and a research scientist at the Cancer Prevention Institute of California, said breast cancer patients could very well be making the decision out of fear instead of medical evidence.\u003c/p>\n\u003cp>\"Our findings really beg the question of the psychology and the thought process that's going behind the decision for these various types of treatment,\" she said. \"We have anecdotally heard, and a study was just presented this week at a breast cancer conference, that ... fear and anxiety does seem to play a large role in that decision for bilateral mastectomy.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/166277026&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dr. Michael Alvarado, director of UCSF's Breast Surgery Oncology Fellowship, said that \"women are initially afraid. This is a huge thing they're dealing with, and they've obviously heard of other women's states of disease, and they have this ... fear and worry and all of the complex emotions going on in the initial consultation. It typically takes some time for them to come off of that craziness to really think about what the options are and what those risks involve. And delving into bilateral mastectomy offers a significant number of risks and complications with the surgery and with reconstruction itself.\"\u003c/p>\n\u003cp>Alvarado said he thought many patients were unnecessarily hurried into surgery.\u003c/p>\n\u003cp>\"It’s a pretty complex time for these women, and I think a lot of them get rushed into doing surgery immediately, and 'it needs to be done within a week or 10 days,' which is absolutely not true. And they’re making these decisions based on emotions, as opposed to a lot of these facts that have been recognized in these studies.\"\u003c/p>\n\u003cp>Still, Alvarado also said the desire to preclude the possibility of going through another traumatic experience is strong.\u003c/p>\n\u003cp>\"The issue of just having to go through the experience again, that just generates this anxiety. To have to go through it once is horrible enough, to have go through it again ... some women feel that even if that's a 2-5 percent chance, they don't ever want to do it again. It's really hard to overcome that psychological thought process.\"\u003c/p>\n\u003cp>\u003cstrong>'Pink-Ribbon Culture'\u003c/strong>\u003c/p>\n\u003cp>Karuna Jaggar is the executive director of San Francisco-based Breast Cancer Action, an education and advocacy organization for women living with and at risk for breast cancer. While making it clear that she in no way wanted to suggest that women were making the \"wrong choice\" for double mastectomies, she said the study's findings are indicative of overkill by the breast cancer awareness movement.\u003c/p>\n\u003cp>\"I think this study is part of a much larger picture. Breast cancer occupies a huge space in our culture, and the pink ribbon is arguably the most successful marketing tool of the 20\u003csup>th\u003c/sup> century,\" Jaggar said \u003ca href=\"http://www.pinkribbon.org/About/History.aspx\" target=\"_blank\">in reference to the ribbon\u003c/a> that has become an international symbol of breast cancer awareness.\u003c/p>\n\u003cp>\"Our job is to look at how women's choices are informed, how they're supported, how they’re influenced, how they're constrained. I would argue that pink-ribbon culture and marketing plays a very important role in this discussion, because the dominant mainstream breast cancer movement is really focused on awareness, and the movement is driven, arguably, by fearmongering, by really fueling this fear of the disease.\u003c/p>\n\u003cp>\u003cem>Forum\u003c/em> host Michael Krasny asked if anyone was profiting from the emphasis on awareness.\u003c/p>\n\u003cp>\"We have some hard questions to ask,\" said Jaggar. \"For the billions of dollars spent each year, what do we have to show for it? What we see is year after year about 40,000 women continue to die of breast cancer. ... We’re not seeing the promised results of the investment in breast cancer, and a lot of this money is going to things like awareness. Do we need more awareness at this stage? You’d be hard-pressed to find anyone over the age of 10 who isn't aware of breast cancer, and screening. Evidence has been increasingly clear that\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/02/50-year-review-mammography-benefits-oversold-harms-minimized/\" target=\"_blank\"> early detection does not in fact save lives\u003c/a> …\"\u003c/p>\n\u003cp>Jaggar said the fear of breast cancer is so strong that the average American woman \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/20/despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online/\" target=\"_blank\">vastly overestimates her risk of breast cancer.\u003c/a> We live in this 'more is better' culture,\" she said. \"More screening, more information, more action, 'do something.' And so many women have been told, 'Get your mammogram.' The thinking is they’ll do anything for the peace of mind, and they’ll remove a healthy breast.\"\u003c/p>\n\u003cp>Yet Jaggar also insisted that she was not questioning any individual woman's choice. Indeed, callers to \u003cem>Forum\u003c/em> included women who had been diagnosed with breast cancer and opted for a double mastectomy. The women spoke of how complex the decision was and now, some years on, they expressed no regrets.\u003c/p>\n\u003cp>\u003cstrong>Ongoing Issue\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>As with many research findings, the devil is in the details, and even Dr. Gomez, the senior study author, cautioned that the research is not based on a clinical trial in which researchers were able to randomize the subjects. The findings, she said, should be \"one piece of evidence that people should factor in when having discussions with physicians.\"\u003c/p>\n\u003cp>LIkewise, as the\u003ca href=\"http://www.fhcrc.org/en/news/center-news/2014/09/Number-women-choosing-preventive-mastectomy-jumps.html\" target=\"_blank\"> Fred Hutchinson news service points out\u003c/a>, the huge jump in women under 40 choosing double mastectomies may have been accounted for by women with a predisposition for the disease having the procedure. \"One limitation of the new study is that it didn’t include data about women with strong family histories or genetic risks of breast cancer, such as BRCA1 or BRCA2 mutations,\" the new service reports.\u003c/p>\n\u003cp>Still, this is an issue that is bound to gain increasing attention as new research comes in and those in the public eye discuss their treatment choices. When \"Good Morning America\" correspondent \u003ca href=\"http://www.people.com/people/article/0,,20762429,00.html\" target=\"_blank\">Amy Robach, for instance, wrote about undergoing a double mastectomy\u003c/a> after receiving results from an on-air mammogram, one cancer doctor wrote a \u003ca href=\"http://nymag.com/thecut/2014/08/avoiding-the-breast-cancer-warrior-trap.html\" target=\"_blank\">criticism of her reasoning for New York Magazine\u003c/a>.\u003c/p>\n\u003cblockquote>\u003cp>She told \u003cem>People\u003c/em> magazine that she went this route because she wants to be around for graduations and grandchildren. But women at average risk of breast cancer (i.e., who lack the genetic defect that Angelina Jolie carries) increase the likelihood that they are alive in 20 years by less than one half of one percent through the surgery Robach chose. No expert or guideline advocates Robach’s choice as the standard for care; many warn it is inappropriate.\u003c/p>\u003c/blockquote>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>For more on the controversies that have popped up over breast cancer screening and treatment, see \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">Lisa Aliferis' post on author Peggy Orenstein's critique\u003c/a> of the \"feel-good war on breast cancer.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21230\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/176984427-e1409872053493.jpg\">\u003cimg class=\"wp-image-21230 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/176984427-640x418.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"418\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">'The pink ribbon is arguably the most successful marketing tool of the 20th century.' -- Karuna Jaggar, Breast Cancer Action (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>You may have read the other day about the big Stanford study on double mastectomies. Researchers looked at outcomes for every women in California diagnosed with early-stage breast cancer from 1998 to 2011 -- -- all 189,734 of them -- and found, surprisingly, that removing both breasts \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/02/stanford-study-double-mastectomies-dont-increase-breast-cancer-survival-rate/\" target=\"_blank\">doesn't increase breast cancer survival rate\u003c/a>.\u003c/p>\n\u003cp>From \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/02/stanford-study-double-mastectomies-dont-increase-breast-cancer-survival-rate/\" target=\"_blank\">NPR\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Women who had breast-conserving surgery had an 83.2 percent survival rate at 10 years, compared with 81.2 percent for those who had a double mastectomy.\u003c/p>\n\u003cp>“What it means is that women should be aware that if they choose double mastectomy, the chances are that it won’t cause them to live any longer than if they had chosen something else,” said Stanford professor Allison Kurian, lead author of the study.\u003c/p>\u003c/blockquote>\n\u003cp>Perhaps even more surprising than the lack of evidence to recommend double mastectomies is the discovery that, from 1998 to 2011, the procedure had risen among the large population studied from 2 percent to 12 percent. And for women under 40, the rate increased from 3.6 percent to a whopping 33 percent, \"even though most of them had stage zero or stage one cancer, a very early, very treatable form,\" NPR reports.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>On \u003ca href=\"http://www.kqed.org/a/forum/R201409040900\" target=\"_blank\">KQED radio's\u003cem> Forum\u003c/em> today\u003c/a>, host Michael Krasny discussed the research with two of the study's authors, a breast surgeon, and a leading advocate for women living with breast cancer. One of the obvious questions that arose:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Why are so many women opting for this more aggressive treatment?\u003c/p>\n\u003caside class=\"pullquote alignleft\">I would argue that pink-ribbon culture and marketing plays a very important role in this discussion because the dominant mainstream breast cancer movement ... is driven, arguably, by fearmongering.\"\n\u003cp>--Karuna Jagger, Breast Cancer Action\u003c/p>\u003c/aside>\n\u003cp>\"It’s been perplexing for people to try to understand why that is,\" said Stanford professor Allison Kurian, the study's lead author, who said no data had emerged over the time period studied to suggest a survival benefit from double mastectomies.\u003c/p>\n\u003cp>\"Many different explanations have been suggested, some of it relating to new sensitive diagnostic tests that might find more cancers or other findings that might prompt surgery,\" she said. \"And others potentially related to some new techniques of breast reconstruction that might encourage bilateral surgery for purposes of symmetry.\"\u003c/p>\n\u003cp>Scarlett Lin Gomez, senior author of the study and a research scientist at the Cancer Prevention Institute of California, said breast cancer patients could very well be making the decision out of fear instead of medical evidence.\u003c/p>\n\u003cp>\"Our findings really beg the question of the psychology and the thought process that's going behind the decision for these various types of treatment,\" she said. \"We have anecdotally heard, and a study was just presented this week at a breast cancer conference, that ... fear and anxiety does seem to play a large role in that decision for bilateral mastectomy.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/166277026&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Dr. Michael Alvarado, director of UCSF's Breast Surgery Oncology Fellowship, said that \"women are initially afraid. This is a huge thing they're dealing with, and they've obviously heard of other women's states of disease, and they have this ... fear and worry and all of the complex emotions going on in the initial consultation. It typically takes some time for them to come off of that craziness to really think about what the options are and what those risks involve. And delving into bilateral mastectomy offers a significant number of risks and complications with the surgery and with reconstruction itself.\"\u003c/p>\n\u003cp>Alvarado said he thought many patients were unnecessarily hurried into surgery.\u003c/p>\n\u003cp>\"It’s a pretty complex time for these women, and I think a lot of them get rushed into doing surgery immediately, and 'it needs to be done within a week or 10 days,' which is absolutely not true. And they’re making these decisions based on emotions, as opposed to a lot of these facts that have been recognized in these studies.\"\u003c/p>\n\u003cp>Still, Alvarado also said the desire to preclude the possibility of going through another traumatic experience is strong.\u003c/p>\n\u003cp>\"The issue of just having to go through the experience again, that just generates this anxiety. To have to go through it once is horrible enough, to have go through it again ... some women feel that even if that's a 2-5 percent chance, they don't ever want to do it again. It's really hard to overcome that psychological thought process.\"\u003c/p>\n\u003cp>\u003cstrong>'Pink-Ribbon Culture'\u003c/strong>\u003c/p>\n\u003cp>Karuna Jaggar is the executive director of San Francisco-based Breast Cancer Action, an education and advocacy organization for women living with and at risk for breast cancer. While making it clear that she in no way wanted to suggest that women were making the \"wrong choice\" for double mastectomies, she said the study's findings are indicative of overkill by the breast cancer awareness movement.\u003c/p>\n\u003cp>\"I think this study is part of a much larger picture. Breast cancer occupies a huge space in our culture, and the pink ribbon is arguably the most successful marketing tool of the 20\u003csup>th\u003c/sup> century,\" Jaggar said \u003ca href=\"http://www.pinkribbon.org/About/History.aspx\" target=\"_blank\">in reference to the ribbon\u003c/a> that has become an international symbol of breast cancer awareness.\u003c/p>\n\u003cp>\"Our job is to look at how women's choices are informed, how they're supported, how they’re influenced, how they're constrained. I would argue that pink-ribbon culture and marketing plays a very important role in this discussion, because the dominant mainstream breast cancer movement is really focused on awareness, and the movement is driven, arguably, by fearmongering, by really fueling this fear of the disease.\u003c/p>\n\u003cp>\u003cem>Forum\u003c/em> host Michael Krasny asked if anyone was profiting from the emphasis on awareness.\u003c/p>\n\u003cp>\"We have some hard questions to ask,\" said Jaggar. \"For the billions of dollars spent each year, what do we have to show for it? What we see is year after year about 40,000 women continue to die of breast cancer. ... We’re not seeing the promised results of the investment in breast cancer, and a lot of this money is going to things like awareness. Do we need more awareness at this stage? You’d be hard-pressed to find anyone over the age of 10 who isn't aware of breast cancer, and screening. Evidence has been increasingly clear that\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/02/50-year-review-mammography-benefits-oversold-harms-minimized/\" target=\"_blank\"> early detection does not in fact save lives\u003c/a> …\"\u003c/p>\n\u003cp>Jaggar said the fear of breast cancer is so strong that the average American woman \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/20/despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online/\" target=\"_blank\">vastly overestimates her risk of breast cancer.\u003c/a> We live in this 'more is better' culture,\" she said. \"More screening, more information, more action, 'do something.' And so many women have been told, 'Get your mammogram.' The thinking is they’ll do anything for the peace of mind, and they’ll remove a healthy breast.\"\u003c/p>\n\u003cp>Yet Jaggar also insisted that she was not questioning any individual woman's choice. Indeed, callers to \u003cem>Forum\u003c/em> included women who had been diagnosed with breast cancer and opted for a double mastectomy. The women spoke of how complex the decision was and now, some years on, they expressed no regrets.\u003c/p>\n\u003cp>\u003cstrong>Ongoing Issue\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>As with many research findings, the devil is in the details, and even Dr. Gomez, the senior study author, cautioned that the research is not based on a clinical trial in which researchers were able to randomize the subjects. The findings, she said, should be \"one piece of evidence that people should factor in when having discussions with physicians.\"\u003c/p>\n\u003cp>LIkewise, as the\u003ca href=\"http://www.fhcrc.org/en/news/center-news/2014/09/Number-women-choosing-preventive-mastectomy-jumps.html\" target=\"_blank\"> Fred Hutchinson news service points out\u003c/a>, the huge jump in women under 40 choosing double mastectomies may have been accounted for by women with a predisposition for the disease having the procedure. \"One limitation of the new study is that it didn’t include data about women with strong family histories or genetic risks of breast cancer, such as BRCA1 or BRCA2 mutations,\" the new service reports.\u003c/p>\n\u003cp>Still, this is an issue that is bound to gain increasing attention as new research comes in and those in the public eye discuss their treatment choices. When \"Good Morning America\" correspondent \u003ca href=\"http://www.people.com/people/article/0,,20762429,00.html\" target=\"_blank\">Amy Robach, for instance, wrote about undergoing a double mastectomy\u003c/a> after receiving results from an on-air mammogram, one cancer doctor wrote a \u003ca href=\"http://nymag.com/thecut/2014/08/avoiding-the-breast-cancer-warrior-trap.html\" target=\"_blank\">criticism of her reasoning for New York Magazine\u003c/a>.\u003c/p>\n\u003cblockquote>\u003cp>She told \u003cem>People\u003c/em> magazine that she went this route because she wants to be around for graduations and grandchildren. But women at average risk of breast cancer (i.e., who lack the genetic defect that Angelina Jolie carries) increase the likelihood that they are alive in 20 years by less than one half of one percent through the surgery Robach chose. No expert or guideline advocates Robach’s choice as the standard for care; many warn it is inappropriate.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For more on the controversies that have popped up over breast cancer screening and treatment, see \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">Lisa Aliferis' post on author Peggy Orenstein's critique\u003c/a> of the \"feel-good war on breast cancer.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stanford Study: Double Mastectomies Don't Increase Breast Cancer Survival Rate",
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"content": "\u003cfigure id=\"attachment_21138\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/78022737-e1409697092845.jpg\">\u003cimg class=\"size-large wp-image-21138\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/78022737-640x591.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"591\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">About one-third of women under 40 diagnosed with breast cancer in California choose double mastectomy. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/09/02/345200586/double-mastectomies-dont-increase-cancer-survival-rates\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>More women are choosing to have bilateral mastectomies when they are diagnosed with early-stage breast cancer, even though there's little evidence that removing both breasts improves their survival compared with more conservative treatments.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Doctors worry that women choose double mastectomy out of the mistaken belief that it eliminates their future risk of cancer.\u003c/aside>\n\u003cp>The biggest study yet on the question has found no survival benefit with bilateral mastectomy compared to breast-conserving surgery with radiation.\u003c/p>\n\u003cp>The\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1900512\" target=\"_blank\"> study\u003c/a>, published Tuesday in JAMA, the Journal of the American Medical Association, looked at the records of all women in California who were diagnosed with early-stage breast cancer from 1998 to 2011 — 189,734 women, all told.\u003c!--more-->\u003c/p>\n\u003cp>Women who had breast-conserving surgery had an 83.2 percent survival rate at 10 years, compared with 81.2 percent for those who had a double mastectomy. \"What it means is that women should be aware that if they choose double mastectomy, the chances are that it won't cause them to live any longer than if they had chosen something else,\" said Stanford professor \u003ca href=\"https://med.stanford.edu/profiles/Allison_Kurian\" target=\"_blank\">Allison Kurian\u003c/a>, lead author of the study.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Women who had a single mastectomy fared worse, with a 79.9 percent survival rate, enough to be statistically significant.\u003c/p>\n\u003cp>\"We think that poorer survival in this group may be due to other factors that we weren't able to account for,\" says \u003ca href=\"http://www.cpic.org/our-research/our-scientists/scarlett-gomez.aspx\" target=\"_blank\">Scarlett Lin Gomez\u003c/a>, a research scientist at the Cancer Prevention Institute of California and the senior author of the study.\u003c/p>\n\u003cp>The women who had single mastectomies tended to be minority, especially Filipina or Hispanic, to be lower income and to be uninsured.\u003c/p>\n\u003cp>One factor affecting these women could be lack of access to medical care, Gomez says. For instance, a woman who has breast-conserving surgery typically has radiation treatment every day for six weeks to kill remaining cancer cells. Lower-income women may have a hard time doing that, Gomez says. \"The only option available to them may be unilateral mastectomy.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"DalZoBNmFtR3nFMelD44GIHbItrKXxbe\"]\u003c/p>\n\u003cp>And if women having single mastectomies tended to be poorer and minority, women who chose bilateral mastectomies tended to be younger, white and better off.\u003c/p>\n\u003cp>Overall, the double mastectomy rate had increased from 2 percent to 12 percent between 1998 and 2011. But for women under 40, the double mastectomy rate had increased to 33 percent, even though most of them had stage zero or stage one cancer, a very early, very treatable form.\u003c/p>\n\u003cp>Those women also were more likely to be treated at an academic medical center, which, along with their youth and low-risk cancer, should make it more likely that they would survive. So why are they not doing any better than women who have lumpectomies and radiation?\u003c/p>\n\u003cp>\"I don't think we know,\" Gomez told NPR. \"This is complete conjecture at this point. A bilateral mastectomy is major surgery, and just like any major surgery there are complications, side effects. So any advantage that comes from lowering your risk of cancer in the [healthy] breast could be offset by the fact that you're having major surgery.\"\u003c/p>\n\u003cp>Doing a randomized trial that directly compares the various treatments could help figure that out, but Gomez and others say it would be pretty much impossible to recruit lots of women in a trial that wouldn't give them a choice of treatments.\u003c/p>\n\u003cp>\"Given the vast size of our data set, I think these findings may be as good as it's going to get in terms of giving us clues,\" Gomez says.\u003c/p>\n\u003cp>Doctors have been increasingly concerned that women are choosing bilateral mastectomy in the mistaken belief that it eliminates their future risk of cancer.\u003c/p>\n\u003cp>Double mastectomies made headlines in 2013, when actress Angelina Jolie had a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/why-angelina-jolies-medical-choice-is-likely-not-yours/\" target=\"_blank\">prophylactic double mastectomy \u003c/a>after being diagnosed with a BRCA gene mutation that vastly increases cancer risk. (Her case was different from this study which exclusively focused on women with breast cancer. Jolie did not have breast cancer, but was at extremely high risk of the disease.)\u003c/p>\n\u003cp>Yet only 5 percent of cancers are caused by BRCA mutations. Most of the women who are choosing double mastectomies haven't been diagnosed with a BRCA mutation.\u003c/p>\n\u003cp>\"Bilateral mastectomy surgery maximally reduces the risk of a breast cancer patient developing a completely new breast cancer, but it does not affect the potentially life-threatening risk of the known first cancer damaging other organs in the body through metatastic spread,\" Dr. Lisa Newman, director of the University of Michigan Breast Care Center, told NPR via email. She wrote an\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1900491\" target=\"_blank\"> editorial\u003c/a> in Tuesday's JAMA on the issue.\u003c/p>\n\u003cp>And since tiny bits of breast tissue can remain in the chest after surgery, a woman who has had a double mastectomy can still get breast cancer again.\u003c/p>\n\u003cp>Still, both Gomez and Stanford's Kurian stressed that the study should not be seen as a treatment recommendation.\u003c/p>\n\u003cp>Gomez hopes that these new numbers will shift the focus to better understanding women's decision-making process, and to educating physicians on better communications.\u003c/p>\n\u003cp>Doctors can't presume to dictate which choice will give a woman the best quality of life, Newman says. But doctors do have to counsel patients to have realistic expectations about their treatment choices.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are trying to understand he factors that might be motivating this trend, since there is no definitive survival advantage that has been demonstrated,\" Newman adds.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21138\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/78022737-e1409697092845.jpg\">\u003cimg class=\"size-large wp-image-21138\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/78022737-640x591.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"591\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">About one-third of women under 40 diagnosed with breast cancer in California choose double mastectomy. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2014/09/02/345200586/double-mastectomies-dont-increase-cancer-survival-rates\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>More women are choosing to have bilateral mastectomies when they are diagnosed with early-stage breast cancer, even though there's little evidence that removing both breasts improves their survival compared with more conservative treatments.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Doctors worry that women choose double mastectomy out of the mistaken belief that it eliminates their future risk of cancer.\u003c/aside>\n\u003cp>The biggest study yet on the question has found no survival benefit with bilateral mastectomy compared to breast-conserving surgery with radiation.\u003c/p>\n\u003cp>The\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1900512\" target=\"_blank\"> study\u003c/a>, published Tuesday in JAMA, the Journal of the American Medical Association, looked at the records of all women in California who were diagnosed with early-stage breast cancer from 1998 to 2011 — 189,734 women, all told.\u003c!--more-->\u003c/p>\n\u003cp>Women who had breast-conserving surgery had an 83.2 percent survival rate at 10 years, compared with 81.2 percent for those who had a double mastectomy. \"What it means is that women should be aware that if they choose double mastectomy, the chances are that it won't cause them to live any longer than if they had chosen something else,\" said Stanford professor \u003ca href=\"https://med.stanford.edu/profiles/Allison_Kurian\" target=\"_blank\">Allison Kurian\u003c/a>, lead author of the study.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Women who had a single mastectomy fared worse, with a 79.9 percent survival rate, enough to be statistically significant.\u003c/p>\n\u003cp>\"We think that poorer survival in this group may be due to other factors that we weren't able to account for,\" says \u003ca href=\"http://www.cpic.org/our-research/our-scientists/scarlett-gomez.aspx\" target=\"_blank\">Scarlett Lin Gomez\u003c/a>, a research scientist at the Cancer Prevention Institute of California and the senior author of the study.\u003c/p>\n\u003cp>The women who had single mastectomies tended to be minority, especially Filipina or Hispanic, to be lower income and to be uninsured.\u003c/p>\n\u003cp>One factor affecting these women could be lack of access to medical care, Gomez says. For instance, a woman who has breast-conserving surgery typically has radiation treatment every day for six weeks to kill remaining cancer cells. Lower-income women may have a hard time doing that, Gomez says. \"The only option available to them may be unilateral mastectomy.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And if women having single mastectomies tended to be poorer and minority, women who chose bilateral mastectomies tended to be younger, white and better off.\u003c/p>\n\u003cp>Overall, the double mastectomy rate had increased from 2 percent to 12 percent between 1998 and 2011. But for women under 40, the double mastectomy rate had increased to 33 percent, even though most of them had stage zero or stage one cancer, a very early, very treatable form.\u003c/p>\n\u003cp>Those women also were more likely to be treated at an academic medical center, which, along with their youth and low-risk cancer, should make it more likely that they would survive. So why are they not doing any better than women who have lumpectomies and radiation?\u003c/p>\n\u003cp>\"I don't think we know,\" Gomez told NPR. \"This is complete conjecture at this point. A bilateral mastectomy is major surgery, and just like any major surgery there are complications, side effects. So any advantage that comes from lowering your risk of cancer in the [healthy] breast could be offset by the fact that you're having major surgery.\"\u003c/p>\n\u003cp>Doing a randomized trial that directly compares the various treatments could help figure that out, but Gomez and others say it would be pretty much impossible to recruit lots of women in a trial that wouldn't give them a choice of treatments.\u003c/p>\n\u003cp>\"Given the vast size of our data set, I think these findings may be as good as it's going to get in terms of giving us clues,\" Gomez says.\u003c/p>\n\u003cp>Doctors have been increasingly concerned that women are choosing bilateral mastectomy in the mistaken belief that it eliminates their future risk of cancer.\u003c/p>\n\u003cp>Double mastectomies made headlines in 2013, when actress Angelina Jolie had a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/why-angelina-jolies-medical-choice-is-likely-not-yours/\" target=\"_blank\">prophylactic double mastectomy \u003c/a>after being diagnosed with a BRCA gene mutation that vastly increases cancer risk. (Her case was different from this study which exclusively focused on women with breast cancer. Jolie did not have breast cancer, but was at extremely high risk of the disease.)\u003c/p>\n\u003cp>Yet only 5 percent of cancers are caused by BRCA mutations. Most of the women who are choosing double mastectomies haven't been diagnosed with a BRCA mutation.\u003c/p>\n\u003cp>\"Bilateral mastectomy surgery maximally reduces the risk of a breast cancer patient developing a completely new breast cancer, but it does not affect the potentially life-threatening risk of the known first cancer damaging other organs in the body through metatastic spread,\" Dr. Lisa Newman, director of the University of Michigan Breast Care Center, told NPR via email. She wrote an\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1900491\" target=\"_blank\"> editorial\u003c/a> in Tuesday's JAMA on the issue.\u003c/p>\n\u003cp>And since tiny bits of breast tissue can remain in the chest after surgery, a woman who has had a double mastectomy can still get breast cancer again.\u003c/p>\n\u003cp>Still, both Gomez and Stanford's Kurian stressed that the study should not be seen as a treatment recommendation.\u003c/p>\n\u003cp>Gomez hopes that these new numbers will shift the focus to better understanding women's decision-making process, and to educating physicians on better communications.\u003c/p>\n\u003cp>Doctors can't presume to dictate which choice will give a woman the best quality of life, Newman says. But doctors do have to counsel patients to have realistic expectations about their treatment choices.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We are trying to understand he factors that might be motivating this trend, since there is no definitive survival advantage that has been demonstrated,\" Newman adds.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "IUD Costs Vary by $600 in Bay Area; What Did You Pay?",
"title": "IUD Costs Vary by $600 in Bay Area; What Did You Pay?",
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"content": "\u003cfigure id=\"attachment_15557\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975.jpg\">\u003cimg class=\"size-large wp-image-15557\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975-640x640.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States. (Spike Mafford/Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control. (Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're one of the 62 million American women of \u003ca href=\"www.guttmacher.org/pubs/fb_contr_use.html#9\" target=\"_blank\">childbearing age\u003c/a>, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking? Let's back up. We've reached the halfway point in our PriceCheck project.\u003c/p>\n\u003cp>We're shining a light on notoriously opaque and highly variable health care costs. We're asking you, the members of our community, to share what you've paid for common procedures including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/24/pricecheck-how-much-does-a-back-mri-cost/\" target=\"_blank\">back MRIs\u003c/a>. We found that both screening mammograms and back MRIs could vary in price ten-fold. Now we're moving on to a new health care service: IUDs.\u003c/p>\n\u003cp>We're asking you to share what you paid for your IUD. The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck database\u003c/a>.\u003c!--more--> [contextly_sidebar id=\"psJwnuCzaS7EPHqra7NYt7I2Omxunr8o\"]\u003c/p>\n\u003cp>We've already found that if you're not insured and are paying out-of-pocket for an IUD, these cash prices in the Bay Area range from about $600 to about $1,200. But we also know that what insurers pay for health care tests and treatments varies widely. We're asking you to share what your insurer paid -- and what your copay was.\u003c/p>\n\u003cp>Right about now you might be thinking that IUDs are supposed to be covered at no copay under rules established by the Affordable Care Act. Isn't that right?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That would be both yes -- and no.\u003c/p>\n\u003cp>Yes, the Affordable Care Act mandates coverage of birth contraceptive methods for all women. On \u003ca href=\"https://www.healthcare.gov/what-are-my-birth-control-benefits/\" target=\"_blank\">healthcare.gov\u003c/a>, it says that plans on the health insurance marketplace, which would include Covered California, \"must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider.\"\u003c/p>\n\u003cp>Yet, just 1.4 million of California's 38 million residents are insured through Covered California. While other people with private insurance should get the same benefit, it won't be true for everyone. That's because many people are in so-called \"grandfathered\" plans -- plans that have been around since before the ACA was signed into law in March, 2010, and so do not have to follow all the regulations required by the ACA. You've also probably heard of the \u003ca href=\"http://www.npr.org/blogs/health/2014/06/30/327065968/hobby-lobby-ruling-cuts-into-contraceptive-mandate\" target=\"_blank\">Hobby Lobby\u003c/a> case allowing some businesses to file a religious objection to providing contraceptives. Some religious nonprofits may also be exempt.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>In addition, \u003ca href=\"http://www.plannedparenthood.org/about-us/newsroom/the-affordable-care-act\" target=\"_blank\">some plans cover some, but not all\u003c/a>, of all the FDA-approved contraceptive services. If you want to know what specific methods are covered under your plan, you call call the member services number on the back of your insurance card.\u003c/p>\n\u003cp>The National Women's Law Center \u003ca href=\"http://www.nwlc.org/resource/how-find-out-if-your-health-plan-covering-women%E2%80%99s-preventive-services-no-co-pay-required-he\" target=\"_blank\">provides this extremely helpful phone guide\u003c/a> for you to use, to help make sure you're getting all the answers you need. ClearHealthCosts \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-iud-cost-covered-one-patient-paid-2-24-another-730/\" target=\"_blank\">details some early submissions\u003c/a> we've already received from women who shared the cost of their IUD. Despite having insurance, one woman paid the entire $730 cost of her IUD because she had not yet met her deductible.Another woman was charged $2.24, but will also have to pay $197 for the six-week follow up appointment. A third woman says the entire cost of her IUD was paid by insurance.\u003c/p>\n\u003cp>The more women who shared what they paid, the more it helps other women be informed consumers. We invite you to share what you paid. It’s helpful if you have your “explanation of benefits” from your insurance company (\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.) Then \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California!\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15557\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975.jpg\">\u003cimg class=\"size-large wp-image-15557\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD001975-640x640.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States. (Spike Mafford/Getty Images)\" width=\"640\" height=\"640\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control. (Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>If you're one of the 62 million American women of \u003ca href=\"www.guttmacher.org/pubs/fb_contr_use.html#9\" target=\"_blank\">childbearing age\u003c/a>, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking? Let's back up. We've reached the halfway point in our PriceCheck project.\u003c/p>\n\u003cp>We're shining a light on notoriously opaque and highly variable health care costs. We're asking you, the members of our community, to share what you've paid for common procedures including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">mammograms\u003c/a> and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/24/pricecheck-how-much-does-a-back-mri-cost/\" target=\"_blank\">back MRIs\u003c/a>. We found that both screening mammograms and back MRIs could vary in price ten-fold. Now we're moving on to a new health care service: IUDs.\u003c/p>\n\u003cp>We're asking you to share what you paid for your IUD. The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck database\u003c/a>.\u003c!--more--> \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>We've already found that if you're not insured and are paying out-of-pocket for an IUD, these cash prices in the Bay Area range from about $600 to about $1,200. But we also know that what insurers pay for health care tests and treatments varies widely. We're asking you to share what your insurer paid -- and what your copay was.\u003c/p>\n\u003cp>Right about now you might be thinking that IUDs are supposed to be covered at no copay under rules established by the Affordable Care Act. Isn't that right?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That would be both yes -- and no.\u003c/p>\n\u003cp>Yes, the Affordable Care Act mandates coverage of birth contraceptive methods for all women. On \u003ca href=\"https://www.healthcare.gov/what-are-my-birth-control-benefits/\" target=\"_blank\">healthcare.gov\u003c/a>, it says that plans on the health insurance marketplace, which would include Covered California, \"must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider.\"\u003c/p>\n\u003cp>Yet, just 1.4 million of California's 38 million residents are insured through Covered California. While other people with private insurance should get the same benefit, it won't be true for everyone. That's because many people are in so-called \"grandfathered\" plans -- plans that have been around since before the ACA was signed into law in March, 2010, and so do not have to follow all the regulations required by the ACA. You've also probably heard of the \u003ca href=\"http://www.npr.org/blogs/health/2014/06/30/327065968/hobby-lobby-ruling-cuts-into-contraceptive-mandate\" target=\"_blank\">Hobby Lobby\u003c/a> case allowing some businesses to file a religious objection to providing contraceptives. Some religious nonprofits may also be exempt.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Read more stories \u003c/a>on health care cost variation from our PriceCheck project.\u003c/aside>\n\u003cp>In addition, \u003ca href=\"http://www.plannedparenthood.org/about-us/newsroom/the-affordable-care-act\" target=\"_blank\">some plans cover some, but not all\u003c/a>, of all the FDA-approved contraceptive services. If you want to know what specific methods are covered under your plan, you call call the member services number on the back of your insurance card.\u003c/p>\n\u003cp>The National Women's Law Center \u003ca href=\"http://www.nwlc.org/resource/how-find-out-if-your-health-plan-covering-women%E2%80%99s-preventive-services-no-co-pay-required-he\" target=\"_blank\">provides this extremely helpful phone guide\u003c/a> for you to use, to help make sure you're getting all the answers you need. ClearHealthCosts \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-iud-cost-covered-one-patient-paid-2-24-another-730/\" target=\"_blank\">details some early submissions\u003c/a> we've already received from women who shared the cost of their IUD. Despite having insurance, one woman paid the entire $730 cost of her IUD because she had not yet met her deductible.Another woman was charged $2.24, but will also have to pay $197 for the six-week follow up appointment. A third woman says the entire cost of her IUD was paid by insurance.\u003c/p>\n\u003cp>The more women who shared what they paid, the more it helps other women be informed consumers. We invite you to share what you paid. It’s helpful if you have your “explanation of benefits” from your insurance company (\u003ca style=\"font-weight: bold;color: #114999\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">Find out more about EOBs here\u003c/a>.) Then \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visit PriceCheck\u003c/a> and share.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Help us make health costs transparent in California!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20671\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/31868593_c758da9bbf_z.jpg\">\u003cimg class=\"size-full wp-image-20671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/31868593_c758da9bbf_z.jpg\" alt=\"Santa Clara University's employee health insurance will stop covering 'elective' abortions next year unless state officials change their minds. (Michael Zimmer/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The two universities affected by the move are Loyola Marymount and Santa Clara University, above. (Michael Zimmer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Ted Goldberg and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>In a reversal, Gov. Jerry Brown's administration is barring two Catholic universities in California from offering health plans to their employees that limit abortion coverage.\u003c/p>\n\u003cp>Previously, state health officials had approved plans used by Santa Clara University and Loyola Marymount in Los Angeles that did not cover any abortion procedures, unless they were \"medically necessary\" to protect the health of the mother.\u003c/p>\n\u003cp>But earlier this month, the Department of Managed Health Care (DMHC) \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/12/california-reconsiders-letting-catholic-universities-limit-abortion-coverage/\" target=\"_blank\">said they were reviewing\u003c/a> that approval.\u003c/p>\n\u003cp>The DMHC is now sending letters to insurance companies for both universities, requiring them to cover all abortions. \u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As the \u003ca href=\"http://www.sfgate.com/news/article/State-reverses-abortion-decision-at-2-Catholic-5705008.php\" target=\"_blank\">San Francisco Chronicle reports\u003c/a>, the DMHC determined that \"the exclusions violate a 1975 state law that requires group health plans to cover all basic services -- defined by the law, as those that are 'medically necessary.'\"\u003c/p>\n\u003cp>The Chronicle said the the DMHC director, Michelle Rouillard states in the letter that \"abortion is a basic health care service,\" and that \u003cspan style=\"color: #000000\">\"the California Constitution prohibits health plans from discriminating against women who choose to terminate a pregnancy. Thus, all health plans must treat maternity services and legal abortion neutrally.\"\u003c/span>\u003c/p>\n\u003cp>The coverage limitations were announced last fall. The schools said they took the action because elective abortion is not consistent with Catholic teachings.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But faculty groups at both Santa Clara and Loyola Marymount universities had protested the limited coverage, saying that the schools had professed to be open to those of all views and faiths, the Chronicle said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20671\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/31868593_c758da9bbf_z.jpg\">\u003cimg class=\"size-full wp-image-20671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/31868593_c758da9bbf_z.jpg\" alt=\"Santa Clara University's employee health insurance will stop covering 'elective' abortions next year unless state officials change their minds. (Michael Zimmer/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The two universities affected by the move are Loyola Marymount and Santa Clara University, above. (Michael Zimmer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Ted Goldberg and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>In a reversal, Gov. Jerry Brown's administration is barring two Catholic universities in California from offering health plans to their employees that limit abortion coverage.\u003c/p>\n\u003cp>Previously, state health officials had approved plans used by Santa Clara University and Loyola Marymount in Los Angeles that did not cover any abortion procedures, unless they were \"medically necessary\" to protect the health of the mother.\u003c/p>\n\u003cp>But earlier this month, the Department of Managed Health Care (DMHC) \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/12/california-reconsiders-letting-catholic-universities-limit-abortion-coverage/\" target=\"_blank\">said they were reviewing\u003c/a> that approval.\u003c/p>\n\u003cp>The DMHC is now sending letters to insurance companies for both universities, requiring them to cover all abortions. \u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As the \u003ca href=\"http://www.sfgate.com/news/article/State-reverses-abortion-decision-at-2-Catholic-5705008.php\" target=\"_blank\">San Francisco Chronicle reports\u003c/a>, the DMHC determined that \"the exclusions violate a 1975 state law that requires group health plans to cover all basic services -- defined by the law, as those that are 'medically necessary.'\"\u003c/p>\n\u003cp>The Chronicle said the the DMHC director, Michelle Rouillard states in the letter that \"abortion is a basic health care service,\" and that \u003cspan style=\"color: #000000\">\"the California Constitution prohibits health plans from discriminating against women who choose to terminate a pregnancy. Thus, all health plans must treat maternity services and legal abortion neutrally.\"\u003c/span>\u003c/p>\n\u003cp>The coverage limitations were announced last fall. The schools said they took the action because elective abortion is not consistent with Catholic teachings.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But faculty groups at both Santa Clara and Loyola Marymount universities had protested the limited coverage, saying that the schools had professed to be open to those of all views and faiths, the Chronicle said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Using Disney Movies to Reach A Son with Autism",
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"content": "\u003cfigure id=\"attachment_20982\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/jdhancock/7486431222/in/photolist-2nPYpL-4MiNPx-dojqwo-cpy3jj-5miHgL-4Zh3yt-66tW-4Fp838-Ku37A-89J7te-eWadd-w9HG9-53iEnb-943FjU-8rCoNh-eF7Gpk-7t38Za-6PScxR-cpxVbo-648doP-aFh8ap-6mnYzN-6miQn4-6miQda-5RzRS-ddCYGh-674fMr-dUru2M-n9Ucgb-6iKanm-e1xvJN-fn6rt7-zN9cF-5AGJWT-6FMy9d-6mod8G-cXUoHE-kK7WFW-83w2vW-6xC4gr-5ByHJ8-89MmNJ-mvXTH-5SfKbs-hrJNp-9hJaaj-4o6FZs-duAp8V-5SfKbL-cb8iwj\">\u003cimg class=\"size-full wp-image-20982\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/7486431222_640d5c139f_z.jpg\" alt='The family first used a scene from the movie \"Aladdin\" to connect to their son. (JD Hancock/Flickr)' width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The family first used a scene from the movie \"Aladdin\" to connect to their son. (JD Hancock/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kathy Shield\u003c/strong>\u003c/p>\n\u003cp>Owen Suskind was a normal toddler, learning to speak in full sentences and happily playing in the backyard with his older brother, Walt.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Owen wasn’t merely watching these movies, he was hearing them and learning through the characters.\u003c/aside>\n\u003cp>That all changed at age 3, when Owen stopped speaking, and in the space of a single month, his entire vocabulary was reduced to one word: juice. Owen was diagnosed with late-onset regressive autism. Though his developmental trajectory was typical for children with this form of autism, this fact offered no comfort to his parents.\u003c/p>\n\u003cp>Today, Owen has grown into a relatively self-sufficient young man. He graduated from a college-like program for young adults on the autism spectrum and is now living semi-independently in an apartment.\u003c!--more-->\u003c/p>\n\u003cp>The story of how Owen went from a 3-year-old who could barely speak for years to living somewhat independently has been chronicled by Owen's father, Pulitzer Prize-winning journalist Ron Suskind, in a book \"\u003ca href=\"http://www.amazon.com/Life-Animated-Sidekicks-Heroes-Autism/dp/1423180364\" target=\"_blank\">Life, Animated\u003c/a>.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's the word \"animated\" in the title of the book that is key. That's because when Owen stopped speaking, he continued watching the Disney movies he had always loved. If anything, his fondness for them became stronger. But after some time, Suskind and his wife Cornelia realized that Owen wasn’t merely watching these movies, he was hearing them and learning through the characters.\u003c/p>\n\u003cp>Suskind realized that this affinity was also an opportunity. He used Owen’s affection for Iago, the parrot sidekick in the movie \"Aladdin,\" to try to have a real conversation with his son. He hid under the blanket in his son's room, held up an Iago puppet and, speaking in Iago's accent, father was able to finally –- after more than three years of silence –- connect to son.\u003c/p>\n\u003cp>Suskind reenacted this conversation for Michael Krasny on \u003ca href=\"http://www.kqed.org/a/forum/R201407151000\" target=\"_blank\">KQED’s Forum\u003c/a> recently, complete with the accents and mannerisms necessary to convince a child –- then 6 –- that he was talking to a parrot.\u003c/p>\n\u003cp>The entire family began to use the movies as a way to get into Owen’s head, communicating with Owen as though they were his favorite characters. They began living double lives. In his book, Suskind explains their basement sessions. “During daylight, we go about our lives,\" he writes. \"At night, we become animated characters.” The first basement session was while watching \"The Jungle Book,\" when its trademark song came on. As Suskind describes in his book:\u003c/p>\n\u003cblockquote>\u003cp>“‘The Bare Necessities’ is a talking song, with the melody broken up by dialogue. … In my best attempt at the voice and inflection of Phil Harris, who voices the bear, I hit play and then say: ‘Look, now it’s like this, little britches. All you’ve got to do is…’\u003cbr>\nJust as Baloo [the bear] looks at Mowgli [the boy], I look at Owen; he looks squarely back at me – then it happens. Right on cue, he says, ‘You eat ants?’ That’s Mowgli’s line – he speaks it as Mowgli, almost like a tape recording. … Cornelia catches my eye; I shake my head – both of us feeling the same unmoored sensation. The inflection, ease of speech, is something he can’t otherwise muster. But it’s in context, as are his reactions. It’s almost like there’s no autism.”\u003c/p>\u003c/blockquote>\n\u003cp>And it went further. As time progressed, the family regularly used segments of Disney dialogue to speak to Owen and, with time, Owen used them to speak back. For the family, often the “last line [of a scene] is the destination, the inspiring kicker to the exchange. Hearing it, Owen smiles … and then he’ll often do something he’s fearful of.”\u003c/p>\n\u003cp>But not always. Sometimes, the scenes were just a fun way for Owen and Walt, his older brother, to have a bit of fun. And as Owen grew older, Disney became his dream. He filled stacks of sketchbooks with versions of his favorite characters. He created mental mappings of all the voice actors, directors, and animators that worked on every video. With his parents, Owen visited Disney’s animation studios, where he still hopes to work someday.\u003c/p>\n\u003cp>The power of the Suskind family's story isn’t just that they persevered and found ways to finally reach their autistic son. The power comes from the fact that their story is not unusual. Many children with autism have what Suskind calls an \"affinity.\" Disney is certainly popular, but so is Tim Burton. Affinities range from maps to logos, wood chimes to hockey stats.\u003c/p>\n\u003cp>One woman who called \u003ca href=\"http://www.kqed.org/a/forum/R201407151000\" target=\"_blank\">Forum\u003c/a> said she “felt you were talking about my son. He is 4 years old, he’s autistic,\" she said, and \"he has memorized tons of Disney shows.” Suskind encouraged this mother to continue connecting and finding ways to relate to her son's affinities, because the affinities themselves are “crucial, but just as crucial is to use them to connect [your autistic child] to you.”\u003c/p>\n\u003cp>Suskind went on to describe a friend whose autistic son has an affection for maps. Though the father was at a loss, Suskind explained that everything can be related to maps, for they “are the two-dimensional rendering of all humanity. … Every town and every map has a history, a narrative.” He said Cornelia made the key revelation: “Respect the affinity, and we respect him.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Helping parents form these connections through their children’s affinities is why Suskind created the \u003ca href=\"http://lifeanimated.net/autism_affinities_project/\" target=\"_blank\">Autism Affinities Project\u003c/a>, where parents of autistic children can come together to describe and understand their child’s obsessions. Neuroscientists and psychologists around the country are also teaming up to study both affinities in autistic children and the affinity therapy that the Suskinds essentially pioneered to help their son navigate the world.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20982\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/jdhancock/7486431222/in/photolist-2nPYpL-4MiNPx-dojqwo-cpy3jj-5miHgL-4Zh3yt-66tW-4Fp838-Ku37A-89J7te-eWadd-w9HG9-53iEnb-943FjU-8rCoNh-eF7Gpk-7t38Za-6PScxR-cpxVbo-648doP-aFh8ap-6mnYzN-6miQn4-6miQda-5RzRS-ddCYGh-674fMr-dUru2M-n9Ucgb-6iKanm-e1xvJN-fn6rt7-zN9cF-5AGJWT-6FMy9d-6mod8G-cXUoHE-kK7WFW-83w2vW-6xC4gr-5ByHJ8-89MmNJ-mvXTH-5SfKbs-hrJNp-9hJaaj-4o6FZs-duAp8V-5SfKbL-cb8iwj\">\u003cimg class=\"size-full wp-image-20982\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/7486431222_640d5c139f_z.jpg\" alt='The family first used a scene from the movie \"Aladdin\" to connect to their son. (JD Hancock/Flickr)' width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/7486431222_640d5c139f_z-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The family first used a scene from the movie \"Aladdin\" to connect to their son. (JD Hancock/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kathy Shield\u003c/strong>\u003c/p>\n\u003cp>Owen Suskind was a normal toddler, learning to speak in full sentences and happily playing in the backyard with his older brother, Walt.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Owen wasn’t merely watching these movies, he was hearing them and learning through the characters.\u003c/aside>\n\u003cp>That all changed at age 3, when Owen stopped speaking, and in the space of a single month, his entire vocabulary was reduced to one word: juice. Owen was diagnosed with late-onset regressive autism. Though his developmental trajectory was typical for children with this form of autism, this fact offered no comfort to his parents.\u003c/p>\n\u003cp>Today, Owen has grown into a relatively self-sufficient young man. He graduated from a college-like program for young adults on the autism spectrum and is now living semi-independently in an apartment.\u003c!--more-->\u003c/p>\n\u003cp>The story of how Owen went from a 3-year-old who could barely speak for years to living somewhat independently has been chronicled by Owen's father, Pulitzer Prize-winning journalist Ron Suskind, in a book \"\u003ca href=\"http://www.amazon.com/Life-Animated-Sidekicks-Heroes-Autism/dp/1423180364\" target=\"_blank\">Life, Animated\u003c/a>.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's the word \"animated\" in the title of the book that is key. That's because when Owen stopped speaking, he continued watching the Disney movies he had always loved. If anything, his fondness for them became stronger. But after some time, Suskind and his wife Cornelia realized that Owen wasn’t merely watching these movies, he was hearing them and learning through the characters.\u003c/p>\n\u003cp>Suskind realized that this affinity was also an opportunity. He used Owen’s affection for Iago, the parrot sidekick in the movie \"Aladdin,\" to try to have a real conversation with his son. He hid under the blanket in his son's room, held up an Iago puppet and, speaking in Iago's accent, father was able to finally –- after more than three years of silence –- connect to son.\u003c/p>\n\u003cp>Suskind reenacted this conversation for Michael Krasny on \u003ca href=\"http://www.kqed.org/a/forum/R201407151000\" target=\"_blank\">KQED’s Forum\u003c/a> recently, complete with the accents and mannerisms necessary to convince a child –- then 6 –- that he was talking to a parrot.\u003c/p>\n\u003cp>The entire family began to use the movies as a way to get into Owen’s head, communicating with Owen as though they were his favorite characters. They began living double lives. In his book, Suskind explains their basement sessions. “During daylight, we go about our lives,\" he writes. \"At night, we become animated characters.” The first basement session was while watching \"The Jungle Book,\" when its trademark song came on. As Suskind describes in his book:\u003c/p>\n\u003cblockquote>\u003cp>“‘The Bare Necessities’ is a talking song, with the melody broken up by dialogue. … In my best attempt at the voice and inflection of Phil Harris, who voices the bear, I hit play and then say: ‘Look, now it’s like this, little britches. All you’ve got to do is…’\u003cbr>\nJust as Baloo [the bear] looks at Mowgli [the boy], I look at Owen; he looks squarely back at me – then it happens. Right on cue, he says, ‘You eat ants?’ That’s Mowgli’s line – he speaks it as Mowgli, almost like a tape recording. … Cornelia catches my eye; I shake my head – both of us feeling the same unmoored sensation. The inflection, ease of speech, is something he can’t otherwise muster. But it’s in context, as are his reactions. It’s almost like there’s no autism.”\u003c/p>\u003c/blockquote>\n\u003cp>And it went further. As time progressed, the family regularly used segments of Disney dialogue to speak to Owen and, with time, Owen used them to speak back. For the family, often the “last line [of a scene] is the destination, the inspiring kicker to the exchange. Hearing it, Owen smiles … and then he’ll often do something he’s fearful of.”\u003c/p>\n\u003cp>But not always. Sometimes, the scenes were just a fun way for Owen and Walt, his older brother, to have a bit of fun. And as Owen grew older, Disney became his dream. He filled stacks of sketchbooks with versions of his favorite characters. He created mental mappings of all the voice actors, directors, and animators that worked on every video. With his parents, Owen visited Disney’s animation studios, where he still hopes to work someday.\u003c/p>\n\u003cp>The power of the Suskind family's story isn’t just that they persevered and found ways to finally reach their autistic son. The power comes from the fact that their story is not unusual. Many children with autism have what Suskind calls an \"affinity.\" Disney is certainly popular, but so is Tim Burton. Affinities range from maps to logos, wood chimes to hockey stats.\u003c/p>\n\u003cp>One woman who called \u003ca href=\"http://www.kqed.org/a/forum/R201407151000\" target=\"_blank\">Forum\u003c/a> said she “felt you were talking about my son. He is 4 years old, he’s autistic,\" she said, and \"he has memorized tons of Disney shows.” Suskind encouraged this mother to continue connecting and finding ways to relate to her son's affinities, because the affinities themselves are “crucial, but just as crucial is to use them to connect [your autistic child] to you.”\u003c/p>\n\u003cp>Suskind went on to describe a friend whose autistic son has an affection for maps. Though the father was at a loss, Suskind explained that everything can be related to maps, for they “are the two-dimensional rendering of all humanity. … Every town and every map has a history, a narrative.” He said Cornelia made the key revelation: “Respect the affinity, and we respect him.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Helping parents form these connections through their children’s affinities is why Suskind created the \u003ca href=\"http://lifeanimated.net/autism_affinities_project/\" target=\"_blank\">Autism Affinities Project\u003c/a>, where parents of autistic children can come together to describe and understand their child’s obsessions. Neuroscientists and psychologists around the country are also teaming up to study both affinities in autistic children and the affinity therapy that the Suskinds essentially pioneered to help their son navigate the world.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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"info": "",
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"tech-nation": {
"id": "tech-nation",
"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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"ted-radio-hour": {
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"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
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