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"content": "\u003cfigure id=\"attachment_20919\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774-e1408556674718.jpg\">\u003cimg class=\"size-large wp-image-20919\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774-640x426.jpg\" alt=\"Ebola virus magnified 108,000 times. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ebola virus magnified 108,000 times. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/20/kaiser-sacramento-patient-being-tested-for-possible-exposure-to-ebola/\" target=\"_blank\"> patient admitted to a Kaiser hospital\u003c/a> in South Sacramento has tested negative for the Ebola virus, said Dr. Ron Chapman, director of the California Department of Public Health (CDPH) in a brief press conference Thursday evening.\u003c/p>\n\u003cp>Chapman said the results came in from the Centers for Disease Control and Prevention earlier in the day. Chapman, Kaiser officials and Sacramento County health officials refused to answer other questions about the patient, citing privacy laws.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/20/kaiser-sacramento-patient-being-tested-for-possible-exposure-to-ebola/\" target=\"_blank\">Earlier this week\u003c/a>, CDPH called the patient \"low risk\" and said the testing was occurring out of an \"abundance of caution.\" Chapman said CDPH and Kaiser made the determination that the patient was low risk by \u003ca href=\"http://www.cdc.gov/vhf/ebola/hcp/case-definition.html\" target=\"_blank\">following established CDC assessment tools\u003c/a>, available to any health care worker.\u003c/p>\n\u003cp>Chapman stressed that Ebola is \"a very difficult infection to spread.\" It does not spread through air, food or water. The virus can only be spread through direct physical contact with an infected person's bodily fluid, including blood and sweat.\u003c/p>\n\u003cp>There are no reported cases of Ebola in California. In West Africa, \u003ca href=\"http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html\" target=\"_blank\">the disease has killed 1,350 people\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cfigure id=\"attachment_20959\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/453874026-e1408646792307.jpg\">\u003cimg class=\"size-large wp-image-20959\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/453874026-640x424.jpg\" alt=\"Shops remain closed in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola. (ZOOM DOSSO/AFP/Getty Images) \" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shops remain closed in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola in Liberia. A doctor trained in California traveled last week to staff a Monrovia hospital. (ZOOM DOSSO/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While Californians worry about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/20/kaiser-sacramento-patient-being-tested-for-possible-exposure-to-ebola/\" target=\"_blank\">a single possible case of Ebola\u003c/a>, considered low risk, the hot spot for this outbreak remains in West Africa where \u003ca href=\"http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html\" target=\"_blank\">1,350 people have died\u003c/a>, and another 2,400 people are sick with the illness. But what happens to people who get sick with something that is not Ebola?\u003c/p>\n\u003cp>Dr. James Appel was trained in the Inland Empire, at the Loma Linda University School of Medicine. He's been working for Adventist Health International at hospitals in Chad for the last decade. Last week, Dr. Appel flew to Liberia to keep the doors open at \u003ca href=\"http://www.adventistdirectory.org/viewEntity.aspx?EntityID=13526\" target=\"_blank\">Cooper Adventist\u003c/a>, a small hospital in the capital, Monrovia, focusing on remaining available to patients with anything but Ebola. He \u003ca href=\"http://www.californiareport.org/archive/R201408210850/b\" target=\"_blank\">talked Thursday morning\u003c/a> with The California Report's Rachael Myrow.\u003c/p>\n\u003cp>Appel described Liberia as \"shutting down\" around him. \"There's a curfew that's been initiated. Many businesses are not open; all the schools are closed, government offices are closed,\" Appel told Myrow. \"So for example our hospital is not getting paid by the insurance companies, because insurance companies are closed. The whole economy is coming to a standstill.\"\u003c!--more-->\u003c/p>\n\u003cp>Appel said that people are starting to think there will be food shortages. There's a \"profound impact not just for those few patients effected by Ebola, but for the whole country,\" Appel said.\u003c/p>\n\u003cp>Many public hospitals in West Africa are closing their doors or refusing new patients, Myrow noted, and asked Appel why the General Conference of 7th Day Adventists wanted to keep Cooper Adventist open.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Cooper has a history of not wanting to shut down during crisis situations,\" Appel said, adding that it stayed open during the Liberia's civil war. \"Staff feels that they have a mission, and that is to provide care to the Liberian people when no one else will.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/164131162&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>\"While Ebola is dramatically killing people in a way that catches the imagination,\" Appel said, still more people are dying from malaria or complications from emergency c-sections. \"With all hospitals shut down because of the Ebola crisis, the death toll would soon far surpass anything that Ebola could do, just due to other normally treatable diseases,\" Appel noted.\u003c/p>\n\u003cp>The hospital is old and run down, he said, a very small, three story structure on a \"tiny parcel of land in the heart of the city.\"\u003c/p>\n\u003cp>Cooper Adventists cannot treat Ebola patients because they do not have the isolation facilities necessary. Appel said they refer any suspected Ebola patients to a bigger hospital. \"Anyone suspicious at all, we send them where they can get better care and where we will not be putting our other patients at risk,\"Appel said, adding there is only one lab in the country that can run tests for Ebola. All blood samples go there.\u003c/p>\n\u003cp>Appel acknowledged his own fears in treating patients during the ongoing crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I can't say I’m not afraid,\" he said. \"In all my medical training, there's only one thing that's ever scared me and that's Ebola -- because it is so lethal and happens so quickly and there's no known treatment.\" But he quickly added that Ebola is not as contagious as people might think. The virus is not airborne. Transmission requires \"direct physical contract with (a patient's) bodily fluids. If normal universal precautions are taken and you're very careful about screening patients and keeping yourself protected with gowns and gloves and masks, there's actually a low likelihood of you getting it.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20959\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/453874026-e1408646792307.jpg\">\u003cimg class=\"size-large wp-image-20959\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/453874026-640x424.jpg\" alt=\"Shops remain closed in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola. (ZOOM DOSSO/AFP/Getty Images) \" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Shops remain closed in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola in Liberia. A doctor trained in California traveled last week to staff a Monrovia hospital. (ZOOM DOSSO/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While Californians worry about \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/20/kaiser-sacramento-patient-being-tested-for-possible-exposure-to-ebola/\" target=\"_blank\">a single possible case of Ebola\u003c/a>, considered low risk, the hot spot for this outbreak remains in West Africa where \u003ca href=\"http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html\" target=\"_blank\">1,350 people have died\u003c/a>, and another 2,400 people are sick with the illness. But what happens to people who get sick with something that is not Ebola?\u003c/p>\n\u003cp>Dr. James Appel was trained in the Inland Empire, at the Loma Linda University School of Medicine. He's been working for Adventist Health International at hospitals in Chad for the last decade. Last week, Dr. Appel flew to Liberia to keep the doors open at \u003ca href=\"http://www.adventistdirectory.org/viewEntity.aspx?EntityID=13526\" target=\"_blank\">Cooper Adventist\u003c/a>, a small hospital in the capital, Monrovia, focusing on remaining available to patients with anything but Ebola. He \u003ca href=\"http://www.californiareport.org/archive/R201408210850/b\" target=\"_blank\">talked Thursday morning\u003c/a> with The California Report's Rachael Myrow.\u003c/p>\n\u003cp>Appel described Liberia as \"shutting down\" around him. \"There's a curfew that's been initiated. Many businesses are not open; all the schools are closed, government offices are closed,\" Appel told Myrow. \"So for example our hospital is not getting paid by the insurance companies, because insurance companies are closed. The whole economy is coming to a standstill.\"\u003c!--more-->\u003c/p>\n\u003cp>Appel said that people are starting to think there will be food shortages. There's a \"profound impact not just for those few patients effected by Ebola, but for the whole country,\" Appel said.\u003c/p>\n\u003cp>Many public hospitals in West Africa are closing their doors or refusing new patients, Myrow noted, and asked Appel why the General Conference of 7th Day Adventists wanted to keep Cooper Adventist open.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Cooper has a history of not wanting to shut down during crisis situations,\" Appel said, adding that it stayed open during the Liberia's civil war. \"Staff feels that they have a mission, and that is to provide care to the Liberian people when no one else will.\"\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/164131162&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>\"While Ebola is dramatically killing people in a way that catches the imagination,\" Appel said, still more people are dying from malaria or complications from emergency c-sections. \"With all hospitals shut down because of the Ebola crisis, the death toll would soon far surpass anything that Ebola could do, just due to other normally treatable diseases,\" Appel noted.\u003c/p>\n\u003cp>The hospital is old and run down, he said, a very small, three story structure on a \"tiny parcel of land in the heart of the city.\"\u003c/p>\n\u003cp>Cooper Adventists cannot treat Ebola patients because they do not have the isolation facilities necessary. Appel said they refer any suspected Ebola patients to a bigger hospital. \"Anyone suspicious at all, we send them where they can get better care and where we will not be putting our other patients at risk,\"Appel said, adding there is only one lab in the country that can run tests for Ebola. All blood samples go there.\u003c/p>\n\u003cp>Appel acknowledged his own fears in treating patients during the ongoing crisis.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I can't say I’m not afraid,\" he said. \"In all my medical training, there's only one thing that's ever scared me and that's Ebola -- because it is so lethal and happens so quickly and there's no known treatment.\" But he quickly added that Ebola is not as contagious as people might think. The virus is not airborne. Transmission requires \"direct physical contract with (a patient's) bodily fluids. If normal universal precautions are taken and you're very careful about screening patients and keeping yourself protected with gowns and gloves and masks, there's actually a low likelihood of you getting it.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20919\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774.jpg\">\u003cimg class=\"size-large wp-image-20919\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774-640x426.jpg\" alt=\"Ebola virus magnified 108,000 times. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ebola virus magnified 108,000 times. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Aliferis and April Dembosky\u003c/strong>\u003c/p>\n\u003cp>Don't panic, folks. Really.\u003c/p>\n\u003cp>A patient who \u003cem>may\u003c/em> have been exposed to the Ebola virus is being tested at Kaiser's South Sacramento Hospital.\u003c/p>\n\u003cp>The other key information here is that California Department of Public Health officials call the unidentified patient \u003ca href=\"http://www.cdph.ca.gov/Pages/NR14-073.aspx\" target=\"_blank\">\"low risk,\"\u003c/a> \u003cspan class=\"Apple-style-span\">\u003cspan style=\"color: #000000\">according to criteria established by the CDC that considers travel history, exposure to infection, and clinical features. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>In a call with reporters Wednesday afternoon, CDPH deputy Dr. Gil Chavez said the state has received no reports of any high risk patients. CDPH said the patient is being tested out of an \"abundance of caution.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://share.kaiserpermanente.org/article/kaiser-permanente-comments-on-patient-being-tested-for-ebola-virus/\" target=\"_blank\">In a statement\u003c/a>, Dr. Stephen Parodi, director of hospital operations for Kaiser Northern California, said the unidentified patient is being kept in a specially equipped negative pressure room, and staff working with the patient are using \"personal protective equipment.\"\u003c!--more-->\u003c/p>\n\u003cp>Samples from the patient are on their way to the Centers for Disease Control and Prevention for testing, and the results will take several days. No other information about the patient was readily available, including whether the person had recently traveled to any of the West African countries where an Ebola outbreak is ongoing.\u003c/p>\n\u003cp>The CDPH said there are no confirmed cases of Ebola in California. \u003ca href=\"http://www.abqjournal.com/447619/abqnewsseeker/health-department-cdc-testing-new-mexico-woman-for-ebola.html\" target=\"_blank\">One woman in New Mexico\u003c/a> who recently returned from Sierra Leone, one of the countries with an Ebola outbreak, is also in quarantine, awaiting results of testing for Ebola. Two patients who were flown in from West Africa are being treated in Atlanta.\u003c/p>\n\u003cp>While Ebola is very deadly, it is difficult to transmit. The virus is passed only through direct contact with bodily fluids, and a person is only infectious once they become very ill.\u003c/p>\n\u003cp>\"Those characteristics of the disease make it very unlikely that it would be something that would spread across the world,” said San Francisco public health officer Tomas Aragon. “We're not going to have a pandemic with Ebola.\"\u003c/p>\n\u003cp>He says any suspected cases that turn up in California will be quickly contained under American infectious disease protocols.\u003c/p>\n\u003cp>“It's not rocket science. It's not high tech,” Aragon said. “But it has to be very disciplined. In the U.S., people are very well trained, and they have the resources to be able to do this kind of work.”\u003c/p>\n\u003cp>Unlike the West African countries hard hit by Ebola, isolation units are widely available in hospitals throughout the state. Any patients would be cared for by specially trained health care workers. And the public has a greater trust of public health officials, so warnings to family members or any other people that may have come in contact with an infected person are much more likely to be heeded.\u003c/p>\n\u003cp>Chavez says the Sacramento case is an example of how quickly the system can identify and isolate potential infections.\u003c/p>\n\u003cp>“We knew it was a matter of time before we had a patient in California. California is a place with much international exposure and travel,” he said. “The case in Sacramento county really exemplifies how well our system is working.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>This post has been updated with details from a press conference with the California Department of Public Health and an interview with the San Francisco Department of Public Health.\u003c/em>\u003c/strong>\u003c/p>\n\n",
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"excerpt": "Don't panic. Officials say the patient is low risk and they are testing out of an 'abundance of caution.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20919\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774.jpg\">\u003cimg class=\"size-large wp-image-20919\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/79997774-640x426.jpg\" alt=\"Ebola virus magnified 108,000 times. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ebola virus magnified 108,000 times. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Lisa Aliferis and April Dembosky\u003c/strong>\u003c/p>\n\u003cp>Don't panic, folks. Really.\u003c/p>\n\u003cp>A patient who \u003cem>may\u003c/em> have been exposed to the Ebola virus is being tested at Kaiser's South Sacramento Hospital.\u003c/p>\n\u003cp>The other key information here is that California Department of Public Health officials call the unidentified patient \u003ca href=\"http://www.cdph.ca.gov/Pages/NR14-073.aspx\" target=\"_blank\">\"low risk,\"\u003c/a> \u003cspan class=\"Apple-style-span\">\u003cspan style=\"color: #000000\">according to criteria established by the CDC that considers travel history, exposure to infection, and clinical features. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>In a call with reporters Wednesday afternoon, CDPH deputy Dr. Gil Chavez said the state has received no reports of any high risk patients. CDPH said the patient is being tested out of an \"abundance of caution.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://share.kaiserpermanente.org/article/kaiser-permanente-comments-on-patient-being-tested-for-ebola-virus/\" target=\"_blank\">In a statement\u003c/a>, Dr. Stephen Parodi, director of hospital operations for Kaiser Northern California, said the unidentified patient is being kept in a specially equipped negative pressure room, and staff working with the patient are using \"personal protective equipment.\"\u003c!--more-->\u003c/p>\n\u003cp>Samples from the patient are on their way to the Centers for Disease Control and Prevention for testing, and the results will take several days. No other information about the patient was readily available, including whether the person had recently traveled to any of the West African countries where an Ebola outbreak is ongoing.\u003c/p>\n\u003cp>The CDPH said there are no confirmed cases of Ebola in California. \u003ca href=\"http://www.abqjournal.com/447619/abqnewsseeker/health-department-cdc-testing-new-mexico-woman-for-ebola.html\" target=\"_blank\">One woman in New Mexico\u003c/a> who recently returned from Sierra Leone, one of the countries with an Ebola outbreak, is also in quarantine, awaiting results of testing for Ebola. Two patients who were flown in from West Africa are being treated in Atlanta.\u003c/p>\n\u003cp>While Ebola is very deadly, it is difficult to transmit. The virus is passed only through direct contact with bodily fluids, and a person is only infectious once they become very ill.\u003c/p>\n\u003cp>\"Those characteristics of the disease make it very unlikely that it would be something that would spread across the world,” said San Francisco public health officer Tomas Aragon. “We're not going to have a pandemic with Ebola.\"\u003c/p>\n\u003cp>He says any suspected cases that turn up in California will be quickly contained under American infectious disease protocols.\u003c/p>\n\u003cp>“It's not rocket science. It's not high tech,” Aragon said. “But it has to be very disciplined. In the U.S., people are very well trained, and they have the resources to be able to do this kind of work.”\u003c/p>\n\u003cp>Unlike the West African countries hard hit by Ebola, isolation units are widely available in hospitals throughout the state. Any patients would be cared for by specially trained health care workers. And the public has a greater trust of public health officials, so warnings to family members or any other people that may have come in contact with an infected person are much more likely to be heeded.\u003c/p>\n\u003cp>Chavez says the Sacramento case is an example of how quickly the system can identify and isolate potential infections.\u003c/p>\n\u003cp>“We knew it was a matter of time before we had a patient in California. California is a place with much international exposure and travel,” he said. “The case in Sacramento county really exemplifies how well our system is working.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>This post has been updated with details from a press conference with the California Department of Public Health and an interview with the San Francisco Department of Public Health.\u003c/em>\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Judge Orders Overhaul in Segregation for California's Mentally Ill Inmates",
"title": "Judge Orders Overhaul in Segregation for California's Mentally Ill Inmates",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_20902\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg\">\u003cimg class=\"size-full wp-image-20902\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg\" alt=\"All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small\u003c/strong>\u003c/p>\n\u003cp>Segregating prison inmates who repeatedly break the rules or turn violent against other inmates or guards is not new in California. For years the state has placed these inmates in special housing sections with multiple barriers between them and others.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Evidence that segregation 'can and does cause serious psychological harm' in inmates with serious mental illness.\u003c/aside>\n\u003cp>But the practice of isolating inmates whose bad behavior may be part of a mental illness is under fire amid a rash of suicides and attempted suicides. The focus on this type of treatment comes against a backdrop of lawsuits brought by inmates against the state over the last two decades. Those lawsuits have exposed a correctional system poorly equipped to handle their extraordinary needs.\u003c/p>\n\u003cp>Now a federal judge says that kind of punishment poses too great a risk for inmates with serious mental illness who, he says, can and do worsen in segregation. \u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Life in segregation\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Think of segregation as a prison within a prison, meant to punish and deter bad behavior.\u003c/p>\n\u003cp>Inmates in segregation spend most of their time in their cells. They’re often restrained in handcuffs and leg chains. They have to submit to constant strip searches for weapons and drugs. Family visits are restricted. They don’t get to make phone calls.\u003c/p>\n\u003cp>“Every time they walk out of their cell, they’re in restraints,” says Lt. Stephan Riley, a spokesman at the California State Prison, Sacramento, a maximum-security prison that includes a variety of segregation units, some with greater restrictions than others. On average, an inmate in segregation spends about 90 percent of his time inside a small cell, essentially a concrete box with a slat of a window. Ten hours a week is exercise in a small yard surrounded by a chain-link fence.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163698381&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>The prison does offer psychiatric services, including group therapy. But group therapy for inmates in segregation looks far different from group therapy outside: Guards lock the inmates into metal holding cells the size of telephone booths, called therapeutic modules.\u003c/p>\n\u003cp>“There’s a metal mesh that’s welded to the frame of the module, and that’s the barrier,” explains Dr. David Wheeler, acting chief of mental health. He says the prison requires that barrier between his staff and any inmates they treat who are in segregation, whenever custody officers are out of the room.\u003c/p>\n\u003cp>For confidential one-on-one sessions, inmates sit in a locked booth with a window that faces a clinician, who is also in a locked booth.\u003c/p>\n\u003cp>But so much time alone is damaging to those with mental illness, advocates say.\u003c/p>\n\u003cp>\u003cstrong>Isolated and idle\u003c/strong>\u003c/p>\n\u003cp>“The person in the segregation cell is almost entirely isolated and idle,” says psychiatrist Terry Kupers, “and those two states are the worst thing you can do to someone with a mental illness.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"kHcNpIg2BYG9XZi1FdwblkbTorEi9abi\"]\u003c/p>\n\u003cp>Kupers, a national expert on correctional mental health care, quickly lists the effects segregation units can have on inmate patients. “High anxiety, which may take the form of panic; disordered thinking, which may become paranoid; mounting anger; problems concentrating; problems with memory; compulsive activity like cleaning their cell many times a day or pacing relentlessly.\"\u003c/p>\n\u003cp>Kupers says segregation worsens mental illness and makes those illnesses less treatable long term.\u003c/p>\n\u003cp>A court-appointed federal monitor for mental health care found that nearly half of 32 suicides in California prisons in 2012 were committed in segregation units. Nearly all of those prisoners were receiving mental health services at the time. In 2013, nearly half the 28 suicides occurred in segregation.\u003c/p>\n\u003cp>\u003cstrong>New restrictions on use of segregation\u003c/strong>\u003c/p>\n\u003cp>U.S. District Judge Lawrence Karlton appointed a special master for mental health care 20 years ago when advocates for inmates first sued the state over shoddy treatment.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/news/2014/04/11/california-mistreating-mentally-ill-inmates/\" target=\"_blank\">In April, Karlton found \u003c/a>that the high rate of suicides is evidence that segregation poses serious risk to mentally ill inmates:\u003c/p>\n\u003cblockquote>\u003cp>“The overwhelming weight of evidence in the record is that placement of seriously mentally ill inmates in California’s segregation housing units can and does cause serious psychological harm, including decompensation, exacerbation of mental illness, inducement of psychosis and increased risk of suicide.”\u003c/p>\u003c/blockquote>\n\u003cp>Karlton imposed a series of hurdles that prisons have to clear before they can put any mentally ill inmate into a segregation unit.\u003c/p>\n\u003cp>Officials with the California Department of Corrections and Rehabilitation declined to comment for this story, citing “sensitive” negotiations on the details of how to comply with Judge Karlton’s order.\u003c/p>\n\u003cp>But Michael Bien, the lead attorney for mentally ill inmates says Karlton’s latest ruling ends a vicious cycle for inmates in the most severe segregated housing known as Security Housing Units (SHUs).\u003c/p>\n\u003cp>“Someone is in one of these segregation units. They get very sick,” Bien says. “(Prison officials) hospitalize them; they stabilize them, but they send them back -- now to a mental health segregation unit. They get sick again, they send them back to the hospital -- that cycle -- we think the judge has ended.”\u003c/p>\n\u003cp>Judge Karlton forbade prison officials to send such an inmate back to the segregation unit where he or she deteriorated.\u003c/p>\n\u003cp>Judge Karlton also said an inmate’s psychiatrist must certify that the action for which the inmate is being segregated wasn’t the result of a mental illness and that there’s no clinical indication that segregation will worsen the inmate’s condition.\u003c/p>\n\u003cp>Bien says prison officials will have to come up with safer alternatives for people who can’t tolerate segregation, and says a start would be giving mental health staff more say over how inmates with mental illness are treated.\u003c/p>\n\u003cp>“You can turn a unit into a less dangerous place,” says Bien, “if you give power to clinicians to say: ‘I need this person to have more out-of-cell time. I want him to be treated outside of the cage;’ ‘Don’t strip search this woman, she’s reacting quite badly to that.’ The clinicians all said they’re not allowed to say any of those things.”\u003c/p>\n\u003cp>The federal judge gave prison officials until Sunday, August 24, to come up with a plan to prevent mentally ill inmates who are at serious psychological risk from being placed in segregation.\u003c/p>\n\u003cp>It’s the final piece of a massive overhaul in how California prisons treat mentally ill prisoners.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Earlier this month Karlton \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/california-prisons-begin-use-of-force-reforms-for-mentally-ill-inmates/?__utma=34673459.1803067961.1357800400.1408366357.1408487621.23&__utmb=34673459.20.10.1408487623&__utmc=34673459&__utmx=-&__utmz=34673459.1407362484.19.4.utmcsr=kqed.org%7Cutmccn=(referral)%7Cutmcmd=referral%7Cutmcct=/search/index.jsp&__utmv=-&__utmk=76842647\" target=\"_blank\">approved significant revisions\u003c/a> to policies on the use of force on mentally ill inmates.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20902\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg\">\u003cimg class=\"size-full wp-image-20902\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg\" alt=\"All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11518_IMG_0193_1-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small\u003c/strong>\u003c/p>\n\u003cp>Segregating prison inmates who repeatedly break the rules or turn violent against other inmates or guards is not new in California. For years the state has placed these inmates in special housing sections with multiple barriers between them and others.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Evidence that segregation 'can and does cause serious psychological harm' in inmates with serious mental illness.\u003c/aside>\n\u003cp>But the practice of isolating inmates whose bad behavior may be part of a mental illness is under fire amid a rash of suicides and attempted suicides. The focus on this type of treatment comes against a backdrop of lawsuits brought by inmates against the state over the last two decades. Those lawsuits have exposed a correctional system poorly equipped to handle their extraordinary needs.\u003c/p>\n\u003cp>Now a federal judge says that kind of punishment poses too great a risk for inmates with serious mental illness who, he says, can and do worsen in segregation. \u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Life in segregation\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Think of segregation as a prison within a prison, meant to punish and deter bad behavior.\u003c/p>\n\u003cp>Inmates in segregation spend most of their time in their cells. They’re often restrained in handcuffs and leg chains. They have to submit to constant strip searches for weapons and drugs. Family visits are restricted. They don’t get to make phone calls.\u003c/p>\n\u003cp>“Every time they walk out of their cell, they’re in restraints,” says Lt. Stephan Riley, a spokesman at the California State Prison, Sacramento, a maximum-security prison that includes a variety of segregation units, some with greater restrictions than others. On average, an inmate in segregation spends about 90 percent of his time inside a small cell, essentially a concrete box with a slat of a window. Ten hours a week is exercise in a small yard surrounded by a chain-link fence.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163698381&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>The prison does offer psychiatric services, including group therapy. But group therapy for inmates in segregation looks far different from group therapy outside: Guards lock the inmates into metal holding cells the size of telephone booths, called therapeutic modules.\u003c/p>\n\u003cp>“There’s a metal mesh that’s welded to the frame of the module, and that’s the barrier,” explains Dr. David Wheeler, acting chief of mental health. He says the prison requires that barrier between his staff and any inmates they treat who are in segregation, whenever custody officers are out of the room.\u003c/p>\n\u003cp>For confidential one-on-one sessions, inmates sit in a locked booth with a window that faces a clinician, who is also in a locked booth.\u003c/p>\n\u003cp>But so much time alone is damaging to those with mental illness, advocates say.\u003c/p>\n\u003cp>\u003cstrong>Isolated and idle\u003c/strong>\u003c/p>\n\u003cp>“The person in the segregation cell is almost entirely isolated and idle,” says psychiatrist Terry Kupers, “and those two states are the worst thing you can do to someone with a mental illness.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Kupers, a national expert on correctional mental health care, quickly lists the effects segregation units can have on inmate patients. “High anxiety, which may take the form of panic; disordered thinking, which may become paranoid; mounting anger; problems concentrating; problems with memory; compulsive activity like cleaning their cell many times a day or pacing relentlessly.\"\u003c/p>\n\u003cp>Kupers says segregation worsens mental illness and makes those illnesses less treatable long term.\u003c/p>\n\u003cp>A court-appointed federal monitor for mental health care found that nearly half of 32 suicides in California prisons in 2012 were committed in segregation units. Nearly all of those prisoners were receiving mental health services at the time. In 2013, nearly half the 28 suicides occurred in segregation.\u003c/p>\n\u003cp>\u003cstrong>New restrictions on use of segregation\u003c/strong>\u003c/p>\n\u003cp>U.S. District Judge Lawrence Karlton appointed a special master for mental health care 20 years ago when advocates for inmates first sued the state over shoddy treatment.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/news/2014/04/11/california-mistreating-mentally-ill-inmates/\" target=\"_blank\">In April, Karlton found \u003c/a>that the high rate of suicides is evidence that segregation poses serious risk to mentally ill inmates:\u003c/p>\n\u003cblockquote>\u003cp>“The overwhelming weight of evidence in the record is that placement of seriously mentally ill inmates in California’s segregation housing units can and does cause serious psychological harm, including decompensation, exacerbation of mental illness, inducement of psychosis and increased risk of suicide.”\u003c/p>\u003c/blockquote>\n\u003cp>Karlton imposed a series of hurdles that prisons have to clear before they can put any mentally ill inmate into a segregation unit.\u003c/p>\n\u003cp>Officials with the California Department of Corrections and Rehabilitation declined to comment for this story, citing “sensitive” negotiations on the details of how to comply with Judge Karlton’s order.\u003c/p>\n\u003cp>But Michael Bien, the lead attorney for mentally ill inmates says Karlton’s latest ruling ends a vicious cycle for inmates in the most severe segregated housing known as Security Housing Units (SHUs).\u003c/p>\n\u003cp>“Someone is in one of these segregation units. They get very sick,” Bien says. “(Prison officials) hospitalize them; they stabilize them, but they send them back -- now to a mental health segregation unit. They get sick again, they send them back to the hospital -- that cycle -- we think the judge has ended.”\u003c/p>\n\u003cp>Judge Karlton forbade prison officials to send such an inmate back to the segregation unit where he or she deteriorated.\u003c/p>\n\u003cp>Judge Karlton also said an inmate’s psychiatrist must certify that the action for which the inmate is being segregated wasn’t the result of a mental illness and that there’s no clinical indication that segregation will worsen the inmate’s condition.\u003c/p>\n\u003cp>Bien says prison officials will have to come up with safer alternatives for people who can’t tolerate segregation, and says a start would be giving mental health staff more say over how inmates with mental illness are treated.\u003c/p>\n\u003cp>“You can turn a unit into a less dangerous place,” says Bien, “if you give power to clinicians to say: ‘I need this person to have more out-of-cell time. I want him to be treated outside of the cage;’ ‘Don’t strip search this woman, she’s reacting quite badly to that.’ The clinicians all said they’re not allowed to say any of those things.”\u003c/p>\n\u003cp>The federal judge gave prison officials until Sunday, August 24, to come up with a plan to prevent mentally ill inmates who are at serious psychological risk from being placed in segregation.\u003c/p>\n\u003cp>It’s the final piece of a massive overhaul in how California prisons treat mentally ill prisoners.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Earlier this month Karlton \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/california-prisons-begin-use-of-force-reforms-for-mentally-ill-inmates/?__utma=34673459.1803067961.1357800400.1408366357.1408487621.23&__utmb=34673459.20.10.1408487623&__utmc=34673459&__utmx=-&__utmz=34673459.1407362484.19.4.utmcsr=kqed.org%7Cutmccn=(referral)%7Cutmcmd=referral%7Cutmcct=/search/index.jsp&__utmv=-&__utmk=76842647\" target=\"_blank\">approved significant revisions\u003c/a> to policies on the use of force on mentally ill inmates.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Here's a truism: Health care costs are wildly variable and utterly confusing. That's why KQED joined forces with \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">launch PriceCheck\u003c/a>. For the last six weeks we've asked you to submit your costs for common procedures. To compare apples-to-apples, we asked how much your provider charged, how much your insurer paid and how much you paid for common procedures. And you've responded! \u003c/p>\n\u003cp>You've showed us that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">back MRIs can cost\u003c/a> anywhere between $255 and $3,700 in the Bay Area. And that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">screening mammograms range\u003c/a> from $125 to $801.\u003c/p>\n\u003cp>We've also surveyed hundreds of providers for cash prices — also known as self-pay — throughout California. Now you can sort through our data below as well as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">search on our site\u003c/a>. Please help us build our database by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">submitting your health care costs\u003c/a>.\u003c/p>\n\u003cp>\u003ciframe src=\"//kqednews.cartodb.com/viz/160ba4aa-1c29-11e4-bb6c-0e10bcd91c2b/embed_map?title=false&description=false&search=false&shareable=true&cartodb_logo=true&layer_selector=false&legends=true&scrollwheel=true&fullscreen=true&sublayer_options=1&sql=&sw_lat=32.75956202565003&sw_lon=-125.22216796875&ne_lat=39.8000959563483&ne_lon=-114.45556640625\" width=\"100%\" height=\"520\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To see more providers in your area, zoom in on the map using the arrows or your mouse wheel. Hover over each dot to see the provider name and procedure. Click to find out how much was charged. This map will update once a day with new information.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's a truism: Health care costs are wildly variable and utterly confusing. That's why KQED joined forces with \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC\u003c/a> and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">launch PriceCheck\u003c/a>. For the last six weeks we've asked you to submit your costs for common procedures. To compare apples-to-apples, we asked how much your provider charged, how much your insurer paid and how much you paid for common procedures. And you've responded! \u003c/p>\n\u003cp>You've showed us that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/pricecheck-how-much-for-a-back-mri-in-the-bay-area-255-or-3700/\" target=\"_blank\">back MRIs can cost\u003c/a> anywhere between $255 and $3,700 in the Bay Area. And that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">screening mammograms range\u003c/a> from $125 to $801.\u003c/p>\n\u003cp>We've also surveyed hundreds of providers for cash prices — also known as self-pay — throughout California. Now you can sort through our data below as well as \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">search on our site\u003c/a>. Please help us build our database by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">submitting your health care costs\u003c/a>.\u003c/p>\n\u003cp>\u003ciframe src=\"//kqednews.cartodb.com/viz/160ba4aa-1c29-11e4-bb6c-0e10bcd91c2b/embed_map?title=false&description=false&search=false&shareable=true&cartodb_logo=true&layer_selector=false&legends=true&scrollwheel=true&fullscreen=true&sublayer_options=1&sql=&sw_lat=32.75956202565003&sw_lon=-125.22216796875&ne_lat=39.8000959563483&ne_lon=-114.45556640625\" width=\"100%\" height=\"520\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Long-Sought Autism Therapy A Medi-Cal Benefit, State Says",
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"content": "\u003cfigure id=\"attachment_13282\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/06/166731138-e1371575513819.jpg\">\u003cimg class=\"size-large wp-image-13282\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/06/166731138-620x465.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/8/state-autism-therapy-a-medical-benefit\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>State officials Tuesday said autism therapy clearly is a covered Medicaid benefit, and they hope to submit a state plan amendment by Sept. 30 to start the process to make it a benefit for those under age 21, enrolled in the state's Medi-Cal program. Medi-Cal is California's version of Medicaid.\u003c/p>\n\u003cp>According to René Mollow, deputy director of benefits and eligibility at the Department of Health Care Services, Medi-Cal children are entitled to applied behavior analysis -- known as ABA therapy.\u003c/p>\n\u003cp>\"Right now we're working on the development of a state plan amendment. We want to engage the stakeholders in developing that,\" Mollow said. \"We're looking to have it submitted at the end of September, and having it retroactive to July 1.\"\u003c!--more-->\u003c/p>\n\u003cp>Medi-Cal children now receiving ABA therapy likely will have that care retroactively paid for by Medi-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Mollow said the state also is in touch with CMS on technical clarifications of the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" target=\"_blank\">federal guidance states recently received \u003c/a>from CMS officials -- guidance that led to implementation of autism therapy under Medi-Cal, she said.\u003c/p>\n\u003cp>\"We plan to have a formal meeting with stakeholders on Aug. 29 regarding this policy we're looking to implement,\" Mollow said.\u003c/p>\n\u003cp>The new policy should start by the beginning of next year, Mollow said. Till then, there is a lot to do to develop the provider network and reimbursement rates, she said.\u003c/p>\n\u003cp>\"And the question is what to do in the interim, when people are looking to get services now,\" Mollow said.\u003c/p>\n\u003cp>Autism advocates were understandably delighted.\u003c/p>\n\u003cp>\"We're thrilled that the state is moving in this direction, and very encouraged by the steps they're taking,\" said Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. \"We want to work with them to implement this as expeditiously as possible.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's important for families to know this is happening,\" said Karen Fessel, executive director of the Autism Health Insurance Project. \"I'm cautiously optimistic. I do believe this is going to happen, and it's a question of when.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13282\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/06/166731138-e1371575513819.jpg\">\u003cimg class=\"size-large wp-image-13282\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/06/166731138-620x465.jpg\" alt=\"(Getty Images)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca href=\"http://www.californiahealthline.org/capitol-desk/2014/8/state-autism-therapy-a-medical-benefit\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>State officials Tuesday said autism therapy clearly is a covered Medicaid benefit, and they hope to submit a state plan amendment by Sept. 30 to start the process to make it a benefit for those under age 21, enrolled in the state's Medi-Cal program. Medi-Cal is California's version of Medicaid.\u003c/p>\n\u003cp>According to René Mollow, deputy director of benefits and eligibility at the Department of Health Care Services, Medi-Cal children are entitled to applied behavior analysis -- known as ABA therapy.\u003c/p>\n\u003cp>\"Right now we're working on the development of a state plan amendment. We want to engage the stakeholders in developing that,\" Mollow said. \"We're looking to have it submitted at the end of September, and having it retroactive to July 1.\"\u003c!--more-->\u003c/p>\n\u003cp>Medi-Cal children now receiving ABA therapy likely will have that care retroactively paid for by Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Mollow said the state also is in touch with CMS on technical clarifications of the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/08/feds-say-autism-aba-therapy-now-covered-as-childrens-medicaid-benefit/\" target=\"_blank\">federal guidance states recently received \u003c/a>from CMS officials -- guidance that led to implementation of autism therapy under Medi-Cal, she said.\u003c/p>\n\u003cp>\"We plan to have a formal meeting with stakeholders on Aug. 29 regarding this policy we're looking to implement,\" Mollow said.\u003c/p>\n\u003cp>The new policy should start by the beginning of next year, Mollow said. Till then, there is a lot to do to develop the provider network and reimbursement rates, she said.\u003c/p>\n\u003cp>\"And the question is what to do in the interim, when people are looking to get services now,\" Mollow said.\u003c/p>\n\u003cp>Autism advocates were understandably delighted.\u003c/p>\n\u003cp>\"We're thrilled that the state is moving in this direction, and very encouraged by the steps they're taking,\" said Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. \"We want to work with them to implement this as expeditiously as possible.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's important for families to know this is happening,\" said Karen Fessel, executive director of the Autism Health Insurance Project. \"I'm cautiously optimistic. I do believe this is going to happen, and it's a question of when.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20483\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667.jpg\">\u003cimg class=\"size-large wp-image-20483\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People can easily save $1,000 or more just by going to another facility, sometimes only a few minutes drive away. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: In June, KQED launched \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, a crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/em>\u003c/p>\n\u003cp>Last week in our PriceCheck project, we turned to MRIs. We asked you, the members of our audience, to share what you have paid for a back MRI. The goal is to shine a light on the notoriously opaque world of health care costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">One person saved $1,270 on a back MRI, just by asking.\u003c/aside>\n\u003cp>What we've found is even more startling than the prices we already collected on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">screening mammograms\u003c/a>. Most of our results so far are from the Bay Area, so I'm focusing on that variation. For a comparison looking at the entire state, check out \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-pay-mri-california-255-973-25-2294/#more-14818\" target=\"_blank\">this post\u003c/a> from our ClearHealthCosts.com partner.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>One Facility, At Least 3 Prices for a Back MRI\u003c/strong>\u003c/p>\n\u003cp>The lowest rate paid by any insurer in our data set so far is Medicare. One contributor went to Health Diagnostics in San Francisco's Financial District and was charged $2,450. Medicare paid \u003cstrong>$255\u003c/strong>. The person did not indicate having to pay any additional money.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Curiously, another person went to the same facility but was charged $602.85 for the same procedure. We know it's the same because the procedure code both patients entered was identical -- CPT code 72148 \"lower back MRI without contrast.\"\u003c/p>\n\u003cp>How can one facility charge two radically different rates -- \u003cstrong>$2,450 and $602.85\u003c/strong> -- for the exact same thing? It turns out the second patient was insured through Blue Shield. This person told us in comments on the form that s/he had to pay the entire amount, \"since I had not yet met my deductible.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Another person could have saved $1,085 by going to another facility an 11-minute drive down the road.\u003c/aside>\n\u003cp>What this tells us is that Blue Shield has negotiated a rate with Health Diagnostics -- a rate of $602.85 for an MRI. The patient gets this rate, even though insurance covers none of it, because the person has not yet met the deductible.\u003c/p>\n\u003cp>We launched PriceCheck because these contractually agreed upon rates between insurers and providers are generally sealed. WIth help from our community, we can see what these prices are.\u003c/p>\n\u003cp>What's even more curious is that the self-pay price for a back MRI at Health Diagnostics is \u003cstrong>$575.\u003c/strong> In other words, if you walk in the door, want an MRI and are uninsured or otherwise agree to pay out of your own pocket, you'll pay $575.\u003c/p>\n\u003cp>\u003cstrong>Other Back MRI Prices from around the Bay Area\u003c/strong>\u003c/p>\n\u003cp>This cash price/insured price differential played out to the benefit of one of our contributors who went to Vallejo MRI, north of San Francisco. This person was charged \u003cstrong>$580\u003c/strong> and paid $580 out of pocket. Here's why, according to the comment: \"I was told the procedure was \u003cstrong>$1,850.\u003c/strong> I have a $7,500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.\"\u003c/p>\n\u003cp>In other words this person saved $1,270, just by asking.\u003c/p>\n\u003cp>Back in San Francisco, another of our contributors went to Radnet Medical Imaging on California Street in the Laurel Village area. (This is where the California Pacific Medical Center is located.) This person was charged \u003cstrong>$1,660\u003c/strong> and paid $1,660 out of \u003ca href=\"http://www.treasury.gov/resource-center/faqs/taxes/pages/health-savings-accounts.aspx\" target=\"_blank\">Health Savings Account\u003c/a> funds.\u003c/p>\n\u003cp>I wonder if the person who went to Radnet and paid $1,660 knows that Health Diagnostics and its $575 rate was an 11-minute drive away?\u003c/p>\n\u003cp>Probably not. We know from this project that consumers do not have a history of shopping on price for health care tests and services -- but people are starting to. One of the most frequent questions we get is from people wondering if it makes sense to shop on price for health care -- do you really want a bargain MRI?\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>There's not a correlation between cost and quality in health care. So it really becomes how much you want to save money. These are personal decisions, but we believe consumers can make informed decisions only when they have all the facts.\u003c/p>\n\u003cp>Here are a couple more submitted prices:\u003c/p>\n\u003cp>Palo Alto Medical Foundation: A member of our audience received a lower back MRI and submitted a charged price of \u003cstrong>$2,650\u003c/strong>, said insurance paid $0 -- and this person paid the full cost. There was no additional comment.\u003c/p>\n\u003cp>Kaiser Antioch Medical Center: A member of our audience received a lower back MRI and was charged \u003cstrong>$973.25\u003c/strong> and paid $973.25. Comment: \"This price was the contracted amount through my insurance. Deductible had not been met so I was responsible for all charges. This does not include the two office visits required to obtain and analyze the results.\"\u003c/p>\n\u003cp>The $3,700 price referred to in the headline of this post -- technically \u003cstrong>$3,732.60\u003c/strong> -- comes from UC San Francisco. It's the self-pay price as long as you pay on the day of service. If you don't pay on the day of service, it might run you $6,221.\u003c/p>\n\u003cp>\u003cstrong>A Couple Prices for a Different MRI\u003c/strong>\u003c/p>\n\u003cp>This next story from a contributor hits close to home -- literally -- because I live just blocks away from Magnetic Imaging Affiliates on Telegraph Avenue in Oakland, where this person went.\u003c/p>\n\u003cp>The charge for a chest MRI with dye (CPT code 72147) was \u003cstrong>$3,163\u003c/strong> -- and insurance covered nothing. Comment: “High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/p>\n\u003cp>Yes, you can get a price quote. You may need to be persistent. Ask for the billing office. They may send you around, but try.\u003c/p>\n\u003cp>Just from this handful of prices, we can see a stunning variation. With more data, we can tell more stories. We invite you to share what you paid. It's helpful if you have your \"explanation of benefits\" from your insurance company (\u003ca 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>.)\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Then vi\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">sit PriceCheck\u003c/a> and share. 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_20483\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667.jpg\">\u003cimg class=\"size-large wp-image-20483\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/168732667-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">People can easily save $1,000 or more just by going to another facility, sometimes only a few minutes drive away. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: In June, KQED launched \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, a crowdsourcing project on health costs. We’re working in collaboration with \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca style=\"font-weight: bold;color: #114999\" href=\"http://clearhealthcosts.com/\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/em>\u003c/p>\n\u003cp>Last week in our PriceCheck project, we turned to MRIs. We asked you, the members of our audience, to share what you have paid for a back MRI. The goal is to shine a light on the notoriously opaque world of health care costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">One person saved $1,270 on a back MRI, just by asking.\u003c/aside>\n\u003cp>What we've found is even more startling than the prices we already collected on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/11/pricecheck-what-insurance-companies-are-paying-for-mammograms/\" target=\"_blank\">screening mammograms\u003c/a>. Most of our results so far are from the Bay Area, so I'm focusing on that variation. For a comparison looking at the entire state, check out \u003ca href=\"http://clearhealthcosts.com/blog/2014/07/much-pay-mri-california-255-973-25-2294/#more-14818\" target=\"_blank\">this post\u003c/a> from our ClearHealthCosts.com partner.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>One Facility, At Least 3 Prices for a Back MRI\u003c/strong>\u003c/p>\n\u003cp>The lowest rate paid by any insurer in our data set so far is Medicare. One contributor went to Health Diagnostics in San Francisco's Financial District and was charged $2,450. Medicare paid \u003cstrong>$255\u003c/strong>. The person did not indicate having to pay any additional money.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Curiously, another person went to the same facility but was charged $602.85 for the same procedure. We know it's the same because the procedure code both patients entered was identical -- CPT code 72148 \"lower back MRI without contrast.\"\u003c/p>\n\u003cp>How can one facility charge two radically different rates -- \u003cstrong>$2,450 and $602.85\u003c/strong> -- for the exact same thing? It turns out the second patient was insured through Blue Shield. This person told us in comments on the form that s/he had to pay the entire amount, \"since I had not yet met my deductible.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Another person could have saved $1,085 by going to another facility an 11-minute drive down the road.\u003c/aside>\n\u003cp>What this tells us is that Blue Shield has negotiated a rate with Health Diagnostics -- a rate of $602.85 for an MRI. The patient gets this rate, even though insurance covers none of it, because the person has not yet met the deductible.\u003c/p>\n\u003cp>We launched PriceCheck because these contractually agreed upon rates between insurers and providers are generally sealed. WIth help from our community, we can see what these prices are.\u003c/p>\n\u003cp>What's even more curious is that the self-pay price for a back MRI at Health Diagnostics is \u003cstrong>$575.\u003c/strong> In other words, if you walk in the door, want an MRI and are uninsured or otherwise agree to pay out of your own pocket, you'll pay $575.\u003c/p>\n\u003cp>\u003cstrong>Other Back MRI Prices from around the Bay Area\u003c/strong>\u003c/p>\n\u003cp>This cash price/insured price differential played out to the benefit of one of our contributors who went to Vallejo MRI, north of San Francisco. This person was charged \u003cstrong>$580\u003c/strong> and paid $580 out of pocket. Here's why, according to the comment: \"I was told the procedure was \u003cstrong>$1,850.\u003c/strong> I have a $7,500 deductible. So I talked to (an employee) who said if I paid upfront and agreed not to report the procedure to Blue Cross, that it would be $580.\"\u003c/p>\n\u003cp>In other words this person saved $1,270, just by asking.\u003c/p>\n\u003cp>Back in San Francisco, another of our contributors went to Radnet Medical Imaging on California Street in the Laurel Village area. (This is where the California Pacific Medical Center is located.) This person was charged \u003cstrong>$1,660\u003c/strong> and paid $1,660 out of \u003ca href=\"http://www.treasury.gov/resource-center/faqs/taxes/pages/health-savings-accounts.aspx\" target=\"_blank\">Health Savings Account\u003c/a> funds.\u003c/p>\n\u003cp>I wonder if the person who went to Radnet and paid $1,660 knows that Health Diagnostics and its $575 rate was an 11-minute drive away?\u003c/p>\n\u003cp>Probably not. We know from this project that consumers do not have a history of shopping on price for health care tests and services -- but people are starting to. One of the most frequent questions we get is from people wondering if it makes sense to shop on price for health care -- do you really want a bargain MRI?\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>There's not a correlation between cost and quality in health care. So it really becomes how much you want to save money. These are personal decisions, but we believe consumers can make informed decisions only when they have all the facts.\u003c/p>\n\u003cp>Here are a couple more submitted prices:\u003c/p>\n\u003cp>Palo Alto Medical Foundation: A member of our audience received a lower back MRI and submitted a charged price of \u003cstrong>$2,650\u003c/strong>, said insurance paid $0 -- and this person paid the full cost. There was no additional comment.\u003c/p>\n\u003cp>Kaiser Antioch Medical Center: A member of our audience received a lower back MRI and was charged \u003cstrong>$973.25\u003c/strong> and paid $973.25. Comment: \"This price was the contracted amount through my insurance. Deductible had not been met so I was responsible for all charges. This does not include the two office visits required to obtain and analyze the results.\"\u003c/p>\n\u003cp>The $3,700 price referred to in the headline of this post -- technically \u003cstrong>$3,732.60\u003c/strong> -- comes from UC San Francisco. It's the self-pay price as long as you pay on the day of service. If you don't pay on the day of service, it might run you $6,221.\u003c/p>\n\u003cp>\u003cstrong>A Couple Prices for a Different MRI\u003c/strong>\u003c/p>\n\u003cp>This next story from a contributor hits close to home -- literally -- because I live just blocks away from Magnetic Imaging Affiliates on Telegraph Avenue in Oakland, where this person went.\u003c/p>\n\u003cp>The charge for a chest MRI with dye (CPT code 72147) was \u003cstrong>$3,163\u003c/strong> -- and insurance covered nothing. Comment: “High deductible so paid the whole thing and then found out I could have had it done for *HALF* the price only blocks away. My first foray into individual insurance and it s***ed. Need to shop around assuming can even get a price quote.”\u003c/p>\n\u003cp>Yes, you can get a price quote. You may need to be persistent. Ask for the billing office. They may send you around, but try.\u003c/p>\n\u003cp>Just from this handful of prices, we can see a stunning variation. With more data, we can tell more stories. We invite you to share what you paid. It's helpful if you have your \"explanation of benefits\" from your insurance company (\u003ca 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>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Then vi\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">sit PriceCheck\u003c/a> and share. Help us make health costs transparent in California!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20380\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566.jpg\">\u003cimg class=\"size-large wp-image-20380\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/139551566-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now, drug labels appear only in English in California, yet 44 percent of Californians speak a language other than English at home. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Every Saturday morning, a steady stream of Chinese and Vietnamese patients line up at the Paul Hom Asian Clinic in Sacramento. Most of them speak little to no English.\u003c/p>\n\u003cp>Patient assistance director Danny Tao says people come here to get free medical consultations and drug prescriptions. But, he says that when patients take those prescriptions to be filled, they don’t understand the instructions on the label.\u003c/p>\n\u003cp>\"They go pick them up, and we don’t exactly know if they’re taking it or not -- or if they know how to take it,\" Tao said.\u003c!--more-->\u003c/p>\n\u003cp>Tao says drug labels at most pharmacies in California are printed only in English. That puts patients in danger of taking of any number or errors -- taking too much medication or not enough, taking it at the wrong time of day, and more. Such mistakes can cause serious harm or even death.\u003c/p>\n\u003cp>Tao says that for the drugs his clinic supplies directly, all have a bilingual label.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s going to be English/Chinese or English/Vietnamese,\" he said. \"By the time they get home they know exactly how to take the medication, because it’s in their own language.\"\u003c/p>\n\u003cp>This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. \u003ca href=\"http://www.rxtran.com/pharmacy-translation-regulations/pharmacy-translation-regulations-new-york-state.html\" target=\"_blank\">New York approved a similar rule \u003c/a>last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.\u003c/p>\n\u003cp>But the board’s executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that requiring translated labels would require larger bottles of pills to fit all the text. But she says patients don’t like larger bottles.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/160863705&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\"They decant the drug out of the large container, put it in a baggie or someplace else,\" Herold said. \"There you’ve separated the drug from the container, now the instructions on how to take it have been separated.\"\u003c/p>\n\u003cp>Pharmacists don’t like the proposal because they say it opens them to liability if there’s a mistake in the translation. Brian Warren is with the California Pharmacists Association.\u003c/p>\n\u003cp>\"If the label is translated into Russian and there’s an error, and I’m a pharmacist that does not speak Russian, I cannot verify that that error exists,\" Warren said.\u003c/p>\n\u003cp>At present, the state's board of pharmacy \u003ca href=\"http://www.pharmacy.ca.gov/publications/translations.shtml\" target=\"_blank\">includes on its website\u003c/a> translations of basic instructions such as \"take one pill at bedtime\" in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.\u003c/p>\n\u003cp>Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.\u003c/p>\n\u003cp>\"There’s a risk right now,\" said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. \"They can’t understand anything on their label because the label is not in their language.\"\u003c/p>\n\u003cp>De Guia says the expansion of insurance under the Affordable Care Act places more urgency on the issue.\u003c/p>\n\u003cp>\"You’re going to have 1.5 million more limited-English proficient individuals in the health care system now that the ACA has passed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages press and who would have responsibility for translation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_12470\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-e1372880137951.jpg\">\u003cimg class=\"size-large wp-image-12470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-620x413.jpg\" alt=\"Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Aerial view of Avenal State Prison near Coalinga, one of two Central Valley prisons where inmates are at high risk from Valley fever. (Buzzbo/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By April Laissle\u003c/strong>\u003c/p>\n\u003cp>Federal health officials say the state must take steps to reduce the outbreaks of Valley fever at its prisons. Their recommendations come after 30 inmates in California died from the illness since 2008.\u003c/p>\n\u003cp>The fungal infection is caused by spores in the soil and can cause fever, chest pain and swelling. Two Central Valley prisons, Avenal and Pleasant Valley, have had especially high rates of the disease. Last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/03/state-to-transfer-inmates-from-prisons-plagued-by-valley-fever/\" target=\"_blank\">California officials agreed to transfer high-risk inmates\u003c/a> from the two prisons.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.prisonlaw.com/pdfs/2014CDCValleyFeverReport.pdf\" target=\"_blank\">experts from the Centers for Disease Control suggest\u003c/a> new inmates should be tested for immunity. They say susceptible inmates should not sent to the two Central Valley prisons.\u003c!--more-->\u003c/p>\n\u003cp>Prison officials are reviewing the report.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Wherever there are ways to mitigate the risk to individuals, we want to take advantage of that,\" said prison health spokeswoman Joyce Hayhoe.\u003c/p>\n\u003cp>The CDC recommends that prisons use skin tests to determine whether inmates have been exposed to Valley fever in the past. If they have been, they are considered at low risk for the infection. CDC researchers predicted that this kind of testing would show that 13 percent of the prison inmate population is immune to valley fever.\u003c/p>\n\u003cp>The San Joaquin Valley is a hotspot for Valley fever because the fungal spores that cause the illness are common in its soil. More than 80 percent of the valley's cases originate in its prisons.\u003c/p>\n\u003cp>\"These prisons are a toxic site for many, many people,\" said prisoner rights advocate and director of the Prison Law Office Don Specter.\u003c/p>\n\u003cp>Several infected prisoners have filed lawsuits against the state, seeking compensation for their life-long medical care.\u003c/p>\n\u003cp>\"The department, in my opinion, has been deliberately indifferent to the serious needs of the prisoners who have contracted these diseases,\" said Specter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Prison officials are expected to formally respond to the recommendations in the coming weeks.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12470\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-e1372880137951.jpg\">\u003cimg class=\"size-large wp-image-12470\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AvenalStatePrison_Buzzbo_Flickr-620x413.jpg\" alt=\"Aerial view of Avenal State Prison, near Coalinga in the Central Valley, where inmates have been hit hard by Valley Fever. (Buzzbo/Flickr)\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Aerial view of Avenal State Prison near Coalinga, one of two Central Valley prisons where inmates are at high risk from Valley fever. (Buzzbo/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By April Laissle\u003c/strong>\u003c/p>\n\u003cp>Federal health officials say the state must take steps to reduce the outbreaks of Valley fever at its prisons. Their recommendations come after 30 inmates in California died from the illness since 2008.\u003c/p>\n\u003cp>The fungal infection is caused by spores in the soil and can cause fever, chest pain and swelling. Two Central Valley prisons, Avenal and Pleasant Valley, have had especially high rates of the disease. Last year, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/03/state-to-transfer-inmates-from-prisons-plagued-by-valley-fever/\" target=\"_blank\">California officials agreed to transfer high-risk inmates\u003c/a> from the two prisons.\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.prisonlaw.com/pdfs/2014CDCValleyFeverReport.pdf\" target=\"_blank\">experts from the Centers for Disease Control suggest\u003c/a> new inmates should be tested for immunity. They say susceptible inmates should not sent to the two Central Valley prisons.\u003c!--more-->\u003c/p>\n\u003cp>Prison officials are reviewing the report.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Wherever there are ways to mitigate the risk to individuals, we want to take advantage of that,\" said prison health spokeswoman Joyce Hayhoe.\u003c/p>\n\u003cp>The CDC recommends that prisons use skin tests to determine whether inmates have been exposed to Valley fever in the past. If they have been, they are considered at low risk for the infection. CDC researchers predicted that this kind of testing would show that 13 percent of the prison inmate population is immune to valley fever.\u003c/p>\n\u003cp>The San Joaquin Valley is a hotspot for Valley fever because the fungal spores that cause the illness are common in its soil. More than 80 percent of the valley's cases originate in its prisons.\u003c/p>\n\u003cp>\"These prisons are a toxic site for many, many people,\" said prisoner rights advocate and director of the Prison Law Office Don Specter.\u003c/p>\n\u003cp>Several infected prisoners have filed lawsuits against the state, seeking compensation for their life-long medical care.\u003c/p>\n\u003cp>\"The department, in my opinion, has been deliberately indifferent to the serious needs of the prisoners who have contracted these diseases,\" said Specter.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Prison officials are expected to formally respond to the recommendations in the coming weeks.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "PriceCheck: How Much Does A Back MRI Cost?",
"title": "PriceCheck: How Much Does A Back MRI Cost?",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_20331\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/doctorow/4751523473/in/photolist-8eSNov-mEwTy8-6JTraD-APuDh-bBZBFE-7i2KDw-mjwKtu-hsLC1-56pdoq-4EuwaZ-D7GFQ-5eDg7f-mxWSn-asuNsS-6qLs2L-8pmybr-fC72FA-7r62wP-6JNkTW-4Rfdog-9ptXra-5p8yAG-56pdiC-dLzvc-58x2wS-79HPBT-pCtxt-4baKok-4beLFS-aBDC1M-6QXKL6-6R2AJb-6R2AKN-6R2ej7-7A9mik-aqUL8N-6QXu82-7Hd2Zu-6R2x1y-6R2x4m-7oNFfu-mExNwk-5aG9mV-2D8Czi-hsKK8-7S9qAu-vtX2T-79MH7C-6QXu7k-a41Hz\">\u003cimg class=\"size-large wp-image-20331\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/BackMRI-640x467.jpg\" alt=\"Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\" width=\"640\" height=\"467\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In June, KQED launched PriceCheck, our crowdsourcing project on health costs. We're working in collaboration with \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Just in San Francisco, back MRIs range in price from $575 to $6,221. \u003c/aside>\n\u003cp>We're asking you, the members of our community, to share what you've paid. We started with mammograms. We have both cash or \"self-pay\" prices in our database. We also have crowdsourced prices. The range we've found, even in close geographic areas, is startling.\u003c/p>\n\u003cp>Here's one example: ClearHealthCosts collected self-pay prices at various centers in the Bay Area and Southern California. If a woman walks into the NorCal Imaging Center in Walnut Creek, a screening mammogram will cost her $125, if she pays out of pocket.\u003c!--more-->\u003c/p>\n\u003cp>Meanwhile, the same mammogram will cost you $173 at NorCal Imaging in Oakland, $48 more, a 38 percent increase.\u003c/p>\n\u003cp>Across the bay in San Francisco, UCSF charges $801 for a screening mammogram -- but offers a 40 percent discount if a woman is paying out of pocket and pays at the time of service. This brings the cost paid down to $480.60.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Which would you rather pay -- $480.60 or $125?\u003c/p>\n\u003cp>Then we heard from a member of our community who has Blue Shield and had her screening mammogram at UCSF. She said UCSF had listed its charged price as $801, but Blue Shield paid $283.55.\u003c/p>\n\u003cp>In other words, those without insurance are paying nearly $200 more for a mammogram than the women with this type of insurance if they get a screening mammogram at UCSF.\u003c/p>\n\u003cp>In Los Angeles, our co-conspirators at \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC's Impatient blog described a woman\u003c/a> whose insurer paid $649 for her mammogram at Glendale Adventist Medical Center. Compare that price with the lowest in our database statewide -- $60 for a mammogram at the H. Claude Hudson Comprehensive Cancer Center.\u003c/p>\n\u003cp>\u003cstrong>Share Your Back MRI Prices\u003c/strong>\u003c/p>\n\u003cp>We're moving on now to back MRIs. (Don't worry, we'll happily accept your mammogram prices if you still want to share those!)\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Learn more: read all our PriceCheck coverage.\u003c/a> \u003c/aside>\n\u003cp>We're interested in comparing MRIs of the lower back or upper back, either with or without contrast.\u003c/p>\n\u003cp>We're already astonished by what we've found.\u003c/p>\n\u003cp>Folks, the range just in the city of San Francisco is $575 to $6,221. Yes, more than a 10-fold difference. That $6,221 MRI of the lower back, without contrast, is done at UCSF. To be fair, it comes with the same 40 percent discount for self-pay that UCSF offers for mammograms as well.\u003c/p>\n\u003cp>The discounted price is $3,732.60, still significantly more expensive than the next one down the list, $2,607 at California Pacific Medical Center.\u003c/p>\n\u003cp>You can search for yourself by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visiting PriceCheck\u003c/a>, entering any zip code in the Bay Area for MRI lower back, without contrast, and search in a 100-mile range.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The $575 MRI is offered at Health Diagnostics. You can get the price down to $500 by heading to San Jose's PremiereScan. You can get it for $300 at Universal MRI & CT Inc. on Wilshire Boulevard in Los Angeles.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20331\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/doctorow/4751523473/in/photolist-8eSNov-mEwTy8-6JTraD-APuDh-bBZBFE-7i2KDw-mjwKtu-hsLC1-56pdoq-4EuwaZ-D7GFQ-5eDg7f-mxWSn-asuNsS-6qLs2L-8pmybr-fC72FA-7r62wP-6JNkTW-4Rfdog-9ptXra-5p8yAG-56pdiC-dLzvc-58x2wS-79HPBT-pCtxt-4baKok-4beLFS-aBDC1M-6QXKL6-6R2AJb-6R2AKN-6R2ej7-7A9mik-aqUL8N-6QXu82-7Hd2Zu-6R2x1y-6R2x4m-7oNFfu-mExNwk-5aG9mV-2D8Czi-hsKK8-7S9qAu-vtX2T-79MH7C-6QXu7k-a41Hz\">\u003cimg class=\"size-large wp-image-20331\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/BackMRI-640x467.jpg\" alt=\"Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\" width=\"640\" height=\"467\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Back MRI costs vary widely, even within the same city. (Cory Doctorow/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In June, KQED launched PriceCheck, our crowdsourcing project on health costs. We're working in collaboration with \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC\u003c/a>, public media in Los Angeles, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, a New York City startup looking at health costs.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Just in San Francisco, back MRIs range in price from $575 to $6,221. \u003c/aside>\n\u003cp>We're asking you, the members of our community, to share what you've paid. We started with mammograms. We have both cash or \"self-pay\" prices in our database. We also have crowdsourced prices. The range we've found, even in close geographic areas, is startling.\u003c/p>\n\u003cp>Here's one example: ClearHealthCosts collected self-pay prices at various centers in the Bay Area and Southern California. If a woman walks into the NorCal Imaging Center in Walnut Creek, a screening mammogram will cost her $125, if she pays out of pocket.\u003c!--more-->\u003c/p>\n\u003cp>Meanwhile, the same mammogram will cost you $173 at NorCal Imaging in Oakland, $48 more, a 38 percent increase.\u003c/p>\n\u003cp>Across the bay in San Francisco, UCSF charges $801 for a screening mammogram -- but offers a 40 percent discount if a woman is paying out of pocket and pays at the time of service. This brings the cost paid down to $480.60.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Which would you rather pay -- $480.60 or $125?\u003c/p>\n\u003cp>Then we heard from a member of our community who has Blue Shield and had her screening mammogram at UCSF. She said UCSF had listed its charged price as $801, but Blue Shield paid $283.55.\u003c/p>\n\u003cp>In other words, those without insurance are paying nearly $200 more for a mammogram than the women with this type of insurance if they get a screening mammogram at UCSF.\u003c/p>\n\u003cp>In Los Angeles, our co-conspirators at \u003ca href=\"http://www.scpr.org/blogs/health/2014/07/21/17024/next-up-for-pricecheck-back-mri-s/\" target=\"_blank\">KPCC's Impatient blog described a woman\u003c/a> whose insurer paid $649 for her mammogram at Glendale Adventist Medical Center. Compare that price with the lowest in our database statewide -- $60 for a mammogram at the H. Claude Hudson Comprehensive Cancer Center.\u003c/p>\n\u003cp>\u003cstrong>Share Your Back MRI Prices\u003c/strong>\u003c/p>\n\u003cp>We're moving on now to back MRIs. (Don't worry, we'll happily accept your mammogram prices if you still want to share those!)\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">Learn more: read all our PriceCheck coverage.\u003c/a> \u003c/aside>\n\u003cp>We're interested in comparing MRIs of the lower back or upper back, either with or without contrast.\u003c/p>\n\u003cp>We're already astonished by what we've found.\u003c/p>\n\u003cp>Folks, the range just in the city of San Francisco is $575 to $6,221. Yes, more than a 10-fold difference. That $6,221 MRI of the lower back, without contrast, is done at UCSF. To be fair, it comes with the same 40 percent discount for self-pay that UCSF offers for mammograms as well.\u003c/p>\n\u003cp>The discounted price is $3,732.60, still significantly more expensive than the next one down the list, $2,607 at California Pacific Medical Center.\u003c/p>\n\u003cp>You can search for yourself by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">visiting PriceCheck\u003c/a>, entering any zip code in the Bay Area for MRI lower back, without contrast, and search in a 100-mile range.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The $575 MRI is offered at Health Diagnostics. You can get the price down to $500 by heading to San Jose's PremiereScan. You can get it for $300 at Universal MRI & CT Inc. on Wilshire Boulevard in Los Angeles.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20284\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg\">\u003cimg class=\"size-large wp-image-20284\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg-640x480.\" alt=\"Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One month, three months, even five months.\u003c/p>\n\u003cp>That's how long some Northern California Kaiser patients wait to see an individual therapist -- according to many Kaiser patients and therapists.\u003c/p>\n\u003cp>KQED's Jon Brooks has reported extensively on this issue over the last two months. He talked to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\">close to two dozen therapists and patients \u003c/a>who said that they were experiencing long wait times. One therapist whose specialty is geriatric care told him that she had written to her superiors saying, \"I can't tell a patient that has six months to live that I'll see them in five months.\"\u003c!--more-->\u003c/p>\n\u003cp>Kaiser maintains that patients do have access to therapy, that it has 14 percent more therapists now than three years ago, and that therapists need to work with patients to ensure patients get the care they need.\u003c/p>\n\u003cp>KQED News anchor Mina Kim interviewed Brooks Monday evening about the questions surrounding Kaiser and its mental health services:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/159722017&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>\u003c/p>\n\u003cp>Earlier this month, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">Brooks reported\u003c/a> that a Sonoma County Supervisor whose husband had committed suicide while in Kaiser's care had taken a public stance on the issue of waiting times.\u003c/p>\n\n",
"disqusIdentifier": "20277 http://blogs.kqed.org/stateofhealth/?p=20277",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20284\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg\">\u003cimg class=\"size-large wp-image-20284\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg-640x480.\" alt=\"Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One month, three months, even five months.\u003c/p>\n\u003cp>That's how long some Northern California Kaiser patients wait to see an individual therapist -- according to many Kaiser patients and therapists.\u003c/p>\n\u003cp>KQED's Jon Brooks has reported extensively on this issue over the last two months. He talked to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\">close to two dozen therapists and patients \u003c/a>who said that they were experiencing long wait times. One therapist whose specialty is geriatric care told him that she had written to her superiors saying, \"I can't tell a patient that has six months to live that I'll see them in five months.\"\u003c!--more-->\u003c/p>\n\u003cp>Kaiser maintains that patients do have access to therapy, that it has 14 percent more therapists now than three years ago, and that therapists need to work with patients to ensure patients get the care they need.\u003c/p>\n\u003cp>KQED News anchor Mina Kim interviewed Brooks Monday evening about the questions surrounding Kaiser and its mental health services:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/159722017&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>\u003c/p>\n\u003cp>Earlier this month, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">Brooks reported\u003c/a> that a Sonoma County Supervisor whose husband had committed suicide while in Kaiser's care had taken a public stance on the issue of waiting times.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>We are wrapping up the first phase of our PriceCheck project. The goal is to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">shine a light \u003c/a>on costs of common health care procedures in California. We're starting with screening mammograms, and already we've found that the cash price (for people who are uninsured or have gone out of network) varies from a low of $60 at the H. Claude Hudson Comprehensive Health Center in Los Angeles, a county-run clinic, to $801 at U.C. San Francisco on the high end.\u003c/p>\n\u003cp>Together with\u003ca href=\"http://www.scpr.org/blogs/health\" target=\"_blank\"> KPCC\u003c/a> in Los Angeles and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, we're also asking you, the members of our community, to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">share what you've been charged\u003c/a> -- and what your provider has been paid -- for common health procedures.\u003c/p>\n\u003cp>In order to do that, you need to get familiar with your insurance company's \"explanation of benefits\" or EOB. That's the form your insurer sends to explain what was paid, to whom, at what level and why.\u003c/p>\n\u003cp>Here's a typical EOB, that we've marked with some explanations below:\u003c/p>\n\u003cfigure id=\"attachment_20256\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2.jpg\">\u003cimg class=\"size-large wp-image-20256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2-640x800.jpg\" alt=\"An explanation of benefits from Anthem Blue Cross. \" width=\"640\" height=\"800\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An explanation of benefits from Anthem Blue Cross.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For help in decoding the EOB, we talked to Pat Palmer, founder and CEO of \u003ca href=\"http://billadvocates.com\" target=\"_blank\">Medical Billing Advocates of America\u003c/a>.\u003c/p>\n\u003cp>The information included on an EOB isn’t consistent from one health care insurance company to the next, Palmer says, and they often include abbreviations and other language difficult for the average consumer to understand.\u003c/p>\n\u003cp>We've numbered items above and here are the descriptions of each:\u003c/p>\n\u003cp>1. \"Paid Amount.\" This is the total amount of money that the insurance company has paid directly to the provider, Palmer says. Or, in an out-of-network situation, it may be paid to the member. If you scan farther across that line to the right, you’ll see who the insurance company paid; in this case, it’s Mills Hospital.\u003c/p>\n\u003cp>2. \"Total Billed.\" These are the amounts being billed to the insurance company by the provider for each service — in this case, $51.50 for mammography (likely what the physician was paid to interpret the mammogram, although it does not say) and $365.12 for the screening mammogram (likely the facility fee for the patient to have the mammogram done, although it does not say). The charges are then totaled below the line.\u003c/p>\n\u003cp>In addition to an EOB, individuals will usually receive an itemized bill from their provider(s). Palmer says it’s important to be sure the total billed amount on the EOB — in this case, $416.62 — matches the total billed amount on the itemized bill from the provider.\u003c/p>\n\u003cp>3. \"Patient Savings.\" This is the difference between what the provider charged for this service and the amount they agreed to accept as a participating provider of your health insurance plan. That's because when a doctor or other provider agrees to contract with an insurer, they agree to accept reimbursement at a lower price than the charged price. In American medicine, the amounts charged by providers generally bear little relation to what they are ultimately paid.\u003c/p>\n\u003cp>There should always be a code that identifies the reason for the savings, Palmer says. And although it’s a little hard to see, there is a “01” that follows each charge in this column — that “01” corresponds to the “detail message” in the box below. “It’s usually clearer than that,” Palmer says, adding that consumers reading this EOB may miss that little “01” mark after the charge. “It’s usually a separate column that says ‘remark’ or ‘reason,’ and they’ll put the ‘01’ in there.”\u003c/p>\n\u003cp>In this case, Palmer says the “01” remark indicates that the provider billed more than was allowed under their agreement with the insurer, and the individual is not responsible for the difference.\u003c/p>\n\u003cp>4. \"Applied to Deductible.\" Many health plans require members to pay out a certain amount of money, a “deductible,” before the insurance will begin paying, Palmer says. If the individual has not met the deductible and has to pay for these medical services, the amount that is being applied toward his or her deductible would be in this column. But the Affordable Care Act mandates that some services are provided outside the deductible, at no cost to patients. These services include some cancer screening tests, such as a mammogram. In this EOB, we see that the patient has no amount applied to deductible.\u003c/p>\n\u003cp>But even if the service is being applied to the deductible, Palmer says that the amount that goes in the “applied to deductible” column will be the lesser, agreed-upon amount — not the higher, original amount that the provider billed.\u003c/p>\n\u003cp>5. \"Coinsurance, Copayment Amount.\" This may vary depending on what health insurance you have. Sometimes, members must make a copay for an office visit, for example. That is a flat fee. Other services may require coinsurance, a percentage of the cost of the service. If the member on this EOB had been required to pay a copay or a coinsurance for the service, the amount would be listed here.\u003c/p>\n\u003cp>6.\"Claims Payment.\" The amounts in this column break down what the insurance company paid to the provider for each service, with a total at the bottom.\u003c/p>\n\u003cp>7. Palmer says this is an important part of this EOB. In this case, it’s the insurance company telling the member that it is not his or her responsibility to pay the difference in price between the agreed-upon charges for these services and the amount the provider billed. “It’s very easy to read this [as], ‘It is your responsibility to pay $104’ — somebody could misread it and think they owe $104.15,” Palmer says. “That word ‘not’ should be bold or stand out a lot more.” On some EOBs, Palmer says there is an additional line that says what the patient’s payment responsibility is; in this case, it would list it as $0.\u003c/p>\n\u003cp>But your EOB might look different from the example above. Or a mailed EOB may look different from what you see online. The above example is a mailed EOB from Anthem Blue Cross, a major health insurer in California. Below is an online EOB, which is also from Anthem Blue Cross, yet it looks quite different. (The numbers in the EOB below line up with the explanations we've provided.)\u003c/p>\n\u003cp>Numbers 1, 2, 4 and 5 line up with explanations we have provided. But there are no terms on this EOB that line up with 3, 6 and 7 above. Yes, we know this is confusing.\u003c/p>\n\u003cfigure id=\"attachment_20262\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised.jpg\">\u003cimg class=\"size-large wp-image-20262\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised-640x639.jpg\" alt=\"An Explanation of Benefits from Anthem Blue Cross, retrieved online.\" width=\"640\" height=\"639\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Explanation of Benefits from Anthem Blue Cross, retrieved online.\u003c/figcaption>\u003c/figure>\n\u003cp>Other things Palmer suggests paying attention to on an EOB:\u003c/p>\n\u003cp>• Look at the “provider of services” and “place of service,” listed on the first EOB in this post as “Mills Hospital” and “outpatient.” Palmer says insurance companies often pay a different rate depending on whether the service was provided in an inpatient setting, outpatient setting or a doctor’s office. “The insurance company is the one that wrote this up, and they may have miscoded the place of service,” Palmer says. “When they do, it will vary on how much your plan pays and how much you’re responsible for.”\u003c/p>\n\u003cp>• Look for a \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT code\u003c/a> (Current Procedural Terminology). CPT codes were developed by the American Medical Association and identify the health care service provided. Palmer says that most times, insurance companies print either a “type of service” (as is listed on the first EOB) or a CPT code. And Palmer says having one, but not both, makes it a bit more difficult to determine if the provider is billing for the right services. Note that the online EOB above does list both a CPT code and a procedure code.\u003c/p>\n\u003cp>Palmer gives the example of a chest x-ray. If “type of service” is listed as chest x-ray, the individual can’t tell if the charge is for one view or three views, and the price will differ depending. Palmer says it’s often a good idea to call the insurance company to get the CPT code. If the CPT code is written on your EOB, instead of a description of service, Palmer says it’s easy to Google that code and see if it matches up with the service you received.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>• Pay close attention to the message or comment box, Palmer says, and be sure you understand why a certain amount is not payable. If an insurance company says something is not payable, it could be a non-covered service that the individual is responsible for. Or, it could be a charge above what the provider and insurer agreed upon, meaning the individual does not have to pay. “Knowing that reason tells you whether you are responsible or not responsible for it,” Palmer says.\u003c/p>\n\u003cp>• Double-check the calculations on the EOB. Know the benefits that are part of your plan, Palmer says, and keep track of any payments you’ve made toward a deductible. Know where you are in your progress of meeting your deductible and when the insurance company is supposed to start paying.\u003c/p>\n\u003cp>If you scour your EOB and you do find an error, Palmer says you should determine who made the error -- the provider or the insurer -- and then follow up with them to correct the error.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Finding and correcting an error on an EOB may mean that you, as the individual member, aren’t overcharged, Palmer says. But it also may mean that the insurance company isn’t overcharged by the provider. While our natural instinct may not be to save a health insurance company some money, Palmer says that insurance companies will make profits regardless — so expensive errors only translate to higher premiums passed on to members down the road.\u003c/p>\n\n",
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"excerpt": "The \"explanation of benefits\" is provided by your insurance company to detail what it has paid to providers and what if your responsibility to pay.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Lynne Shallcross\u003c/strong>\u003c/p>\n\u003cp>We are wrapping up the first phase of our PriceCheck project. The goal is to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/kqed-launches-project-to-help-make-health-costs-transparent/\" target=\"_blank\">shine a light \u003c/a>on costs of common health care procedures in California. We're starting with screening mammograms, and already we've found that the cash price (for people who are uninsured or have gone out of network) varies from a low of $60 at the H. Claude Hudson Comprehensive Health Center in Los Angeles, a county-run clinic, to $801 at U.C. San Francisco on the high end.\u003c/p>\n\u003cp>Together with\u003ca href=\"http://www.scpr.org/blogs/health\" target=\"_blank\"> KPCC\u003c/a> in Los Angeles and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com\u003c/a>, we're also asking you, the members of our community, to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">share what you've been charged\u003c/a> -- and what your provider has been paid -- for common health procedures.\u003c/p>\n\u003cp>In order to do that, you need to get familiar with your insurance company's \"explanation of benefits\" or EOB. That's the form your insurer sends to explain what was paid, to whom, at what level and why.\u003c/p>\n\u003cp>Here's a typical EOB, that we've marked with some explanations below:\u003c/p>\n\u003cfigure id=\"attachment_20256\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2.jpg\">\u003cimg class=\"size-large wp-image-20256\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/EOB_2-640x800.jpg\" alt=\"An explanation of benefits from Anthem Blue Cross. \" width=\"640\" height=\"800\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An explanation of benefits from Anthem Blue Cross.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For help in decoding the EOB, we talked to Pat Palmer, founder and CEO of \u003ca href=\"http://billadvocates.com\" target=\"_blank\">Medical Billing Advocates of America\u003c/a>.\u003c/p>\n\u003cp>The information included on an EOB isn’t consistent from one health care insurance company to the next, Palmer says, and they often include abbreviations and other language difficult for the average consumer to understand.\u003c/p>\n\u003cp>We've numbered items above and here are the descriptions of each:\u003c/p>\n\u003cp>1. \"Paid Amount.\" This is the total amount of money that the insurance company has paid directly to the provider, Palmer says. Or, in an out-of-network situation, it may be paid to the member. If you scan farther across that line to the right, you’ll see who the insurance company paid; in this case, it’s Mills Hospital.\u003c/p>\n\u003cp>2. \"Total Billed.\" These are the amounts being billed to the insurance company by the provider for each service — in this case, $51.50 for mammography (likely what the physician was paid to interpret the mammogram, although it does not say) and $365.12 for the screening mammogram (likely the facility fee for the patient to have the mammogram done, although it does not say). The charges are then totaled below the line.\u003c/p>\n\u003cp>In addition to an EOB, individuals will usually receive an itemized bill from their provider(s). Palmer says it’s important to be sure the total billed amount on the EOB — in this case, $416.62 — matches the total billed amount on the itemized bill from the provider.\u003c/p>\n\u003cp>3. \"Patient Savings.\" This is the difference between what the provider charged for this service and the amount they agreed to accept as a participating provider of your health insurance plan. That's because when a doctor or other provider agrees to contract with an insurer, they agree to accept reimbursement at a lower price than the charged price. In American medicine, the amounts charged by providers generally bear little relation to what they are ultimately paid.\u003c/p>\n\u003cp>There should always be a code that identifies the reason for the savings, Palmer says. And although it’s a little hard to see, there is a “01” that follows each charge in this column — that “01” corresponds to the “detail message” in the box below. “It’s usually clearer than that,” Palmer says, adding that consumers reading this EOB may miss that little “01” mark after the charge. “It’s usually a separate column that says ‘remark’ or ‘reason,’ and they’ll put the ‘01’ in there.”\u003c/p>\n\u003cp>In this case, Palmer says the “01” remark indicates that the provider billed more than was allowed under their agreement with the insurer, and the individual is not responsible for the difference.\u003c/p>\n\u003cp>4. \"Applied to Deductible.\" Many health plans require members to pay out a certain amount of money, a “deductible,” before the insurance will begin paying, Palmer says. If the individual has not met the deductible and has to pay for these medical services, the amount that is being applied toward his or her deductible would be in this column. But the Affordable Care Act mandates that some services are provided outside the deductible, at no cost to patients. These services include some cancer screening tests, such as a mammogram. In this EOB, we see that the patient has no amount applied to deductible.\u003c/p>\n\u003cp>But even if the service is being applied to the deductible, Palmer says that the amount that goes in the “applied to deductible” column will be the lesser, agreed-upon amount — not the higher, original amount that the provider billed.\u003c/p>\n\u003cp>5. \"Coinsurance, Copayment Amount.\" This may vary depending on what health insurance you have. Sometimes, members must make a copay for an office visit, for example. That is a flat fee. Other services may require coinsurance, a percentage of the cost of the service. If the member on this EOB had been required to pay a copay or a coinsurance for the service, the amount would be listed here.\u003c/p>\n\u003cp>6.\"Claims Payment.\" The amounts in this column break down what the insurance company paid to the provider for each service, with a total at the bottom.\u003c/p>\n\u003cp>7. Palmer says this is an important part of this EOB. In this case, it’s the insurance company telling the member that it is not his or her responsibility to pay the difference in price between the agreed-upon charges for these services and the amount the provider billed. “It’s very easy to read this [as], ‘It is your responsibility to pay $104’ — somebody could misread it and think they owe $104.15,” Palmer says. “That word ‘not’ should be bold or stand out a lot more.” On some EOBs, Palmer says there is an additional line that says what the patient’s payment responsibility is; in this case, it would list it as $0.\u003c/p>\n\u003cp>But your EOB might look different from the example above. Or a mailed EOB may look different from what you see online. The above example is a mailed EOB from Anthem Blue Cross, a major health insurer in California. Below is an online EOB, which is also from Anthem Blue Cross, yet it looks quite different. (The numbers in the EOB below line up with the explanations we've provided.)\u003c/p>\n\u003cp>Numbers 1, 2, 4 and 5 line up with explanations we have provided. But there are no terms on this EOB that line up with 3, 6 and 7 above. Yes, we know this is confusing.\u003c/p>\n\u003cfigure id=\"attachment_20262\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised.jpg\">\u003cimg class=\"size-large wp-image-20262\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/OnlineEOBrevised-640x639.jpg\" alt=\"An Explanation of Benefits from Anthem Blue Cross, retrieved online.\" width=\"640\" height=\"639\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Explanation of Benefits from Anthem Blue Cross, retrieved online.\u003c/figcaption>\u003c/figure>\n\u003cp>Other things Palmer suggests paying attention to on an EOB:\u003c/p>\n\u003cp>• Look at the “provider of services” and “place of service,” listed on the first EOB in this post as “Mills Hospital” and “outpatient.” Palmer says insurance companies often pay a different rate depending on whether the service was provided in an inpatient setting, outpatient setting or a doctor’s office. “The insurance company is the one that wrote this up, and they may have miscoded the place of service,” Palmer says. “When they do, it will vary on how much your plan pays and how much you’re responsible for.”\u003c/p>\n\u003cp>• Look for a \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page\" target=\"_blank\">CPT code\u003c/a> (Current Procedural Terminology). CPT codes were developed by the American Medical Association and identify the health care service provided. Palmer says that most times, insurance companies print either a “type of service” (as is listed on the first EOB) or a CPT code. And Palmer says having one, but not both, makes it a bit more difficult to determine if the provider is billing for the right services. Note that the online EOB above does list both a CPT code and a procedure code.\u003c/p>\n\u003cp>Palmer gives the example of a chest x-ray. If “type of service” is listed as chest x-ray, the individual can’t tell if the charge is for one view or three views, and the price will differ depending. Palmer says it’s often a good idea to call the insurance company to get the CPT code. If the CPT code is written on your EOB, instead of a description of service, Palmer says it’s easy to Google that code and see if it matches up with the service you received.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more: \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">read all our PriceCheck coverage\u003c/a>. \u003c/aside>\n\u003cp>• Pay close attention to the message or comment box, Palmer says, and be sure you understand why a certain amount is not payable. If an insurance company says something is not payable, it could be a non-covered service that the individual is responsible for. Or, it could be a charge above what the provider and insurer agreed upon, meaning the individual does not have to pay. “Knowing that reason tells you whether you are responsible or not responsible for it,” Palmer says.\u003c/p>\n\u003cp>• Double-check the calculations on the EOB. Know the benefits that are part of your plan, Palmer says, and keep track of any payments you’ve made toward a deductible. Know where you are in your progress of meeting your deductible and when the insurance company is supposed to start paying.\u003c/p>\n\u003cp>If you scour your EOB and you do find an error, Palmer says you should determine who made the error -- the provider or the insurer -- and then follow up with them to correct the error.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Finding and correcting an error on an EOB may mean that you, as the individual member, aren’t overcharged, Palmer says. But it also may mean that the insurance company isn’t overcharged by the provider. While our natural instinct may not be to save a health insurance company some money, Palmer says that insurance companies will make profits regardless — so expensive errors only translate to higher premiums passed on to members down the road.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
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},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
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