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"content": "\u003cp>As a mother of young children, I've heard the following rosy message from more than one slightly more-seasoned mom: \"Don't worry, it gets easier!\"\u003c/p>\n\u003cp>It's a message of hope and encouragement, a recognition of how hard some aspects of early motherhood can be. But according to new research, it might also be wrong.\u003c/p>\n\u003caside class=\"pullquote alignright\">Yes, parenting toddlers is exhausting, but research suggests middle school age is toughest on mothers\u003cbr>\n\u003c/aside>\n\u003cp>A new \u003ca href=\"http://dx.doi.org/10.1037/dev0000062\" target=\"_blank\">paper\u003c/a>, published earlier this year in the journal \u003cem>Developmental Psychology,\u003c/em> suggests that the hardest time for mothers isn't when their children are in early childhood, but later — when their children reach middle school.\u003c/p>\n\u003cp>The paper, by Suniya Luthar and Lucia Ciciolla of Arizona State University, reports the findings from an Internet-based survey of 2,247 relatively well-educated American mothers.\u003c/p>\n\u003cp>The participants responded to a series of questions designed to assess multiple facets of their well-being, including aspects of their personal adjustment (such as stress and life satisfaction), perceptions of their child's behavior (including both positive and negative behaviors toward the mother) and aspects of their experiences as a parent (including feelings of guilt and being subsumed by parenthood). The mothers were also classified according to the ages of their children, with categories including infancy, preschool, elementary school, middle school, high school and adulthood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The data revealed different patterns of well-being for mothers with children of different ages.\u003c/p>\n\u003cp>In the early years, when motherhood is often portrayed as especially demanding, mothers reported high levels of parenting \"overload.\" They felt that mothering crowded out time and energy for themselves and for other facets of their identities. But they also reported high levels of positive behaviors from their children and relatively high levels of parenting satisfaction overall. This suggests that the early challenges of motherhood were partially offset by high rewards.\u003c/p>\n\u003cp>By the time children reached adulthood, mothers reported significantly lower levels of parenting overload and guilt but maintained relatively high levels of parenting satisfaction. Contrary to the idea that mothers suffer from an empty nest, the data suggested that mothers of adult children enjoy relatively high levels of maternal well-being.\u003c/p>\n\u003cp>It was between these two periods that mothers reported the highest levels of dissatisfaction with parenting, with mothers of middle-school children representing the peak. Overall, life satisfaction also dipped in this period, with highs in stress, loneliness and feelings of emptiness — though ratings for these dimensions did not differ significantly between mothers of middle-school children and those in neighboring age groups. Mothers with middle school children also tended to perceive more negative behaviors from their children, and to perceive their children as less well-adjusted.\u003c/p>\n\u003cp>Importantly, these trends reflected group averages; there was considerable variation in the experiences of individual mothers. But the findings do suggest that some of the periods that are typically most difficult for children themselves — with the onset of puberty, a renegotiation of identities and sometimes forays into risky behavior — are also the most difficult for their mothers.\u003c/p>\n\u003cp>In a conversation by email, professor Luthar suggested that some of these threats to maternal well-being could be offset by \"mutually supportive groups for moms\" at schools, in the workplace or in individual communities. She also speculated that fathers similarly experience their children's middle school years as an especially stressful period.\u003c/p>\n\u003cp>So for mothers of young children, does it get easier? The data suggest that \u003cem>eventually\u003c/em> it does, but it might take longer than you expect — and there might be some rough spots along the way.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tania Lombrozo is a psychology professor at the University of California, Berkeley. She writes about psychology, cognitive science and philosophy, with occasional forays into parenting and veganism. You can keep up with more of what she is thinking on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/tanialombrozo\" target=\"_blank\">@TaniaLombrozo\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The data revealed different patterns of well-being for mothers with children of different ages.\u003c/p>\n\u003cp>In the early years, when motherhood is often portrayed as especially demanding, mothers reported high levels of parenting \"overload.\" They felt that mothering crowded out time and energy for themselves and for other facets of their identities. But they also reported high levels of positive behaviors from their children and relatively high levels of parenting satisfaction overall. This suggests that the early challenges of motherhood were partially offset by high rewards.\u003c/p>\n\u003cp>By the time children reached adulthood, mothers reported significantly lower levels of parenting overload and guilt but maintained relatively high levels of parenting satisfaction. Contrary to the idea that mothers suffer from an empty nest, the data suggested that mothers of adult children enjoy relatively high levels of maternal well-being.\u003c/p>\n\u003cp>It was between these two periods that mothers reported the highest levels of dissatisfaction with parenting, with mothers of middle-school children representing the peak. Overall, life satisfaction also dipped in this period, with highs in stress, loneliness and feelings of emptiness — though ratings for these dimensions did not differ significantly between mothers of middle-school children and those in neighboring age groups. Mothers with middle school children also tended to perceive more negative behaviors from their children, and to perceive their children as less well-adjusted.\u003c/p>\n\u003cp>Importantly, these trends reflected group averages; there was considerable variation in the experiences of individual mothers. But the findings do suggest that some of the periods that are typically most difficult for children themselves — with the onset of puberty, a renegotiation of identities and sometimes forays into risky behavior — are also the most difficult for their mothers.\u003c/p>\n\u003cp>In a conversation by email, professor Luthar suggested that some of these threats to maternal well-being could be offset by \"mutually supportive groups for moms\" at schools, in the workplace or in individual communities. She also speculated that fathers similarly experience their children's middle school years as an especially stressful period.\u003c/p>\n\u003cp>So for mothers of young children, does it get easier? The data suggest that \u003cem>eventually\u003c/em> it does, but it might take longer than you expect — and there might be some rough spots along the way.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tania Lombrozo is a psychology professor at the University of California, Berkeley. She writes about psychology, cognitive science and philosophy, with occasional forays into parenting and veganism. You can keep up with more of what she is thinking on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/tanialombrozo\" target=\"_blank\">@TaniaLombrozo\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Think+Mothering+Young+Kids+Is+Hard%3F+Get+Ready+For+Even+Tougher+Times&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California falls significantly short of a new recommendation by an influential group of pediatricians calling for every school in the United States to have at least one nurse on site.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Districts are stretched for money, and school nurses aren’t required, so they don’t see the need.\"\u003ccite>Linda Davis-Alldritt, former president, National Association of School Nurses \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Fifty-seven percent of California’s public school districts, with 1.2 million students, do not employ nurses, according to research from Sacramento State University’s School of Nursing.\u003c/p>\n\u003cp>The call for a nurse in every school appeared this week in a policy statement by the \u003ca href=\"https://www.aap.org/\" target=\"_blank\">American Academy of Pediatrics\u003c/a>. The group’s \u003ca href=\"http://pediatrics.aappublications.org/content/early/2016/05/19/peds.2016-0852\" target=\"_blank\">new guideline\u003c/a> replaces its previous one, which recommended that school districts have one nurse for every 750 healthy students, and one for every 225 students who need daily assistance.\u003c/p>\n\u003cp>The academy said the use of a numerical ratio was “inadequate to fill the increasingly complex health needs of students.”\u003c/p>\n\u003cp>Even when measured against that old yardstick, California’s schools are woefully deficient. Statewide, there is one nurse for every 2,784 students, according to 2014 numbers from \u003ca href=\"http://www.kidsdata.org/\" target=\"_blank\">KidsData\u003c/a>, a program of the Lucile Packard Foundation for Children’s Health. That’s nearly four times more students per nurse than the academy had recommended.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And in some regions it is far worse than that. In Santa Cruz County, for example, there were 13,432 students for every nurse in 2014.\u003c/p>\n\u003cp>California’s school nursing shortage is troublesome, experts say, because nurses provide much more than basic health services to students. They help manage chronic diseases, assist with obesity prevention, and participate in emergency preparedness and behavioral assessment, among other things.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//datawrapper.dwcdn.net/417Hs/3/\" frameborder=\"0\" allowtransparency=\"true\" allowfullscreen=\"allowfullscreen\" webkitallowfullscreen=\"webkitallowfullscreen\" mozallowfullscreen=\"mozallowfullscreen\" oallowfullscreen=\"oallowfullscreen\" msallowfullscreen=\"msallowfullscreen\" width=\"100%\" height=\"570\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“School nursing is one of the most effective ways to keep children healthy and in school and to prevent chronic absenteeism,” said Breena Welch Holmes, lead author of the academy’s policy statement.\u003c/p>\n\u003cp>Kathy Ryan, president of the \u003ca href=\"http://www.csno.org/\" target=\"_blank\">California School Nurses Organization\u003c/a>, said the academy’s new guideline, which also calls for access to a physician in every school district, underscores the vital need to upgrade health services in the state’s schools.\u003c/p>\n\u003cp>She noted that the new recommendation is stronger than the previous ratio-based guideline for whole school districts. Having a nurse across town, even if it means a school district is meeting a numerical target, is not as effective as having a full-time nurse on site every day, she explained.\u003c/p>\n\u003cp>Ryan noted that when children are absent, schools loses money. So when school nurses help reduce absenteeism, they could eventually pay for themselves, she said.\u003c/p>\n\u003cp>California’s school nurse deficiency is due in large part to the fact that schools are not legally obliged to hire nurses, and employing them competes with other priorities for scarce funding, said Linda Davis-Alldritt, ex-president of the \u003ca href=\"https://www.nasn.org/\" target=\"_blank\">National Association of School Nurses\u003c/a> and a former nursing consultant to the state’s Department of Education.\u003c/p>\n\u003cp>“Districts are stretched for money, and school nurses aren’t required, so they don’t see the need,” she said.\u003c/p>\n\u003cp>For California to attain the academy’s goal of a nurse in every school, the state legislature would need to make it a requirement, Davis-Alldritt said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder-Ostrov contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California falls significantly short of a new recommendation by an influential group of pediatricians calling for every school in the United States to have at least one nurse on site.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Districts are stretched for money, and school nurses aren’t required, so they don’t see the need.\"\u003ccite>Linda Davis-Alldritt, former president, National Association of School Nurses \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Fifty-seven percent of California’s public school districts, with 1.2 million students, do not employ nurses, according to research from Sacramento State University’s School of Nursing.\u003c/p>\n\u003cp>The call for a nurse in every school appeared this week in a policy statement by the \u003ca href=\"https://www.aap.org/\" target=\"_blank\">American Academy of Pediatrics\u003c/a>. The group’s \u003ca href=\"http://pediatrics.aappublications.org/content/early/2016/05/19/peds.2016-0852\" target=\"_blank\">new guideline\u003c/a> replaces its previous one, which recommended that school districts have one nurse for every 750 healthy students, and one for every 225 students who need daily assistance.\u003c/p>\n\u003cp>The academy said the use of a numerical ratio was “inadequate to fill the increasingly complex health needs of students.”\u003c/p>\n\u003cp>Even when measured against that old yardstick, California’s schools are woefully deficient. Statewide, there is one nurse for every 2,784 students, according to 2014 numbers from \u003ca href=\"http://www.kidsdata.org/\" target=\"_blank\">KidsData\u003c/a>, a program of the Lucile Packard Foundation for Children’s Health. That’s nearly four times more students per nurse than the academy had recommended.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And in some regions it is far worse than that. In Santa Cruz County, for example, there were 13,432 students for every nurse in 2014.\u003c/p>\n\u003cp>California’s school nursing shortage is troublesome, experts say, because nurses provide much more than basic health services to students. They help manage chronic diseases, assist with obesity prevention, and participate in emergency preparedness and behavioral assessment, among other things.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//datawrapper.dwcdn.net/417Hs/3/\" frameborder=\"0\" allowtransparency=\"true\" allowfullscreen=\"allowfullscreen\" webkitallowfullscreen=\"webkitallowfullscreen\" mozallowfullscreen=\"mozallowfullscreen\" oallowfullscreen=\"oallowfullscreen\" msallowfullscreen=\"msallowfullscreen\" width=\"100%\" height=\"570\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“School nursing is one of the most effective ways to keep children healthy and in school and to prevent chronic absenteeism,” said Breena Welch Holmes, lead author of the academy’s policy statement.\u003c/p>\n\u003cp>Kathy Ryan, president of the \u003ca href=\"http://www.csno.org/\" target=\"_blank\">California School Nurses Organization\u003c/a>, said the academy’s new guideline, which also calls for access to a physician in every school district, underscores the vital need to upgrade health services in the state’s schools.\u003c/p>\n\u003cp>She noted that the new recommendation is stronger than the previous ratio-based guideline for whole school districts. Having a nurse across town, even if it means a school district is meeting a numerical target, is not as effective as having a full-time nurse on site every day, she explained.\u003c/p>\n\u003cp>Ryan noted that when children are absent, schools loses money. So when school nurses help reduce absenteeism, they could eventually pay for themselves, she said.\u003c/p>\n\u003cp>California’s school nurse deficiency is due in large part to the fact that schools are not legally obliged to hire nurses, and employing them competes with other priorities for scarce funding, said Linda Davis-Alldritt, ex-president of the \u003ca href=\"https://www.nasn.org/\" target=\"_blank\">National Association of School Nurses\u003c/a> and a former nursing consultant to the state’s Department of Education.\u003c/p>\n\u003cp>“Districts are stretched for money, and school nurses aren’t required, so they don’t see the need,” she said.\u003c/p>\n\u003cp>For California to attain the academy’s goal of a nurse in every school, the state legislature would need to make it a requirement, Davis-Alldritt said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Barbara Feder-Ostrov contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Brandy Beck considers herself lucky. As a breast-feeding mom, the Frontier Airlines pilot has experienced severe breast pain, engorged breasts, clogged ducts, decreased milk supply, three interruptions while pumping at work, and pumping in airport and airplane bathrooms.\u003c/p>\n\u003cp>But unlike some of her colleagues, she escaped mastitis. Mastitis is a bacterial infection of the breast that can occur with clogged milk ducts if women cannot fully express their breast milk. And not receiving adequate, legally required accommodations for pumping breast milk at work is precisely why Beck and fellow Frontier pilots Randi Freyer, \u003ca href=\"https://www.aclu.org/blog/speak-freely/airline-pilots-should-not-have-choose-between-their-jobs-and-breastfeeding-their\">Shannon Kiedrowski\u003c/a> and Erin Zielinski are involved in a complaint against Frontier Airlines.\u003c/p>\n\u003cp>\"All four of us love our jobs, we love flying for Frontier and we love flying airplanes,\" Beck says. \"Most of us have wanted to do it all our lives, and we just want some equality in the workplace.\"\u003c/p>\n\u003cp>The American Civil Liberties Union, the ACLU of Colorado and the law firm Holwell Shuster & Goldberg LLP filed discrimination charges May 10 with the Equal Employment Opportunity Commission on the women's behalf. The charges claim that Frontier is discriminating against women by not providing sufficient accommodations for pregnant and breastfeeding employees.\u003c/p>\n\u003cp>\"This has been a long process of trying to struggle to get these accommodations with no success,\" says Galen Sherwin, a senior staff attorney with the ACLU in the women's right project. \"This lawsuit is the necessary last resort.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to Sherwin, the ACLU and the law firm sent Frontier management a letter describing the women's difficulties and several possible solutions, including temporary non-flying assignments that would allow easier accommodations, extension of maternity leave if the women wanted it and designated places where the women could pump in airports Frontier uses and on the plane when necessary.\u003c/p>\n\u003cp>For its part, the airline says that it already provides places that comply with federal and Colorado state requirements in all airports it uses, according to Cindi Ruff, vice president of human resources at Frontier. Women can contact the station manager of each airport to find the location, she says.\u003c/p>\n\u003cp>\"If they do [have those stations], they have not communicated that to the women I've spoken with, including women beyond these four pilots, despite repeated requests,\" Sherwin says. \"If it's up to the individual woman to contact each individual airport on her own, that would not be a sufficient accommodation. It's tantamount to providing no support to the women.\"\u003c/p>\n\u003cp>Beck says the stations she does know of are often a half mile from Frontier gates and are sometimes insufficient, such as the one at Denver airport that was being used for storage when she needed it. As directed by an assistant pilot, she used a vacated office — and movers attempted to enter while she was pumping.\u003c/p>\n\u003cp>Any temporary reassignments are governed by the \u003ca href=\"http://www.airlinepilotcentral.com/files/frontiercontract2007.pdf\">collective bargaining agreement\u003c/a> of the pilots' union, Ruff told Shots. That \u003ca href=\"http://www.airlinepilotcentral.com/files/frontiercontract2007.pdf\">contract\u003c/a> only addresses non-flying reassignments for on-the-job injuries and states that pilots who cannot return to work after four months may be entitled to receive an unpaid medical leave of absence. Maternity leave also is unpaid.\u003c/p>\n\u003cp>\"We assume that Frontier is in compliance with the Americans with Disabilities Act, which requires employers to provide reasonable accommodations, and temporary reassignment is one potential accommodation that Frontier that would be legally obligated to provide,\" Sherwin said. \"If they're offering that to people with disabilities, then they should be offering that to women.\"\u003c/p>\n\u003cp>Sherwin added that medical leave has only been granted for serious childbirth complications leading to physical injury or postpartum depression, and that breast-feeding women who requested it were denied.\u003c/p>\n\u003cp>Shannon Kiedrowski, one of the pilots involved in the suit, \u003ca href=\"https://www.aclu.org/blog/speak-freely/airline-pilots-should-not-have-choose-between-their-jobs-and-breastfeeding-their\">writes\u003c/a> that she \"battled for months to get Frontier's management to help future new moms.\" But, she says, \"my efforts went nowhere.\"\u003c/p>\n\u003cp>Frontier's Ruff says that the airline has worked with pilots who have raised concerns and adjusted their schedules to have less flying time.\u003c/p>\n\u003cp>But less flying time doesn't address the needs for accommodations during flying time, Sherwin says. Beck says she plans her flight days carefully to schedule in pumping time, but unexpected and sometimes long flight delays can interfere, necessitating pumping during a flight.\u003c/p>\n\u003cp>\"This situation is unique, but ultimately it's all about the safety of our passengers,\" Ruff says. \"Being on an aircraft and being a pilot is a very unique situation, unlike any other profession, and unfortunately there are sometimes limitations in what can be extended to an individual.\"\u003c/p>\n\u003cp>The challenges for pilots are similar to those for surgeons operating, where the patient's safety is paramount, says \u003ca href=\"http://sph.umn.edu/faculty1/name/katy-kozhimannil/\">Katy Kozhimannil\u003c/a>, an associate professor of health policy and management at the University of Minnesota School of Public Health.\u003c/p>\n\u003cp>\"It is a unique circumstance, but there are other circumstances where businesses face similar challenges in managing the trade-off between the safety of the patients or passengers and the urgent health needs of their employees,\" Kozhimannil says. \"If there are barriers, that's certainly understandable, and maybe there's a need for greater support for employers. But there have to be ways to try to address the needs of nursing mothers. It's extraordinarily important, and it's the law.\"\u003c/p>\n\u003cp>Pilots needing bathroom breaks leave the cockpit to do so, and the copilot must don an oxygen mask while the pilot is gone, Ruff says.\u003c/p>\n\u003cp>\"The request is that women be permitted to take breaks during flights as needed on the same terms that pilots are able to address their other bodily needs,\" Sherwin says. \"To say to a woman who's breast-feeding that you can't leave the cockpit to take care of her bodily needs but to allow everyone else to leave to use the bathroom is sex discrimination.\"\u003c/p>\n\u003cp>It can also have health consequences, Kozhimannil says. Her \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1049386715001176\">research\u003c/a> has \u003ca href=\"http://www.forbes.com/sites/tarahaelle/2015/10/20/less-than-half-of-breastfeeding-mothers-have-legally-required-pumping-accommodations-at-work/#147d43073785\">found that only 40 percent\u003c/a> of full-time or part-time employed women surveyed in 2011 and 2012 have been provided both break time and private space to express breast milk, as required by the Affordable Care Act. Those women were also twice as likely to be exclusively breast-feeding at 6 months and more likely to breast-feed at all with each passing month.\u003c/p>\n\u003cp>\"That's unsurprising, given the physiology of breast-feeding, because women need to express breast milk during the day when they're away from their child for their bodies to keep producing breast milk,\" Kozhimannil says. \"When you stop expressing breast milk, your supply diminishes and you're no longer able to breast-feed.\" Clogged ducts and mastitis are other risks of not adequately expressing breast milk.\u003c/p>\n\u003cp>One possible solution more broadly would be state or federal laws requiring paid family leave, enabling the pilots to take a longer unpaid leave without losing as much income. Pilots are already required to start unpaid maternity leave 8 weeks before their due date and have the option of four more unpaid months after delivery.\u003c/p>\n\u003cp>\"I believe it's unrealistic to ask a working mom to come back after four months and be away from her child for four to five days,\" Beck says, adding that the problem is industry wide for pilots and flight attendants. \"Some people can afford that, and some people can't. The most ideal solution is to have choices, because every individual needs something different.\"\u003c/p>\n\u003cp>The U.S. is the only country in the world besides Papua New Guinea that does not require employers to provide any paid family leave, says Ellen Bravo, executive director of \u003ca href=\"http://familyvaluesatwork.org/\">Family Values @ Work\u003c/a>, a network of coalitions working for paid leave policies.\u003c/p>\n\u003cp>\"We tell women to be good mothers and then we punish them for doing so by making their family suffer financial insecurity or by shaming them for doing something like breast-feeding,\" Bravo says. \"That's got to change. It's a scandal that nearly one in four women go back to work within two weeks.\"\u003c/p>\n\u003cp>The only states currently requiring paid family leave are California, New Jersey, Rhode Island and, as of April 1, New York.\u003c/p>\n\u003cp>The lawsuit does not request money, Sherwin says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"They would like ideally to have Frontier adopt these solutions so no other women would have to go through what they went through,\" Sherwin says. \"It's 2016. It shouldn't be that women have to choose between their jobs and breast-feeding their babies, and that's why our clients are bringing the case.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pilots+And+ACLU+Sue+Airline+Over+Breast+Milk+Pumping+At+Work&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Brandy Beck considers herself lucky. As a breast-feeding mom, the Frontier Airlines pilot has experienced severe breast pain, engorged breasts, clogged ducts, decreased milk supply, three interruptions while pumping at work, and pumping in airport and airplane bathrooms.\u003c/p>\n\u003cp>But unlike some of her colleagues, she escaped mastitis. Mastitis is a bacterial infection of the breast that can occur with clogged milk ducts if women cannot fully express their breast milk. And not receiving adequate, legally required accommodations for pumping breast milk at work is precisely why Beck and fellow Frontier pilots Randi Freyer, \u003ca href=\"https://www.aclu.org/blog/speak-freely/airline-pilots-should-not-have-choose-between-their-jobs-and-breastfeeding-their\">Shannon Kiedrowski\u003c/a> and Erin Zielinski are involved in a complaint against Frontier Airlines.\u003c/p>\n\u003cp>\"All four of us love our jobs, we love flying for Frontier and we love flying airplanes,\" Beck says. \"Most of us have wanted to do it all our lives, and we just want some equality in the workplace.\"\u003c/p>\n\u003cp>The American Civil Liberties Union, the ACLU of Colorado and the law firm Holwell Shuster & Goldberg LLP filed discrimination charges May 10 with the Equal Employment Opportunity Commission on the women's behalf. The charges claim that Frontier is discriminating against women by not providing sufficient accommodations for pregnant and breastfeeding employees.\u003c/p>\n\u003cp>\"This has been a long process of trying to struggle to get these accommodations with no success,\" says Galen Sherwin, a senior staff attorney with the ACLU in the women's right project. \"This lawsuit is the necessary last resort.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to Sherwin, the ACLU and the law firm sent Frontier management a letter describing the women's difficulties and several possible solutions, including temporary non-flying assignments that would allow easier accommodations, extension of maternity leave if the women wanted it and designated places where the women could pump in airports Frontier uses and on the plane when necessary.\u003c/p>\n\u003cp>For its part, the airline says that it already provides places that comply with federal and Colorado state requirements in all airports it uses, according to Cindi Ruff, vice president of human resources at Frontier. Women can contact the station manager of each airport to find the location, she says.\u003c/p>\n\u003cp>\"If they do [have those stations], they have not communicated that to the women I've spoken with, including women beyond these four pilots, despite repeated requests,\" Sherwin says. \"If it's up to the individual woman to contact each individual airport on her own, that would not be a sufficient accommodation. It's tantamount to providing no support to the women.\"\u003c/p>\n\u003cp>Beck says the stations she does know of are often a half mile from Frontier gates and are sometimes insufficient, such as the one at Denver airport that was being used for storage when she needed it. As directed by an assistant pilot, she used a vacated office — and movers attempted to enter while she was pumping.\u003c/p>\n\u003cp>Any temporary reassignments are governed by the \u003ca href=\"http://www.airlinepilotcentral.com/files/frontiercontract2007.pdf\">collective bargaining agreement\u003c/a> of the pilots' union, Ruff told Shots. That \u003ca href=\"http://www.airlinepilotcentral.com/files/frontiercontract2007.pdf\">contract\u003c/a> only addresses non-flying reassignments for on-the-job injuries and states that pilots who cannot return to work after four months may be entitled to receive an unpaid medical leave of absence. Maternity leave also is unpaid.\u003c/p>\n\u003cp>\"We assume that Frontier is in compliance with the Americans with Disabilities Act, which requires employers to provide reasonable accommodations, and temporary reassignment is one potential accommodation that Frontier that would be legally obligated to provide,\" Sherwin said. \"If they're offering that to people with disabilities, then they should be offering that to women.\"\u003c/p>\n\u003cp>Sherwin added that medical leave has only been granted for serious childbirth complications leading to physical injury or postpartum depression, and that breast-feeding women who requested it were denied.\u003c/p>\n\u003cp>Shannon Kiedrowski, one of the pilots involved in the suit, \u003ca href=\"https://www.aclu.org/blog/speak-freely/airline-pilots-should-not-have-choose-between-their-jobs-and-breastfeeding-their\">writes\u003c/a> that she \"battled for months to get Frontier's management to help future new moms.\" But, she says, \"my efforts went nowhere.\"\u003c/p>\n\u003cp>Frontier's Ruff says that the airline has worked with pilots who have raised concerns and adjusted their schedules to have less flying time.\u003c/p>\n\u003cp>But less flying time doesn't address the needs for accommodations during flying time, Sherwin says. Beck says she plans her flight days carefully to schedule in pumping time, but unexpected and sometimes long flight delays can interfere, necessitating pumping during a flight.\u003c/p>\n\u003cp>\"This situation is unique, but ultimately it's all about the safety of our passengers,\" Ruff says. \"Being on an aircraft and being a pilot is a very unique situation, unlike any other profession, and unfortunately there are sometimes limitations in what can be extended to an individual.\"\u003c/p>\n\u003cp>The challenges for pilots are similar to those for surgeons operating, where the patient's safety is paramount, says \u003ca href=\"http://sph.umn.edu/faculty1/name/katy-kozhimannil/\">Katy Kozhimannil\u003c/a>, an associate professor of health policy and management at the University of Minnesota School of Public Health.\u003c/p>\n\u003cp>\"It is a unique circumstance, but there are other circumstances where businesses face similar challenges in managing the trade-off between the safety of the patients or passengers and the urgent health needs of their employees,\" Kozhimannil says. \"If there are barriers, that's certainly understandable, and maybe there's a need for greater support for employers. But there have to be ways to try to address the needs of nursing mothers. It's extraordinarily important, and it's the law.\"\u003c/p>\n\u003cp>Pilots needing bathroom breaks leave the cockpit to do so, and the copilot must don an oxygen mask while the pilot is gone, Ruff says.\u003c/p>\n\u003cp>\"The request is that women be permitted to take breaks during flights as needed on the same terms that pilots are able to address their other bodily needs,\" Sherwin says. \"To say to a woman who's breast-feeding that you can't leave the cockpit to take care of her bodily needs but to allow everyone else to leave to use the bathroom is sex discrimination.\"\u003c/p>\n\u003cp>It can also have health consequences, Kozhimannil says. Her \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1049386715001176\">research\u003c/a> has \u003ca href=\"http://www.forbes.com/sites/tarahaelle/2015/10/20/less-than-half-of-breastfeeding-mothers-have-legally-required-pumping-accommodations-at-work/#147d43073785\">found that only 40 percent\u003c/a> of full-time or part-time employed women surveyed in 2011 and 2012 have been provided both break time and private space to express breast milk, as required by the Affordable Care Act. Those women were also twice as likely to be exclusively breast-feeding at 6 months and more likely to breast-feed at all with each passing month.\u003c/p>\n\u003cp>\"That's unsurprising, given the physiology of breast-feeding, because women need to express breast milk during the day when they're away from their child for their bodies to keep producing breast milk,\" Kozhimannil says. \"When you stop expressing breast milk, your supply diminishes and you're no longer able to breast-feed.\" Clogged ducts and mastitis are other risks of not adequately expressing breast milk.\u003c/p>\n\u003cp>One possible solution more broadly would be state or federal laws requiring paid family leave, enabling the pilots to take a longer unpaid leave without losing as much income. Pilots are already required to start unpaid maternity leave 8 weeks before their due date and have the option of four more unpaid months after delivery.\u003c/p>\n\u003cp>\"I believe it's unrealistic to ask a working mom to come back after four months and be away from her child for four to five days,\" Beck says, adding that the problem is industry wide for pilots and flight attendants. \"Some people can afford that, and some people can't. The most ideal solution is to have choices, because every individual needs something different.\"\u003c/p>\n\u003cp>The U.S. is the only country in the world besides Papua New Guinea that does not require employers to provide any paid family leave, says Ellen Bravo, executive director of \u003ca href=\"http://familyvaluesatwork.org/\">Family Values @ Work\u003c/a>, a network of coalitions working for paid leave policies.\u003c/p>\n\u003cp>\"We tell women to be good mothers and then we punish them for doing so by making their family suffer financial insecurity or by shaming them for doing something like breast-feeding,\" Bravo says. \"That's got to change. It's a scandal that nearly one in four women go back to work within two weeks.\"\u003c/p>\n\u003cp>The only states currently requiring paid family leave are California, New Jersey, Rhode Island and, as of April 1, New York.\u003c/p>\n\u003cp>The lawsuit does not request money, Sherwin says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"They would like ideally to have Frontier adopt these solutions so no other women would have to go through what they went through,\" Sherwin says. \"It's 2016. It shouldn't be that women have to choose between their jobs and breast-feeding their babies, and that's why our clients are bringing the case.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pilots+And+ACLU+Sue+Airline+Over+Breast+Milk+Pumping+At+Work&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Let the courts decide.\u003c/p>\n\u003cp>That appears to be the stance of the California Department of Education as state regulators have so far declined to answer pleas from school districts to clarify what California’s new vaccination law means for the 700,000 students who receive special education services.\u003c/p>\n\u003caside class=\"pullquote alignright\">Tension between state law mandating vaccines for virtually all students and federal law requiring services for special ed students \u003c/aside>\n\u003cp>Known as \u003ca class=\"external\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">Senate Bill 277\u003c/a>, the state law makes California one of \u003ca class=\"external\" href=\"http://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx\" target=\"_blank\">three\u003c/a> states to permit exemptions to school vaccinations only for medical reasons.\u003c/p>\n\u003cp>Gone are exemptions based on religious or personal beliefs. The law says all public and private school students must be vaccinated against 10 communicable diseases unless they have a medical exemption, they are home-schooled or they are enrolled in independent study with no classroom instruction.\u003c/p>\n\u003cp>With school districts beginning to enforce the law on July 1, legal experts say a conflict is likely to arise between the state mandate and the federal Individuals with Disabilities Education Act, which says students who qualify for special education services, such as intensive reading interventions that are provided in general classrooms, must receive those services. A conflict also has the potential to unite two impassioned groups of parents — those who oppose vaccinations and those who insist on the right of students to receive special education services in mainstream classrooms, attorneys said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"RzCoOu28F4oCnl3RdfxSSMmp01KRQ7iw\"]But what if the special education student is unvaccinated? Would that student be allowed to attend school? Or would an unvaccinated special education student have to receive services at home? Lawyers have lined up on both sides of the issue, offering conflicting opinions on how the state law intends school districts to carry out its mandate. It’s an argument that lawyers on both sides say is likely to end up in court.\u003c/p>\n\u003cp>The California Department of Education has said it will not be providing guidance on interpreting the new law, although it typically does so with new legislation, said Greg Rhoten, chairman of the Special Education Local Plan Area Administrators of California, which represents special education programs in the state. Rhoten said he asked two experts -- Fred Balcom, the director of the special education division of the California Department of Education who retired last year, and Chris Drouin, now the interim director of special education -- for guidance from the department and was told by both that none would be forthcoming.\u003c/p>\n\u003cp>He said he was told to follow guidance from the California Department of Public Health. “That wasn’t helpful to us,” Rhoten said, noting that public health department officials are not likely to be well-versed in special education law.\u003c/p>\n\u003cp>“I assume the state is trying to be careful about assuming risk for interpretation of the law,” which could make the department a party to a lawsuit, Rhoten said. “In the end, it’s the implementers,” he said, referring to the school districts. “They’re the ones who have to make the calls and do their best.”\u003c/p>\n\u003cp>In lieu of state guidance, districts have hired lawyers or turned to their general counsel for advice on how to proceed. Los Angeles Unified School District, which serves more than 640,000 K-12 students, said that on the advice of legal counsel, the district \u003ca href=\"http://edsource.org/2016/some-districts-exempt-students-in-special-ed-from-vaccination-law/92868\">will not require\u003c/a> students in special education to comply with required immunizations if that requirement would prevent them from getting services, including instruction in general education classrooms, to which they are legally entitled.\u003c/p>\n\u003cp>The California Department of Education referred media inquiries about the vaccination law to the California Department of Public Health, which in turn, referred questioners to its \u003ca class=\"external\" href=\"http://www.shotsforschool.org/laws/sb277faq/\" target=\"_blank\">Senate Bill 277 Frequently Asked Questions\u003c/a> web page. Last month, the department quietly posted \u003ca class=\"external\" href=\"http://www.shotsforschool.org/laws/sb277faq/#Q3A\" target=\"_blank\">an update\u003c/a> that had been long anticipated by districts, but the information fell short of providing helpful guidance, some lawyers said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"8uBPZ6s0m8Np0oB5t2hQs51ACsD2QKrY\"]In describing students who have individualized education programs through special education, the update explained in words underlined for emphasis that “parents or guardians must continue to provide immunization records for these students to their schools, and schools must continue to maintain and report records of immunizations that have been received for these students.”\u003c/p>\n\u003cp>But does “continue to provide immunization records” mean that students in special education must be vaccinated? Ronald Wenkart, general counsel for the Orange County Office of Education, says it does. “You wouldn’t have a record if you were not immunized,” said Wenkart, who has become a bit of a Kremlinologist in trying to decipher the text of the law and the public health department updates. His office has advised districts that the intention of the law — to improve immunization rates — calls for all students who receive special education services to be vaccinated, unless they have a medical exemption.\u003c/p>\n\u003cp>“This is about the same guidance we got to begin with,” said Paul Lavigne, executive director of the Greater Anaheim Special Education Local Plan Area. “The law is vague on it. It says students need to receive IEP services but it also says they need to be vaccinated. More guidance would be great.”\u003c/p>\n\u003cp>“I would have hoped that if the state were to clarify this, they would provide a little more specific clarification than that,” said Jonathan Read, a partner at the law firm Fagen Friedman & Fulfrost.\u003c/p>\n\u003cp>At the same time, a March 1 revision to the California Department of Education Audit Guide, which instructs auditors how to monitor district compliance with the law, states that auditors who are checking on immunization compliance \u003ca class=\"external\" href=\"https://www.documentcloud.org/documents/2822871-2015-16-Supplemental-Audit-Guide-March-2016-PDF-1.html#document/p44/a292701\" target=\"_blank\">should exclude\u003c/a> students who have individualized education programs and receive special education services.\u003c/p>\n\u003cp>Wenkart said the audit guidance would create further confusion. “That will give people the false impression that these kids don’t have to be vaccinated,” he said.\u003c/p>\n\u003cp>With this much uncertainty, the issue will likely make its way to court, said Rhoten of the statewide special education association. “What happens is that case law gets made,” he said.\u003c/p>\n\u003cp>Rhoten offered this scenario: A district decides that an unvaccinated special education student must be taught at home. The student’s parents file a complaint, arguing that their child is not receiving a “free and appropriate education” in the least restrictive environment. The matter goes before an administrative judge in a due process hearing. The judge considers the student’s right to special education services as well as the school’s obligation to protect the health and safety of other students and staff. One way or another, a ruling is made.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Then things get decided,” Rhoten said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Let the courts decide.\u003c/p>\n\u003cp>That appears to be the stance of the California Department of Education as state regulators have so far declined to answer pleas from school districts to clarify what California’s new vaccination law means for the 700,000 students who receive special education services.\u003c/p>\n\u003caside class=\"pullquote alignright\">Tension between state law mandating vaccines for virtually all students and federal law requiring services for special ed students \u003c/aside>\n\u003cp>Known as \u003ca class=\"external\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">Senate Bill 277\u003c/a>, the state law makes California one of \u003ca class=\"external\" href=\"http://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx\" target=\"_blank\">three\u003c/a> states to permit exemptions to school vaccinations only for medical reasons.\u003c/p>\n\u003cp>Gone are exemptions based on religious or personal beliefs. The law says all public and private school students must be vaccinated against 10 communicable diseases unless they have a medical exemption, they are home-schooled or they are enrolled in independent study with no classroom instruction.\u003c/p>\n\u003cp>With school districts beginning to enforce the law on July 1, legal experts say a conflict is likely to arise between the state mandate and the federal Individuals with Disabilities Education Act, which says students who qualify for special education services, such as intensive reading interventions that are provided in general classrooms, must receive those services. A conflict also has the potential to unite two impassioned groups of parents — those who oppose vaccinations and those who insist on the right of students to receive special education services in mainstream classrooms, attorneys said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But what if the special education student is unvaccinated? Would that student be allowed to attend school? Or would an unvaccinated special education student have to receive services at home? Lawyers have lined up on both sides of the issue, offering conflicting opinions on how the state law intends school districts to carry out its mandate. It’s an argument that lawyers on both sides say is likely to end up in court.\u003c/p>\n\u003cp>The California Department of Education has said it will not be providing guidance on interpreting the new law, although it typically does so with new legislation, said Greg Rhoten, chairman of the Special Education Local Plan Area Administrators of California, which represents special education programs in the state. Rhoten said he asked two experts -- Fred Balcom, the director of the special education division of the California Department of Education who retired last year, and Chris Drouin, now the interim director of special education -- for guidance from the department and was told by both that none would be forthcoming.\u003c/p>\n\u003cp>He said he was told to follow guidance from the California Department of Public Health. “That wasn’t helpful to us,” Rhoten said, noting that public health department officials are not likely to be well-versed in special education law.\u003c/p>\n\u003cp>“I assume the state is trying to be careful about assuming risk for interpretation of the law,” which could make the department a party to a lawsuit, Rhoten said. “In the end, it’s the implementers,” he said, referring to the school districts. “They’re the ones who have to make the calls and do their best.”\u003c/p>\n\u003cp>In lieu of state guidance, districts have hired lawyers or turned to their general counsel for advice on how to proceed. Los Angeles Unified School District, which serves more than 640,000 K-12 students, said that on the advice of legal counsel, the district \u003ca href=\"http://edsource.org/2016/some-districts-exempt-students-in-special-ed-from-vaccination-law/92868\">will not require\u003c/a> students in special education to comply with required immunizations if that requirement would prevent them from getting services, including instruction in general education classrooms, to which they are legally entitled.\u003c/p>\n\u003cp>The California Department of Education referred media inquiries about the vaccination law to the California Department of Public Health, which in turn, referred questioners to its \u003ca class=\"external\" href=\"http://www.shotsforschool.org/laws/sb277faq/\" target=\"_blank\">Senate Bill 277 Frequently Asked Questions\u003c/a> web page. Last month, the department quietly posted \u003ca class=\"external\" href=\"http://www.shotsforschool.org/laws/sb277faq/#Q3A\" target=\"_blank\">an update\u003c/a> that had been long anticipated by districts, but the information fell short of providing helpful guidance, some lawyers said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In describing students who have individualized education programs through special education, the update explained in words underlined for emphasis that “parents or guardians must continue to provide immunization records for these students to their schools, and schools must continue to maintain and report records of immunizations that have been received for these students.”\u003c/p>\n\u003cp>But does “continue to provide immunization records” mean that students in special education must be vaccinated? Ronald Wenkart, general counsel for the Orange County Office of Education, says it does. “You wouldn’t have a record if you were not immunized,” said Wenkart, who has become a bit of a Kremlinologist in trying to decipher the text of the law and the public health department updates. His office has advised districts that the intention of the law — to improve immunization rates — calls for all students who receive special education services to be vaccinated, unless they have a medical exemption.\u003c/p>\n\u003cp>“This is about the same guidance we got to begin with,” said Paul Lavigne, executive director of the Greater Anaheim Special Education Local Plan Area. “The law is vague on it. It says students need to receive IEP services but it also says they need to be vaccinated. More guidance would be great.”\u003c/p>\n\u003cp>“I would have hoped that if the state were to clarify this, they would provide a little more specific clarification than that,” said Jonathan Read, a partner at the law firm Fagen Friedman & Fulfrost.\u003c/p>\n\u003cp>At the same time, a March 1 revision to the California Department of Education Audit Guide, which instructs auditors how to monitor district compliance with the law, states that auditors who are checking on immunization compliance \u003ca class=\"external\" href=\"https://www.documentcloud.org/documents/2822871-2015-16-Supplemental-Audit-Guide-March-2016-PDF-1.html#document/p44/a292701\" target=\"_blank\">should exclude\u003c/a> students who have individualized education programs and receive special education services.\u003c/p>\n\u003cp>Wenkart said the audit guidance would create further confusion. “That will give people the false impression that these kids don’t have to be vaccinated,” he said.\u003c/p>\n\u003cp>With this much uncertainty, the issue will likely make its way to court, said Rhoten of the statewide special education association. “What happens is that case law gets made,” he said.\u003c/p>\n\u003cp>Rhoten offered this scenario: A district decides that an unvaccinated special education student must be taught at home. The student’s parents file a complaint, arguing that their child is not receiving a “free and appropriate education” in the least restrictive environment. The matter goes before an administrative judge in a due process hearing. The judge considers the student’s right to special education services as well as the school’s obligation to protect the health and safety of other students and staff. One way or another, a ruling is made.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Stanford Study: How To Teach Children That Failure Is Secret To Success",
"title": "Stanford Study: How To Teach Children That Failure Is Secret To Success",
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"content": "\u003cp>Is failure a positive opportunity to learn and grow, or is it a negative experience that hinders success? How parents answer that question has a big influence on how much children think they can improve their intelligence through hard work, a study says.\u003c/p>\n\u003cp>\"Parents are a really critical force in child development when you think about how motivation and mindsets develop,\" says \u003ca href=\"http://https/psychology.stanford.edu/node/2343\">Kyla Haimovitz\u003c/a>, a professor of psychology at Stanford University. She coauthored the \u003ca href=\"http://pss.sagepub.com/content/early/2016/04/23/0956797616639727.abstract\" target=\"_blank\">study, published\u003c/a> in \u003cem>Psychological Science\u003c/em> with colleague \u003ca href=\"http://https/psychology.stanford.edu/cdweck\">Carol Dweck\u003c/a>, who \u003ca href=\"http://https/www.ted.com/speakers/carol_dweck\">pioneered\u003c/a> \u003ca href=\"http://mindsetonline.com/abouttheauthor/\">research on mindsets\u003c/a>. \"Parents have this powerful effect really early on and throughout childhood to send messages about what is failure, how to respond to it.\"\u003c/p>\n\u003cp>Although there's been a lot of research on how these forces play out, relatively little looks at what parents can do to motivate their kids in school, Haimovitz says. This study begins filling that gap.\u003c/p>\n\u003cp>\"There is a fair amount of evidence showing that when children view their abilities as more malleable and something they can change over time, then they deal with obstacles in a more constructive way,\" says \u003ca href=\"http://heymanlab.ucsd.edu/\">Gail Heyman\u003c/a>, a professor of psychology at the University of California at San Diego who was not involved in this study.\u003c/p>\n\u003cp>But communicating that message to children is not so .\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Parents need to represent this to their kids in the ways they react about their kids' failures and setbacks,\" Haimovitz says. \"We need to really think about what's visible to the other person, what message I'm sending in terms of my words and my deeds.\"\u003c/p>\n\u003cp>In other words, if a child comes home with a D on a math test, how a parent responds will influence how the child perceives their own ability to learn math. Even a well-intentioned, comforting response of \"It's okay, you're still a great writer\" may send the message that it's time to give up on math rather than learn from the problems they got wrong, Haimovitz explains.\u003c/p>\n\u003cp>She and Dweck conducted a series of smaller studies to explore how the interactions between parents' failure and intelligence mindsets affected their children's beliefs about intelligence.\u003c/p>\n\u003cp>First they interviewed 73 parents and their fourth- and fifth-grade children about their beliefs on failure and intelligence. The parents were mostly mothers with at least a college degree; they lived in the Bay Area. The questions focused on whether they viewed intelligence as something that could change and whether they saw failure as positive, facilitating growth and enhancing productivity or as negative, debilitating and inhibiting learning.\u003c/p>\n\u003cp>The way children perceived \"being smart\" was not related to how their parents perceived intelligence, but it was related to how their parents reacted toward failure.\u003c/p>\n\u003cp>\"Parents who had more of a failure-is-debilitating mindset had children who were significantly more likely to believe that intelligence is fixed,\" they found, even after accounting for how parents perceived their children's academic success.\u003c/p>\n\u003cp>\"The more parents believed that failure is debilitating, the more likely their children were to see them as concerned with their performance outcomes and grades rather than their learning and improvement,\" the study found.\u003c/p>\n\u003cp>Then the researchers surveyed 160 different parents online to find out how they would respond to their child coming home with a failing quiz grade. Those who saw failure as negative were more likely to worry about their child's abilities in that subject or to comfort their child about not being talented in all subjects. But parents who saw failure as an opportunity were more likely to ask their child what they learned from the quiz, what they still can learn and whether asking the teacher for help would be useful.\u003c/p>\n\u003cp>Through two more surveys of 102 Bay Area parents and their children and 100 fourth- and fifth-grade students, the researchers found that children could correctly identify their parents' beliefs about failure but not necessarily about intelligence — and it was the former that matched up with the children's own beliefs about intelligence. Finally, the researchers conducted a randomized experiment with 132 parents to discover whether parents' failure beliefs directly cause their children's beliefs through parents' reactions to failure: they did.\u003c/p>\n\u003cp>\"The takeaway is that when your child is struggling on something or has setbacks, don't focus on their abilities, focus on what they can learn from it,\" Haimovitz says. One way, she says, is to ask a child: \"How can you use this as a jumping-off point?\"\u003c/p>\n\u003cp>But it's unclear how much the study's findings relate to children of various ethnic, racial and socioeconomic backgrounds. Related research Heyman has done in China revealed a mixed bag in terms of results.\u003c/p>\n\u003cp>\"Cultures have very different beliefs about effort and ability, and asking subtly different questions you can get different answers,\" Heyman says.\u003c/p>\n\u003cp>Whereas academic success often correlates with athletic or social success among white students, the same is not necessarily true among black or Latino students, according to \u003ca href=\"http://gero.usc.edu/faculty/abdou/\">Cleopatra Abdou\u003c/a>, an assistant professor of psychology at the University of Southern California. What is consistent across cultures, however, is the powerful influence that beliefs people internalize as children follow them through life.\u003c/p>\n\u003cp>\"The messages we get from our parents, whether explicitly or symbolically or subconsciously, stay with us and are very hard to unlearn and to overcome\" if they're not helpful, she says. \"Sometimes we have internalized faulty beliefs or beliefs that don't serve us.\"\u003c/p>\n\u003cp>Further, taking the learn-from-failure message too far might backfire eventually. \"If you're being told this message you can learn anything and you've done everything you can and you're not getting anywhere, then maybe at a certain point you say you're going to say I just don't believe this,\" she adds.\u003c/p>\n\u003cp>Further, children's mindsets can also be influenced by their temperament, such as their tolerance for frustration, she says.\u003c/p>\n\u003cp>\"One thing we do know in recent years, there's too much blaming of parents,\" Heyman says. \"Temperament is extremely important and it's biologically based, and to deny that causes all kinds of problems.\"\u003c/p>\n\u003cp>The challenge for parents is to support children without setting them up for failure.\u003c/p>\n\u003cp>\"There's this very difficult fine line between parents and teachers helping children enough so that they can do things on their own that they couldn't do otherwise but not to help them so much that they expect other people to do it for them and don't get pulled up to a higher level,\" Heyman says. \"You slowly pull back as the kids get better on their own. but not let them flail around so much that they get frustrated and give up.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Tara Haelle is the co-author of \u003c/em>\u003ca href=\"http://www.npr.org/books/titles/473075468/the-informed-parent-a-science-based-resource-for-your-childs-first-four-years\">The Informed Parent: A Science-Based Resource for Your Child's First Four Years\u003c/a>\u003cem>. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/tarahaelle\">@tarahaelle\u003c/a>\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+To+Teach+Children+That+Failure+Is+The+Secret+To+Success&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Is failure a positive opportunity to learn and grow, or is it a negative experience that hinders success? How parents answer that question has a big influence on how much children think they can improve their intelligence through hard work, a study says.\u003c/p>\n\u003cp>\"Parents are a really critical force in child development when you think about how motivation and mindsets develop,\" says \u003ca href=\"http://https/psychology.stanford.edu/node/2343\">Kyla Haimovitz\u003c/a>, a professor of psychology at Stanford University. She coauthored the \u003ca href=\"http://pss.sagepub.com/content/early/2016/04/23/0956797616639727.abstract\" target=\"_blank\">study, published\u003c/a> in \u003cem>Psychological Science\u003c/em> with colleague \u003ca href=\"http://https/psychology.stanford.edu/cdweck\">Carol Dweck\u003c/a>, who \u003ca href=\"http://https/www.ted.com/speakers/carol_dweck\">pioneered\u003c/a> \u003ca href=\"http://mindsetonline.com/abouttheauthor/\">research on mindsets\u003c/a>. \"Parents have this powerful effect really early on and throughout childhood to send messages about what is failure, how to respond to it.\"\u003c/p>\n\u003cp>Although there's been a lot of research on how these forces play out, relatively little looks at what parents can do to motivate their kids in school, Haimovitz says. This study begins filling that gap.\u003c/p>\n\u003cp>\"There is a fair amount of evidence showing that when children view their abilities as more malleable and something they can change over time, then they deal with obstacles in a more constructive way,\" says \u003ca href=\"http://heymanlab.ucsd.edu/\">Gail Heyman\u003c/a>, a professor of psychology at the University of California at San Diego who was not involved in this study.\u003c/p>\n\u003cp>But communicating that message to children is not so .\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Parents need to represent this to their kids in the ways they react about their kids' failures and setbacks,\" Haimovitz says. \"We need to really think about what's visible to the other person, what message I'm sending in terms of my words and my deeds.\"\u003c/p>\n\u003cp>In other words, if a child comes home with a D on a math test, how a parent responds will influence how the child perceives their own ability to learn math. Even a well-intentioned, comforting response of \"It's okay, you're still a great writer\" may send the message that it's time to give up on math rather than learn from the problems they got wrong, Haimovitz explains.\u003c/p>\n\u003cp>She and Dweck conducted a series of smaller studies to explore how the interactions between parents' failure and intelligence mindsets affected their children's beliefs about intelligence.\u003c/p>\n\u003cp>First they interviewed 73 parents and their fourth- and fifth-grade children about their beliefs on failure and intelligence. The parents were mostly mothers with at least a college degree; they lived in the Bay Area. The questions focused on whether they viewed intelligence as something that could change and whether they saw failure as positive, facilitating growth and enhancing productivity or as negative, debilitating and inhibiting learning.\u003c/p>\n\u003cp>The way children perceived \"being smart\" was not related to how their parents perceived intelligence, but it was related to how their parents reacted toward failure.\u003c/p>\n\u003cp>\"Parents who had more of a failure-is-debilitating mindset had children who were significantly more likely to believe that intelligence is fixed,\" they found, even after accounting for how parents perceived their children's academic success.\u003c/p>\n\u003cp>\"The more parents believed that failure is debilitating, the more likely their children were to see them as concerned with their performance outcomes and grades rather than their learning and improvement,\" the study found.\u003c/p>\n\u003cp>Then the researchers surveyed 160 different parents online to find out how they would respond to their child coming home with a failing quiz grade. Those who saw failure as negative were more likely to worry about their child's abilities in that subject or to comfort their child about not being talented in all subjects. But parents who saw failure as an opportunity were more likely to ask their child what they learned from the quiz, what they still can learn and whether asking the teacher for help would be useful.\u003c/p>\n\u003cp>Through two more surveys of 102 Bay Area parents and their children and 100 fourth- and fifth-grade students, the researchers found that children could correctly identify their parents' beliefs about failure but not necessarily about intelligence — and it was the former that matched up with the children's own beliefs about intelligence. Finally, the researchers conducted a randomized experiment with 132 parents to discover whether parents' failure beliefs directly cause their children's beliefs through parents' reactions to failure: they did.\u003c/p>\n\u003cp>\"The takeaway is that when your child is struggling on something or has setbacks, don't focus on their abilities, focus on what they can learn from it,\" Haimovitz says. One way, she says, is to ask a child: \"How can you use this as a jumping-off point?\"\u003c/p>\n\u003cp>But it's unclear how much the study's findings relate to children of various ethnic, racial and socioeconomic backgrounds. Related research Heyman has done in China revealed a mixed bag in terms of results.\u003c/p>\n\u003cp>\"Cultures have very different beliefs about effort and ability, and asking subtly different questions you can get different answers,\" Heyman says.\u003c/p>\n\u003cp>Whereas academic success often correlates with athletic or social success among white students, the same is not necessarily true among black or Latino students, according to \u003ca href=\"http://gero.usc.edu/faculty/abdou/\">Cleopatra Abdou\u003c/a>, an assistant professor of psychology at the University of Southern California. What is consistent across cultures, however, is the powerful influence that beliefs people internalize as children follow them through life.\u003c/p>\n\u003cp>\"The messages we get from our parents, whether explicitly or symbolically or subconsciously, stay with us and are very hard to unlearn and to overcome\" if they're not helpful, she says. \"Sometimes we have internalized faulty beliefs or beliefs that don't serve us.\"\u003c/p>\n\u003cp>Further, taking the learn-from-failure message too far might backfire eventually. \"If you're being told this message you can learn anything and you've done everything you can and you're not getting anywhere, then maybe at a certain point you say you're going to say I just don't believe this,\" she adds.\u003c/p>\n\u003cp>Further, children's mindsets can also be influenced by their temperament, such as their tolerance for frustration, she says.\u003c/p>\n\u003cp>\"One thing we do know in recent years, there's too much blaming of parents,\" Heyman says. \"Temperament is extremely important and it's biologically based, and to deny that causes all kinds of problems.\"\u003c/p>\n\u003cp>The challenge for parents is to support children without setting them up for failure.\u003c/p>\n\u003cp>\"There's this very difficult fine line between parents and teachers helping children enough so that they can do things on their own that they couldn't do otherwise but not to help them so much that they expect other people to do it for them and don't get pulled up to a higher level,\" Heyman says. \"You slowly pull back as the kids get better on their own. but not let them flail around so much that they get frustrated and give up.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Tara Haelle is the co-author of \u003c/em>\u003ca href=\"http://www.npr.org/books/titles/473075468/the-informed-parent-a-science-based-resource-for-your-childs-first-four-years\">The Informed Parent: A Science-Based Resource for Your Child's First Four Years\u003c/a>\u003cem>. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/tarahaelle\">@tarahaelle\u003c/a>\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+To+Teach+Children+That+Failure+Is+The+Secret+To+Success&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA to Permit Folic Acid in Corn Masa to Prevent Birth Defects",
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"content": "\u003cp>It's been almost 20 years since the Food and Drug Administration (FDA) required that folic acid, a B vitamin that can prevent a serious birth defect when taken by pregnant women, be added to certain enriched grains like breads and pasta. In the decade after, the rate of these neural tube defects plummeted and is estimated to have prevented 10,000 cases in a decade.\u003c/p>\n\u003cp>But corn masa was not included in the FDA's recommendation back in the '90s, and since then the Hispanic population of the U.S. has grown dramatically. Now a quarter of all babies are born to Hispanic mothers, and they have a \u003ca href=\"http://www.cdc.gov/mmWR/pdf/wk/mm6401.pdf\" target=\"_blank\">much higher risk \u003c/a>of neural tube defects than their white counterparts.\u003c/p>\n\u003cp>On Thursday, \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm496104.htm\" target=\"_blank\">the FDA announced \u003c/a>that folic acid may be added to corn masa flour, a staple for many Hispanic families, with a goal of reducing the risk of neural tube defects.\u003c/p>\n\u003cp>Advocacy groups, including the March of Dimes, have been lobbying the FDA for years to make the recommendation. They applauded the move.\u003c/p>\n\u003cp>\u003ca href=\"http://www.prnewswire.com/news-releases/advocates-hail-fda-decision-to-improve-infant-health-prevent-birth-defects-300251337.html#continue-jump\" target=\"_blank\">In a statement\u003c/a>, March of Dimes president Dr. Jennifer Howse called the announcement a \"major victory for maternal and child health, especially in our Hispanic communities.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a developing fetus, the neural tube starts as a flat ribbon and develops into a tube by the end of the first month of pregnancy. The tube goes on to develop into the brain and spinal cord. \u003ca href=\"http://www.marchofdimes.org/complications/neural-tube-defects.aspx#\" target=\"_blank\">Serious defects \u003c/a>can happen if the tube does not close completely. That can lead to conditions such as spina bifida.\u003c/p>\n\u003cp>But if a woman consumes appropriate amounts of folic acid -- 400 micrograms a day -- before becoming pregnant, it can prevent many cases of neural tube defects, \u003ca href=\"http://www.cdc.gov/features/folicacidbenefits/\" target=\"_blank\">according to the Centers for Disease Control and Prevention\u003c/a>. Most multivitamins contain the recommended amount of folic acid, and many fortified cereals -- now soon to include masa flour -- also can provide the amount of folic acid women need each day.\u003c/p>\n\u003cp>The only question is if the FDA delayed in making the recommendation, reports the\u003ca href=\"http://www.seattletimes.com/seattle-news/health/fda-to-allow-folic-acid-in-corn-masa-to-stop-birth-defects/\" target=\"_blank\"> Seattle Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Adding folic acid to corn masa could prevent an average of 40 neural-tube defects in Hispanic women each year, and as many as 120 annually across the nation, \u003ca class=\"content-link external\" href=\"http://onlinelibrary.wiley.com/doi/10.1111/nyas.12325/abstract\" target=\"_blank\">according to research\u003c/a> by the Centers for Disease Control and Prevention (CDC).\u003c/p>\n\u003cp>Critics, including a former director of the CDC’s birth-defects division, said about 800 defects could have been prevented if the action had been taken earlier.\u003c/p>\n\u003cp>“That’s great news,” said Dr. Godfrey Oakley, director of the Center for Spina Bifida Research, Prevention and Policy at Emory University. “It’s only about 20 years too late.”\u003c/p>\n\u003cp>Susan Mayne [director of the FDA Center for Food Safety and Applied Nutrition], said the agency was required to follow the rules governing additives in the food supply.\u003c/p>\n\u003cp>“The big hitch, obviously, is that we need data,” she said. “Once we had the data, the process went very quickly.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The Times also reported that Gruma, the world's largest maker of corn masa flour already adds folic acid to masa flour in other countries, and will begin adding the vitamin to its U.S. products as soon as manufacturing plants can be reconfigured.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's been almost 20 years since the Food and Drug Administration (FDA) required that folic acid, a B vitamin that can prevent a serious birth defect when taken by pregnant women, be added to certain enriched grains like breads and pasta. In the decade after, the rate of these neural tube defects plummeted and is estimated to have prevented 10,000 cases in a decade.\u003c/p>\n\u003cp>But corn masa was not included in the FDA's recommendation back in the '90s, and since then the Hispanic population of the U.S. has grown dramatically. Now a quarter of all babies are born to Hispanic mothers, and they have a \u003ca href=\"http://www.cdc.gov/mmWR/pdf/wk/mm6401.pdf\" target=\"_blank\">much higher risk \u003c/a>of neural tube defects than their white counterparts.\u003c/p>\n\u003cp>On Thursday, \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm496104.htm\" target=\"_blank\">the FDA announced \u003c/a>that folic acid may be added to corn masa flour, a staple for many Hispanic families, with a goal of reducing the risk of neural tube defects.\u003c/p>\n\u003cp>Advocacy groups, including the March of Dimes, have been lobbying the FDA for years to make the recommendation. They applauded the move.\u003c/p>\n\u003cp>\u003ca href=\"http://www.prnewswire.com/news-releases/advocates-hail-fda-decision-to-improve-infant-health-prevent-birth-defects-300251337.html#continue-jump\" target=\"_blank\">In a statement\u003c/a>, March of Dimes president Dr. Jennifer Howse called the announcement a \"major victory for maternal and child health, especially in our Hispanic communities.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a developing fetus, the neural tube starts as a flat ribbon and develops into a tube by the end of the first month of pregnancy. The tube goes on to develop into the brain and spinal cord. \u003ca href=\"http://www.marchofdimes.org/complications/neural-tube-defects.aspx#\" target=\"_blank\">Serious defects \u003c/a>can happen if the tube does not close completely. That can lead to conditions such as spina bifida.\u003c/p>\n\u003cp>But if a woman consumes appropriate amounts of folic acid -- 400 micrograms a day -- before becoming pregnant, it can prevent many cases of neural tube defects, \u003ca href=\"http://www.cdc.gov/features/folicacidbenefits/\" target=\"_blank\">according to the Centers for Disease Control and Prevention\u003c/a>. Most multivitamins contain the recommended amount of folic acid, and many fortified cereals -- now soon to include masa flour -- also can provide the amount of folic acid women need each day.\u003c/p>\n\u003cp>The only question is if the FDA delayed in making the recommendation, reports the\u003ca href=\"http://www.seattletimes.com/seattle-news/health/fda-to-allow-folic-acid-in-corn-masa-to-stop-birth-defects/\" target=\"_blank\"> Seattle Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Adding folic acid to corn masa could prevent an average of 40 neural-tube defects in Hispanic women each year, and as many as 120 annually across the nation, \u003ca class=\"content-link external\" href=\"http://onlinelibrary.wiley.com/doi/10.1111/nyas.12325/abstract\" target=\"_blank\">according to research\u003c/a> by the Centers for Disease Control and Prevention (CDC).\u003c/p>\n\u003cp>Critics, including a former director of the CDC’s birth-defects division, said about 800 defects could have been prevented if the action had been taken earlier.\u003c/p>\n\u003cp>“That’s great news,” said Dr. Godfrey Oakley, director of the Center for Spina Bifida Research, Prevention and Policy at Emory University. “It’s only about 20 years too late.”\u003c/p>\n\u003cp>Susan Mayne [director of the FDA Center for Food Safety and Applied Nutrition], said the agency was required to follow the rules governing additives in the food supply.\u003c/p>\n\u003cp>“The big hitch, obviously, is that we need data,” she said. “Once we had the data, the process went very quickly.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>The Times also reported that Gruma, the world's largest maker of corn masa flour already adds folic acid to masa flour in other countries, and will begin adding the vitamin to its U.S. products as soon as manufacturing plants can be reconfigured.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report",
"title": "Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>The State of California’s dental health system for the poor is “dysfunctional” according to a \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">scathing report\u003c/a> issued Friday by a bipartisan oversight commission.\u003c/p>\n\u003cp>The program, Denti-Cal, “ranks among state government’s greatest deficiencies,” said the report by the \u003ca href=\"http://www.lhc.ca.gov/about/about.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, a statutorily independent oversight agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In California we have kids’ teeth rotting out of their heads.'\u003ccite> Pedro Nava, Chairman, Little Hoover Commission \u003c/cite>\u003c/aside>\n\u003cp>The state bureaucracy that runs Denti-Cal draws only part of the blame. The legislature, the governor’s office, and the political culture of California share culpability for decades of neglect and strategic misdirection, the commission says.\u003c/p>\n\u003cp>The program falls “disastrously short in providing dental care to a third of California’s population and more than half of its children.”\u003c/p>\n\u003cp>A more vivid description comes from Pedro Nava, the commission’s chairman:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“In California we have kids’ teeth rotting out of their heads,” he says. “That’s utterly inexcusable.”\u003c/p>\n\u003cp>\u003cb>Dental Profession 'Thoroughly Alienated'\u003c/b>\u003c/p>\n\u003cp>The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities, children and adults are plagued with toothaches, whole counties have no Denti-Cal providers and families don’t understand basic preventative dental care,” it said.\u003c/p>\n\u003cp>Meanwhile, Denti-Cal has “thoroughly alienated the dental profession” with tangles of red tape and “reimbursement rates among the nation’s lowest,” the report said.\u003c/p>\n\u003cp>In sum, the commission said it’s time to “reboot” Denti-Cal.\u003c/p>\n\u003cp>[contextly_sidebar id=\"MvOmIplCazK7Ew4ddY2etXumhgCTSgzr\"]The program is run by the state Department of Health Care Services, which oversees Medi-Care, California’s version of Medicaid.\u003c/p>\n\u003cp>The department released a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/californiahealthline-denti-cal-040116.pdf\" target=\"_blank\">lengthy prepared response to questions\u003c/a> from CHL, which includes this statement:\u003c/p>\n\u003cp>“DHCS is strongly committed to providing access to quality dental care for our millions of Medi-Cal members, and Director Jennifer Kent has publicly stated that improving the Denti-Cal program is one of her top priorities.”\u003c/p>\n\u003cp>Nava has heard it before. “I have been completely underwhelmed by the response of the department,” he said. “Their efforts have been far too little and far too late.”\u003c/p>\n\u003cp>It’s not just the department though. Acccording to the report, “Blame goes so much deeper.”\u003c/p>\n\u003cp>“Successive legislatures and administrations,” the commission said, “have underfunded the Denti-Cal program and slashed reimbursement rates for dental providers to national lows. The state has historically lacked any strategy to prevent dental disease among its neediest populations.”\u003c/p>\n\u003cp>Evidence is widespread that bad dental health can seriously affect general health, making more people sick and driving health costs even higher.\u003c/p>\n\u003cp>But in California, there is a Denti-Cal dentist shortage.\u003c/p>\n\u003cp>Many dentists say they lose money on state-funded patients, so caring for them becomes a form of charity work.\u003c/p>\n\u003cp>John Blake is a dentist who gave up a private practice in Long Beach to run the Children’s Dental Health Clinic in Long Beach, where about 85 percent of patients are on Denti-Cal.\u003c/p>\n\u003cp>Blake said he just wants to break even — the business is a non-profit — 25 percent of his overhead is paid for through donations and fund-raising events. It’s impossible to cover costs with the low payments from the state, he said.\u003c/p>\n\u003cp>“A lot of my colleagues used to take Denti-Cal, but it’s not just the low rates, it’s that the hassle of the system is so much worse than reimbursement. The hassle factor just got to be too much,” Blake said. “They just gave up.”\u003c/p>\n\u003cp>Little Hoover more formally addressed the hassle factor, noting that copious pre-authorizations for basic procedures are a major hassle, never mind a a clunky billing system, much of it still paper-based, and a 22-page application form just to participate in the program.\u003c/p>\n\u003cp>Camille Nishikawa is a dentist in Los Angeles who doesn’t have those problems. She runs the QueensCare mobile dental clinic in partnership with USC Medical Center, which travels to the poorest parts of LA to take care of kids’ teeth. The mobile dental van is funded by grants; it doesn’t accept any money from patients or from Denti-Cal.\u003c/p>\n\u003cp>\u003cstrong>Children 'Suffer in Pain'\u003c/strong>\u003c/p>\n\u003cp>Organizational dysfunction is only part of the problem with Denti-Cal, Nishikawa said. Many poor people who are eligible for the program’s benefits don’t even know about them.\u003c/p>\n\u003cp>“A lot of the community isn’t aware of what they’re entitled to,” she said. “And if they do, they don’t know where to go to find a dentist.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"YqwmVIo7HQrzTrqAnpvYUxl7c1QcyMYV\"]Ruth Sandoval is one of those low-income people, a mostly Spanish-speaking mother of two in Los Angeles. She said she had no idea she and her two children could even get dental care as part of their Medi-Cal program. “It has been hard to find a dentist; it’s very hard to find one,” Sandoval said.\u003c/p>\n\u003cp>She went to a clinic in LA for a different health problem and discovered a dentist on staff. She’s grateful for that, she said, because she wouldn’t have a dentist otherwise. “It’s so important to us, we were so happy to find her there,” Sandoval said.\u003c/p>\n\u003cp>Most low-income Californians aren’t that lucky. Only about half of the children eligible for dental coverage actually see a dentist, said Jenny Kattlove of the Santa Monica-based Children’s Partnership advocacy group.\u003c/p>\n\u003cp>She said the severity of the dental problem was accurately outlined in the Little Hoover report, saying it lays out “an ambitious but necessary path” toward revamping the entire low-income dental system.\u003c/p>\n\u003cp>People think of dental care as just getting a teeth-cleaning, and that it’s not seen as a health issue.\u003c/p>\n\u003cp>“Look, when children don’t get the oral health care they need, they suffer in pain,” she said. “Untreated dental problems actually can lead to death, I don’t know what’s more health-related than that.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Nava said access problems may only get worse as more Californians are added to the Medi-Cal rolls. In mid-May, an estimated 170,000 undocumented children will become eligible for full Medi-Cal benefits, including dental care, and Nava worries that they won’t get it.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The State of California’s dental health system for the poor is “dysfunctional” according to a \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">scathing report\u003c/a> issued Friday by a bipartisan oversight commission.\u003c/p>\n\u003cp>The program, Denti-Cal, “ranks among state government’s greatest deficiencies,” said the report by the \u003ca href=\"http://www.lhc.ca.gov/about/about.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, a statutorily independent oversight agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In California we have kids’ teeth rotting out of their heads.'\u003ccite> Pedro Nava, Chairman, Little Hoover Commission \u003c/cite>\u003c/aside>\n\u003cp>The state bureaucracy that runs Denti-Cal draws only part of the blame. The legislature, the governor’s office, and the political culture of California share culpability for decades of neglect and strategic misdirection, the commission says.\u003c/p>\n\u003cp>The program falls “disastrously short in providing dental care to a third of California’s population and more than half of its children.”\u003c/p>\n\u003cp>A more vivid description comes from Pedro Nava, the commission’s chairman:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“In California we have kids’ teeth rotting out of their heads,” he says. “That’s utterly inexcusable.”\u003c/p>\n\u003cp>\u003cb>Dental Profession 'Thoroughly Alienated'\u003c/b>\u003c/p>\n\u003cp>The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities, children and adults are plagued with toothaches, whole counties have no Denti-Cal providers and families don’t understand basic preventative dental care,” it said.\u003c/p>\n\u003cp>Meanwhile, Denti-Cal has “thoroughly alienated the dental profession” with tangles of red tape and “reimbursement rates among the nation’s lowest,” the report said.\u003c/p>\n\u003cp>In sum, the commission said it’s time to “reboot” Denti-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The program is run by the state Department of Health Care Services, which oversees Medi-Care, California’s version of Medicaid.\u003c/p>\n\u003cp>The department released a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/californiahealthline-denti-cal-040116.pdf\" target=\"_blank\">lengthy prepared response to questions\u003c/a> from CHL, which includes this statement:\u003c/p>\n\u003cp>“DHCS is strongly committed to providing access to quality dental care for our millions of Medi-Cal members, and Director Jennifer Kent has publicly stated that improving the Denti-Cal program is one of her top priorities.”\u003c/p>\n\u003cp>Nava has heard it before. “I have been completely underwhelmed by the response of the department,” he said. “Their efforts have been far too little and far too late.”\u003c/p>\n\u003cp>It’s not just the department though. Acccording to the report, “Blame goes so much deeper.”\u003c/p>\n\u003cp>“Successive legislatures and administrations,” the commission said, “have underfunded the Denti-Cal program and slashed reimbursement rates for dental providers to national lows. The state has historically lacked any strategy to prevent dental disease among its neediest populations.”\u003c/p>\n\u003cp>Evidence is widespread that bad dental health can seriously affect general health, making more people sick and driving health costs even higher.\u003c/p>\n\u003cp>But in California, there is a Denti-Cal dentist shortage.\u003c/p>\n\u003cp>Many dentists say they lose money on state-funded patients, so caring for them becomes a form of charity work.\u003c/p>\n\u003cp>John Blake is a dentist who gave up a private practice in Long Beach to run the Children’s Dental Health Clinic in Long Beach, where about 85 percent of patients are on Denti-Cal.\u003c/p>\n\u003cp>Blake said he just wants to break even — the business is a non-profit — 25 percent of his overhead is paid for through donations and fund-raising events. It’s impossible to cover costs with the low payments from the state, he said.\u003c/p>\n\u003cp>“A lot of my colleagues used to take Denti-Cal, but it’s not just the low rates, it’s that the hassle of the system is so much worse than reimbursement. The hassle factor just got to be too much,” Blake said. “They just gave up.”\u003c/p>\n\u003cp>Little Hoover more formally addressed the hassle factor, noting that copious pre-authorizations for basic procedures are a major hassle, never mind a a clunky billing system, much of it still paper-based, and a 22-page application form just to participate in the program.\u003c/p>\n\u003cp>Camille Nishikawa is a dentist in Los Angeles who doesn’t have those problems. She runs the QueensCare mobile dental clinic in partnership with USC Medical Center, which travels to the poorest parts of LA to take care of kids’ teeth. The mobile dental van is funded by grants; it doesn’t accept any money from patients or from Denti-Cal.\u003c/p>\n\u003cp>\u003cstrong>Children 'Suffer in Pain'\u003c/strong>\u003c/p>\n\u003cp>Organizational dysfunction is only part of the problem with Denti-Cal, Nishikawa said. Many poor people who are eligible for the program’s benefits don’t even know about them.\u003c/p>\n\u003cp>“A lot of the community isn’t aware of what they’re entitled to,” she said. “And if they do, they don’t know where to go to find a dentist.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Ruth Sandoval is one of those low-income people, a mostly Spanish-speaking mother of two in Los Angeles. She said she had no idea she and her two children could even get dental care as part of their Medi-Cal program. “It has been hard to find a dentist; it’s very hard to find one,” Sandoval said.\u003c/p>\n\u003cp>She went to a clinic in LA for a different health problem and discovered a dentist on staff. She’s grateful for that, she said, because she wouldn’t have a dentist otherwise. “It’s so important to us, we were so happy to find her there,” Sandoval said.\u003c/p>\n\u003cp>Most low-income Californians aren’t that lucky. Only about half of the children eligible for dental coverage actually see a dentist, said Jenny Kattlove of the Santa Monica-based Children’s Partnership advocacy group.\u003c/p>\n\u003cp>She said the severity of the dental problem was accurately outlined in the Little Hoover report, saying it lays out “an ambitious but necessary path” toward revamping the entire low-income dental system.\u003c/p>\n\u003cp>People think of dental care as just getting a teeth-cleaning, and that it’s not seen as a health issue.\u003c/p>\n\u003cp>“Look, when children don’t get the oral health care they need, they suffer in pain,” she said. “Untreated dental problems actually can lead to death, I don’t know what’s more health-related than that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When it comes to school breakfasts, two is better than none, says a new report released Thursday in the journal \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/ijpo.v11.2/issuetoc\" target=\"_blank\">Pediatric Obesity\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Researchers tracked nearly 600 middle-school students from fifth to seventh grade, looking to see if students ate no breakfast; ate breakfast at home or school; or ate both — and whether that affected obesity rates. The result: Weight gain among students who ate \"double-breakfast\" was no different than that seen among all other students. Meanwhile, the risk of obesity doubled among students who skipped breakfast or ate it inconsistently.\u003c/p>\n\u003cp>\"It seems it's a bigger problem to have kids skipping breakfast than to have these kids eating two breakfasts,\" says Marlene Schwartz of the \u003ca href=\"http://chip.uconn.edu/person/marlene-schwartz/\" target=\"_blank\">Rudd Center for Food Policy and Obesity\u003c/a> and one of the study's authors.\u003c/p>\n\u003cp>\"This study ... debunks an important misconception that school breakfast contributes to childhood obesity,\" says Duke Storen from \u003ca href=\"http://https/www.nokidhungry.org/about-us\" target=\"_blank\">Share Our Strength\u003c/a>, a national group that runs anti-hunger and nutrition programs for children.\u003c/p>\n\u003cp>While direct opposition to free school breakfast is unusual, says Storen, officials sometimes balk at implementing \"alternative breakfast models\" designed to encourage use of the program — such as offering breakfast in grab-and-go bags or in classrooms, rather than traditional sit-down meals in a cafeteria. That's a concern, say hunger advocates, because while eligibility rules for free and reduced-price breakfast are the same as for lunch, only about \u003ca href=\"http://frac.org/pdf/School_Breakfast_Scorecard_SY_2014_2015.pdf\" target=\"_blank\">half as many children get subsidized breakfast as receive lunch\u003c/a>, according to the Food Research and Action Center, an advocacy group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Indeed, the study was inspired in part by real-world concerns that school breakfast programs might promote obesity, says Schwartz.\u003c/p>\n\u003cp>In 2012, the administration of New York City's then-Mayor Michael Bloomberg \u003ca href=\"http://www.nytimes.com/2012/04/20/nyregion/with-classroom-breakfasts-some-children-may-eat-twice.html\" target=\"_blank\">opposed\u003c/a> offering breakfast in classrooms instead of school cafeterias, arguing that the change would exacerbate childhood obesity. A year later, an \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23947326\" target=\"_blank\">American Journal of Public Health study\u003c/a> showed that, on average, kids eating two breakfasts in New York City schools consumed 95 more calories daily than did those eating one breakfast.\u003c/p>\n\u003cp>Researchers of the new study didn't examine why eating double breakfasts did not affect obesity, but skipping the meal did. But Schwartz has a few hypotheses. First, school breakfast is fairly healthful; \"they weren't eating doughnuts or Denny's Grand Slam,\" she says.\u003c/p>\n\u003cp>Second, kids who skip breakfast — a habit that doubled in frequency between grades 5 and 7, according to the study — are likely to overeat later in the day. And, of course, just the fact that growing adolescents often need a lot of food to grow means that they can eat more without necessarily gaining weight.\u003c/p>\n\u003cp>The study also draws a direct line between school breakfast and fighting childhood hunger, underscoring the idea that malnourishment and obesity in the U.S. are not so much opposites as two sides of the same coin.\u003c/p>\n\u003cp>\"The latest figures show that 15 million children live in food insecure households,\" says Heather Hardline-Grafton, a senior researcher at FRAC. \"While obesity is a serious problem for many children in the United States, so, too, is food insecurity.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tracie McMillan is the author of \u003c/em>\u003ca href=\"http://www.americanwayofeating.com/\">The American Way of Eating\u003c/a>,\u003cem> a \u003c/em>New York Times \u003cem>best-seller, and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. You can follow her on Twitter @tmmcmillan.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=2+Breakfasts+May+Be+Better+Than+None+For+School+Kids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When it comes to school breakfasts, two is better than none, says a new report released Thursday in the journal \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/ijpo.v11.2/issuetoc\" target=\"_blank\">Pediatric Obesity\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>Researchers tracked nearly 600 middle-school students from fifth to seventh grade, looking to see if students ate no breakfast; ate breakfast at home or school; or ate both — and whether that affected obesity rates. The result: Weight gain among students who ate \"double-breakfast\" was no different than that seen among all other students. Meanwhile, the risk of obesity doubled among students who skipped breakfast or ate it inconsistently.\u003c/p>\n\u003cp>\"It seems it's a bigger problem to have kids skipping breakfast than to have these kids eating two breakfasts,\" says Marlene Schwartz of the \u003ca href=\"http://chip.uconn.edu/person/marlene-schwartz/\" target=\"_blank\">Rudd Center for Food Policy and Obesity\u003c/a> and one of the study's authors.\u003c/p>\n\u003cp>\"This study ... debunks an important misconception that school breakfast contributes to childhood obesity,\" says Duke Storen from \u003ca href=\"http://https/www.nokidhungry.org/about-us\" target=\"_blank\">Share Our Strength\u003c/a>, a national group that runs anti-hunger and nutrition programs for children.\u003c/p>\n\u003cp>While direct opposition to free school breakfast is unusual, says Storen, officials sometimes balk at implementing \"alternative breakfast models\" designed to encourage use of the program — such as offering breakfast in grab-and-go bags or in classrooms, rather than traditional sit-down meals in a cafeteria. That's a concern, say hunger advocates, because while eligibility rules for free and reduced-price breakfast are the same as for lunch, only about \u003ca href=\"http://frac.org/pdf/School_Breakfast_Scorecard_SY_2014_2015.pdf\" target=\"_blank\">half as many children get subsidized breakfast as receive lunch\u003c/a>, according to the Food Research and Action Center, an advocacy group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Indeed, the study was inspired in part by real-world concerns that school breakfast programs might promote obesity, says Schwartz.\u003c/p>\n\u003cp>In 2012, the administration of New York City's then-Mayor Michael Bloomberg \u003ca href=\"http://www.nytimes.com/2012/04/20/nyregion/with-classroom-breakfasts-some-children-may-eat-twice.html\" target=\"_blank\">opposed\u003c/a> offering breakfast in classrooms instead of school cafeterias, arguing that the change would exacerbate childhood obesity. A year later, an \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23947326\" target=\"_blank\">American Journal of Public Health study\u003c/a> showed that, on average, kids eating two breakfasts in New York City schools consumed 95 more calories daily than did those eating one breakfast.\u003c/p>\n\u003cp>Researchers of the new study didn't examine why eating double breakfasts did not affect obesity, but skipping the meal did. But Schwartz has a few hypotheses. First, school breakfast is fairly healthful; \"they weren't eating doughnuts or Denny's Grand Slam,\" she says.\u003c/p>\n\u003cp>Second, kids who skip breakfast — a habit that doubled in frequency between grades 5 and 7, according to the study — are likely to overeat later in the day. And, of course, just the fact that growing adolescents often need a lot of food to grow means that they can eat more without necessarily gaining weight.\u003c/p>\n\u003cp>The study also draws a direct line between school breakfast and fighting childhood hunger, underscoring the idea that malnourishment and obesity in the U.S. are not so much opposites as two sides of the same coin.\u003c/p>\n\u003cp>\"The latest figures show that 15 million children live in food insecure households,\" says Heather Hardline-Grafton, a senior researcher at FRAC. \"While obesity is a serious problem for many children in the United States, so, too, is food insecurity.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tracie McMillan is the author of \u003c/em>\u003ca href=\"http://www.americanwayofeating.com/\">The American Way of Eating\u003c/a>,\u003cem> a \u003c/em>New York Times \u003cem>best-seller, and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. You can follow her on Twitter @tmmcmillan.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=2+Breakfasts+May+Be+Better+Than+None+For+School+Kids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State Won't Move Fragile Kids to Managed Care -- For Now",
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"content": "\u003cp>Lauren Brady, a Whittier resident, has lived all her 19 years with Rett syndrome, a rare neurological illness that can cause seizures and limits muscle movement. She can’t speak, needs a feeding tube and uses a wheelchair to get around.\u003c/p>\n\u003cp>“It affects her from head to toe, but we don’t let all of that get in our way,” her mother, Sherri Brady said this week. “Lauren has lots of friends; she goes horseback riding. Next weekend she’s going on a ski trip.”\u003c/p>\n\u003cp>That Lauren can even contemplate those activities is testimony to a $2.9 billion a year state program, \u003ca href=\"http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx\" target=\"_blank\">California Children’s Services\u003c/a>, her mother said. The program provides specialized care to some 180,000 children and young adults who suffer from a range of complicated, debilitating illnesses including Rett syndrome, sickle cell anemia, cancer, cerebral palsy, hemophilia and more.\u003c/p>\n\u003cp>In recent years, Sherri Brady and other parents of children in the program have lived in fear that the care of their kids could be disrupted — at what they see as a great risk of physical and emotional harm. That’s because the state’s Department of Health Care Services ultimately wants to move all the children into managed care.\u003c/p>\n\u003cp>But the first phase of that move, which would have targeted just under one-fifth of the children beginning next January, is now on hold. The state Assembly’s influential budget subcommittee voted earlier this week to shelve it and send the department back to the drawing board. The Senate’s budget subcommittee is expected to endorse that ruling next week.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This means all of those children will be able to keep seeing the same providers and get the same services they’ve been receiving — at least for now.\u003c/p>\n\u003cp>That’s a big relief to their parents, who fear that in managed care their children could lose relationships with the caregivers who know them best and could face difficulty getting appointments with specialists.\u003c/p>\n\u003cp>“It’s wonderful that the legislators did this,” said Sherri Brady. But she knows her battle isn’t over.\u003c/p>\n\u003cp>The state has been under pressure for years to restructure the program both to improve the care it delivers and reduce its cost, according to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20A/PDF%20AssessingTheCAChildrensServicesProgram.pdf\" target=\"_blank\">study by the California Health Care Foundation\u003c/a>.\u003c/p>\n\u003cp>“This isn’t the end of it,” Brady said. We’ve been fighting it and we’ll keep fighting it.”\u003c/p>\n\u003cp>Brady has trouble understanding why the state wants to move the kids into managed care. “To make a change that could be harmful for individuals who already live with such harm, that’s just not right,” she said.\u003c/p>\n\u003cp>Jennifer Kent, director of the California Department of Health Care Services, testified to the Assembly subcommittee that the first-phase proposal to move nearly 20 percent of the the kids into managed care plans would provide them with better care.\u003c/p>\n\u003cp>“One of the key components is because (California Children's Services) is a program around a condition rather than a child, the different payers don’t look at the whole child,” Kent said. “We want to better manage the care of these children across the spectrum.”\u003c/p>\n\u003cp>Under managed care, health plans are paid fixed rates to cover and coordinate nearly all health care services for patients.\u003c/p>\n\u003cp>Kent told legislators the department’s plan was “budget-neutral,” meaning it would result neither in savings nor additional costs for taxpayers.\u003c/p>\n\u003cp>Nearly half the cost of the program, or about $1.4 billion, is paid for out of the state’s general fund, according to Kent’s department.\u003c/p>\n\u003cp>About 70 percent of children in the program get benefits from Medi-Cal, the state-federal health coverage program for people with low incomes. The other 30 percent have private insurance, but the state helps pay for some of the care not covered by their insurers. The federal and county governments also pick up a portion of the tab.\u003c/p>\n\u003cp>Assuming the Senate subcommittee concurs with its Assembly counterpart, the health department will be instructed to develop a new proposal requiring what is known in Capitol lingo as “enabling legislation,” and ultimately floor votes in both houses. The process is expected to take a long time, though nobody can say how long.\u003c/p>\n\u003cp>Child advocates fear that the ultimate outcome will be the same — the kids will end up being moved into managed care.\u003c/p>\n\u003cp>“The assumption has always been that the state wants to move all of the kids,” said Yvette Baptiste, executive director of the Eastern Los Angeles Family Resource Center in Alhambra, which helps children with developmental disabilities and their families.\u003c/p>\n\u003cp>Before the Assembly subcommittee voted, its staff had recommended rejecting the department’s plan out of concern that the children’s quality of care could be compromised.\u003c/p>\n\u003cp>The Legislative Analyst’s Office agreed, as did a conga line of children’s advocates, providers and families, who all appeared at the hearing to urge the legislature to scrub the proposal from the calendar.\u003c/p>\n\u003cp>California Children’s Services, established in 1927, is one of the oldest public health programs in the nation.\u003c/p>\n\u003cp>The subcommittee chairman, Tony Thurmond, D-Richmond, said that given the program’s longevity and the apparent satisfaction of the children’s families, he didn’t want to change it.\u003c/p>\n\u003cp>“If this is one of the oldest programs around and it’s something we can hold up as a shining example of how to do things right, then let’s not mess with it,” Thurmond said.\u003c/p>\n\u003cfigure id=\"attachment_161060\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-161060\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/fragile-kids_finnie_770.jpg\" alt=\"Lisa and Jaheen Finnie of Brentwood. Jaheen is 14 and has a rare condition that, since he was 3 years old, sometimes causes his brain fluid to leak, and that prompts episodes of meningitis. \" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770-768x512.jpg 768w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Lisa and Jaheen Finnie of Brentwood. Jaheen is 14 and has a rare condition that, since he was 3 years old, sometimes causes his brain fluid to leak, and that prompts episodes of meningitis. \u003ccite>(David Gorn/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That was music to the ears of Lisa Finnie and her 14-year-old son Jaheen of Brentwood, 45 miles east of Oakland. Jaheen struggles with a rare medical condition that sometimes causes brain fluid to leak from his skull.\u003c/p>\n\u003cp>Since he was 3, Jaheen has had six surgeries and survived seven bouts of life-threatening meningitis caused by the defect. He has had periods of blindness, and at one point was in a coma for a month.\u003c/p>\n\u003cp>But right now, Jaheen can see just fine. His only outward signs of the condition are faulty hearing and a face that droops a bit on one side.\u003c/p>\n\u003cp>“I kind of smile on one side right now,” Jaheen explained. “I’m learning how to get this side of my face up,” he said, touching his left cheek.\u003c/p>\n\u003cp>His mom Lisa credits the Children’s Services program with helping her family survive and thrive, she said.\u003c/p>\n\u003cp>“I don’t know what we’d do without it.”\u003c/p>\n\u003cfigure id=\"attachment_161061\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-161061\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/fragile-kids_mia_370.jpg\" alt=\"Mia Vasquez, 8 , has cerebral palsy and bone deformities.\" width=\"370\" height=\"464\">\u003cfigcaption class=\"wp-caption-text\">Mia Vasquez, 8 , has cerebral palsy and bone deformities. \u003ccite>(Courtesy of Emelyn Lacayo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That sentiment was echoed by Emelyn Lacayo of Hayward, the mother of a seven-year-old daughter, Mia, who has cerebral palsy, bone deformities and is also believed to suffer from a rare condition called Cockayne syndrome.\u003c/p>\n\u003cp>“The doctors thought she wouldn’t live past a year, but she’s almost 8 now,” Lacayo said.\u003c/p>\n\u003cp>A possible transition into managed care worries Lacayo, because Mia might lose one of her key specialists.\u003c/p>\n\u003cp>“Our biggest fear is that Mia would fall through the cracks,” she said. “You can’t just throw us into managed care. These are kids who need the specialty care.”\u003c/p>\n\u003cp>Lacayo says the state has long wanted to replace this high-need, high-cost program, and she was heartened when the subcommittee applied the brakes to the plan that would have started to do that. But she understands the fight has only been put off for another day.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We’re okay for now, but we still have a lot of work to do,” she said. “The moral of the story is, these kids are expensive, yes — but they need that care,” Lacayo said. “They didn’t choose to have these conditions.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lauren Brady, a Whittier resident, has lived all her 19 years with Rett syndrome, a rare neurological illness that can cause seizures and limits muscle movement. She can’t speak, needs a feeding tube and uses a wheelchair to get around.\u003c/p>\n\u003cp>“It affects her from head to toe, but we don’t let all of that get in our way,” her mother, Sherri Brady said this week. “Lauren has lots of friends; she goes horseback riding. Next weekend she’s going on a ski trip.”\u003c/p>\n\u003cp>That Lauren can even contemplate those activities is testimony to a $2.9 billion a year state program, \u003ca href=\"http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx\" target=\"_blank\">California Children’s Services\u003c/a>, her mother said. The program provides specialized care to some 180,000 children and young adults who suffer from a range of complicated, debilitating illnesses including Rett syndrome, sickle cell anemia, cancer, cerebral palsy, hemophilia and more.\u003c/p>\n\u003cp>In recent years, Sherri Brady and other parents of children in the program have lived in fear that the care of their kids could be disrupted — at what they see as a great risk of physical and emotional harm. That’s because the state’s Department of Health Care Services ultimately wants to move all the children into managed care.\u003c/p>\n\u003cp>But the first phase of that move, which would have targeted just under one-fifth of the children beginning next January, is now on hold. The state Assembly’s influential budget subcommittee voted earlier this week to shelve it and send the department back to the drawing board. The Senate’s budget subcommittee is expected to endorse that ruling next week.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This means all of those children will be able to keep seeing the same providers and get the same services they’ve been receiving — at least for now.\u003c/p>\n\u003cp>That’s a big relief to their parents, who fear that in managed care their children could lose relationships with the caregivers who know them best and could face difficulty getting appointments with specialists.\u003c/p>\n\u003cp>“It’s wonderful that the legislators did this,” said Sherri Brady. But she knows her battle isn’t over.\u003c/p>\n\u003cp>The state has been under pressure for years to restructure the program both to improve the care it delivers and reduce its cost, according to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20A/PDF%20AssessingTheCAChildrensServicesProgram.pdf\" target=\"_blank\">study by the California Health Care Foundation\u003c/a>.\u003c/p>\n\u003cp>“This isn’t the end of it,” Brady said. We’ve been fighting it and we’ll keep fighting it.”\u003c/p>\n\u003cp>Brady has trouble understanding why the state wants to move the kids into managed care. “To make a change that could be harmful for individuals who already live with such harm, that’s just not right,” she said.\u003c/p>\n\u003cp>Jennifer Kent, director of the California Department of Health Care Services, testified to the Assembly subcommittee that the first-phase proposal to move nearly 20 percent of the the kids into managed care plans would provide them with better care.\u003c/p>\n\u003cp>“One of the key components is because (California Children's Services) is a program around a condition rather than a child, the different payers don’t look at the whole child,” Kent said. “We want to better manage the care of these children across the spectrum.”\u003c/p>\n\u003cp>Under managed care, health plans are paid fixed rates to cover and coordinate nearly all health care services for patients.\u003c/p>\n\u003cp>Kent told legislators the department’s plan was “budget-neutral,” meaning it would result neither in savings nor additional costs for taxpayers.\u003c/p>\n\u003cp>Nearly half the cost of the program, or about $1.4 billion, is paid for out of the state’s general fund, according to Kent’s department.\u003c/p>\n\u003cp>About 70 percent of children in the program get benefits from Medi-Cal, the state-federal health coverage program for people with low incomes. The other 30 percent have private insurance, but the state helps pay for some of the care not covered by their insurers. The federal and county governments also pick up a portion of the tab.\u003c/p>\n\u003cp>Assuming the Senate subcommittee concurs with its Assembly counterpart, the health department will be instructed to develop a new proposal requiring what is known in Capitol lingo as “enabling legislation,” and ultimately floor votes in both houses. The process is expected to take a long time, though nobody can say how long.\u003c/p>\n\u003cp>Child advocates fear that the ultimate outcome will be the same — the kids will end up being moved into managed care.\u003c/p>\n\u003cp>“The assumption has always been that the state wants to move all of the kids,” said Yvette Baptiste, executive director of the Eastern Los Angeles Family Resource Center in Alhambra, which helps children with developmental disabilities and their families.\u003c/p>\n\u003cp>Before the Assembly subcommittee voted, its staff had recommended rejecting the department’s plan out of concern that the children’s quality of care could be compromised.\u003c/p>\n\u003cp>The Legislative Analyst’s Office agreed, as did a conga line of children’s advocates, providers and families, who all appeared at the hearing to urge the legislature to scrub the proposal from the calendar.\u003c/p>\n\u003cp>California Children’s Services, established in 1927, is one of the oldest public health programs in the nation.\u003c/p>\n\u003cp>The subcommittee chairman, Tony Thurmond, D-Richmond, said that given the program’s longevity and the apparent satisfaction of the children’s families, he didn’t want to change it.\u003c/p>\n\u003cp>“If this is one of the oldest programs around and it’s something we can hold up as a shining example of how to do things right, then let’s not mess with it,” Thurmond said.\u003c/p>\n\u003cfigure id=\"attachment_161060\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-161060\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/fragile-kids_finnie_770.jpg\" alt=\"Lisa and Jaheen Finnie of Brentwood. Jaheen is 14 and has a rare condition that, since he was 3 years old, sometimes causes his brain fluid to leak, and that prompts episodes of meningitis. \" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/fragile-kids_finnie_770-768x512.jpg 768w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Lisa and Jaheen Finnie of Brentwood. Jaheen is 14 and has a rare condition that, since he was 3 years old, sometimes causes his brain fluid to leak, and that prompts episodes of meningitis. \u003ccite>(David Gorn/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That was music to the ears of Lisa Finnie and her 14-year-old son Jaheen of Brentwood, 45 miles east of Oakland. Jaheen struggles with a rare medical condition that sometimes causes brain fluid to leak from his skull.\u003c/p>\n\u003cp>Since he was 3, Jaheen has had six surgeries and survived seven bouts of life-threatening meningitis caused by the defect. He has had periods of blindness, and at one point was in a coma for a month.\u003c/p>\n\u003cp>But right now, Jaheen can see just fine. His only outward signs of the condition are faulty hearing and a face that droops a bit on one side.\u003c/p>\n\u003cp>“I kind of smile on one side right now,” Jaheen explained. “I’m learning how to get this side of my face up,” he said, touching his left cheek.\u003c/p>\n\u003cp>His mom Lisa credits the Children’s Services program with helping her family survive and thrive, she said.\u003c/p>\n\u003cp>“I don’t know what we’d do without it.”\u003c/p>\n\u003cfigure id=\"attachment_161061\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-161061\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/fragile-kids_mia_370.jpg\" alt=\"Mia Vasquez, 8 , has cerebral palsy and bone deformities.\" width=\"370\" height=\"464\">\u003cfigcaption class=\"wp-caption-text\">Mia Vasquez, 8 , has cerebral palsy and bone deformities. \u003ccite>(Courtesy of Emelyn Lacayo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That sentiment was echoed by Emelyn Lacayo of Hayward, the mother of a seven-year-old daughter, Mia, who has cerebral palsy, bone deformities and is also believed to suffer from a rare condition called Cockayne syndrome.\u003c/p>\n\u003cp>“The doctors thought she wouldn’t live past a year, but she’s almost 8 now,” Lacayo said.\u003c/p>\n\u003cp>A possible transition into managed care worries Lacayo, because Mia might lose one of her key specialists.\u003c/p>\n\u003cp>“Our biggest fear is that Mia would fall through the cracks,” she said. “You can’t just throw us into managed care. These are kids who need the specialty care.”\u003c/p>\n\u003cp>Lacayo says the state has long wanted to replace this high-need, high-cost program, and she was heartened when the subcommittee applied the brakes to the plan that would have started to do that. But she understands the fight has only been put off for another day.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’re okay for now, but we still have a lot of work to do,” she said. “The moral of the story is, these kids are expensive, yes — but they need that care,” Lacayo said. “They didn’t choose to have these conditions.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>New research finds that young transgender children who have “socially transitioned” — living their lives under the gender they identify with — had positive mental health outcomes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Crucially important’ research\u003ccite>Dr. Ilana Sherer, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Until now, studies had shown significantly higher rates for depression and anxiety in transgender children. \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">Nearly half attempt suicide \u003c/a>by age 24.\u003c/p>\n\u003cp>Researchers at the University of Washington looked at 73 children ages 3-12 living as their identified gender and compared those children against two control groups — their own siblings and another group. They found average scores for depression and only slightly elevated anxiety rates.\u003c/p>\n\u003cp>“It puts out the possibility that being a transgender child doesn’t have to be associated with negative mental health outcomes in the way that to date the research has suggested,” said \u003ca href=\"https://depts.washington.edu/transyp/people/\" target=\"_blank\" rel=\"noopener\">Kristina Olson\u003c/a>, Ph.D., lead author of the study and director of the university’s TransYouth Project. She hopes to follow these children for 20 years.\u003c/p>\n\u003cp>It is the first analysis of mental health outcomes in a group of socially transitioned transgender children. The study was published in the journal Pediatrics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Parents who had suspected their children might be transgender and began research on their own would find depressing mental health outcomes, until now.\u003c/p>\n\u003cp>“Those felt like terrifying statistics to hold as a parent,” said one mother (who did not want to be identified by name out of concern for her child’s privacy), 42, of Oakland, one of the families in the study. She and her partner have two children, an older girl and a second child, now 6, born as a boy.\u003c/p>\n\u003cp>By age 3 and a half “it became increasingly clear,” she said said, “that there was something going on … that was pulling him into the realm of traditional girliness, and as it continued, it grew in intensity and grew in its consistency.”\u003c/p>\n\u003cp>The intensity of gender identity was true of most kids in the study, “These are kids who are very persistent and insistent about their gender identity,” said Olson, “and those are the only kids that experts working in this area have advised that these social transitions might be useful for.”\u003c/p>\n\u003cp>The mother and her partner began researching on their own and later with experts. While she knew adults who had transitioned, “I had never heard of transgender children. I didn’t know it had the capability of dating back to such early childhood.”\u003c/p>\n\u003cp>Just before his 5th birthday her son asked to be called a girl. The Oakland mother and her partner supported their child’s choice to live as girl. She already had a gender neutral name and began dressing as a girl.\u003c/p>\n\u003cp>“Now having a child who has lived in their identified gender for a year and a half, I have no doubt that we’re making the right decision,” she said, adding that her daughter is well-adjusted at school and is accepted as a girl by her peers.\u003c/p>\n\u003cp>None of the children in the study had any medical or surgical treatments. “No one in the country does medical or surgical interventions with kids this young,” said Olson. Estimates of the rate of transgender children range from 0.3 to 0.8 percent of the population.\u003c/p>\n\u003cp>The group of children Olson is studying, initially 73, has now grown to 153. None has transitioned back. She said her project \u003ca href=\"https://depts.washington.edu/transyp/participate/\" target=\"_blank\" rel=\"noopener\">welcomes additional participants\u003c/a>.\u003c/p>\n\u003cp>In an accompanying editorial, Ilana Sherer a pediatrician and assistant medical director of UC San Francisco’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">Child and Adolescent Gender Center\u003c/a> called the research “crucially important.”\u003c/p>\n\u003cblockquote>\u003cp>“Olson and her colleagues give supporters of social transition evidence of what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety … up to 3 times higher for non-socially transitioned children.”\u003c/p>\u003c/blockquote>\n\u003cp>For the children in this study, family support appears to be key. But Olson pointed out that it’s a big decision for a family to take the step of supporting a socially-transitioned child, and not all families today are likely to make this decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Probably there are some attributes about the families who have done this that are unique to them,” Olson said. She stressed the need for more research to illuminate whether it’s those “other qualities” or the social transition itself that promotes the positive mental health outcomes seen in this analysis.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>New research finds that young transgender children who have “socially transitioned” — living their lives under the gender they identify with — had positive mental health outcomes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Crucially important’ research\u003ccite>Dr. Ilana Sherer, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Until now, studies had shown significantly higher rates for depression and anxiety in transgender children. \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">Nearly half attempt suicide \u003c/a>by age 24.\u003c/p>\n\u003cp>Researchers at the University of Washington looked at 73 children ages 3-12 living as their identified gender and compared those children against two control groups — their own siblings and another group. They found average scores for depression and only slightly elevated anxiety rates.\u003c/p>\n\u003cp>“It puts out the possibility that being a transgender child doesn’t have to be associated with negative mental health outcomes in the way that to date the research has suggested,” said \u003ca href=\"https://depts.washington.edu/transyp/people/\" target=\"_blank\" rel=\"noopener\">Kristina Olson\u003c/a>, Ph.D., lead author of the study and director of the university’s TransYouth Project. She hopes to follow these children for 20 years.\u003c/p>\n\u003cp>It is the first analysis of mental health outcomes in a group of socially transitioned transgender children. The study was published in the journal Pediatrics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Parents who had suspected their children might be transgender and began research on their own would find depressing mental health outcomes, until now.\u003c/p>\n\u003cp>“Those felt like terrifying statistics to hold as a parent,” said one mother (who did not want to be identified by name out of concern for her child’s privacy), 42, of Oakland, one of the families in the study. She and her partner have two children, an older girl and a second child, now 6, born as a boy.\u003c/p>\n\u003cp>By age 3 and a half “it became increasingly clear,” she said said, “that there was something going on … that was pulling him into the realm of traditional girliness, and as it continued, it grew in intensity and grew in its consistency.”\u003c/p>\n\u003cp>The intensity of gender identity was true of most kids in the study, “These are kids who are very persistent and insistent about their gender identity,” said Olson, “and those are the only kids that experts working in this area have advised that these social transitions might be useful for.”\u003c/p>\n\u003cp>The mother and her partner began researching on their own and later with experts. While she knew adults who had transitioned, “I had never heard of transgender children. I didn’t know it had the capability of dating back to such early childhood.”\u003c/p>\n\u003cp>Just before his 5th birthday her son asked to be called a girl. The Oakland mother and her partner supported their child’s choice to live as girl. She already had a gender neutral name and began dressing as a girl.\u003c/p>\n\u003cp>“Now having a child who has lived in their identified gender for a year and a half, I have no doubt that we’re making the right decision,” she said, adding that her daughter is well-adjusted at school and is accepted as a girl by her peers.\u003c/p>\n\u003cp>None of the children in the study had any medical or surgical treatments. “No one in the country does medical or surgical interventions with kids this young,” said Olson. Estimates of the rate of transgender children range from 0.3 to 0.8 percent of the population.\u003c/p>\n\u003cp>The group of children Olson is studying, initially 73, has now grown to 153. None has transitioned back. She said her project \u003ca href=\"https://depts.washington.edu/transyp/participate/\" target=\"_blank\" rel=\"noopener\">welcomes additional participants\u003c/a>.\u003c/p>\n\u003cp>In an accompanying editorial, Ilana Sherer a pediatrician and assistant medical director of UC San Francisco’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">Child and Adolescent Gender Center\u003c/a> called the research “crucially important.”\u003c/p>\n\u003cblockquote>\u003cp>“Olson and her colleagues give supporters of social transition evidence of what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety … up to 3 times higher for non-socially transitioned children.”\u003c/p>\u003c/blockquote>\n\u003cp>For the children in this study, family support appears to be key. But Olson pointed out that it’s a big decision for a family to take the step of supporting a socially-transitioned child, and not all families today are likely to make this decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Probably there are some attributes about the families who have done this that are unique to them,” Olson said. She stressed the need for more research to illuminate whether it’s those “other qualities” or the social transition itself that promotes the positive mental health outcomes seen in this analysis.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The earlier a child with autism can be identified and get treatment the better, child development specialists say. So there's been a push to have pediatricians give all toddlers screening tests for autism during well child visits.\u003c/p>\n\u003cp>But the influential U.S. Preventive Services Task Force\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2491642\" target=\"_blank\"> said Tuesday \u003c/a>that there's not yet enough evidence to show that screening all children delivers measurable benefits, a decision sure to frustrate or anger many in the autism community.\u003c/p>\n\u003cp>It's not a recommendation against screening, says \u003ca href=\"pediatrics.duke.edu/faculty/details/0014640\" target=\"_blank\">Alex Kemper\u003c/a>, a professor of pediatrics at the Duke University School of Medicine and a member of the panel. \"It's really a call for more research to be done around treatment for children identified through screening.\"\u003c/p>\n\u003cp>Studies have found that it's possible to identify symptoms of autism such as avoiding eye contact or not responding to one's name in children as young as 18 months. But usually those children are flagged for screening because a parent or caregiver sees behavior they think is troubling. Most studies finding a benefit in early intervention have involved those children, not children who appear be developing typically.\u003c/p>\n\u003cp>Child development specialists say there's plenty of evidence in favor of early screening and intervention, and that avoiding it could delay or deny crucial treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We all acknowledge that more work needs to be done. More work is being done,\" says \u003ca href=\"http://www.kennedykrieger.org/patient-care/faculty-staff/rebecca-landa\" target=\"_blank\">Rebecca Landa,\u003c/a> director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore.\"But the risk [of screening] is so minimal, why wouldn't we be all behind the children?\"\u003c/p>\n\u003cp>Landa hopes that the USPSTF will be quick to change their \"insufficient evidence\" finding, \"and as they're sending out this inconclusive message, that they will be very vocal in standing with the American Academy of Pediatrics in saying that screening should happen as early as 18 months.\"\u003c/p>\n\u003cp>When the task force released the draft of this recommendation last August, the pediatricians issued a \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Statement-on-U-S-Preventive-Services-Task-Force-Draft-Recommendation-Statement-on-Autism-Screening.aspx\" target=\"_blank\">statement \u003c/a>saying that \"it runs counter to AAP guidelines.\" The academy recommends screening all children at 18 and 24 months.\u003c/p>\n\u003cp>Kemper does screen toddlers for autism in his own medical practice in Durham, N.C. \"We've thought a lot about it,\" he says. Many of the families don't have English as their primary language and sometimes have problems getting health care, he says. \"We were concerned that parents or other caregivers might not pick up on the signs or symptoms of autism.\"\u003c/p>\n\u003cp>The 20-question \u003ca href=\"https://www.m-chat.org/mchat.php\" target=\"_blank\">M-CHAT\u003c/a> test takes five minutes or so, asking parents questions like \"If you point at something across the room, does your child look at it?\"\u003c/p>\n\u003cp>The USPSTF \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2491642\" target=\"_blank\">statement\u003c/a>, which was published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, notes that potential harms of the test are minor, but could include the anxiety associated with a false positive result, as well as the time and expense of therapy if it later proved unnecessary.\u003c/p>\n\u003cp>Two editorials published Tuesday in \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=2491680\" target=\"_blank\">\u003cem>JAMA Psychiatry\u003c/em> \u003c/a>and \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=2487491\" target=\"_blank\">\u003cem>JAMA Pediatrics\u003c/em> \u003c/a>both criticized the USPSTF, saying that the \"insufficient evidence\" recommendation could make it less likely that children who are members of minorities get screened, and also make it less likely that insurance will pay for it. \"Rigid, inflexible approach results in no recommendation for autism screening,\" the \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=2491680\">JAMA Psychiatry\u003c/a> headline says.\u003c/p>\n\u003cp>\"When the task force makes recommendations it doesn't take up issues of cost or insurance coverage,\" Kemper says. \"But because the AAP recommends autism screening, it's still covered under the Affordable Care Act.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And he's standing firm with the panel's recommendation. \"I think again, by highlighting this gap in knowledge there's a real opportunity to figure out what the deal is,\" Kemper says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Panel+Says+Evidence+Is+Lacking+On+Universal+Screening+For+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The earlier a child with autism can be identified and get treatment the better, child development specialists say. So there's been a push to have pediatricians give all toddlers screening tests for autism during well child visits.\u003c/p>\n\u003cp>But the influential U.S. Preventive Services Task Force\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2491642\" target=\"_blank\"> said Tuesday \u003c/a>that there's not yet enough evidence to show that screening all children delivers measurable benefits, a decision sure to frustrate or anger many in the autism community.\u003c/p>\n\u003cp>It's not a recommendation against screening, says \u003ca href=\"pediatrics.duke.edu/faculty/details/0014640\" target=\"_blank\">Alex Kemper\u003c/a>, a professor of pediatrics at the Duke University School of Medicine and a member of the panel. \"It's really a call for more research to be done around treatment for children identified through screening.\"\u003c/p>\n\u003cp>Studies have found that it's possible to identify symptoms of autism such as avoiding eye contact or not responding to one's name in children as young as 18 months. But usually those children are flagged for screening because a parent or caregiver sees behavior they think is troubling. Most studies finding a benefit in early intervention have involved those children, not children who appear be developing typically.\u003c/p>\n\u003cp>Child development specialists say there's plenty of evidence in favor of early screening and intervention, and that avoiding it could delay or deny crucial treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We all acknowledge that more work needs to be done. More work is being done,\" says \u003ca href=\"http://www.kennedykrieger.org/patient-care/faculty-staff/rebecca-landa\" target=\"_blank\">Rebecca Landa,\u003c/a> director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore.\"But the risk [of screening] is so minimal, why wouldn't we be all behind the children?\"\u003c/p>\n\u003cp>Landa hopes that the USPSTF will be quick to change their \"insufficient evidence\" finding, \"and as they're sending out this inconclusive message, that they will be very vocal in standing with the American Academy of Pediatrics in saying that screening should happen as early as 18 months.\"\u003c/p>\n\u003cp>When the task force released the draft of this recommendation last August, the pediatricians issued a \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Statement-on-U-S-Preventive-Services-Task-Force-Draft-Recommendation-Statement-on-Autism-Screening.aspx\" target=\"_blank\">statement \u003c/a>saying that \"it runs counter to AAP guidelines.\" The academy recommends screening all children at 18 and 24 months.\u003c/p>\n\u003cp>Kemper does screen toddlers for autism in his own medical practice in Durham, N.C. \"We've thought a lot about it,\" he says. Many of the families don't have English as their primary language and sometimes have problems getting health care, he says. \"We were concerned that parents or other caregivers might not pick up on the signs or symptoms of autism.\"\u003c/p>\n\u003cp>The 20-question \u003ca href=\"https://www.m-chat.org/mchat.php\" target=\"_blank\">M-CHAT\u003c/a> test takes five minutes or so, asking parents questions like \"If you point at something across the room, does your child look at it?\"\u003c/p>\n\u003cp>The USPSTF \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2491642\" target=\"_blank\">statement\u003c/a>, which was published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, notes that potential harms of the test are minor, but could include the anxiety associated with a false positive result, as well as the time and expense of therapy if it later proved unnecessary.\u003c/p>\n\u003cp>Two editorials published Tuesday in \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=2491680\" target=\"_blank\">\u003cem>JAMA Psychiatry\u003c/em> \u003c/a>and \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=2487491\" target=\"_blank\">\u003cem>JAMA Pediatrics\u003c/em> \u003c/a>both criticized the USPSTF, saying that the \"insufficient evidence\" recommendation could make it less likely that children who are members of minorities get screened, and also make it less likely that insurance will pay for it. \"Rigid, inflexible approach results in no recommendation for autism screening,\" the \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=2491680\">JAMA Psychiatry\u003c/a> headline says.\u003c/p>\n\u003cp>\"When the task force makes recommendations it doesn't take up issues of cost or insurance coverage,\" Kemper says. \"But because the AAP recommends autism screening, it's still covered under the Affordable Care Act.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And he's standing firm with the panel's recommendation. \"I think again, by highlighting this gap in knowledge there's a real opportunity to figure out what the deal is,\" Kemper says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Panel+Says+Evidence+Is+Lacking+On+Universal+Screening+For+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mobile Clinics Serve California's Growing Homeless Youth Population",
"title": "Mobile Clinics Serve California's Growing Homeless Youth Population",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>Dr. Seth Ammerman listens intently to his new patient. Ernesto, who does not want his last name disclosed, is homeless. Ernesto is earning a high school degree and working part time, but at night, he and his brother share a tent that they set up on San Jose streets. The daily stress of being homeless is wearing Ernesto out and making him light up too many cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These kids, because of all these access barriers — lack of insurance, lack of transportation — they’re not going to get this kind of care unless we go to them.'\u003ccite>Dr. Seth Ammerman, medical director, Stanford Teen Health Van \u003c/cite>\u003c/aside>\n\u003cp>“I just want to cut down on my smoking,” says Ernesto, 21, with a tentative, soft voice. “I’ve been on the streets all the time, you know? I just want to make sure I’m OK.”\u003c/p>\n\u003cp>That's why Ernesto walked into this mobile clinic parked just a few steps away from his classroom at the San Jose Conservation Corps & Charter School. He's sitting in a fully equipped exam room inside a shiny blue tour bus with Wi-Fi and the ability to get HIV test results in 20 minutes.\u003c/p>\n\u003cp>During the consultation with Ernesto, Ammerman nods sympathetically. In his 20 years working in this teen health van, Ammerman has treated thousands of uninsured and homeless adolescents ages 24 and under.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/247566086\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Twice a week, Ammerman and two nurses park the clinic at continuation high schools and other places frequented by at-risk adolescents in Santa Clara, San Mateo and San Francisco counties. The van is a community project of the Lucile Packard Children's Hospital Stanford and Children's Health Fund, with support from Samsung.\u003c/p>\n\u003cfigure id=\"attachment_146678\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146678 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The teen health van parks at continuation high schools and other places frequented by adolescents in Santa Clara, San Mateo and San Francisco counties. Inside, patients are seen in two exam rooms and a nursing station. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The team provides free medical, nutrition and mental health services, including reproductive health care and treatment for chronic illnesses, substance abuse and depression. All medications are free and provided at the time of consultation. A social worker is available for counseling and connects adolescents to additional resources; a registered dietitian works with patients who are malnourished, a frequent health issue for this population.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some of the 400 patients who visit the teen health van each year have never seen a doctor, says Ammerman.\u003c/p>\n\u003cp>“Going to the patients makes all the difference, and it's not just a matter of convenience,” says Ammerman, a clinical professor of adolescent medicine at Stanford University. “It really is that these kids, because of all these access barriers -- lack of insurance, lack of transportation -- they're not going to get this kind of care unless we go to them.”\u003c/p>\n\u003cp>For many patients here, the teen health van can become a trustworthy and reliable place in an otherwise unstable world.\u003c/p>\n\u003cp>Grace Kim first set foot in the van 10 years ago when she was 17. She admits she was skeptical.\u003c/p>\n\u003cp>\"Because it was a van, and I wasn't really sure what they could really provide for me,\" says Kim, 27. \"Off the bat I don't trust people very easily and that probably comes from the territory that I grew up in.\"\u003c/p>\n\u003cp>Kim, a second-generation Korean-American, says she grew up with abusive relatives in a house \"full of conflict.\" By the time she was 14, she had already attempted suicide. With the help of a high school counselor, Kim moved out of her parents' home into a transitional living program, which required her to get medical checkups at the van initially. For the next four years, Kim was a regular patient.\u003c/p>\n\u003cfigure id=\"attachment_147012\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-147012 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg\" alt=\"Grace Kim, 27, credits the teen health van with helping her overcome depression, malnutrition and other health issues when she 17. Kim was photographed near Santa Clara University, where she is a masters student.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Grace Kim credits the teen health van with helping her overcome depression and other health issues when she was 17. Kim was photographed near Santa Clara University, where she is a master's student in counseling psychology.\u003c/figcaption>\u003c/figure>\n\u003cp>Ammerman and other staff at the van treated Kim's malnutrition, substance abuse and other health issues. They connected her with free visits to see a psychiatrist at Stanford Medical Center who treated her depression, and she thrived.\u003c/p>\n\u003cp>\"If I didn't get that help, I would probably be in a very bad place,\" says Kim, now a master's student in counseling psychology at Santa Clara University. \"The whole mental health aspect of it was probably the most beneficial, probably the most powerful.\"\u003c/p>\n\u003cp>Today, Kim facilitates a support group for suicide survivors at Santa Clara Valley Medical Center and says her passion for her work comes from those dark days in her past. She still keeps in touch with Ammerman, calling him once in a while with health-related questions.\u003c/p>\n\u003cp>\"I trust him absolutely with everything because he's seen me at my worst, and he still to this day has the most faith in me,\" says Kim, adding that Ammerman motivated her to take care of herself and do better. \"To have someone care for you and tell you that you can get better and do anything that you put you heart into. ... I mean, there are no words for that.\"\u003c/p>\n\u003cp>Kim recognizes she was lucky to have access to housing, medical and mental health resources, but that may not be true for others.\u003c/p>\n\u003cp>\u003cstrong>Health Van Patients Often Face Precarious Housing\u003c/strong>\u003c/p>\n\u003cp>Over 40 percent of Stanford's teen health van patients are homeless, says Ammerman. These are adolescents up to age 25 living on the streets, in cars and, most commonly, overcrowded apartments. While doubling up with relatives or friends may sound like housing, it's not stable because people can be asked to leave at any time.\u003c/p>\n\u003cp>Ammerman says he's seen a significant increase in this population of teens and young adults -- those living in overcrowded conditions -- since 2008. Working families unable to make rent are more likely to end up in these challenging conditions.\u003c/p>\n\u003cp>\"We are seeing, unfortunately, more homeless kids. And that's really due to the housing crisis that we are all aware of here in the Bay Area,\" says Ammerman.\u003c/p>\n\u003cp>\u003cstrong>Homeless Youth Population Growing in California\u003c/strong>\u003c/p>\n\u003cp>Most Bay Area counties and the state as a whole are seeing a greater number of homeless kids in recent years, according to figures collected by the California Department of Education and crunched by \u003ca href=\"http://www.kidsdata.org/topic/230/homeless-students/table#fmt=355&loc=2,265,59,4,127,171,341,338,339,217&tf=79,73,67,64&sortType=asc\" target=\"_blank\">Kidsdata.org\u003c/a>. The education department designates students as \"homeless\" if their primary residence at any point in the school year was a:\u003c/p>\n\u003cul>\n\u003cli>Shelter\u003c/li>\n\u003cli>Hotel or motel\u003c/li>\n\u003cli>Shared housing with others due to loss of housing or economic hardship\u003c/li>\n\u003cli>No shelter at all.\u003c/li>\n\u003c/ul>\n\u003cp>Statewide, the rate of homeless public school students in grades K-12 jumped by one-third in just three years -- from 3.6 percent in 2011 to 4.8 percent in 2014. \u003ca href=\"http://www.kidsdata.org/topic/793/homeless-students-residence/table#fmt=1211&loc=2&tf=79,73,67,64&ch=1132,1133,1134,1135&sortColumnId=0&sortType=asc\" target=\"_blank\">More than 86 percent\u003c/a> of the nearly 300,000 homeless public school students statewide are living doubled up with friends or relatives.\u003c/p>\n\u003cp>\"So it's a very unstable housing situation, and that is always problematic for your health,\" says Ammerman.\u003c/p>\n\u003cp>Children and youth facing homelessness or housing insecurity are more likely than their peers to face \u003ca href=\"http://pediatrics.aappublications.org/content/131/6/1206\" target=\"_blank\">chronic illness\u003c/a> and mental health problems, as well as\u003ca href=\"http://www.homelesschildrenamerica.org/\"> traumas\u003c/a> and safety risks, studies show.\u003c/p>\n\u003cp>\u003cstrong>Resources for Homeless Youth are Not Keeping Up\u003c/strong>\u003c/p>\n\u003cp>Shahera Hyatt directs the California Homeless Youth Project at the \u003ca href=\"https://www.library.ca.gov/crb/\" target=\"_blank\">California Research Bureau\u003c/a> in Sacramento. She supports Ammerman's experience as to why the state is seeing a lot more child, youth and family homelessness.\u003c/p>\n\u003cp>\"We know that housing affordability is in crisis proportions,\" says Hyatt. \"In many communities across the state there's rapid gentrification happening and a very low housing stock.\"\u003c/p>\n\u003cp>Homeless youth -- particularly those constantly on the streets or without any access to shelters -- risk sexual abuse, police harassment and substance addiction. Yet the state is woefully lacking in services and resources for this population, says Hyatt.\u003c/p>\n\u003cp>Sacramento has a single six-bed transitional housing center for young adults -- and a nine-month waiting list of about 100 people, says Hyatt. She added that two-thirds of the state's counties lack shelters and other basic services for homeless youth.\u003c/p>\n\u003cp>\"There’s a lot of mythology about why young people become homeless ... that they are unruly or want to live outside. But that's not true,\" says Hyatt. \"A lot of these people are really disenfranchised by the lack of services out there and become homeless.\"\u003c/p>\n\u003cp>Since 1988, California has spent $1.1 million annually on programs that serve homeless youth: the Homeless Youth and Exploitation Program and the California Youth Crisis Line, according to the California Coalition for Youth.\u003c/p>\n\u003cp>A bill introduced last month by Assemblywoman Young Kim, \u003ca href=\"https://ad65.asmrc.org/press-release/14533\" target=\"_blank\">AB1699\u003c/a>, would provide $25 million in funding for homeless youth emergency service projects. The bill's first hearing should be in the next two months, according to Bryan Shroyer in Kim's office.\u003c/p>\n\u003cp>\u003cstrong>Popularity of Mobile Clinics Increases\u003c/strong>\u003c/p>\n\u003cp>Meanwhile, mobile health clinics like Ammerman's in San Jose continue to fill a gap in access to care for uninsured youth. That model of delivering care directly to underserved populations has been gaining popularity nationwide.\u003c/p>\n\u003cp>In the last two decades, the number of mobile clinics has grown to about 2,000 throughout the country, according to the Mobile Health Clinics Association.\u003c/p>\n\u003cp>\"What we are seeing is greater acceptance that mobile care can be really high-quality care,\" says Dr. Delaney Gracy, chief medical officer with the Children's Health Fund. \"More people are realizing that mobile health is an important part of safety net care.\"\u003c/p>\n\u003cfigure id=\"attachment_146679\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146679 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg\" alt=\"Ammerman fill a prescription for a patient. The teen health van provides medications for free.\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-960x720.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ammerman fills a prescription for a patient. The teen health van provides medications for free. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the teen health van's exam room, Ammerman is ending his consultation with Ernesto by handing him packages of nicotine gum, the medication Ernesto chose from several options to help him quit smoking. Before Ernesto leaves, Ammerman has one last question for first-time patients like him.\u003c/p>\n\u003cp>\"We literally ask each kid, 'What are you good at, what are your strengths?' And they're shocked at this question because no one's ever asked that before,\" says Ammerman.\u003c/p>\n\u003cp>When Ernesto's turn comes to answer, he thinks for a while before responding.\u003c/p>\n\u003cp>\"Um ... I like to work and stay busy,\" says Ernesto. \"And I motivate my brothers a lot, as much as I can.\"\u003c/p>\n\u003cp>\"Cool! That's a really cool thing,\" responds Ammerman.\u003c/p>\n\u003cp>As his patients successfully take steps to care for their health, says Ammerman, they also gain the confidence to tackle other goals, like getting steady housing.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"These kids have strengths, and by focusing on their strengths it can really make a difference. Because strength builds strength. And success builds success,\" says Ammerman.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Seth Ammerman listens intently to his new patient. Ernesto, who does not want his last name disclosed, is homeless. Ernesto is earning a high school degree and working part time, but at night, he and his brother share a tent that they set up on San Jose streets. The daily stress of being homeless is wearing Ernesto out and making him light up too many cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These kids, because of all these access barriers — lack of insurance, lack of transportation — they’re not going to get this kind of care unless we go to them.'\u003ccite>Dr. Seth Ammerman, medical director, Stanford Teen Health Van \u003c/cite>\u003c/aside>\n\u003cp>“I just want to cut down on my smoking,” says Ernesto, 21, with a tentative, soft voice. “I’ve been on the streets all the time, you know? I just want to make sure I’m OK.”\u003c/p>\n\u003cp>That's why Ernesto walked into this mobile clinic parked just a few steps away from his classroom at the San Jose Conservation Corps & Charter School. He's sitting in a fully equipped exam room inside a shiny blue tour bus with Wi-Fi and the ability to get HIV test results in 20 minutes.\u003c/p>\n\u003cp>During the consultation with Ernesto, Ammerman nods sympathetically. In his 20 years working in this teen health van, Ammerman has treated thousands of uninsured and homeless adolescents ages 24 and under.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/247566086&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/247566086'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Twice a week, Ammerman and two nurses park the clinic at continuation high schools and other places frequented by at-risk adolescents in Santa Clara, San Mateo and San Francisco counties. The van is a community project of the Lucile Packard Children's Hospital Stanford and Children's Health Fund, with support from Samsung.\u003c/p>\n\u003cfigure id=\"attachment_146678\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146678 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The teen health van parks at continuation high schools and other places frequented by adolescents in Santa Clara, San Mateo and San Francisco counties. Inside, patients are seen in two exam rooms and a nursing station. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The team provides free medical, nutrition and mental health services, including reproductive health care and treatment for chronic illnesses, substance abuse and depression. All medications are free and provided at the time of consultation. A social worker is available for counseling and connects adolescents to additional resources; a registered dietitian works with patients who are malnourished, a frequent health issue for this population.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some of the 400 patients who visit the teen health van each year have never seen a doctor, says Ammerman.\u003c/p>\n\u003cp>“Going to the patients makes all the difference, and it's not just a matter of convenience,” says Ammerman, a clinical professor of adolescent medicine at Stanford University. “It really is that these kids, because of all these access barriers -- lack of insurance, lack of transportation -- they're not going to get this kind of care unless we go to them.”\u003c/p>\n\u003cp>For many patients here, the teen health van can become a trustworthy and reliable place in an otherwise unstable world.\u003c/p>\n\u003cp>Grace Kim first set foot in the van 10 years ago when she was 17. She admits she was skeptical.\u003c/p>\n\u003cp>\"Because it was a van, and I wasn't really sure what they could really provide for me,\" says Kim, 27. \"Off the bat I don't trust people very easily and that probably comes from the territory that I grew up in.\"\u003c/p>\n\u003cp>Kim, a second-generation Korean-American, says she grew up with abusive relatives in a house \"full of conflict.\" By the time she was 14, she had already attempted suicide. With the help of a high school counselor, Kim moved out of her parents' home into a transitional living program, which required her to get medical checkups at the van initially. For the next four years, Kim was a regular patient.\u003c/p>\n\u003cfigure id=\"attachment_147012\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-147012 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg\" alt=\"Grace Kim, 27, credits the teen health van with helping her overcome depression, malnutrition and other health issues when she 17. Kim was photographed near Santa Clara University, where she is a masters student.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Grace Kim credits the teen health van with helping her overcome depression and other health issues when she was 17. Kim was photographed near Santa Clara University, where she is a master's student in counseling psychology.\u003c/figcaption>\u003c/figure>\n\u003cp>Ammerman and other staff at the van treated Kim's malnutrition, substance abuse and other health issues. They connected her with free visits to see a psychiatrist at Stanford Medical Center who treated her depression, and she thrived.\u003c/p>\n\u003cp>\"If I didn't get that help, I would probably be in a very bad place,\" says Kim, now a master's student in counseling psychology at Santa Clara University. \"The whole mental health aspect of it was probably the most beneficial, probably the most powerful.\"\u003c/p>\n\u003cp>Today, Kim facilitates a support group for suicide survivors at Santa Clara Valley Medical Center and says her passion for her work comes from those dark days in her past. She still keeps in touch with Ammerman, calling him once in a while with health-related questions.\u003c/p>\n\u003cp>\"I trust him absolutely with everything because he's seen me at my worst, and he still to this day has the most faith in me,\" says Kim, adding that Ammerman motivated her to take care of herself and do better. \"To have someone care for you and tell you that you can get better and do anything that you put you heart into. ... I mean, there are no words for that.\"\u003c/p>\n\u003cp>Kim recognizes she was lucky to have access to housing, medical and mental health resources, but that may not be true for others.\u003c/p>\n\u003cp>\u003cstrong>Health Van Patients Often Face Precarious Housing\u003c/strong>\u003c/p>\n\u003cp>Over 40 percent of Stanford's teen health van patients are homeless, says Ammerman. These are adolescents up to age 25 living on the streets, in cars and, most commonly, overcrowded apartments. While doubling up with relatives or friends may sound like housing, it's not stable because people can be asked to leave at any time.\u003c/p>\n\u003cp>Ammerman says he's seen a significant increase in this population of teens and young adults -- those living in overcrowded conditions -- since 2008. Working families unable to make rent are more likely to end up in these challenging conditions.\u003c/p>\n\u003cp>\"We are seeing, unfortunately, more homeless kids. And that's really due to the housing crisis that we are all aware of here in the Bay Area,\" says Ammerman.\u003c/p>\n\u003cp>\u003cstrong>Homeless Youth Population Growing in California\u003c/strong>\u003c/p>\n\u003cp>Most Bay Area counties and the state as a whole are seeing a greater number of homeless kids in recent years, according to figures collected by the California Department of Education and crunched by \u003ca href=\"http://www.kidsdata.org/topic/230/homeless-students/table#fmt=355&loc=2,265,59,4,127,171,341,338,339,217&tf=79,73,67,64&sortType=asc\" target=\"_blank\">Kidsdata.org\u003c/a>. The education department designates students as \"homeless\" if their primary residence at any point in the school year was a:\u003c/p>\n\u003cul>\n\u003cli>Shelter\u003c/li>\n\u003cli>Hotel or motel\u003c/li>\n\u003cli>Shared housing with others due to loss of housing or economic hardship\u003c/li>\n\u003cli>No shelter at all.\u003c/li>\n\u003c/ul>\n\u003cp>Statewide, the rate of homeless public school students in grades K-12 jumped by one-third in just three years -- from 3.6 percent in 2011 to 4.8 percent in 2014. \u003ca href=\"http://www.kidsdata.org/topic/793/homeless-students-residence/table#fmt=1211&loc=2&tf=79,73,67,64&ch=1132,1133,1134,1135&sortColumnId=0&sortType=asc\" target=\"_blank\">More than 86 percent\u003c/a> of the nearly 300,000 homeless public school students statewide are living doubled up with friends or relatives.\u003c/p>\n\u003cp>\"So it's a very unstable housing situation, and that is always problematic for your health,\" says Ammerman.\u003c/p>\n\u003cp>Children and youth facing homelessness or housing insecurity are more likely than their peers to face \u003ca href=\"http://pediatrics.aappublications.org/content/131/6/1206\" target=\"_blank\">chronic illness\u003c/a> and mental health problems, as well as\u003ca href=\"http://www.homelesschildrenamerica.org/\"> traumas\u003c/a> and safety risks, studies show.\u003c/p>\n\u003cp>\u003cstrong>Resources for Homeless Youth are Not Keeping Up\u003c/strong>\u003c/p>\n\u003cp>Shahera Hyatt directs the California Homeless Youth Project at the \u003ca href=\"https://www.library.ca.gov/crb/\" target=\"_blank\">California Research Bureau\u003c/a> in Sacramento. She supports Ammerman's experience as to why the state is seeing a lot more child, youth and family homelessness.\u003c/p>\n\u003cp>\"We know that housing affordability is in crisis proportions,\" says Hyatt. \"In many communities across the state there's rapid gentrification happening and a very low housing stock.\"\u003c/p>\n\u003cp>Homeless youth -- particularly those constantly on the streets or without any access to shelters -- risk sexual abuse, police harassment and substance addiction. Yet the state is woefully lacking in services and resources for this population, says Hyatt.\u003c/p>\n\u003cp>Sacramento has a single six-bed transitional housing center for young adults -- and a nine-month waiting list of about 100 people, says Hyatt. She added that two-thirds of the state's counties lack shelters and other basic services for homeless youth.\u003c/p>\n\u003cp>\"There’s a lot of mythology about why young people become homeless ... that they are unruly or want to live outside. But that's not true,\" says Hyatt. \"A lot of these people are really disenfranchised by the lack of services out there and become homeless.\"\u003c/p>\n\u003cp>Since 1988, California has spent $1.1 million annually on programs that serve homeless youth: the Homeless Youth and Exploitation Program and the California Youth Crisis Line, according to the California Coalition for Youth.\u003c/p>\n\u003cp>A bill introduced last month by Assemblywoman Young Kim, \u003ca href=\"https://ad65.asmrc.org/press-release/14533\" target=\"_blank\">AB1699\u003c/a>, would provide $25 million in funding for homeless youth emergency service projects. The bill's first hearing should be in the next two months, according to Bryan Shroyer in Kim's office.\u003c/p>\n\u003cp>\u003cstrong>Popularity of Mobile Clinics Increases\u003c/strong>\u003c/p>\n\u003cp>Meanwhile, mobile health clinics like Ammerman's in San Jose continue to fill a gap in access to care for uninsured youth. That model of delivering care directly to underserved populations has been gaining popularity nationwide.\u003c/p>\n\u003cp>In the last two decades, the number of mobile clinics has grown to about 2,000 throughout the country, according to the Mobile Health Clinics Association.\u003c/p>\n\u003cp>\"What we are seeing is greater acceptance that mobile care can be really high-quality care,\" says Dr. Delaney Gracy, chief medical officer with the Children's Health Fund. \"More people are realizing that mobile health is an important part of safety net care.\"\u003c/p>\n\u003cfigure id=\"attachment_146679\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146679 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg\" alt=\"Ammerman fill a prescription for a patient. The teen health van provides medications for free.\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-960x720.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ammerman fills a prescription for a patient. The teen health van provides medications for free. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the teen health van's exam room, Ammerman is ending his consultation with Ernesto by handing him packages of nicotine gum, the medication Ernesto chose from several options to help him quit smoking. Before Ernesto leaves, Ammerman has one last question for first-time patients like him.\u003c/p>\n\u003cp>\"We literally ask each kid, 'What are you good at, what are your strengths?' And they're shocked at this question because no one's ever asked that before,\" says Ammerman.\u003c/p>\n\u003cp>When Ernesto's turn comes to answer, he thinks for a while before responding.\u003c/p>\n\u003cp>\"Um ... I like to work and stay busy,\" says Ernesto. \"And I motivate my brothers a lot, as much as I can.\"\u003c/p>\n\u003cp>\"Cool! That's a really cool thing,\" responds Ammerman.\u003c/p>\n\u003cp>As his patients successfully take steps to care for their health, says Ammerman, they also gain the confidence to tackle other goals, like getting steady housing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"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.",
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"onourwatch": {
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"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?",
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"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",
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"perspectives": {
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"order": 14
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
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