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"content": "\u003cp>Several California congressional Republicans want the Obama administration to block the state's request to sell health insurance to undocumented immigrants on the state's exchange.\u003c/p>\n\u003cp>The move comes after Gov. Jerry Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB10\" target=\"_blank\">a bill\u003c/a> earlier this month authorizing California to formally request a waiver from the Affordable Care Act provision that bars undocumented immigrants from any of the law's benefits. Under a waiver, undocumented immigrants would be able to purchase Covered California health insurance -- but they would not be eligible for subsidies. They would only be able to purchase insurance with their own money.\u003c/p>\n\u003cp>Nine of California's 14 Republican representatives have signed a letter to cabinet officials appealing to them to deny this waiver. The representatives called California's request \"a brazen attempt to circumvent the will of Congress.\"\u003c/p>\n\u003cp>The letter went on:\u003c/p>\n\u003cblockquote>\u003cp>The issue of extending coverage to illegal immigrants on the healthcare exchanges was the subject of vigorous debate during the drafting and passage of the ACA. Both the American people and lawmakers were repeatedly promised illegal immigrants would not be able to receive coverage under the law.\u003c/p>\u003c/blockquote>\n\u003cp>In a statement, State Sen. Ricardo Lara, D-Bell Gardens, author of the measure, called the law \"a zero-cost proposal\" and that the move by the representatives \"reveals the signers for what they really are: fringe, anti-immigrant obstructionists who ... are clearly out of touch with the reality in California where several immigrant integration measures -- including this waiver -- were approved in both legislative houses with bipartisan support.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Affordable Care Act allows federal agencies to grant waivers beginning next year.\u003c/p>\n\u003cp>The nine signatories to the letter are:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Rep. Darrell Issa\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Tom McClintock\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Ken Calvert\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Dana Rohrabacher\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Duncan Hunter\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Doug LaMalfa\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Paul Cook\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Ed Royce\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Mimi Walters\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Several California congressional Republicans want the Obama administration to block the state's request to sell health insurance to undocumented immigrants on the state's exchange.\u003c/p>\n\u003cp>The move comes after Gov. Jerry Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB10\" target=\"_blank\">a bill\u003c/a> earlier this month authorizing California to formally request a waiver from the Affordable Care Act provision that bars undocumented immigrants from any of the law's benefits. Under a waiver, undocumented immigrants would be able to purchase Covered California health insurance -- but they would not be eligible for subsidies. They would only be able to purchase insurance with their own money.\u003c/p>\n\u003cp>Nine of California's 14 Republican representatives have signed a letter to cabinet officials appealing to them to deny this waiver. The representatives called California's request \"a brazen attempt to circumvent the will of Congress.\"\u003c/p>\n\u003cp>The letter went on:\u003c/p>\n\u003cblockquote>\u003cp>The issue of extending coverage to illegal immigrants on the healthcare exchanges was the subject of vigorous debate during the drafting and passage of the ACA. Both the American people and lawmakers were repeatedly promised illegal immigrants would not be able to receive coverage under the law.\u003c/p>\u003c/blockquote>\n\u003cp>In a statement, State Sen. Ricardo Lara, D-Bell Gardens, author of the measure, called the law \"a zero-cost proposal\" and that the move by the representatives \"reveals the signers for what they really are: fringe, anti-immigrant obstructionists who ... are clearly out of touch with the reality in California where several immigrant integration measures -- including this waiver -- were approved in both legislative houses with bipartisan support.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Affordable Care Act allows federal agencies to grant waivers beginning next year.\u003c/p>\n\u003cp>The nine signatories to the letter are:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Rep. Darrell Issa\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Tom McClintock\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Ken Calvert\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Dana Rohrabacher\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Duncan Hunter\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Doug LaMalfa\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Paul Cook\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Ed Royce\u003cbr>\n\u003c/span>\u003cspan class=\"s1\">Rep. Mimi Walters\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A measure that would compel pharmaceutical companies to disclose and justify drug price increases overcame a show of skepticism by Democratic lawmakers on Tuesday afternoon, passing the Assembly Health Committee 12-4 on a party-line vote.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">bill\u003c/a> — softened from earlier versions — would require drug manufacturers to notify state agencies and health insurers within days of federal approval for a new drug that cost $10,000 or more per year or for one course of treatment.\u003c/p>\n\u003cp>Drugmakers would be required to provide 30 days’ notice before increasing the price of a drug. The pharmaceutical industry also would have to justify the price increases as well as the introduction of high-cost drugs.\u003c/p>\n\u003cp>“This bill renders prescription drugs in line with other sectors of health care,” said the bill’s author, state Sen. Ed Hernandez, D-West Covina, who is chairman of the Senate Committee on Health. Hernandez said other industries, such as health insurance, already face pricing and transparency rules.\u003c/p>\n\u003cp>California is among about a dozen states that have considered proposals this year to impose greater price transparency on pharmaceutical companies, as dramatic drug price hikes make headlines and stoke public ire.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The bill’s supporters say advance notice of a price increase can help drug purchasers negotiate the best deal for consumers. Pharmaceutical companies had \u003ca href=\"http://californiahealthline.org/news/california-drug-price-measure-fiercely-opposed-by-pharmaceutical-industry/\" target=\"_blank\">criticized that provision\u003c/a>, saying it could prompt “hoarding” by large pharmacies.\u003c/p>\n\u003cp>A few lawmakers commented on the complexity of the measure, seeming overwhelmed by the topic of pharmaceutical pricing and uncertain how the bill would affect it.\u003c/p>\n\u003cp>“I’m very afraid that this is only going to disrupt the marketplace and further increase the prices,” said Assemblyman Adrin Nazarian, D-Sherman Oaks. He ended up supporting the bill.\u003c/p>\n\u003cp>Assemblyman Freddie Rodriguez, D-Pomona, asked if the bill would cause health care premiums to go down.\u003c/p>\n\u003cp>“I’ve got a lot of different answers, so it’s hard for me to grasp it,” said Rodriguez. “I’ve been trying to look at this for the last probably two weeks,” he said. He, too, voted for the measure.\u003c/p>\n\u003cp>Before the hearing, Hernandez said lawmakers on the committee had been asking for amendments to the bill in favor of “what pharma is asking for.” He said he wasn’t sure whether the measure would have enough support to win committee approval.\u003c/p>\n\u003cp>Over the past week, the bill was altered to ease the proposed rules for the pharmaceutical industry. The advance notice drugmakers would have to give before a price increase was shortened from 60 to 30 days. A requirement to hold a yearly public hearing on drug price increases was deleted. And pharmaceutical companies would only have to notify buyers of the affected drugs.\u003c/p>\n\u003cp>The California Life Sciences Association said it had been seeking amendments on the measure over the past week. The CLSA spent $492,936 on lobbying the California legislature from January 2015 through March of this year — more than any other pharmaceutical company or trade association.\u003c/p>\n\u003cp>At the hearing, Mike Carpenter, a lobbyist speaking on behalf of CLSA, said the bill “will provide a distorted picture of the role that medicines play in overall health care costs.” He said the legislation seeks selective information that won’t “meaningfully inform” the dialogue about controlling health care spending.\u003c/p>\n\u003cp>Fred Noteware, a lobbyist speaking on behalf of the Pharmaceutical Research and Manufacturers Association (PhRMA) said the measure creates “unnecessary and onerous” requirements and doesn’t provide insight into the role health plans and pharmaceutical benefits managers (PBMs) play in pharmaceutical spending.\u003c/p>\n\u003cp>However, the bill was amended to require disclosures about and reporting from PBMs, which are companies that contract with health insurers and state agencies to negotiate lower drug prices with manufacturers.\u003c/p>\n\u003cp>Insurers backed the bill, even though it requires health plans to disclose how much they spend on prescription drugs.\u003c/p>\n\u003cp>The bill moves next to the Assembly Appropriations Committee, and if it passes, it would then go to the assembly floor for a vote.\u003c/p>\n\u003cp>If the legislation becomes law, “we will be continuing this discussion on a national level,” Hernandez said.\u003c/p>\n\u003cp>But Assemblymember David Chiu, D-San Francisco, who introduced a different drug price transparency measure last year that never made it to a vote, said getting the political support to pass the bill may be tricky.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“These fights are very unpredictable,” he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A measure that would compel pharmaceutical companies to disclose and justify drug price increases overcame a show of skepticism by Democratic lawmakers on Tuesday afternoon, passing the Assembly Health Committee 12-4 on a party-line vote.\u003c/p>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">bill\u003c/a> — softened from earlier versions — would require drug manufacturers to notify state agencies and health insurers within days of federal approval for a new drug that cost $10,000 or more per year or for one course of treatment.\u003c/p>\n\u003cp>Drugmakers would be required to provide 30 days’ notice before increasing the price of a drug. The pharmaceutical industry also would have to justify the price increases as well as the introduction of high-cost drugs.\u003c/p>\n\u003cp>“This bill renders prescription drugs in line with other sectors of health care,” said the bill’s author, state Sen. Ed Hernandez, D-West Covina, who is chairman of the Senate Committee on Health. Hernandez said other industries, such as health insurance, already face pricing and transparency rules.\u003c/p>\n\u003cp>California is among about a dozen states that have considered proposals this year to impose greater price transparency on pharmaceutical companies, as dramatic drug price hikes make headlines and stoke public ire.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The bill’s supporters say advance notice of a price increase can help drug purchasers negotiate the best deal for consumers. Pharmaceutical companies had \u003ca href=\"http://californiahealthline.org/news/california-drug-price-measure-fiercely-opposed-by-pharmaceutical-industry/\" target=\"_blank\">criticized that provision\u003c/a>, saying it could prompt “hoarding” by large pharmacies.\u003c/p>\n\u003cp>A few lawmakers commented on the complexity of the measure, seeming overwhelmed by the topic of pharmaceutical pricing and uncertain how the bill would affect it.\u003c/p>\n\u003cp>“I’m very afraid that this is only going to disrupt the marketplace and further increase the prices,” said Assemblyman Adrin Nazarian, D-Sherman Oaks. He ended up supporting the bill.\u003c/p>\n\u003cp>Assemblyman Freddie Rodriguez, D-Pomona, asked if the bill would cause health care premiums to go down.\u003c/p>\n\u003cp>“I’ve got a lot of different answers, so it’s hard for me to grasp it,” said Rodriguez. “I’ve been trying to look at this for the last probably two weeks,” he said. He, too, voted for the measure.\u003c/p>\n\u003cp>Before the hearing, Hernandez said lawmakers on the committee had been asking for amendments to the bill in favor of “what pharma is asking for.” He said he wasn’t sure whether the measure would have enough support to win committee approval.\u003c/p>\n\u003cp>Over the past week, the bill was altered to ease the proposed rules for the pharmaceutical industry. The advance notice drugmakers would have to give before a price increase was shortened from 60 to 30 days. A requirement to hold a yearly public hearing on drug price increases was deleted. And pharmaceutical companies would only have to notify buyers of the affected drugs.\u003c/p>\n\u003cp>The California Life Sciences Association said it had been seeking amendments on the measure over the past week. The CLSA spent $492,936 on lobbying the California legislature from January 2015 through March of this year — more than any other pharmaceutical company or trade association.\u003c/p>\n\u003cp>At the hearing, Mike Carpenter, a lobbyist speaking on behalf of CLSA, said the bill “will provide a distorted picture of the role that medicines play in overall health care costs.” He said the legislation seeks selective information that won’t “meaningfully inform” the dialogue about controlling health care spending.\u003c/p>\n\u003cp>Fred Noteware, a lobbyist speaking on behalf of the Pharmaceutical Research and Manufacturers Association (PhRMA) said the measure creates “unnecessary and onerous” requirements and doesn’t provide insight into the role health plans and pharmaceutical benefits managers (PBMs) play in pharmaceutical spending.\u003c/p>\n\u003cp>However, the bill was amended to require disclosures about and reporting from PBMs, which are companies that contract with health insurers and state agencies to negotiate lower drug prices with manufacturers.\u003c/p>\n\u003cp>Insurers backed the bill, even though it requires health plans to disclose how much they spend on prescription drugs.\u003c/p>\n\u003cp>The bill moves next to the Assembly Appropriations Committee, and if it passes, it would then go to the assembly floor for a vote.\u003c/p>\n\u003cp>If the legislation becomes law, “we will be continuing this discussion on a national level,” Hernandez said.\u003c/p>\n\u003cp>But Assemblymember David Chiu, D-San Francisco, who introduced a different drug price transparency measure last year that never made it to a vote, said getting the political support to pass the bill may be tricky.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“These fights are very unpredictable,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Editor's note: This essay was originally published by the\u003ca href=\"http://www.healthycal.org\" target=\"_blank\"> California Health Report\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003cb>\u003c/b>California’s day programs for adults with autism are underfunded and overcrowded. But with thousands of young people with developmental delays or disabilities about to reach the age at which they can no longer attend a public school and receive the many services offered there, the problem is soon going to get much, much worse.\u003c/p>\n\u003cp>My daughter’s story is just one example of the limited options available for these young adults and the parents who care for them.\u003c/p>\n\u003cp>When Briana’s special education school abruptly closed in the fall, I was faced with the premature task of finding her a placement in an adult day program. Because she is just turning 21, she would only have one more year of special education services under the 1990 \u003ca href=\"https://www.disability.gov/individuals-disabilities-education-act-idea/\" target=\"_blank\">Individuals with Disabilities Educatio\u003c/a>n Act -- or IDEA -- which assures a free and appropriate public education to disabled students to age 22.\u003c/p>\n\u003cp>I had not heard great things about the options out there, primarily because my daughter has a severe form of autism that requires a high staff-to-student ratio just to keep her safe and on task.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Several months prior to this I had gotten a small head start by touring a residential and adult day program, in a bucolic setting among redwoods, hills and the quaint downtown streets of Marin County.\u003c/p>\n\u003cp>The feeling I got upon walking through the door was happiness and inclusion. A music session was winding down and most participants were engaged. Several art classes were also going on concurrently, and that was just the beginning. A textile art center was abuzz with some 30 people busy at their looms, while another group was outdoors working on the nearby garden. A residential hall and six group homes were scattered about in neighboring towns where most of the clients live. \"OK,\" I thought. \"This is a program I could see my Briana in. How do I sign her up?\"\u003c/p>\n\u003cp>Not so easy. There is not even a waiting list per se, and the program prefers clients that are more independent than Briana. She still needs help sometimes in the bathroom, and she needs a pair of eyeballs on her at all times due to her wandering tendencies. There really was no space for someone with such great needs.\u003c/p>\n\u003cp>So what else was out there? I began the search again, this time out of urgency due to Briana’s impending loss of school placement. Our social worker at the regional center, a state-funded agency that serves people with disabilities, loosely explained the structure of existing programs. There are behavioral programs in which staff members are trained to deal with severe behaviors, such as wandering, self-injury, aggression, and toileting needs. The staff-to-client ratios in these behavioral programs start at 1:3 – one staff person for every three clients — and if needed can be moved up to 1:2 and even 1:1. In other words clients first have to try the 1:3 and fail, 1:2 and fail to get a 1:1 -- instead of just asking for the 1:1 to begin with. The program I saw in Marin was non-behavioral, so the ratio is more like 1:6.\u003c/p>\n\u003cp>My daughter’s social worker set up more tours, and I dutifully went to each one. The first one, another non-behavioral program, was quite the opposite of the Marin program. I saw 50-plus clients crowded into two run-down rooms, many in wheelchairs parked in front of a big-screen television. It was noisy and chaotic. There were some smiles, but I didn’t picture Briana there at all.\u003c/p>\n\u003cp>I asked the director how often the clients went out in the community. He said once a week and with special arrangements by parents if they wanted activities like swimming.\u003c/p>\n\u003cp>I couldn’t wait to get out of there, but the following two programs, which were behavioral, were not much better. They had greater staff-to-client ratio, but the clients almost never left the building. There was no outdoor space to utilize or enjoy.\u003c/p>\n\u003cp>Briana is outdoorsy, energetic, enthusiastic and for the most part happy. She has her down days just like all of us, but I want her to access the most the community has to offer. I was overwhelmed by a sense of sadness that felt like an open wound for months.\u003c/p>\n\u003cp>These programs, with some exceptions like the well-established one in Marin, are buckling under current conditions, and they are only going to get worse with the increasing number of adults like my daughter about to age out of the school setting.\u003c/p>\n\u003cp>The demand is leading some new programs to open, but they are faced with trying to operate a business without failing. This can mean sub-optimal buildings, and paying low wages to staff.\u003c/p>\n\u003cp>The ratios of staff members to clients are controlled by reimbursement rates by the regional centers. The regional centers receive funding from the state Department of Developmental Services. The pay rates of some of these professionals are on par with what caregivers are paid, which is close to minimum wage. Pet sitters or baristas that serve us our coffee may earn more than we pay those important, compassionate people that care for our loved ones. Are we OK with this?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Time is needed to find a good day program for a disabled young adult because there are not enough options. In the next decade, 500,000 children with developmental delays will enter adulthood nationwide, overwhelming a system that is already inadequate for the current numbers. Legislative leaders need to know how bad the problem already is so that plans can be made to avoid this looming public crisis.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: This essay was originally published by the\u003ca href=\"http://www.healthycal.org\" target=\"_blank\"> California Health Report\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003cb>\u003c/b>California’s day programs for adults with autism are underfunded and overcrowded. But with thousands of young people with developmental delays or disabilities about to reach the age at which they can no longer attend a public school and receive the many services offered there, the problem is soon going to get much, much worse.\u003c/p>\n\u003cp>My daughter’s story is just one example of the limited options available for these young adults and the parents who care for them.\u003c/p>\n\u003cp>When Briana’s special education school abruptly closed in the fall, I was faced with the premature task of finding her a placement in an adult day program. Because she is just turning 21, she would only have one more year of special education services under the 1990 \u003ca href=\"https://www.disability.gov/individuals-disabilities-education-act-idea/\" target=\"_blank\">Individuals with Disabilities Educatio\u003c/a>n Act -- or IDEA -- which assures a free and appropriate public education to disabled students to age 22.\u003c/p>\n\u003cp>I had not heard great things about the options out there, primarily because my daughter has a severe form of autism that requires a high staff-to-student ratio just to keep her safe and on task.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Several months prior to this I had gotten a small head start by touring a residential and adult day program, in a bucolic setting among redwoods, hills and the quaint downtown streets of Marin County.\u003c/p>\n\u003cp>The feeling I got upon walking through the door was happiness and inclusion. A music session was winding down and most participants were engaged. Several art classes were also going on concurrently, and that was just the beginning. A textile art center was abuzz with some 30 people busy at their looms, while another group was outdoors working on the nearby garden. A residential hall and six group homes were scattered about in neighboring towns where most of the clients live. \"OK,\" I thought. \"This is a program I could see my Briana in. How do I sign her up?\"\u003c/p>\n\u003cp>Not so easy. There is not even a waiting list per se, and the program prefers clients that are more independent than Briana. She still needs help sometimes in the bathroom, and she needs a pair of eyeballs on her at all times due to her wandering tendencies. There really was no space for someone with such great needs.\u003c/p>\n\u003cp>So what else was out there? I began the search again, this time out of urgency due to Briana’s impending loss of school placement. Our social worker at the regional center, a state-funded agency that serves people with disabilities, loosely explained the structure of existing programs. There are behavioral programs in which staff members are trained to deal with severe behaviors, such as wandering, self-injury, aggression, and toileting needs. The staff-to-client ratios in these behavioral programs start at 1:3 – one staff person for every three clients — and if needed can be moved up to 1:2 and even 1:1. In other words clients first have to try the 1:3 and fail, 1:2 and fail to get a 1:1 -- instead of just asking for the 1:1 to begin with. The program I saw in Marin was non-behavioral, so the ratio is more like 1:6.\u003c/p>\n\u003cp>My daughter’s social worker set up more tours, and I dutifully went to each one. The first one, another non-behavioral program, was quite the opposite of the Marin program. I saw 50-plus clients crowded into two run-down rooms, many in wheelchairs parked in front of a big-screen television. It was noisy and chaotic. There were some smiles, but I didn’t picture Briana there at all.\u003c/p>\n\u003cp>I asked the director how often the clients went out in the community. He said once a week and with special arrangements by parents if they wanted activities like swimming.\u003c/p>\n\u003cp>I couldn’t wait to get out of there, but the following two programs, which were behavioral, were not much better. They had greater staff-to-client ratio, but the clients almost never left the building. There was no outdoor space to utilize or enjoy.\u003c/p>\n\u003cp>Briana is outdoorsy, energetic, enthusiastic and for the most part happy. She has her down days just like all of us, but I want her to access the most the community has to offer. I was overwhelmed by a sense of sadness that felt like an open wound for months.\u003c/p>\n\u003cp>These programs, with some exceptions like the well-established one in Marin, are buckling under current conditions, and they are only going to get worse with the increasing number of adults like my daughter about to age out of the school setting.\u003c/p>\n\u003cp>The demand is leading some new programs to open, but they are faced with trying to operate a business without failing. This can mean sub-optimal buildings, and paying low wages to staff.\u003c/p>\n\u003cp>The ratios of staff members to clients are controlled by reimbursement rates by the regional centers. The regional centers receive funding from the state Department of Developmental Services. The pay rates of some of these professionals are on par with what caregivers are paid, which is close to minimum wage. Pet sitters or baristas that serve us our coffee may earn more than we pay those important, compassionate people that care for our loved ones. Are we OK with this?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Time is needed to find a good day program for a disabled young adult because there are not enough options. In the next decade, 500,000 children with developmental delays will enter adulthood nationwide, overwhelming a system that is already inadequate for the current numbers. Legislative leaders need to know how bad the problem already is so that plans can be made to avoid this looming public crisis.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Surpasses National HIV Target -- 6 Years Early",
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"content": "\u003cp>State health officials say California has passed a major goal in fighting HIV/AIDS: more than 90 percent of people living with the virus have been diagnosed, a necessary first step in treatment.\u003c/p>\n\u003cp>The state accomplished this goal six years ahead of the target 2020 set in the \u003ca href=\"https://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/https://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/\" target=\"_blank\">National HIV/AIDS Strategy\u003c/a>, established by the White House.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdph.ca.gov/programs/aids/Documents/California%20Continuum%20of%20HIV%20Care%20-%202014.pdf\" target=\"_blank\">Data\u003c/a> released Monday from 2014 shows 91 percent of Californians with HIV had been diagnosed.\u003c/p>\n\u003cp>In a statement, state public health officer Dr. Karen Smith said she was \"proud of the work we’ve done across the Golden State to meet and surpass this key indicator, which will help us improve viral suppression rates and reduce new HIV infections.”\u003c/p>\n\u003cp>Only after people have been diagnosed can they be treated and dramatically reduce the virus in their blood, usually to undetectable levels. Successful treatment can reduce the risk of transmitting the virus to sex partners by 96 percent, according to the California Department of Public Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Chris Richey, a spokesman for the San Francisco AIDS Foundation, called the milestone \"a huge deal\" and said that diagnosis was a sign of being engaged in care.\u003c/p>\n\u003cp>\"If you're not engaged in care in general,\" Richey said, \"then you're not able to know or be in control of your sexual health or your overall health.\"\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention recommend that everyone between the ages of 13 and 64 get tested for HIV at least once, as part of routine health care. Some people should be tested more frequently, CDC says. State health officials recommend annual testing for sexually active gay and bisexual men, transgender individuals and anyone who injects drugs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 140,000 people in California are living with HIV.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State health officials say California has passed a major goal in fighting HIV/AIDS: more than 90 percent of people living with the virus have been diagnosed, a necessary first step in treatment.\u003c/p>\n\u003cp>The state accomplished this goal six years ahead of the target 2020 set in the \u003ca href=\"https://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/https://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/\" target=\"_blank\">National HIV/AIDS Strategy\u003c/a>, established by the White House.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdph.ca.gov/programs/aids/Documents/California%20Continuum%20of%20HIV%20Care%20-%202014.pdf\" target=\"_blank\">Data\u003c/a> released Monday from 2014 shows 91 percent of Californians with HIV had been diagnosed.\u003c/p>\n\u003cp>In a statement, state public health officer Dr. Karen Smith said she was \"proud of the work we’ve done across the Golden State to meet and surpass this key indicator, which will help us improve viral suppression rates and reduce new HIV infections.”\u003c/p>\n\u003cp>Only after people have been diagnosed can they be treated and dramatically reduce the virus in their blood, usually to undetectable levels. Successful treatment can reduce the risk of transmitting the virus to sex partners by 96 percent, according to the California Department of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Chris Richey, a spokesman for the San Francisco AIDS Foundation, called the milestone \"a huge deal\" and said that diagnosis was a sign of being engaged in care.\u003c/p>\n\u003cp>\"If you're not engaged in care in general,\" Richey said, \"then you're not able to know or be in control of your sexual health or your overall health.\"\u003c/p>\n\u003cp>The Centers for Disease Control and Prevention recommend that everyone between the ages of 13 and 64 get tested for HIV at least once, as part of routine health care. Some people should be tested more frequently, CDC says. State health officials recommend annual testing for sexually active gay and bisexual men, transgender individuals and anyone who injects drugs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 140,000 people in California are living with HIV.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>After someone has a health crisis and gets emergency medical care, the patient is sent home to recover. But what if that person has no home? The homeless can’t get well when they go back to the street, and they end up cycling back into expensive hospitals and emergency rooms.\u003c/p>\n\u003cp>Now one program in Southern California has tackled that dilemma by giving people just out of the hospital a place to heal – by turning cheap motels into triage and recovery wards.\u003c/p>\n\u003cp>Just up the freeway from Disneyland, in the city of Buena Park in Orange County, Paul Leon stands outside the beat-up remnant of a seedy motel. Above him, a faded pink sign advertises the Coral Motel – whose rooms back in its prime cost 35 bucks a night.\u003c/p>\n\u003cp>“This particular motel was going to be taken back by the city of Buena Park,” Leon says, “because of the drugs, alcohol, prostitution at the motel.”\u003c/p>\n\u003cfigure id=\"attachment_204668\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204668\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-10-e1467050104697.jpg\" alt=\"The Coral Motel in Buena Park, Calif., used by the Illumination Foundation Recuperative Care, serves as a respite for people needing a place to recover after being discharged from the hospital. \" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">The Coral Motel in Buena Park, Calif., used by the Illumination Foundation Recuperative Care, serves as a respite for people needing a place to recover after being discharged from the hospital. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Leon had another idea. As a public health nurse in Orange County, he proposed turning the motel lobby into a triage center and converting the rooms into clean recovery facilities for homeless people recently released from local hospitals.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Usually recuperative care centers are pricey to set up — but this, Leon says, was just the opposite.\u003c/p>\n\u003cp>“The beauty of this, it’s the poor man’s recuperative,” Leon says. “They’re not the Hyatt or the Hilton, but they do serve a purpose for us. The costs to run it are much less.”\u003c/p>\n\u003cp>The motel recovery room costs about half as much as a hospital would, that’s about $2,000 less per person for each day. In some ways, it’s better than being at home, because it has a nurse on staff to help supervise care and handle complications.\u003c/p>\n\u003cp>Elvin Quiñones is one of the patients staying at the Coral Motel. He walks me across the motel parking lot so he can show off his previous home -– a small white Datsun B210 sedan.\u003c/p>\n\u003cp>“I’ll show you my house,” he says, “it’s not very big.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_204670\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204670\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-13-e1467050409396.jpg\" alt=\"After Elvin Quiñones had gallbladder surgery, he didn’t have anywhere to recover. He ended up at the motel used by the Illumination Foundation Recuperative Care.\" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">After Elvin Quiñones had gallbladder surgery, he didn’t have anywhere to recover. He ended up at the motel used by the Illumination Foundation Recuperative Care. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Quiñones is a solid guy, and it’s hard to picture him crammed in the car along with his two dogs. In the days right after his gall bladder operation, he had a bunch of medical gear, too.\u003c/p>\n\u003cp>“I’ll be honest, I was sleeping in front of Walmart, the 24-hour Walmart, because they had a bathroom,” Quiñones says. “I still had a tube stuck inside me that was draining, so I needed someplace where I could empty out the drain.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>Being homeless and helpless, he says, is “surreal.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>“You think you’re going to wake up, and it’ll all be a nightmare. And you wake up and it’s not,” he says. “It’s just the next day.”\u003c/p>\n\u003cp>A week after his medical release, the hospital called and helped place him in the motel. Ginny Ripslinger is a nurse administrator at St. Joseph’s Hospital in the city of Orange.\u003c/p>\n\u003cp>“This is a new model of care for Orange County,” she says.\u003c/p>\n\u003cp>Over and above any state payments from Medi-Cal, California’s health care program for the poor, hospitals and health insurers are happy to pony up some cash, she says. They save money by stabilizing these patients.\u003c/p>\n\u003cp>More than that, Ripslinger says, it’s just the right thing to do.\u003c/p>\n\u003cp>“We don’t want to discharge them to the street,” she says. “And there’s an obligation on the hospitals to provide continuity of care and safe discharges.”\u003c/p>\n\u003cp>While those homeless patients are recovering in the motel room over two or three weeks, there’s a hidden benefit, Ripslinger says.\u003c/p>\n\u003cp>“You might say they’re a captured audience. We can then provide the social services and the linkages to the community for stable housing and get them in a protected environment,” she says.\u003c/p>\n\u003cfigure id=\"attachment_204664\" class=\"wp-caption aligncenter\" style=\"max-width: 1921px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204664\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-2-e1467049303242.jpg\" alt=\"Victor Ramirez, 61, uses his ventilator at the men’s dorm at the Illumination Foundation Recuperative Care in Santa Fe Springs, Calif.\" width=\"1921\" height=\"1282\">\u003cfigcaption class=\"wp-caption-text\">Victor Ramirez, 61, uses his ventilator at the men’s dorm at the Illumination Foundation Recuperative Care in Santa Fe Springs, Calif. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Leon launched the homeless services nonprofit called the Illumination Foundation to help provide those community links and health services.\u003c/p>\n\u003cp>The foundation now has expanded the motel model of care to six sites in four counties –- Orange, Los Angeles, Riverside, San Bernardino — and Leon says he has been working with dozens of cities across the country to establish similar models elsewhere.\u003c/p>\n\u003cp>“If you’re just starting and you don’t have a recuperative care program,” Leon says, “one easy quick method is to use motels. They could basically start within days to house some of the patients that are the most vulnerable.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Every city has a homeless problem, he adds, and every city has its own version of the beat-up Coral Motel. It’s a rare opportunity, Leon says, to turn two big problems into one solution.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After someone has a health crisis and gets emergency medical care, the patient is sent home to recover. But what if that person has no home? The homeless can’t get well when they go back to the street, and they end up cycling back into expensive hospitals and emergency rooms.\u003c/p>\n\u003cp>Now one program in Southern California has tackled that dilemma by giving people just out of the hospital a place to heal – by turning cheap motels into triage and recovery wards.\u003c/p>\n\u003cp>Just up the freeway from Disneyland, in the city of Buena Park in Orange County, Paul Leon stands outside the beat-up remnant of a seedy motel. Above him, a faded pink sign advertises the Coral Motel – whose rooms back in its prime cost 35 bucks a night.\u003c/p>\n\u003cp>“This particular motel was going to be taken back by the city of Buena Park,” Leon says, “because of the drugs, alcohol, prostitution at the motel.”\u003c/p>\n\u003cfigure id=\"attachment_204668\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204668\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-10-e1467050104697.jpg\" alt=\"The Coral Motel in Buena Park, Calif., used by the Illumination Foundation Recuperative Care, serves as a respite for people needing a place to recover after being discharged from the hospital. \" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">The Coral Motel in Buena Park, Calif., used by the Illumination Foundation Recuperative Care, serves as a respite for people needing a place to recover after being discharged from the hospital. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Leon had another idea. As a public health nurse in Orange County, he proposed turning the motel lobby into a triage center and converting the rooms into clean recovery facilities for homeless people recently released from local hospitals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Usually recuperative care centers are pricey to set up — but this, Leon says, was just the opposite.\u003c/p>\n\u003cp>“The beauty of this, it’s the poor man’s recuperative,” Leon says. “They’re not the Hyatt or the Hilton, but they do serve a purpose for us. The costs to run it are much less.”\u003c/p>\n\u003cp>The motel recovery room costs about half as much as a hospital would, that’s about $2,000 less per person for each day. In some ways, it’s better than being at home, because it has a nurse on staff to help supervise care and handle complications.\u003c/p>\n\u003cp>Elvin Quiñones is one of the patients staying at the Coral Motel. He walks me across the motel parking lot so he can show off his previous home -– a small white Datsun B210 sedan.\u003c/p>\n\u003cp>“I’ll show you my house,” he says, “it’s not very big.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_204670\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204670\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-13-e1467050409396.jpg\" alt=\"After Elvin Quiñones had gallbladder surgery, he didn’t have anywhere to recover. He ended up at the motel used by the Illumination Foundation Recuperative Care.\" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">After Elvin Quiñones had gallbladder surgery, he didn’t have anywhere to recover. He ended up at the motel used by the Illumination Foundation Recuperative Care. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Quiñones is a solid guy, and it’s hard to picture him crammed in the car along with his two dogs. In the days right after his gall bladder operation, he had a bunch of medical gear, too.\u003c/p>\n\u003cp>“I’ll be honest, I was sleeping in front of Walmart, the 24-hour Walmart, because they had a bathroom,” Quiñones says. “I still had a tube stuck inside me that was draining, so I needed someplace where I could empty out the drain.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>Being homeless and helpless, he says, is “surreal.”\u003c/p>\n\u003cp>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>“You think you’re going to wake up, and it’ll all be a nightmare. And you wake up and it’s not,” he says. “It’s just the next day.”\u003c/p>\n\u003cp>A week after his medical release, the hospital called and helped place him in the motel. Ginny Ripslinger is a nurse administrator at St. Joseph’s Hospital in the city of Orange.\u003c/p>\n\u003cp>“This is a new model of care for Orange County,” she says.\u003c/p>\n\u003cp>Over and above any state payments from Medi-Cal, California’s health care program for the poor, hospitals and health insurers are happy to pony up some cash, she says. They save money by stabilizing these patients.\u003c/p>\n\u003cp>More than that, Ripslinger says, it’s just the right thing to do.\u003c/p>\n\u003cp>“We don’t want to discharge them to the street,” she says. “And there’s an obligation on the hospitals to provide continuity of care and safe discharges.”\u003c/p>\n\u003cp>While those homeless patients are recovering in the motel room over two or three weeks, there’s a hidden benefit, Ripslinger says.\u003c/p>\n\u003cp>“You might say they’re a captured audience. We can then provide the social services and the linkages to the community for stable housing and get them in a protected environment,” she says.\u003c/p>\n\u003cfigure id=\"attachment_204664\" class=\"wp-caption aligncenter\" style=\"max-width: 1921px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-204664\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/homeless-hotel-2-e1467049303242.jpg\" alt=\"Victor Ramirez, 61, uses his ventilator at the men’s dorm at the Illumination Foundation Recuperative Care in Santa Fe Springs, Calif.\" width=\"1921\" height=\"1282\">\u003cfigcaption class=\"wp-caption-text\">Victor Ramirez, 61, uses his ventilator at the men’s dorm at the Illumination Foundation Recuperative Care in Santa Fe Springs, Calif. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Leon launched the homeless services nonprofit called the Illumination Foundation to help provide those community links and health services.\u003c/p>\n\u003cp>The foundation now has expanded the motel model of care to six sites in four counties –- Orange, Los Angeles, Riverside, San Bernardino — and Leon says he has been working with dozens of cities across the country to establish similar models elsewhere.\u003c/p>\n\u003cp>“If you’re just starting and you don’t have a recuperative care program,” Leon says, “one easy quick method is to use motels. They could basically start within days to house some of the patients that are the most vulnerable.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Every city has a homeless problem, he adds, and every city has its own version of the beat-up Coral Motel. It’s a rare opportunity, Leon says, to turn two big problems into one solution.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Are Your Pipes Made Of Lead? Here's A Quick Way To Find Out",
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"content": "\u003cp>Until the 1970s, lead was a common additive in gasoline and household paints. But now, scientists agree that \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1601013\" target=\"_blank\">no amount\u003c/a> of lead in a child's blood is \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/su6104a1.htm?s_cid=su6104a1_w\" target=\"_blank\">considered safe\u003c/a>.\u003c/p>\n\u003cp>In kids, even low levels of \u003ca href=\"http://www.atsdr.cdc.gov/csem/csem.asp?csem=7&po=10\">lead exposure\u003c/a> can cause behavior and learning problems. In adults, it's associated with high blood pressure and kidney problems. And there's evidence it can \u003ca href=\"http://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf\">affect\u003c/a> a developing fetus.\u003c/p>\n\u003caside class=\"pullquote alignright\">What are your pipes made of? \u003ca href=\"http://apps.npr.org/find-lead-pipes-in-your-home/#intro\" target=\"_blank\">Click here to find out\u003c/a>. All you need is a key and a magnet\u003c/aside>\n\u003cp>Corrosive water running through lead pipes in Flint, Mich., led to a public health crisis — signaled in part by \u003ca href=\"http://ajph.aphapublications.org/doi/10.2105/AJPH.2015.303003\" target=\"_blank\">a rise\u003c/a> in the amount of lead in children's blood. Conditions in Flint were particularly disastrous, but lead pipes continue to bring water to homes in much of the country. And wherever lead plumbing is in place, there is a risk that small amounts of the metal could leach into drinking water.\u003c/p>\n\u003cp>The main source of lead in domestic drinking water is the service line. It's like a straw that carries water to the house from the main, and it \u003ca href=\"http://www.cdc.gov/nceh/lead/tips/water.htm\" target=\"_blank\">can be\u003c/a> pure lead. (If it isn't made of lead, it might be soldered together with lead or connected to brass fixtures containing lead.) And in many cities, most of the service line is considered private property – the homeowner's responsibility.\u003c/p>\n\u003cp>Anti-corrosive chemicals can reduce the amount of lead leaching into the water, but they can't stop it entirely. Lead can still flake off from pipes or soldering in tiny pieces and end up in drinking water, especially when it sits in pipes for more than a few hours. Other things can shake lead free, like construction or heavy trucks driving down the road.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We'll help you find out if your drinking water is at risk. And if you do find lead, we'll show you what you can do. Check \u003ca href=\"http://apps.npr.org/find-lead-pipes-in-your-home/#intro\" target=\"_blank\">our app\u003c/a> for help.\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=Are+Your+Pipes+Made+Of+Lead%3F+Here%27s+A+Quick+Way+To+Find+Out&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Until the 1970s, lead was a common additive in gasoline and household paints. But now, scientists agree that \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1601013\" target=\"_blank\">no amount\u003c/a> of lead in a child's blood is \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/su6104a1.htm?s_cid=su6104a1_w\" target=\"_blank\">considered safe\u003c/a>.\u003c/p>\n\u003cp>In kids, even low levels of \u003ca href=\"http://www.atsdr.cdc.gov/csem/csem.asp?csem=7&po=10\">lead exposure\u003c/a> can cause behavior and learning problems. In adults, it's associated with high blood pressure and kidney problems. And there's evidence it can \u003ca href=\"http://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf\">affect\u003c/a> a developing fetus.\u003c/p>\n\u003caside class=\"pullquote alignright\">What are your pipes made of? \u003ca href=\"http://apps.npr.org/find-lead-pipes-in-your-home/#intro\" target=\"_blank\">Click here to find out\u003c/a>. All you need is a key and a magnet\u003c/aside>\n\u003cp>Corrosive water running through lead pipes in Flint, Mich., led to a public health crisis — signaled in part by \u003ca href=\"http://ajph.aphapublications.org/doi/10.2105/AJPH.2015.303003\" target=\"_blank\">a rise\u003c/a> in the amount of lead in children's blood. Conditions in Flint were particularly disastrous, but lead pipes continue to bring water to homes in much of the country. And wherever lead plumbing is in place, there is a risk that small amounts of the metal could leach into drinking water.\u003c/p>\n\u003cp>The main source of lead in domestic drinking water is the service line. It's like a straw that carries water to the house from the main, and it \u003ca href=\"http://www.cdc.gov/nceh/lead/tips/water.htm\" target=\"_blank\">can be\u003c/a> pure lead. (If it isn't made of lead, it might be soldered together with lead or connected to brass fixtures containing lead.) And in many cities, most of the service line is considered private property – the homeowner's responsibility.\u003c/p>\n\u003cp>Anti-corrosive chemicals can reduce the amount of lead leaching into the water, but they can't stop it entirely. Lead can still flake off from pipes or soldering in tiny pieces and end up in drinking water, especially when it sits in pipes for more than a few hours. Other things can shake lead free, like construction or heavy trucks driving down the road.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We'll help you find out if your drinking water is at risk. And if you do find lead, we'll show you what you can do. Check \u003ca href=\"http://apps.npr.org/find-lead-pipes-in-your-home/#intro\" target=\"_blank\">our app\u003c/a> for help.\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=Are+Your+Pipes+Made+Of+Lead%3F+Here%27s+A+Quick+Way+To+Find+Out&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Parent Alert: Nasal Flu Vaccine Doesn't Actually Work",
"title": "Parent Alert: Nasal Flu Vaccine Doesn't Actually Work",
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"content": "\u003cp>What you see in the photo above is a young child getting a flu vaccine via nasal mist. The picture was taken in 2014. But you likely won't see any children getting that version of the vaccine this year.\u003c/p>\n\u003cp>Health officials have studied its effectiveness and found \"no evidence\" the spray actually prevented the flu.\u003c/p>\n\u003cp>When I found this out last night, all I could think was \"My kids are going to have a cow.\" My son is at sleepaway camp, so is temporarily spared the news. But when I told my 15-year-old daughter that she would have to switch to a shot, she exclaimed, \"OH NO\" and threw her head in my lap.\u003c/p>\n\u003cfigure id=\"attachment_202763\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-202763\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/IMG_1756-e1466702366826.jpg\" alt=\"A 15-year-old girl in mock horror after learning she can no longer get a flu vaccine via nasal mist. \" width=\"1920\" height=\"1715\">\u003cfigcaption class=\"wp-caption-text\">A 15-year-old girl in mock horror after learning she can no longer get a flu vaccine via nasal mist. \u003ccite>(John Storella)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>(She quickly recovered.)\u003c/p>\n\u003cp>The sad news comes from the Center for Disease Control's Advisory Committee on Immunization Practice which voted Wednesday that the live attenuated influenza vaccine (that's the \"nasal spray\" vaccine) should not be used in the 2016-2017 influenza season.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CDC usually adopts the committee's recommendations.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2016/06/23/483239744/bad-news-for-kids-who-dont-like-flu-shots\" target=\"_blank\">NPR reports \u003c/a>that scientists aren't really sure why the nasal spray is no longer working:\u003c/p>\n\u003cblockquote>\u003cp>\"The company [that manufactures FluMist], the FDA, and other investigators still haven't been able to put their scientific finger on the exact reason, but there are several studies that have indicated that in the United States the vaccine has underperformed in a very substantial way,\" said \u003ca href=\"https://medicine.mc.vanderbilt.edu/node/451\" target=\"_blank\">Dr. William Schaffner\u003c/a>, an infectious disease specialist at the Vanderbilt University School of Medicine and longtime member of the Influenza Vaccine Working Group.\u003c/p>\n\u003cp>Schaffner did note, however, that the spray began performing poorly when all flu vaccines were adjusted to protect against four influenza strains instead of three.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, AstraZeneca, the maker of FluMist, \u003ca href=\"https://www.astrazeneca.com/media-centre/press-releases/2016/astrazeneca-provides-update-on-flumist-quadrivalent-vaccine-in-the-us-for-the-2016-17-influenza-season-23062016.html\" target=\"_blank\">said in a statement \u003c/a>that it \"is working with the CDC to better understand its data to help ensure eligible patients continue to receive the vaccine in future seasons in the U.S.\"\u003c/p>\n\u003cp>Early studies, including randomized trials coordinated by the manufacturer, showed FluMist was highly effective, and in children performed better than traditional flu shots.\u003c/p>\n\u003cp>The numbers looked so good that in 2014 the committee made the unusual decision to advise doctors that FluMist was better at preventing flu in healthy kids ages 2 through 8.\u003c/p>\n\u003cp>But since then, studies have shown the vaccine didn't work well against the most common flu strains in any of the past three flu seasons. All flu vaccines performed poorly two winters ago, but data show FluMist performed poorly the two other seasons as well.\u003c/p>\n\u003cp>During the winter that just ended, flu shots were nearly 50 percent effective against the flu strain that made most people sick. But FluMist didn't work at all, CDC researchers said, citing preliminary results from a study of about 2,300 U.S. children.\u003c/p>\n\u003cp>Dr. Joseph Bresee, a flu expert at the CDC said there's no evidence of an increase in flu deaths among kids who had the FluMist.\u003c/p>\n\u003cp>CDC recommends that everyone over age six months receives a flu vaccine every year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>What you see in the photo above is a young child getting a flu vaccine via nasal mist. The picture was taken in 2014. But you likely won't see any children getting that version of the vaccine this year.\u003c/p>\n\u003cp>Health officials have studied its effectiveness and found \"no evidence\" the spray actually prevented the flu.\u003c/p>\n\u003cp>When I found this out last night, all I could think was \"My kids are going to have a cow.\" My son is at sleepaway camp, so is temporarily spared the news. But when I told my 15-year-old daughter that she would have to switch to a shot, she exclaimed, \"OH NO\" and threw her head in my lap.\u003c/p>\n\u003cfigure id=\"attachment_202763\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-202763\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/IMG_1756-e1466702366826.jpg\" alt=\"A 15-year-old girl in mock horror after learning she can no longer get a flu vaccine via nasal mist. \" width=\"1920\" height=\"1715\">\u003cfigcaption class=\"wp-caption-text\">A 15-year-old girl in mock horror after learning she can no longer get a flu vaccine via nasal mist. \u003ccite>(John Storella)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>(She quickly recovered.)\u003c/p>\n\u003cp>The sad news comes from the Center for Disease Control's Advisory Committee on Immunization Practice which voted Wednesday that the live attenuated influenza vaccine (that's the \"nasal spray\" vaccine) should not be used in the 2016-2017 influenza season.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CDC usually adopts the committee's recommendations.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2016/06/23/483239744/bad-news-for-kids-who-dont-like-flu-shots\" target=\"_blank\">NPR reports \u003c/a>that scientists aren't really sure why the nasal spray is no longer working:\u003c/p>\n\u003cblockquote>\u003cp>\"The company [that manufactures FluMist], the FDA, and other investigators still haven't been able to put their scientific finger on the exact reason, but there are several studies that have indicated that in the United States the vaccine has underperformed in a very substantial way,\" said \u003ca href=\"https://medicine.mc.vanderbilt.edu/node/451\" target=\"_blank\">Dr. William Schaffner\u003c/a>, an infectious disease specialist at the Vanderbilt University School of Medicine and longtime member of the Influenza Vaccine Working Group.\u003c/p>\n\u003cp>Schaffner did note, however, that the spray began performing poorly when all flu vaccines were adjusted to protect against four influenza strains instead of three.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, AstraZeneca, the maker of FluMist, \u003ca href=\"https://www.astrazeneca.com/media-centre/press-releases/2016/astrazeneca-provides-update-on-flumist-quadrivalent-vaccine-in-the-us-for-the-2016-17-influenza-season-23062016.html\" target=\"_blank\">said in a statement \u003c/a>that it \"is working with the CDC to better understand its data to help ensure eligible patients continue to receive the vaccine in future seasons in the U.S.\"\u003c/p>\n\u003cp>Early studies, including randomized trials coordinated by the manufacturer, showed FluMist was highly effective, and in children performed better than traditional flu shots.\u003c/p>\n\u003cp>The numbers looked so good that in 2014 the committee made the unusual decision to advise doctors that FluMist was better at preventing flu in healthy kids ages 2 through 8.\u003c/p>\n\u003cp>But since then, studies have shown the vaccine didn't work well against the most common flu strains in any of the past three flu seasons. All flu vaccines performed poorly two winters ago, but data show FluMist performed poorly the two other seasons as well.\u003c/p>\n\u003cp>During the winter that just ended, flu shots were nearly 50 percent effective against the flu strain that made most people sick. But FluMist didn't work at all, CDC researchers said, citing preliminary results from a study of about 2,300 U.S. children.\u003c/p>\n\u003cp>Dr. Joseph Bresee, a flu expert at the CDC said there's no evidence of an increase in flu deaths among kids who had the FluMist.\u003c/p>\n\u003cp>CDC recommends that everyone over age six months receives a flu vaccine every year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It was a circuitous route, but a ballot measure was submitted to the San Francisco Department of Elections Tuesday afternoon, and voters in November will decide whether to levy a penny-per-ounce tax on sugar-sweetened beverages.\u003c/p>\n\u003cp>The soda tax was supposed to be placed on the ballot last month, following a signature gathering campaign. Proponents were thrilled that they had collected twice the number of signatures needed.\u003c/p>\n\u003cp>Just one problem: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/12/san-francisco-soda-tax-in-jeopardy-signatures-submitted-day-late/\" target=\"_blank\">they turned those signatures in a day late.\u003c/a>\u003c/p>\n\u003cp>So they pivoted. San Francisco law permits four supervisors to directly place an initiative on the ballot, and that's what happened here. Supervisors Malia Cohen, Eric Mar, Scott Wiener and Mark Farrell all signed the initiative.\u003c/p>\n\u003cp>The 14-page proposal links sugary beverages to the problems of obesity and diabetes, and says the measure \"is intended to discourage the distribution and consumption of sugar-sweetened beverages in San Francisco by taxing their distribution.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We're very excited about taking on 'big soda' and look forward to talking with voters about this very important public health issue,\" said Yoyo Chan, legislative aide to Supervisor Malia Cohen.\u003c/p>\n\u003cp>The \u003ca href=\"http://yourcartyourchoice.com/aba/advocacy/ca/postdetail.aspx?Id=114\" target=\"_blank\">beverage industry opposes\u003c/a> such taxes, calling them regressive and unfairly singling out beverages as responsible for the problems of obesity and diabetes.\u003c/p>\n\u003cp>A soda tax in San Franciso \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">failed two years ago\u003c/a>, but that measure differed from this one. In 2014, the proposal was two-cents-per-ounce with the money dedicated to specific health programs. Because the proceeds were earmarked, the measure required a two-thirds supermajority for passage. The measure fell short, with 54.5 percent of the vote.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/oakland-city-council-puts-soda-tax-on-november-ballot/\" target=\"_blank\">Oakland\u003c/a> and \u003ca href=\"http://www.eastbaytimes.com/richmond/ci_29904998/albany-voters-decide-sidewalk-repair-and-soda-tax\" target=\"_blank\">Albany\u003c/a> voters will also consider a soda tax this fall. Two years ago, Berkeley became the\u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\"> first city in the country \u003c/a>with such a tax. All the measures are a penny per ounce, with proceeds intended for health programs. The funds generated will be general fund revenue.\u003c/p>\n\u003cp>The San Francisco measure calls for the creation of a 16-person advisory panel to advise the Board of Supervisors and the mayor to create and/or fund programs to reduce the consumption of sugar-sweetened beverages in San Francisco.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/16/philadelphia-first-major-u-s-city-to-pass-soda-tax/\" target=\"_blank\">Philadelphia City Council\u003c/a> passed a 1.5 cents per ounce soda tax. Most of the proceeds will be used to pay for pre-kindergarten in the city.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was a circuitous route, but a ballot measure was submitted to the San Francisco Department of Elections Tuesday afternoon, and voters in November will decide whether to levy a penny-per-ounce tax on sugar-sweetened beverages.\u003c/p>\n\u003cp>The soda tax was supposed to be placed on the ballot last month, following a signature gathering campaign. Proponents were thrilled that they had collected twice the number of signatures needed.\u003c/p>\n\u003cp>Just one problem: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/12/san-francisco-soda-tax-in-jeopardy-signatures-submitted-day-late/\" target=\"_blank\">they turned those signatures in a day late.\u003c/a>\u003c/p>\n\u003cp>So they pivoted. San Francisco law permits four supervisors to directly place an initiative on the ballot, and that's what happened here. Supervisors Malia Cohen, Eric Mar, Scott Wiener and Mark Farrell all signed the initiative.\u003c/p>\n\u003cp>The 14-page proposal links sugary beverages to the problems of obesity and diabetes, and says the measure \"is intended to discourage the distribution and consumption of sugar-sweetened beverages in San Francisco by taxing their distribution.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're very excited about taking on 'big soda' and look forward to talking with voters about this very important public health issue,\" said Yoyo Chan, legislative aide to Supervisor Malia Cohen.\u003c/p>\n\u003cp>The \u003ca href=\"http://yourcartyourchoice.com/aba/advocacy/ca/postdetail.aspx?Id=114\" target=\"_blank\">beverage industry opposes\u003c/a> such taxes, calling them regressive and unfairly singling out beverages as responsible for the problems of obesity and diabetes.\u003c/p>\n\u003cp>A soda tax in San Franciso \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">failed two years ago\u003c/a>, but that measure differed from this one. In 2014, the proposal was two-cents-per-ounce with the money dedicated to specific health programs. Because the proceeds were earmarked, the measure required a two-thirds supermajority for passage. The measure fell short, with 54.5 percent of the vote.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/oakland-city-council-puts-soda-tax-on-november-ballot/\" target=\"_blank\">Oakland\u003c/a> and \u003ca href=\"http://www.eastbaytimes.com/richmond/ci_29904998/albany-voters-decide-sidewalk-repair-and-soda-tax\" target=\"_blank\">Albany\u003c/a> voters will also consider a soda tax this fall. Two years ago, Berkeley became the\u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\"> first city in the country \u003c/a>with such a tax. All the measures are a penny per ounce, with proceeds intended for health programs. The funds generated will be general fund revenue.\u003c/p>\n\u003cp>The San Francisco measure calls for the creation of a 16-person advisory panel to advise the Board of Supervisors and the mayor to create and/or fund programs to reduce the consumption of sugar-sweetened beverages in San Francisco.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/16/philadelphia-first-major-u-s-city-to-pass-soda-tax/\" target=\"_blank\">Philadelphia City Council\u003c/a> passed a 1.5 cents per ounce soda tax. Most of the proceeds will be used to pay for pre-kindergarten in the city.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Targeting and Healing Medi-Cal's Most Expensive Patients -- And Saving Money",
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"content": "\u003cp>SANTA FE SPRINGS -- Don Meade may not like hospitals, but he uses them. In just one year, he made 62 trips to the emergency room. He rattles off the names of local hospitals in Orange and Los Angeles counties like they're a handful of pills.\u003c/p>\n\u003cp>\"St. Joseph's, Laguna Hills,\" he says. \"The best one for me around here is PIH in Whittier.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was them relying on the ER for everything. They got a common cold, they’d run to the ER.'\u003ccite> John Simmons, lead nurse in Chronic Care Plus program\u003c/cite>\u003c/aside>\n\u003cp>At 52, Meade has chronic heart disease and other serious ailments, and he is recovering from a longtime addiction to crack cocaine. Today, he lives with his dog Scrappy in a small apartment in Fullerton.\u003c/p>\n\u003cp>As health care costs continue to rise, attention has turned to a tiny number of expensive patients like Meade, called super-utilizers. One program in Southern California has taken a different approach to treating Meade and other high-cost patients: Over the past two years, it has tracked them, healed them and saved a ton of money along the way.\u003c/p>\n\u003cp>Beyond making a trip to the ER pretty much every week of the year, Meade has had innumerable X-rays, scans, tests and hospital admissions — all of it on the taxpayers' and hospitals' dime, since he is a beneficiary of Medi-Cal, the state and federal program for the poor.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The doctors and a few nurses knew me [by name], and I told them I should get some stock in the hospital because I was there so much,\" he muses.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/270183668\" 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>Meade received more than $1 million in care each year in the two years before he entered the Orange County program, according to Paul León, CEO of the Illumination Foundation, which runs the Chronic Care Plus program that has stabilized Meade and found him housing.\u003c/p>\n\u003cp>\"It's crazy,\" says Maria Raven, an associate professor at UC San Francisco who specializes in frequent-user policy. \"This small group of people makes quite an impact on the health care system, and on the finances of the health care system.\"\u003c/p>\n\u003cp>Within Medi-Cal, frequent health care users make up just 1 percent of the patient population, but soak up about one-fourth of health care spending, according to Dr. Kenneth Kizer at the Institute for Population Health Improvement at UC Davis.\u003c/p>\n\u003cp>That's why health professionals across California have started targeting this problem group.\u003c/p>\n\u003cfigure id=\"attachment_201680\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-201680 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/super-utilizer-6-e1466531188307.jpg\" alt=\"Donald Meade plays with his puppy, Scrappy, at his new apartment in Fullerton, Calif.\" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">Donald Meade plays with his puppy, Scrappy, at his new apartment in Fullerton, California. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a small, busy room in a facility in Santa Fe Springs, just up Interstate 5 from Disneyland, the Chronic Care Plus program's lead nurse, John Simmons, directs care for a select group of homeless frequent users.\u003c/p>\n\u003cp>Simmons says the big secret about these health care frequent fliers is that they're not necessarily the sickest patients -- they're often just homeless, with substance abuse or mental health issues, and they routinely end up in the emergency room.\u003c/p>\n\u003cp>\"It was them relying on the ER for everything,\" Simmons says. \"They got a common cold, they’d want to run to the ER.\"\u003c/p>\n\u003cp>To break the cycle, Simmons does what is known as intensive care coordination. He helps the 37 participants, including Don Meade, find housing, get off drugs, get access to services and make an appointment with a primary care doctor.\u003c/p>\n\u003cp>The Illumination Foundation, a homeless health services group based in Orange County, started the program with the goal of breaking the vicious cycle into which these people had fallen, and then following them over a two-year period. That length of time, Simmons says, can change their lives for good.\u003c/p>\n\u003cp>\"The beauty of the program was, we took those people and got them self-sufficient,\" Simmons says, \"and you notice their health [go] on an upward trend.\"\u003c/p>\n\u003cp>The program saved $14 million in health care spending for just those 37 people over two years, compared with the two years prior to the launch of the program.\u003c/p>\n\u003cp>That doesn't count the savings of requiring fewer police and emergency transportation services, Simmons says.\u003c/p>\n\u003cp>Saving so much money with so few participants is an open invitation to expand the program, says Pat Brydges, an administrator at St. Joseph's Hospital, which helped fund the program.\u003c/p>\n\u003cp>\"There are homeless people in every city in every state,\" Brydges says. \"There's no reason why this wouldn't work across the nation.\"\u003c/p>\n\u003cp>It is consistent with St. Joseph's mission to help all people, and the cost savings is an extra perk, she says.\u003c/p>\n\u003cp>She pauses briefly to contemplate how much money would be saved if this tiny pilot program went national.\u003c/p>\n\u003cp>\"Wow, I don’t even know if I could count that much,\" Brydges says. \"But if we can do $14 million in this one area alone, it’s amazing what we could do across the nation.\"\u003c/p>\n\u003cp>Back in his Fullerton apartment, Meade says he now sees a primary care doctor instead of going to the emergency department. His weekly trips to the hospital have decreased, though he still has ongoing heart and health problems.\u003c/p>\n\u003cp>Being followed by program coordinators over such a long time has really made a difference in his life, Meade says.\u003c/p>\n\u003cp>\"A lot of the stress leaves after you’re in your own home, but if you're out in the street you’re worried so much all the time,\" he says.\u003c/p>\n\u003cp>Getting off the street is one thing, Meade says, but staying off the street is another. It's not just that he has his own doctor now, and better health. He has a new life, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Illumination Foundation plans to release data at the end of June on its first two years.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SANTA FE SPRINGS -- Don Meade may not like hospitals, but he uses them. In just one year, he made 62 trips to the emergency room. He rattles off the names of local hospitals in Orange and Los Angeles counties like they're a handful of pills.\u003c/p>\n\u003cp>\"St. Joseph's, Laguna Hills,\" he says. \"The best one for me around here is PIH in Whittier.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was them relying on the ER for everything. They got a common cold, they’d run to the ER.'\u003ccite> John Simmons, lead nurse in Chronic Care Plus program\u003c/cite>\u003c/aside>\n\u003cp>At 52, Meade has chronic heart disease and other serious ailments, and he is recovering from a longtime addiction to crack cocaine. Today, he lives with his dog Scrappy in a small apartment in Fullerton.\u003c/p>\n\u003cp>As health care costs continue to rise, attention has turned to a tiny number of expensive patients like Meade, called super-utilizers. One program in Southern California has taken a different approach to treating Meade and other high-cost patients: Over the past two years, it has tracked them, healed them and saved a ton of money along the way.\u003c/p>\n\u003cp>Beyond making a trip to the ER pretty much every week of the year, Meade has had innumerable X-rays, scans, tests and hospital admissions — all of it on the taxpayers' and hospitals' dime, since he is a beneficiary of Medi-Cal, the state and federal program for the poor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The doctors and a few nurses knew me [by name], and I told them I should get some stock in the hospital because I was there so much,\" he muses.\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/270183668&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/270183668'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Meade received more than $1 million in care each year in the two years before he entered the Orange County program, according to Paul León, CEO of the Illumination Foundation, which runs the Chronic Care Plus program that has stabilized Meade and found him housing.\u003c/p>\n\u003cp>\"It's crazy,\" says Maria Raven, an associate professor at UC San Francisco who specializes in frequent-user policy. \"This small group of people makes quite an impact on the health care system, and on the finances of the health care system.\"\u003c/p>\n\u003cp>Within Medi-Cal, frequent health care users make up just 1 percent of the patient population, but soak up about one-fourth of health care spending, according to Dr. Kenneth Kizer at the Institute for Population Health Improvement at UC Davis.\u003c/p>\n\u003cp>That's why health professionals across California have started targeting this problem group.\u003c/p>\n\u003cfigure id=\"attachment_201680\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-201680 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/super-utilizer-6-e1466531188307.jpg\" alt=\"Donald Meade plays with his puppy, Scrappy, at his new apartment in Fullerton, Calif.\" width=\"1920\" height=\"1281\">\u003cfigcaption class=\"wp-caption-text\">Donald Meade plays with his puppy, Scrappy, at his new apartment in Fullerton, California. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a small, busy room in a facility in Santa Fe Springs, just up Interstate 5 from Disneyland, the Chronic Care Plus program's lead nurse, John Simmons, directs care for a select group of homeless frequent users.\u003c/p>\n\u003cp>Simmons says the big secret about these health care frequent fliers is that they're not necessarily the sickest patients -- they're often just homeless, with substance abuse or mental health issues, and they routinely end up in the emergency room.\u003c/p>\n\u003cp>\"It was them relying on the ER for everything,\" Simmons says. \"They got a common cold, they’d want to run to the ER.\"\u003c/p>\n\u003cp>To break the cycle, Simmons does what is known as intensive care coordination. He helps the 37 participants, including Don Meade, find housing, get off drugs, get access to services and make an appointment with a primary care doctor.\u003c/p>\n\u003cp>The Illumination Foundation, a homeless health services group based in Orange County, started the program with the goal of breaking the vicious cycle into which these people had fallen, and then following them over a two-year period. That length of time, Simmons says, can change their lives for good.\u003c/p>\n\u003cp>\"The beauty of the program was, we took those people and got them self-sufficient,\" Simmons says, \"and you notice their health [go] on an upward trend.\"\u003c/p>\n\u003cp>The program saved $14 million in health care spending for just those 37 people over two years, compared with the two years prior to the launch of the program.\u003c/p>\n\u003cp>That doesn't count the savings of requiring fewer police and emergency transportation services, Simmons says.\u003c/p>\n\u003cp>Saving so much money with so few participants is an open invitation to expand the program, says Pat Brydges, an administrator at St. Joseph's Hospital, which helped fund the program.\u003c/p>\n\u003cp>\"There are homeless people in every city in every state,\" Brydges says. \"There's no reason why this wouldn't work across the nation.\"\u003c/p>\n\u003cp>It is consistent with St. Joseph's mission to help all people, and the cost savings is an extra perk, she says.\u003c/p>\n\u003cp>She pauses briefly to contemplate how much money would be saved if this tiny pilot program went national.\u003c/p>\n\u003cp>\"Wow, I don’t even know if I could count that much,\" Brydges says. \"But if we can do $14 million in this one area alone, it’s amazing what we could do across the nation.\"\u003c/p>\n\u003cp>Back in his Fullerton apartment, Meade says he now sees a primary care doctor instead of going to the emergency department. His weekly trips to the hospital have decreased, though he still has ongoing heart and health problems.\u003c/p>\n\u003cp>Being followed by program coordinators over such a long time has really made a difference in his life, Meade says.\u003c/p>\n\u003cp>\"A lot of the stress leaves after you’re in your own home, but if you're out in the street you’re worried so much all the time,\" he says.\u003c/p>\n\u003cp>Getting off the street is one thing, Meade says, but staying off the street is another. It's not just that he has his own doctor now, and better health. He has a new life, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Illumination Foundation plans to release data at the end of June on its first two years.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "UCSF Study Links Pharma Meals to Brand-Name Prescribing by Doctors",
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"content": "\u003cp>Evidence is mounting that doctors who receive as little as one meal from a drug company tend to prescribe more expensive, brand-name medications for common ailments than those who don’t.\u003c/p>\n\u003cp>A study from researchers at UC San Francisco that was \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2528290\" target=\"_blank\">published online Monday in JAMA Internal Medicine\u003c/a> found significant evidence that doctors who received meals tied to specific drugs prescribed a higher proportion of those products than their peers. Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. And the more meals they received, the greater share of those drugs they tended to prescribe relative to other medications in the same category.\u003c/p>\n\u003caside class=\"pullquote alignright\">Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug\u003c/aside>\n\u003cp>The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.propublica.org/article/doctors-who-take-company-cash-tend-to-prescribe-more-brand-name-drugs\" target=\"_blank\">ProPublica story\u003c/a> published in March found that doctors who took payments from the pharmaceutical and medical device industries prescribed a higher proportion of brand-name medications than those who didn’t. It also found that the more money a doctor received, the higher the percentage of brand-name drugs he or she prescribed, on average.\u003c/p>\n\u003cp>Similarly, a \u003ca href=\"https://www.propublica.org/article/another-study-finds-link-between-pharma-money-and-brand-name-prescribing\" target=\"_blank\">Harvard Medical School study\u003c/a> published in May found that Massachusetts physicians prescribed a larger proportion of brand-name statins — the category of drugs that treat high cholesterol — the more industry money they received. There was no significant increase in brand-name prescribing for those who received less than $2,000.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What makes the current study different is that it looked at specific drugs.\u003c/p>\n\u003cp>In an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/17/orlando-shooting-raises-questions-about-internalized-homophobia-and-violence/\" target=\"_blank\">editor’s note\u003c/a>, Dr. Robert Steinbrook wrote that the recent analyses “raise a broader question. Is it necessary to prove a causal relationship between industry payments to physicians and the prescribing of brand-name medications?”\u003c/p>\n\u003cp>Other than for research and development, and related consulting, Steinbrook wrote, “it is already evident that there are few reasons for physicians to have financial associations with industry. Outright gifts, such as meals, may be legal, but why should physicians either expect or accept them?”\u003c/p>\n\u003cp>Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the latest study creates more confusion than clarity. In part, that’s because the researchers acknowledge that they could not determine whether the drugs were prescribed before or after doctors received meals paid for by companies.\u003c/p>\n\u003cp>“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative,” Campbell wrote in an email. “Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines. As the study says, the exchange of this critical information could impact physicians’ prescribing decisions in an effort to improve patient care.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.'\u003ccite> R. Adams Dudley, UCSF \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Since 2013, the government has required all pharmaceutical and medical device makers to publicly report their payments to doctors. The government has released data on transactions from August 2013 to December 2014; data from 2015 is set to be made public next week. Those payments can be searched in ProPublica’s \u003ca href=\"https://projects.propublica.org/docdollars/\" target=\"_blank\">Dollars for Docs\u003c/a> tool.\u003c/p>\n\u003cp>In the study released today, a team led by Colette DeJong at UC San Francisco examined four classes of medications, including those that treat high cholesterol, heart rhythm disorders, high blood pressure and depression. The researchers identified one heavily marketed brand-name drug in each class – Crestor, Bystolic, Benicar and Pristiq – for which there are cheaper, equally effective options.\u003c/p>\n\u003cp>DeJong and her colleagues then looked at physicians who received meals specifically tied to those drugs (companies have to list the products associated with each of their payments) and their 2013 prescriptions in Medicare’s drug program. The researchers excluded physicians who received other types of payments—such as for promotional speaking and consulting–in an effort to isolate any relationship to the meals alone.\u003c/p>\n\u003cp>Though only a relatively small percent of physicians who prescribed the drugs examined in the study received payments from their makers, those doctors prescribed the drugs more often than other doctors.\u003c/p>\n\u003cp>Physicians who received meals related to Crestor on four or more days prescribed the drug at almost twice the rate of doctors who received no meals. The difference was even more marked for the other drugs. Physicians who received meals prescribed Bystolic at more than 5 times the rate of their uncompensated peers, Benicar at a rate 4.5 times higher, and Pristiq at a rate 3.4 times higher.\u003c/p>\n\u003cp>Higher rates of prescribing were also observed when doctors received just a single meal, even after taking into account a physician’s specialty and region of practice.\u003c/p>\n\u003cp>Dr. R. Adams Dudley, a professor of medicine and health policy at UCSF and one of the study’s authors, said he and his colleagues expected to see “some evidence that doctors were responsive to incentives, what with their being humans and all.”\u003c/p>\n\u003cp>Still, he said, “I think we were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.”\u003c/p>\n\u003cp>DeJong said the researchers don’t think the meals themselves cause doctors to prescribe more of a drug, but rather the time they spend interacting with drug reps when they drop off those meals.\u003c/p>\n\u003cp>“There’s really no way that a $10 bagel sandwich can influence a doctor in a gift way,” she said. “We think it represents more reciprocity, the time spent with the drug rep and the fact that the doctor is listening to this 10-minute pitch.”\u003c/p>\n\u003cp>Dudley suggested that patients talk to their doctors and ask “Is there a generic that’s just as good?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Hopefully they can get the doctor off of the prescribing behaviors that we’re observing.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Evidence is mounting that doctors who receive as little as one meal from a drug company tend to prescribe more expensive, brand-name medications for common ailments than those who don’t.\u003c/p>\n\u003cp>A study from researchers at UC San Francisco that was \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2528290\" target=\"_blank\">published online Monday in JAMA Internal Medicine\u003c/a> found significant evidence that doctors who received meals tied to specific drugs prescribed a higher proportion of those products than their peers. Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. And the more meals they received, the greater share of those drugs they tended to prescribe relative to other medications in the same category.\u003c/p>\n\u003caside class=\"pullquote alignright\">Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug\u003c/aside>\n\u003cp>The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.propublica.org/article/doctors-who-take-company-cash-tend-to-prescribe-more-brand-name-drugs\" target=\"_blank\">ProPublica story\u003c/a> published in March found that doctors who took payments from the pharmaceutical and medical device industries prescribed a higher proportion of brand-name medications than those who didn’t. It also found that the more money a doctor received, the higher the percentage of brand-name drugs he or she prescribed, on average.\u003c/p>\n\u003cp>Similarly, a \u003ca href=\"https://www.propublica.org/article/another-study-finds-link-between-pharma-money-and-brand-name-prescribing\" target=\"_blank\">Harvard Medical School study\u003c/a> published in May found that Massachusetts physicians prescribed a larger proportion of brand-name statins — the category of drugs that treat high cholesterol — the more industry money they received. There was no significant increase in brand-name prescribing for those who received less than $2,000.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What makes the current study different is that it looked at specific drugs.\u003c/p>\n\u003cp>In an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/17/orlando-shooting-raises-questions-about-internalized-homophobia-and-violence/\" target=\"_blank\">editor’s note\u003c/a>, Dr. Robert Steinbrook wrote that the recent analyses “raise a broader question. Is it necessary to prove a causal relationship between industry payments to physicians and the prescribing of brand-name medications?”\u003c/p>\n\u003cp>Other than for research and development, and related consulting, Steinbrook wrote, “it is already evident that there are few reasons for physicians to have financial associations with industry. Outright gifts, such as meals, may be legal, but why should physicians either expect or accept them?”\u003c/p>\n\u003cp>Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the latest study creates more confusion than clarity. In part, that’s because the researchers acknowledge that they could not determine whether the drugs were prescribed before or after doctors received meals paid for by companies.\u003c/p>\n\u003cp>“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative,” Campbell wrote in an email. “Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines. As the study says, the exchange of this critical information could impact physicians’ prescribing decisions in an effort to improve patient care.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.'\u003ccite> R. Adams Dudley, UCSF \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Since 2013, the government has required all pharmaceutical and medical device makers to publicly report their payments to doctors. The government has released data on transactions from August 2013 to December 2014; data from 2015 is set to be made public next week. Those payments can be searched in ProPublica’s \u003ca href=\"https://projects.propublica.org/docdollars/\" target=\"_blank\">Dollars for Docs\u003c/a> tool.\u003c/p>\n\u003cp>In the study released today, a team led by Colette DeJong at UC San Francisco examined four classes of medications, including those that treat high cholesterol, heart rhythm disorders, high blood pressure and depression. The researchers identified one heavily marketed brand-name drug in each class – Crestor, Bystolic, Benicar and Pristiq – for which there are cheaper, equally effective options.\u003c/p>\n\u003cp>DeJong and her colleagues then looked at physicians who received meals specifically tied to those drugs (companies have to list the products associated with each of their payments) and their 2013 prescriptions in Medicare’s drug program. The researchers excluded physicians who received other types of payments—such as for promotional speaking and consulting–in an effort to isolate any relationship to the meals alone.\u003c/p>\n\u003cp>Though only a relatively small percent of physicians who prescribed the drugs examined in the study received payments from their makers, those doctors prescribed the drugs more often than other doctors.\u003c/p>\n\u003cp>Physicians who received meals related to Crestor on four or more days prescribed the drug at almost twice the rate of doctors who received no meals. The difference was even more marked for the other drugs. Physicians who received meals prescribed Bystolic at more than 5 times the rate of their uncompensated peers, Benicar at a rate 4.5 times higher, and Pristiq at a rate 3.4 times higher.\u003c/p>\n\u003cp>Higher rates of prescribing were also observed when doctors received just a single meal, even after taking into account a physician’s specialty and region of practice.\u003c/p>\n\u003cp>Dr. R. Adams Dudley, a professor of medicine and health policy at UCSF and one of the study’s authors, said he and his colleagues expected to see “some evidence that doctors were responsive to incentives, what with their being humans and all.”\u003c/p>\n\u003cp>Still, he said, “I think we were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.”\u003c/p>\n\u003cp>DeJong said the researchers don’t think the meals themselves cause doctors to prescribe more of a drug, but rather the time they spend interacting with drug reps when they drop off those meals.\u003c/p>\n\u003cp>“There’s really no way that a $10 bagel sandwich can influence a doctor in a gift way,” she said. “We think it represents more reciprocity, the time spent with the drug rep and the fact that the doctor is listening to this 10-minute pitch.”\u003c/p>\n\u003cp>Dudley suggested that patients talk to their doctors and ask “Is there a generic that’s just as good?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Hopefully they can get the doctor off of the prescribing behaviors that we’re observing.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Health Budget: Small Gains, Advocates Look to Nov. Ballot for Big-Ticket Items",
"title": "California Health Budget: Small Gains, Advocates Look to Nov. Ballot for Big-Ticket Items",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>The $122.5 billion state budget \u003ca href=\"http://ww2.kqed.org/news/2016/06/15/legislature-approves-122-billion-general-fund-budget\" target=\"_blank\">approved last week\u003c/a> by California lawmakers will fund a variety of health-related efforts, including training of primary care physicians, dental care for schoolchildren and medical interpreters for Medi-Cal, the government-funded insurance program for people with low incomes.\u003c/p>\n\u003cp>But big-ticket health items such as higher payments to Medi-Cal providers and potential Medi-Cal coverage for undocumented adults didn’t make it into the budget agreement for next fiscal year that’s now awaiting the governor’s signature.\u003c/p>\n\u003cp>“Investments are minor but could be important for individual consumers,” said Anthony Wright, executive director of the consumer advocacy coalition Health Access.\u003c/p>\n\u003cp>Wright said the most notable health funding item in the budget was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/16/california-budget-includes-limit-on-medi-cal-estate-recovery/\" target=\"_blank\">the rollback of a policy \u003c/a>to recover assets of deceased Californians who received basic health care services through Medi-Cal — a reversal consumer advocates had been pursuing for years.\u003c/p>\n\u003cp>“It was inequitable, and it was counterproductive,” said Wright, adding that the policy discouraged low-income people from signing up for Medi-Cal for fear their loved ones might lose family homes. Under the terms of the new budget, California may only recover assets to reimburse itself for Medi-Cal spending on long-term nursing home care. This reimbursement for nursing home care is required by federal law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The budget includes:\u003c/p>\n\u003cp>• About $100 million over three years for primary care physician residencies in medically underserved areas.\u003c/p>\n\u003cp>• $5 million for efforts by the Department of Public Health to prevent sexually transmitted disease prevention efforts.\u003c/p>\n\u003cp>• $4.4 million to restore Medi-Cal acupuncture benefits that were cut during the recession.\u003c/p>\n\u003cp>• $3.2 million to restore school-based dental programs for low-income children that were cut during the recession.\u003c/p>\n\u003cp>• $3 million to pay interpreters for non-English-speaking Medi-Cal recipients.\u003c/p>\n\u003cp>Having failed to get some of their most desired policies through the Legislature, advocates are now turning to voter initiatives, a common political procedure in California.\u003c/p>\n\u003cp>\u003cstrong>Ballot Initiative to Raise Tobacco Tax\u003c/strong>\u003c/p>\n\u003cp>The California Medical Association, the state’s primary physician lobbying group, sponsored a ballot proposal that would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/16/move-to-triple-californias-tobacco-tax-appears-headed-to-ballot/?utm_source=dlvr.it&utm_medium=twitter&utm_campaign=kqednews\" target=\"_blank\">increase cigarette taxes by $2 per pack\u003c/a>. The CMA collaborated on the measure with other groups, including health worker unions.\u003c/p>\n\u003cp>Signatures for the initiative are still being verified. If the proposal qualifies for the ballot and is passed by voters, it could initially raise up to $1.6 billion in fiscal year 2017-2018, mostly for payments to health care providers, according to California’s secretary of state.\u003c/p>\n\u003cp>Raising doctor rates for Medi-Cal, the state’s Medicaid program that now covers more than a third of Californians, has been a priority for supporters since state lawmakers cut rates by 10 percent in 2011. Undoing those cuts would cost at least $250 million a year, supporters estimate.\u003c/p>\n\u003cp>The CMA last year led a coalition called “We Care for California” to raise payments for doctors and other providers. CMA says Medi-Cal payments are among the lowest of any state Medicaid program in the nation — as low as $16 for an office visit. But the coalition hasn’t been meeting regularly, according to the California Hospital Association.\u003c/p>\n\u003cp>“While increasing Medi-Cal reimbursements rates remains a top priority for CMA, the administration has thus far not been supportive of broad-based provider rate increases, preferring targeted investments to improve access to care,” CMA officials said in a written statement.\u003c/p>\n\u003cp>“Because of this, CMA decided to focus on other means of improving access through this budget, such as directing funds to train more primary care physicians. Each additional primary care physician can see approximately 600 patients per year during training alone, thereby making a dramatic improvement in areas of the state that lack access to these providers.”\u003c/p>\n\u003cp>\u003cstrong>Ballot Initiative to Extend Tax on Higher-Income People\u003c/strong>\u003c/p>\n\u003cp>Another\u003ca href=\"http://www.scpr.org/news/2016/05/12/60570/prop-30-income-tax-increase-extension-likely-heade/\" target=\"_blank\"> ballot initiative would extend Proposition 30\u003c/a>, a tax on higher-income Californians that funds education and could funnel up to $2 billion in some years to the agency that manages Medi-Cal, according to the secretary of state.\u003c/p>\n\u003cp>Health consumer advocates say passage of the tobacco tax and Prop. 30 measures could provide the money needed to increase Medi-Cal reimbursement rates and restore other recession-era cuts.\u003c/p>\n\u003cp>Immigrant rights groups say the measures could also provide some of the funding needed to extend Medi-Cal coverage to undocumented adults, should the Legislature pass that proposal. A bill to compel the state to expand Medi-Cal to unauthorized adults was introduced this year but is not expected to be taken up again until 2017.\u003c/p>\n\u003cp>Health care advocates who are neutral on the issue of raising Medi-Cal provider rates say there are practical reasons why proponents are using the initiative process instead of the budget process.\u003c/p>\n\u003cp>“The governor ... made it very clear that ongoing spending was something that he had concerns with,” said Linda Nguy, policy advocate at the Western Center on Law and Poverty.\u003c/p>\n\u003cp>Nguy says advocates may be holding off on a renewed push for higher Medi-Cal provider rates until after the state convenes a working group this fall to evaluate how easily Medi-Cal patients can obtain the care they need in a timely way.\u003c/p>\n\u003cp>If the work group can link low Medi-Cal payments to patient access problems, the evidence could provide a stronger case for increasing provider rates, said Senate Health Committee Chairman Ed Hernandez, D-San Gabriel Valley.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Access is really tied into rates. So if we can address that, [we can] have a more serious conversation next year,” Hernandez said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The $122.5 billion state budget \u003ca href=\"http://ww2.kqed.org/news/2016/06/15/legislature-approves-122-billion-general-fund-budget\" target=\"_blank\">approved last week\u003c/a> by California lawmakers will fund a variety of health-related efforts, including training of primary care physicians, dental care for schoolchildren and medical interpreters for Medi-Cal, the government-funded insurance program for people with low incomes.\u003c/p>\n\u003cp>But big-ticket health items such as higher payments to Medi-Cal providers and potential Medi-Cal coverage for undocumented adults didn’t make it into the budget agreement for next fiscal year that’s now awaiting the governor’s signature.\u003c/p>\n\u003cp>“Investments are minor but could be important for individual consumers,” said Anthony Wright, executive director of the consumer advocacy coalition Health Access.\u003c/p>\n\u003cp>Wright said the most notable health funding item in the budget was \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/16/california-budget-includes-limit-on-medi-cal-estate-recovery/\" target=\"_blank\">the rollback of a policy \u003c/a>to recover assets of deceased Californians who received basic health care services through Medi-Cal — a reversal consumer advocates had been pursuing for years.\u003c/p>\n\u003cp>“It was inequitable, and it was counterproductive,” said Wright, adding that the policy discouraged low-income people from signing up for Medi-Cal for fear their loved ones might lose family homes. Under the terms of the new budget, California may only recover assets to reimburse itself for Medi-Cal spending on long-term nursing home care. This reimbursement for nursing home care is required by federal law.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The budget includes:\u003c/p>\n\u003cp>• About $100 million over three years for primary care physician residencies in medically underserved areas.\u003c/p>\n\u003cp>• $5 million for efforts by the Department of Public Health to prevent sexually transmitted disease prevention efforts.\u003c/p>\n\u003cp>• $4.4 million to restore Medi-Cal acupuncture benefits that were cut during the recession.\u003c/p>\n\u003cp>• $3.2 million to restore school-based dental programs for low-income children that were cut during the recession.\u003c/p>\n\u003cp>• $3 million to pay interpreters for non-English-speaking Medi-Cal recipients.\u003c/p>\n\u003cp>Having failed to get some of their most desired policies through the Legislature, advocates are now turning to voter initiatives, a common political procedure in California.\u003c/p>\n\u003cp>\u003cstrong>Ballot Initiative to Raise Tobacco Tax\u003c/strong>\u003c/p>\n\u003cp>The California Medical Association, the state’s primary physician lobbying group, sponsored a ballot proposal that would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/16/move-to-triple-californias-tobacco-tax-appears-headed-to-ballot/?utm_source=dlvr.it&utm_medium=twitter&utm_campaign=kqednews\" target=\"_blank\">increase cigarette taxes by $2 per pack\u003c/a>. The CMA collaborated on the measure with other groups, including health worker unions.\u003c/p>\n\u003cp>Signatures for the initiative are still being verified. If the proposal qualifies for the ballot and is passed by voters, it could initially raise up to $1.6 billion in fiscal year 2017-2018, mostly for payments to health care providers, according to California’s secretary of state.\u003c/p>\n\u003cp>Raising doctor rates for Medi-Cal, the state’s Medicaid program that now covers more than a third of Californians, has been a priority for supporters since state lawmakers cut rates by 10 percent in 2011. Undoing those cuts would cost at least $250 million a year, supporters estimate.\u003c/p>\n\u003cp>The CMA last year led a coalition called “We Care for California” to raise payments for doctors and other providers. CMA says Medi-Cal payments are among the lowest of any state Medicaid program in the nation — as low as $16 for an office visit. But the coalition hasn’t been meeting regularly, according to the California Hospital Association.\u003c/p>\n\u003cp>“While increasing Medi-Cal reimbursements rates remains a top priority for CMA, the administration has thus far not been supportive of broad-based provider rate increases, preferring targeted investments to improve access to care,” CMA officials said in a written statement.\u003c/p>\n\u003cp>“Because of this, CMA decided to focus on other means of improving access through this budget, such as directing funds to train more primary care physicians. Each additional primary care physician can see approximately 600 patients per year during training alone, thereby making a dramatic improvement in areas of the state that lack access to these providers.”\u003c/p>\n\u003cp>\u003cstrong>Ballot Initiative to Extend Tax on Higher-Income People\u003c/strong>\u003c/p>\n\u003cp>Another\u003ca href=\"http://www.scpr.org/news/2016/05/12/60570/prop-30-income-tax-increase-extension-likely-heade/\" target=\"_blank\"> ballot initiative would extend Proposition 30\u003c/a>, a tax on higher-income Californians that funds education and could funnel up to $2 billion in some years to the agency that manages Medi-Cal, according to the secretary of state.\u003c/p>\n\u003cp>Health consumer advocates say passage of the tobacco tax and Prop. 30 measures could provide the money needed to increase Medi-Cal reimbursement rates and restore other recession-era cuts.\u003c/p>\n\u003cp>Immigrant rights groups say the measures could also provide some of the funding needed to extend Medi-Cal coverage to undocumented adults, should the Legislature pass that proposal. A bill to compel the state to expand Medi-Cal to unauthorized adults was introduced this year but is not expected to be taken up again until 2017.\u003c/p>\n\u003cp>Health care advocates who are neutral on the issue of raising Medi-Cal provider rates say there are practical reasons why proponents are using the initiative process instead of the budget process.\u003c/p>\n\u003cp>“The governor ... made it very clear that ongoing spending was something that he had concerns with,” said Linda Nguy, policy advocate at the Western Center on Law and Poverty.\u003c/p>\n\u003cp>Nguy says advocates may be holding off on a renewed push for higher Medi-Cal provider rates until after the state convenes a working group this fall to evaluate how easily Medi-Cal patients can obtain the care they need in a timely way.\u003c/p>\n\u003cp>If the work group can link low Medi-Cal payments to patient access problems, the evidence could provide a stronger case for increasing provider rates, said Senate Health Committee Chairman Ed Hernandez, D-San Gabriel Valley.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Access is really tied into rates. So if we can address that, [we can] have a more serious conversation next year,” Hernandez said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Update, March 26, 2025: \u003c/strong>Timon Curtis has grown and developed a new perspective in the nine years since he relied on homeless services for youth as an 18-year-old in Sacramento.\u003c/p>\n\u003cp>He recently contacted KQED asking to remove this article featuring him. Instead, Curtis agreed to an interview for an update on what’s changed for him since 2016.\u003c/p>\n\u003cp>“To all the people out there, no matter what you want to do in life, no matter how you do it, continue to keep pushing,” he said in a phone interview on March 24. “Continue to chase that dream, don’t ever stop chasing it, and always be humble no matter what.”\u003c/p>\n\u003cp>Curtis is now pursuing a career in music under the rap name Tpuma, and he founded Sayless Records, an LLC, two years ago. He credits a move out of Sacramento to Los Angeles as one of the first steps he took to change his life. It wasn’t easy.\u003c/p>\n\u003cp>“I wanted to give up so many times,” Curtis said. “My real supporters say, don’t give up. Your music is very passionate. Don’t ever give up no matter what.”\u003c/p>\n\u003cp>He talked about his mother’s death in 2004 and the difficulties of being homeless at a young age.\u003c/p>\n\u003cp>“Not a lot of people get to see this type of life,” he said. “At the end of the day, I can’t say it’s a gift, but I’m alive. I’m alive at the age of 27, and I’m blessed to see another day.”\u003c/p>\n\u003cp>Curtis said he is studying music at Los Angeles City College, and he’s looking to transfer to a business of music program.\u003c/p>\n\u003cp>\u003cem>– Alex Emslie, KQED\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Update, June 30, 12:17 p.m: \u003c/strong>The state legislature gave final approval today to allocate an additional $10 million specifically for homeless youth emergency services over the next five years. Assembly Republicans negotiated the budget increase for shelters, food and counseling for homeless youth — the first one in over 15 years — as part of the No Place Like Home bond, which provides $2 billion for supportive housing for homeless individuals with mental illness. Governor Brown is expected to sign the measure.\u003c/p>\n\u003cp>\u003cstrong>Original Story:\u003c/strong>\u003c/p>\n\u003cp>The Wind Youth Services drop-in center for homeless youth in Sacramento is busiest during lunch time. The air conditioned house in the city’s Oak Park neighborhood has a couple of showers, free meals and a small staff of case managers and counselors. During the day, teens and young adults let themselves in to get cleaned up, rest on the living room couches, and see about potential housing.\u003c/p>\n\u003cp>Timon Curtis has been a frequent visitor since he ran away from home. He’d had enough of his family, he says.\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/269600852″ 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>“I’ve been abused, neglected, treated like mess,” says Timon, 18. “Been called names such as stupid, dumb retarded. Telling me I’d never make it, and that nobody will take me for who I am.”\u003c/p>\n\u003cp>Timon slept in a random laundry room for months, and dropped out of high school. Then someone told him about the center. From there, he began staying at an overnight shelter he trusts, the only one dedicated for homeless youth in the county.\u003c/p>\n\u003cfigure id=\"attachment_199600\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-199600\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut.jpg\" alt=\"Timon Curtis, 18, at a drop in center for homeless youth in Sacramento. He is staying overnight at a local shelter for youth under age 24, the only one of its kind in the county.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-960x640.jpg 960w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Timon Curtis, 18, at a drop in center for homeless youth in Sacramento. He is staying overnight at a local shelter for youth under age 24, the only one of its kind in the county. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Timon can stay in the shelter for three months. But case managers back at the drop-in center are helping find him permanent housing.\u003c/p>\n\u003cp>“If this wasn’t here, I’d probably be going to people on the streets asking for money, panhandling, trying to get some food,” he says.\u003c/p>\n\u003cp>Instead, Timon is trying to get a job and go back to high school. He dreams of becoming a radio show host one day, and works diligently writing hip-hop lyrics and recording music.\u003c/p>\n\u003cp>In a way, Timon was lucky to land a bed at all. The county-funded shelter has just a total of 6 beds for 18- to 24-year-olds.\u003c/p>\n\u003cp>\u003cstrong>‘Intense Need’ for Homeless Youth Shelters\u003c/strong>\u003c/p>\n\u003cp>While this year’s state budget deal includes \u003ca href=\"http://www.accoc.org/california-legislature-approves-2016-2017-state-budget/\" target=\"_blank\" rel=\"noopener\">money set aside for housing\u003c/a> and bolsters social safety net programs, advocates question how much of those dollars will actually benefit young people living on the streets. Teens and young adults face barriers to accessing services for the wider homeless population, they say.\u003c/p>\n\u003cp>Most California counties — 38 out of 58 — lack services for homeless youth, according to a 2011 \u003ca href=\"http://cahomelessyouth.library.ca.gov/docs/pdf/SUMMARY-Inventory.pdf\" target=\"_blank\" rel=\"noopener\">survey \u003c/a>by the California Homeless Youth Project. The programs and shelters in the remaining 20 counties are strapped, says Shahera Hyatt, director of the California Homeless Youth Project.\u003c/p>\n\u003cp>At Timon’s shelter in Sacramento, demand outstrips supply, and there’s a months-long waiting list, says Anne Salvatori, from Wind Youth Services, which runs the shelter.\u003c/p>\n\u003cp>“On a bad day, … I would say (we get) between five and 10 calls for youth seeking shelter. Some with babies and kids, some without,” says Salvatori, 38. “[We] have to tell them, ‘Oh gosh, there’s a wait list.’ ”\u003c/p>\n\u003cfigure id=\"attachment_199601\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-199601\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut.jpg\" alt=\"Daniel Quirk, 24, visits the drop-in center run by Wind Youth Services in Sacramento. Quirk says he was beaten up several times while living on the streets.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-960x640.jpg 960w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Daniel Quirk, 24, visits the drop-in center run by Wind Youth Services in Sacramento. Quirk says he was beaten up several times while living on the streets. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California has the largest share of unaccompanied homeless youth in the country — more than 10,000 people under age 25 not accompanied by a parent, 28 percent of the national total, according \u003ca href=\"https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf\" target=\"_blank\" rel=\"noopener\">to a federal study. \u003c/a>\u003c/p>\n\u003cp>Homeless teens are often fleeing abuse at home. But living on the streets is not safer, says Salvatori. “From rape to being jumped. A lot of times people get their stuff stolen in the middle of the night,” she says. “We had a youth that was sleeping on the streets, and somebody dropped a cinder block on his head while he was sleeping in the middle of the night.”\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/269600852″ 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>\u003cstrong>Advocates Worry Not Enough Funds Devoted To Homeless Youth \u003c/strong>\u003c/p>\n\u003cp>Top state legislators say they are helping these efforts by making key investments to fight homelessness in the new budget agreement, which Gov. Jerry Brown has yet to sign. Those include $45 million for sheltering the general population on the streets, and $22 million to prevent homelessness in poor families.\u003c/p>\n\u003cp>But advocates say that youth are being shortchanged since they benefit the most from programs that target their specific age group, instead of the general homeless population.\u003c/p>\n\u003cp>“Our concern is how much of that will specifically go towards serving homeless youth,” says Paul Curtis, with the non-profit California Coalition for Youth. “It all depends how it’s going to be implemented.”\u003c/p>\n\u003cp>Homeless youth on their own often fail to qualify for child welfare, and they won’t go to programs for the older chronically homeless because they don’t feel safe, he says.\u003c/p>\n\u003cp>“They look at the adult homeless population, and they don’t identify with them. And we often don’t want them to go into those adult programs. \u003cspan style=\"font-weight: 400;\">It can be older chronic homeless adults and there’s potential for exploitation and abuse\u003c/span>,” says Curtis.\u003c/p>\n\u003cp>Curtis’ coalition advocated for lawmakers to set aside more funds for the \u003ca href=\"http://www.caloes.ca.gov/GrantsManagementSite/Documents/HX%2013%20done.pdf\" target=\"_blank\" rel=\"noopener\">Homeless Youth and Exploitation Program\u003c/a>, the only dedicated state funding for shelters, food, counseling and other short term services aimed at youth exiting street life who might also be victims of sexual exploitation. The program has received about $1 million annually in state funding for over 15 years.\u003c/p>\n\u003cp>An Assembly budget proposal to add over $12 million to the funding fell through last week during negotiations with the governor’s office and senate, says Assemblymember Phil Ting, D-San Francisco.\u003c/p>\n\u003cp>“We fought for it, but we just weren’t able to get it across the finish line,” says Ting. “We did a lot for homelessness. I personally would like to do even more, but we have financial constraints.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, March 26, 2025: \u003c/strong>Timon Curtis has grown and developed a new perspective in the nine years since he relied on homeless services for youth as an 18-year-old in Sacramento.\u003c/p>\n\u003cp>He recently contacted KQED asking to remove this article featuring him. Instead, Curtis agreed to an interview for an update on what’s changed for him since 2016.\u003c/p>\n\u003cp>“To all the people out there, no matter what you want to do in life, no matter how you do it, continue to keep pushing,” he said in a phone interview on March 24. “Continue to chase that dream, don’t ever stop chasing it, and always be humble no matter what.”\u003c/p>\n\u003cp>Curtis is now pursuing a career in music under the rap name Tpuma, and he founded Sayless Records, an LLC, two years ago. He credits a move out of Sacramento to Los Angeles as one of the first steps he took to change his life. It wasn’t easy.\u003c/p>\n\u003cp>“I wanted to give up so many times,” Curtis said. “My real supporters say, don’t give up. Your music is very passionate. Don’t ever give up no matter what.”\u003c/p>\n\u003cp>He talked about his mother’s death in 2004 and the difficulties of being homeless at a young age.\u003c/p>\n\u003cp>“Not a lot of people get to see this type of life,” he said. “At the end of the day, I can’t say it’s a gift, but I’m alive. I’m alive at the age of 27, and I’m blessed to see another day.”\u003c/p>\n\u003cp>Curtis said he is studying music at Los Angeles City College, and he’s looking to transfer to a business of music program.\u003c/p>\n\u003cp>\u003cem>– Alex Emslie, KQED\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Update, June 30, 12:17 p.m: \u003c/strong>The state legislature gave final approval today to allocate an additional $10 million specifically for homeless youth emergency services over the next five years. Assembly Republicans negotiated the budget increase for shelters, food and counseling for homeless youth — the first one in over 15 years — as part of the No Place Like Home bond, which provides $2 billion for supportive housing for homeless individuals with mental illness. Governor Brown is expected to sign the measure.\u003c/p>\n\u003cp>\u003cstrong>Original Story:\u003c/strong>\u003c/p>\n\u003cp>The Wind Youth Services drop-in center for homeless youth in Sacramento is busiest during lunch time. The air conditioned house in the city’s Oak Park neighborhood has a couple of showers, free meals and a small staff of case managers and counselors. During the day, teens and young adults let themselves in to get cleaned up, rest on the living room couches, and see about potential housing.\u003c/p>\n\u003cp>Timon Curtis has been a frequent visitor since he ran away from home. He’d had enough of his family, he says.\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/269600852″&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/269600852″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I’ve been abused, neglected, treated like mess,” says Timon, 18. “Been called names such as stupid, dumb retarded. Telling me I’d never make it, and that nobody will take me for who I am.”\u003c/p>\n\u003cp>Timon slept in a random laundry room for months, and dropped out of high school. Then someone told him about the center. From there, he began staying at an overnight shelter he trusts, the only one dedicated for homeless youth in the county.\u003c/p>\n\u003cfigure id=\"attachment_199600\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-199600\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut.jpg\" alt=\"Timon Curtis, 18, at a drop in center for homeless youth in Sacramento. He is staying overnight at a local shelter for youth under age 24, the only one of its kind in the county.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19872_IMG_0035-qut-960x640.jpg 960w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Timon Curtis, 18, at a drop in center for homeless youth in Sacramento. He is staying overnight at a local shelter for youth under age 24, the only one of its kind in the county. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Timon can stay in the shelter for three months. But case managers back at the drop-in center are helping find him permanent housing.\u003c/p>\n\u003cp>“If this wasn’t here, I’d probably be going to people on the streets asking for money, panhandling, trying to get some food,” he says.\u003c/p>\n\u003cp>Instead, Timon is trying to get a job and go back to high school. He dreams of becoming a radio show host one day, and works diligently writing hip-hop lyrics and recording music.\u003c/p>\n\u003cp>In a way, Timon was lucky to land a bed at all. The county-funded shelter has just a total of 6 beds for 18- to 24-year-olds.\u003c/p>\n\u003cp>\u003cstrong>‘Intense Need’ for Homeless Youth Shelters\u003c/strong>\u003c/p>\n\u003cp>While this year’s state budget deal includes \u003ca href=\"http://www.accoc.org/california-legislature-approves-2016-2017-state-budget/\" target=\"_blank\" rel=\"noopener\">money set aside for housing\u003c/a> and bolsters social safety net programs, advocates question how much of those dollars will actually benefit young people living on the streets. Teens and young adults face barriers to accessing services for the wider homeless population, they say.\u003c/p>\n\u003cp>Most California counties — 38 out of 58 — lack services for homeless youth, according to a 2011 \u003ca href=\"http://cahomelessyouth.library.ca.gov/docs/pdf/SUMMARY-Inventory.pdf\" target=\"_blank\" rel=\"noopener\">survey \u003c/a>by the California Homeless Youth Project. The programs and shelters in the remaining 20 counties are strapped, says Shahera Hyatt, director of the California Homeless Youth Project.\u003c/p>\n\u003cp>At Timon’s shelter in Sacramento, demand outstrips supply, and there’s a months-long waiting list, says Anne Salvatori, from Wind Youth Services, which runs the shelter.\u003c/p>\n\u003cp>“On a bad day, … I would say (we get) between five and 10 calls for youth seeking shelter. Some with babies and kids, some without,” says Salvatori, 38. “[We] have to tell them, ‘Oh gosh, there’s a wait list.’ ”\u003c/p>\n\u003cfigure id=\"attachment_199601\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-199601\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut.jpg\" alt=\"Daniel Quirk, 24, visits the drop-in center run by Wind Youth Services in Sacramento. Quirk says he was beaten up several times while living on the streets.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/06/RS19873_IMG_0039-qut-960x640.jpg 960w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Daniel Quirk, 24, visits the drop-in center run by Wind Youth Services in Sacramento. Quirk says he was beaten up several times while living on the streets. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California has the largest share of unaccompanied homeless youth in the country — more than 10,000 people under age 25 not accompanied by a parent, 28 percent of the national total, according \u003ca href=\"https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf\" target=\"_blank\" rel=\"noopener\">to a federal study. \u003c/a>\u003c/p>\n\u003cp>Homeless teens are often fleeing abuse at home. But living on the streets is not safer, says Salvatori. “From rape to being jumped. A lot of times people get their stuff stolen in the middle of the night,” she says. “We had a youth that was sleeping on the streets, and somebody dropped a cinder block on his head while he was sleeping in the middle of the night.”\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/269600852″&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/269600852″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Advocates Worry Not Enough Funds Devoted To Homeless Youth \u003c/strong>\u003c/p>\n\u003cp>Top state legislators say they are helping these efforts by making key investments to fight homelessness in the new budget agreement, which Gov. Jerry Brown has yet to sign. Those include $45 million for sheltering the general population on the streets, and $22 million to prevent homelessness in poor families.\u003c/p>\n\u003cp>But advocates say that youth are being shortchanged since they benefit the most from programs that target their specific age group, instead of the general homeless population.\u003c/p>\n\u003cp>“Our concern is how much of that will specifically go towards serving homeless youth,” says Paul Curtis, with the non-profit California Coalition for Youth. “It all depends how it’s going to be implemented.”\u003c/p>\n\u003cp>Homeless youth on their own often fail to qualify for child welfare, and they won’t go to programs for the older chronically homeless because they don’t feel safe, he says.\u003c/p>\n\u003cp>“They look at the adult homeless population, and they don’t identify with them. And we often don’t want them to go into those adult programs. \u003cspan style=\"font-weight: 400;\">It can be older chronic homeless adults and there’s potential for exploitation and abuse\u003c/span>,” says Curtis.\u003c/p>\n\u003cp>Curtis’ coalition advocated for lawmakers to set aside more funds for the \u003ca href=\"http://www.caloes.ca.gov/GrantsManagementSite/Documents/HX%2013%20done.pdf\" target=\"_blank\" rel=\"noopener\">Homeless Youth and Exploitation Program\u003c/a>, the only dedicated state funding for shelters, food, counseling and other short term services aimed at youth exiting street life who might also be victims of sexual exploitation. The program has received about $1 million annually in state funding for over 15 years.\u003c/p>\n\u003cp>An Assembly budget proposal to add over $12 million to the funding fell through last week during negotiations with the governor’s office and senate, says Assemblymember Phil Ting, D-San Francisco.\u003c/p>\n\u003cp>“We fought for it, but we just weren’t able to get it across the finish line,” says Ting. “We did a lot for homelessness. I personally would like to do even more, but we have financial constraints.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"order": 9
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"id": "fresh-air",
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"order": 15
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"order": 18
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"source": "American Public Media"
},
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
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"meta": {
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
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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": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 11
},
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
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"planet-money": {
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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.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"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",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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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",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"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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},
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