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"content": "\u003cp>Last night, California's governor \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21/\" target=\"_blank\">signed into law \u003c/a>a package of sweeping tobacco regulations.\u003c/p>\n\u003cp>This morning, the federal Food and Drug Administration (FDA) handed down its own \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/05/476865753/fda-acts-to-regulate-e-cigarettes-and-cigars-for-the-first-time\" target=\"_blank\">landmark regulations\u003c/a> on e-cigarettes.\u003c/p>\n\u003cp>What's the difference?\u003c/p>\n\u003cp>First, no, they do not overlap. The FDA and the states have distinct regulatory authority.\u003c/p>\n\u003cp>\u003cstrong>FDA Regulations\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Starting with the FDA: E-cigarettes had been largely unregulated. The liquid nicotine product was \"of varying quality and unknown provenance,\" says the \u003ca href=\"http://www.nytimes.com/2016/05/06/science/fda-rules-electronic-cigarettes.html\" target=\"_blank\">New York Times\u003c/a>.\u003c/p>\n\u003cp>Now, producers of e-cigarettes will have to provide the FDA with a detailed list of the ingredients in their products, and information about the manufacturing process.\u003c/p>\n\u003cp>You can read the full \u003ca href=\"https://www.federalregister.gov/articles/2016/05/10/2016-10685/deeming-tobacco-products-to-be-subject-to-the-federal-food-drug-and-cosmetic-act-as-amended-by-the\" target=\"_blank\">499-page document\u003c/a> from the FDA here.\u003c/p>\n\u003cp>\u003cstrong>New California Laws\u003c/strong>\u003c/p>\n\u003cp>The five bills signed last night by Gov. Brown have to do with who can buy tobacco/e-cigarettes and where they can use them.\u003c/p>\n\u003cp>While the federal government sets the age to buy tobacco at 18, states may raise the age. (Lowering it would likely be pretty tough.) California has become the second state, after Hawaii, to raise it to 21.\u003c/p>\n\u003cp>The goal with this change is to get cigarettes out of the hands of young teens. Plenty of kids 15 to 17 years old have friends who are 18 and can illegally buy cigarettes for them. But not as many young teens have friends who are 21.\u003c/p>\n\u003cp>A second major bill will require that e-cigarettes be regulated as tobacco products, meaning that you will need to be 21 to buy e-cigarettes. In addition, e-cigarette use will not be permitted anywhere that traditional cigarette use is not allowed.\u003c/p>\n\u003cp>\"What our bill does specifically is bring e-cigarettes,\" says Sen. Mark Leno, D-San Francisco, who wrote the bill, \"under our smoke-free laws in California, which determine where someone can use a tobacco product.\"\u003c/p>\n\u003cp>Those smoke-free areas include restaurants, all indoor workplaces, plenty of public parks, government buildings and more.\u003c/p>\n\u003cp>Yet a third law approved yesterday expands the places subject to smoke-free laws. Going forward, there will be no lighting up -- either a traditional or an e-cigarette -- in hotel lobbies, banquet rooms and small businesses.\u003c/p>\n\u003cp>The FDA's new regulations will take effect in about 90 days, and e-cigarette manufacturers have two years from that date to submit their first application for their devices or products.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But in California, the five laws were initially approved in a special session on health care. Laws passed in a special session take effect 90 days after the session ends. That's June 9, just five weeks away.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last night, California's governor \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/04/gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21/\" target=\"_blank\">signed into law \u003c/a>a package of sweeping tobacco regulations.\u003c/p>\n\u003cp>This morning, the federal Food and Drug Administration (FDA) handed down its own \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/05/476865753/fda-acts-to-regulate-e-cigarettes-and-cigars-for-the-first-time\" target=\"_blank\">landmark regulations\u003c/a> on e-cigarettes.\u003c/p>\n\u003cp>What's the difference?\u003c/p>\n\u003cp>First, no, they do not overlap. The FDA and the states have distinct regulatory authority.\u003c/p>\n\u003cp>\u003cstrong>FDA Regulations\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Starting with the FDA: E-cigarettes had been largely unregulated. The liquid nicotine product was \"of varying quality and unknown provenance,\" says the \u003ca href=\"http://www.nytimes.com/2016/05/06/science/fda-rules-electronic-cigarettes.html\" target=\"_blank\">New York Times\u003c/a>.\u003c/p>\n\u003cp>Now, producers of e-cigarettes will have to provide the FDA with a detailed list of the ingredients in their products, and information about the manufacturing process.\u003c/p>\n\u003cp>You can read the full \u003ca href=\"https://www.federalregister.gov/articles/2016/05/10/2016-10685/deeming-tobacco-products-to-be-subject-to-the-federal-food-drug-and-cosmetic-act-as-amended-by-the\" target=\"_blank\">499-page document\u003c/a> from the FDA here.\u003c/p>\n\u003cp>\u003cstrong>New California Laws\u003c/strong>\u003c/p>\n\u003cp>The five bills signed last night by Gov. Brown have to do with who can buy tobacco/e-cigarettes and where they can use them.\u003c/p>\n\u003cp>While the federal government sets the age to buy tobacco at 18, states may raise the age. (Lowering it would likely be pretty tough.) California has become the second state, after Hawaii, to raise it to 21.\u003c/p>\n\u003cp>The goal with this change is to get cigarettes out of the hands of young teens. Plenty of kids 15 to 17 years old have friends who are 18 and can illegally buy cigarettes for them. But not as many young teens have friends who are 21.\u003c/p>\n\u003cp>A second major bill will require that e-cigarettes be regulated as tobacco products, meaning that you will need to be 21 to buy e-cigarettes. In addition, e-cigarette use will not be permitted anywhere that traditional cigarette use is not allowed.\u003c/p>\n\u003cp>\"What our bill does specifically is bring e-cigarettes,\" says Sen. Mark Leno, D-San Francisco, who wrote the bill, \"under our smoke-free laws in California, which determine where someone can use a tobacco product.\"\u003c/p>\n\u003cp>Those smoke-free areas include restaurants, all indoor workplaces, plenty of public parks, government buildings and more.\u003c/p>\n\u003cp>Yet a third law approved yesterday expands the places subject to smoke-free laws. Going forward, there will be no lighting up -- either a traditional or an e-cigarette -- in hotel lobbies, banquet rooms and small businesses.\u003c/p>\n\u003cp>The FDA's new regulations will take effect in about 90 days, and e-cigarette manufacturers have two years from that date to submit their first application for their devices or products.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But in California, the five laws were initially approved in a special session on health care. Laws passed in a special session take effect 90 days after the session ends. That's June 9, just five weeks away.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21",
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"content": "\u003cp>Gov. Jerry Brown signed a sweeping package of tobacco bills into law on Wednesday, including one that will \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB7\" target=\"_blank\">raise the legal age \u003c/a>to buy products from 18 to 21 and another that dramatically\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\"> tightens restrictions\u003c/a> on e-cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What this means for California is our youth are less likely to be addicted to this horrible drug of tobacco.'\u003ccite> Sen. Ed Hernandez, author of the new law\u003c/cite>\u003c/aside>\n\u003cp>But the governor \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB10\" target=\"_blank\">vetoed a bill\u003c/a> that would have permitted cities and counties to establish their own tobacco taxes.\u003c/p>\n\u003cp>“Although California has one of the lowest cigarette taxes in the nation,” the governor said in a veto message, “I am reluctant to approve this measure in view of all the taxes being proposed for the 2016 ballot.”\u003c/p>\n\u003cp>California becomes just the second state after Hawaii to raise the lawful age to buy tobacco products, a move that backers applaud as a certain way to curtail harm to adolescents, and reduce the number of adult smokers.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, was the lead author of the bill to raise the tobacco age. In a phone interview, he said he was \"ecstatic.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"What this means for California is now we can know that our youth are less likely to be addicted to this horrible drug of tobacco,\" he said. \"There’s going to be less addiction to tobacco, [and] we’re going to reduce health care costs and save lives.\"\u003c/p>\n\u003cp>The law, which takes effect next month on June 9, applies to all 18 to 20-year-olds, except military personnel. The bill had stalled for months until a compromise was reached to permit service members under 21 to continue purchasing tobacco.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/262622063\" 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>A major \u003ca href=\"http://www.nationalacademies.org/hmd/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">Institute of Medicine report\u003c/a> last year concluded that if all states raised the tobacco age to 21, there would be a 12 percent drop in the number of teen and young adult smokers.\u003c/p>\n\u003cp>\"The biggest drops in tobacco use (will) likely occur among teens ages 15 to 17 -- kids who can’t legally buy tobacco products in California now but who run in the same social circles as 18-year-olds who may illegally purchase tobacco products for younger friends,\" said Larry Cohen, executive director of the Oakland-based Prevention Institute and a longtime advocate for tobacco control policies.\u003c/p>\n\u003cp>Adolescents are at particular risk for nicotine addiction since their brains are still developing, says longtime tobacco critic, Stan Glantz, a professor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"Exposing the developing brain to nicotine, which is in both e-cigarettes and conventional cigarettes, physically changes the brain,\" Glantz said. \"That's why the younger someone starts to smoke, the more addicted they tend to get … and the harder time they have stopping.\u003c/p>\n\u003cp>\u003cstrong>Vaping Banned in Many Public Places\u003c/strong>\u003c/p>\n\u003cp>But Glantz said the new regulations on e-cigarettes may be even more significant. \"There's no question that e-cigarettes aren't as dangerous as cigarettes are,\" he said, \"but they're still dangerous.\"\u003c/p>\n\u003cp>Under \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\">the law\u003c/a>, written by Sen. Mark Leno, D-San Francisco, e-cigarettes will be banned in all the same places that traditional cigarettes are -- workplaces, schools, restaurants, hospitals and more. And like other tobacco products, users will need to be 21 to buy e-cigarettes.\u003c/p>\n\u003cp>“The e-cigarette is nothing more than a new delivery system for toxic and addictive nicotine,” Leno said in a statement. “Ensuring that e-cigarettes fall under California’s comprehensive smoke-free laws is critical to protecting public health, especially given the alarming rate at which young people are picking up these devices.\"\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cdc.gov/media/releases/2015/p0416-e-cigarette-use.html\" target=\"_blank\">study\u003c/a> last year from the Centers for Disease Control found that e-cigarette use among middle and high school students had tripled in just one year, from 2013 to 2014.\u003c/p>\n\u003cp>Brown signed three other bills:\u003c/p>\n\u003cul>\n\u003cli>An \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB7\">expansion of smoke-free workspaces\u003c/a> to include hotel lobbies, bars, banquet rooms and employee break rooms\u003c/li>\n\u003cli>Expansion of eligibility for \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB9\">tobacco prevention funds to charter schools\u003c/a>\u003c/li>\n\u003cli>Increases \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520162AB11\">tobacco retailer license fees\u003c/a> from a one-time $100 fee to an annual $265 fee\u003c/li>\n\u003c/ul>\n\u003cp>Anti-tobacco groups are now focusing their efforts on an effort to gather signatures for a November ballot initiative that would raise cigarette taxes from the current $0.87 per pack to $2.\u003c/p>\n\u003cp>While California is seen as tough on tobacco, it ranks \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\">36\u003csup>th\u003c/sup> in the country\u003c/a> on per-pack taxes. A \u003ca href=\"http://www.sfgate.com/politics/article/Prop-29-cigarette-tax-backers-concede-defeat-3656640.php\">2012 ballot initiative to raise taxes by $1 per pack\u003c/a> failed by less than half a percentage point after the tobacco industry spent $47 million to defeat it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A statewide Field Poll last year found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/26/california-voters-back-tobacco-tax-hike-poll-shows/\">two-thirds of California voters support\u003c/a> an increase in tobacco taxes.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown signed a sweeping package of tobacco bills into law on Wednesday, including one that will \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB7\" target=\"_blank\">raise the legal age \u003c/a>to buy products from 18 to 21 and another that dramatically\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\"> tightens restrictions\u003c/a> on e-cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What this means for California is our youth are less likely to be addicted to this horrible drug of tobacco.'\u003ccite> Sen. Ed Hernandez, author of the new law\u003c/cite>\u003c/aside>\n\u003cp>But the governor \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB10\" target=\"_blank\">vetoed a bill\u003c/a> that would have permitted cities and counties to establish their own tobacco taxes.\u003c/p>\n\u003cp>“Although California has one of the lowest cigarette taxes in the nation,” the governor said in a veto message, “I am reluctant to approve this measure in view of all the taxes being proposed for the 2016 ballot.”\u003c/p>\n\u003cp>California becomes just the second state after Hawaii to raise the lawful age to buy tobacco products, a move that backers applaud as a certain way to curtail harm to adolescents, and reduce the number of adult smokers.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, was the lead author of the bill to raise the tobacco age. In a phone interview, he said he was \"ecstatic.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"What this means for California is now we can know that our youth are less likely to be addicted to this horrible drug of tobacco,\" he said. \"There’s going to be less addiction to tobacco, [and] we’re going to reduce health care costs and save lives.\"\u003c/p>\n\u003cp>The law, which takes effect next month on June 9, applies to all 18 to 20-year-olds, except military personnel. The bill had stalled for months until a compromise was reached to permit service members under 21 to continue purchasing tobacco.\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/262622063&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/262622063'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A major \u003ca href=\"http://www.nationalacademies.org/hmd/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">Institute of Medicine report\u003c/a> last year concluded that if all states raised the tobacco age to 21, there would be a 12 percent drop in the number of teen and young adult smokers.\u003c/p>\n\u003cp>\"The biggest drops in tobacco use (will) likely occur among teens ages 15 to 17 -- kids who can’t legally buy tobacco products in California now but who run in the same social circles as 18-year-olds who may illegally purchase tobacco products for younger friends,\" said Larry Cohen, executive director of the Oakland-based Prevention Institute and a longtime advocate for tobacco control policies.\u003c/p>\n\u003cp>Adolescents are at particular risk for nicotine addiction since their brains are still developing, says longtime tobacco critic, Stan Glantz, a professor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"Exposing the developing brain to nicotine, which is in both e-cigarettes and conventional cigarettes, physically changes the brain,\" Glantz said. \"That's why the younger someone starts to smoke, the more addicted they tend to get … and the harder time they have stopping.\u003c/p>\n\u003cp>\u003cstrong>Vaping Banned in Many Public Places\u003c/strong>\u003c/p>\n\u003cp>But Glantz said the new regulations on e-cigarettes may be even more significant. \"There's no question that e-cigarettes aren't as dangerous as cigarettes are,\" he said, \"but they're still dangerous.\"\u003c/p>\n\u003cp>Under \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\">the law\u003c/a>, written by Sen. Mark Leno, D-San Francisco, e-cigarettes will be banned in all the same places that traditional cigarettes are -- workplaces, schools, restaurants, hospitals and more. And like other tobacco products, users will need to be 21 to buy e-cigarettes.\u003c/p>\n\u003cp>“The e-cigarette is nothing more than a new delivery system for toxic and addictive nicotine,” Leno said in a statement. “Ensuring that e-cigarettes fall under California’s comprehensive smoke-free laws is critical to protecting public health, especially given the alarming rate at which young people are picking up these devices.\"\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cdc.gov/media/releases/2015/p0416-e-cigarette-use.html\" target=\"_blank\">study\u003c/a> last year from the Centers for Disease Control found that e-cigarette use among middle and high school students had tripled in just one year, from 2013 to 2014.\u003c/p>\n\u003cp>Brown signed three other bills:\u003c/p>\n\u003cul>\n\u003cli>An \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB7\">expansion of smoke-free workspaces\u003c/a> to include hotel lobbies, bars, banquet rooms and employee break rooms\u003c/li>\n\u003cli>Expansion of eligibility for \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB9\">tobacco prevention funds to charter schools\u003c/a>\u003c/li>\n\u003cli>Increases \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520162AB11\">tobacco retailer license fees\u003c/a> from a one-time $100 fee to an annual $265 fee\u003c/li>\n\u003c/ul>\n\u003cp>Anti-tobacco groups are now focusing their efforts on an effort to gather signatures for a November ballot initiative that would raise cigarette taxes from the current $0.87 per pack to $2.\u003c/p>\n\u003cp>While California is seen as tough on tobacco, it ranks \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\">36\u003csup>th\u003c/sup> in the country\u003c/a> on per-pack taxes. A \u003ca href=\"http://www.sfgate.com/politics/article/Prop-29-cigarette-tax-backers-concede-defeat-3656640.php\">2012 ballot initiative to raise taxes by $1 per pack\u003c/a> failed by less than half a percentage point after the tobacco industry spent $47 million to defeat it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A statewide Field Poll last year found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/26/california-voters-back-tobacco-tax-hike-poll-shows/\">two-thirds of California voters support\u003c/a> an increase in tobacco taxes.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Oakland City Council Puts Soda Tax on November Ballot",
"title": "Oakland City Council Puts Soda Tax on November Ballot",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Oakland's City Council voted unanimously to place a soda tax on the November ballot. If approved, Oakland would become the second city in the nation, after Berkeley, where a fee is charged on sugar-sweetened beverages.\u003c/p>\n\u003cp>Councilwoman Annie Campbell Washington sponsored the measure and expects big pushback from the beverage industry.\u003c/p>\n\u003cp>\"We're expecting a huge fight,\" she said. \"We saw in Berkeley that the beverage industry is willing to pour millions and millions into the fight against these kinds of taxes, and we expect the same thing here.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"nsFXAIYfQdOxeTI74gzSZYjAAPNSEY1m\"]The Oakland measure is very similar to the one passed in Berkeley in 2014. It would levy a penny-per-ounce fee on most sugar-sweetened beverages (sodas, energy drinks, fruit-flavored beverages and more). The fee would be paid by distributors but is expected to be passed through to consumers.\u003c/p>\n\u003cp>Washington said the fee is projected to raise $6 million to $10 million for Oakland. An advisory panel would recommend health programs to fund with the generated revenue, but monies from the fee would not be earmarked for specific programs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The measure requires a simple majority, 50 percent plus one vote, for passage.\u003c/p>\n\u003cp>The soda industry opposes such fees, arguing that the focus on sugar-sweetened beverages oversimplifies complex health problems such as obesity and diabetes. It also says such fees hit poor people hardest.\u003c/p>\n\u003cp>Yet a \u003ca href=\"http://www.yes4healthyoaklandchildren.com/endorsements\" target=\"_blank\">long list of public health and community groups\u003c/a> have already indicated their support for a soda tax. In a statement, Mary Pittman, president of the Oakland-based Public Health Institute, said sugar-sweetened beverages are among the biggest contributors to diabetes and other illnesses and disproportionately impact poor communities.\u003c/p>\n\u003cp>[contextly_sidebar id=\"DKnUC4l3u7O6dl7DwgCocEnnO9FQ8As3\"]\"It is time that big beverage companies dip into their millions of dollars of profits and help pay for the damage their products cause,\" Pittman said.\u003c/p>\n\u003cp>Soda tax supporters in San Francisco are gathering signatures to put a measure on the November ballot. A 2014 soda tax effort there failed, but that was an earmarked tax and needed a supermajority -- more than two-thirds vote -- to pass. It got only 55 percent. The new effort would follow the Berkeley/Oakland model. Proceeds would become general revenue, but an advisory board would recommend health programs to fund.\u003c/p>\n\u003cp>The deadline for signatures is July, but San Francisco Supervisor Malia Cohen, a supporter of the tax, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/04/san-francisco-oakland-working-to-put-soda-tax-before-voters/\" target=\"_blank\">earlier said\u003c/a> she expected the 10,000 signatures to be in by late May.\u003c/p>\n\u003cp>Later this month, the Albany City Council will consider putting a soda tax on its November ballot.\u003c/p>\n\u003cp>\"I believe when you look around the country, you'll see this is a movement,\" said Oakland City Council member Washington, referring to other Bay Area efforts and a proposal in Philadelphia. Advocates in Boulder, Colorado. \u003ca href=\"http://www.healthyfoodamerica.org/breaking_boulder_will_pursue_a_sugary_drinks_tax\" target=\"_blank\">are also working\u003c/a> to place a soda tax on the ballot.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think Oakland is a leader on this, with Berkeley,\" she said. \"Oakland is going to be an incredibly important city. If this passes, it really gives a boost to the entire movement.\"\u003c/p>\n\n",
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"excerpt": "The measure is nearly identical to the sugar-sweetened beverage fee passed in Berkeley in 2014. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oakland's City Council voted unanimously to place a soda tax on the November ballot. If approved, Oakland would become the second city in the nation, after Berkeley, where a fee is charged on sugar-sweetened beverages.\u003c/p>\n\u003cp>Councilwoman Annie Campbell Washington sponsored the measure and expects big pushback from the beverage industry.\u003c/p>\n\u003cp>\"We're expecting a huge fight,\" she said. \"We saw in Berkeley that the beverage industry is willing to pour millions and millions into the fight against these kinds of taxes, and we expect the same thing here.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The Oakland measure is very similar to the one passed in Berkeley in 2014. It would levy a penny-per-ounce fee on most sugar-sweetened beverages (sodas, energy drinks, fruit-flavored beverages and more). The fee would be paid by distributors but is expected to be passed through to consumers.\u003c/p>\n\u003cp>Washington said the fee is projected to raise $6 million to $10 million for Oakland. An advisory panel would recommend health programs to fund with the generated revenue, but monies from the fee would not be earmarked for specific programs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The measure requires a simple majority, 50 percent plus one vote, for passage.\u003c/p>\n\u003cp>The soda industry opposes such fees, arguing that the focus on sugar-sweetened beverages oversimplifies complex health problems such as obesity and diabetes. It also says such fees hit poor people hardest.\u003c/p>\n\u003cp>Yet a \u003ca href=\"http://www.yes4healthyoaklandchildren.com/endorsements\" target=\"_blank\">long list of public health and community groups\u003c/a> have already indicated their support for a soda tax. In a statement, Mary Pittman, president of the Oakland-based Public Health Institute, said sugar-sweetened beverages are among the biggest contributors to diabetes and other illnesses and disproportionately impact poor communities.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"It is time that big beverage companies dip into their millions of dollars of profits and help pay for the damage their products cause,\" Pittman said.\u003c/p>\n\u003cp>Soda tax supporters in San Francisco are gathering signatures to put a measure on the November ballot. A 2014 soda tax effort there failed, but that was an earmarked tax and needed a supermajority -- more than two-thirds vote -- to pass. It got only 55 percent. The new effort would follow the Berkeley/Oakland model. Proceeds would become general revenue, but an advisory board would recommend health programs to fund.\u003c/p>\n\u003cp>The deadline for signatures is July, but San Francisco Supervisor Malia Cohen, a supporter of the tax, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/04/san-francisco-oakland-working-to-put-soda-tax-before-voters/\" target=\"_blank\">earlier said\u003c/a> she expected the 10,000 signatures to be in by late May.\u003c/p>\n\u003cp>Later this month, the Albany City Council will consider putting a soda tax on its November ballot.\u003c/p>\n\u003cp>\"I believe when you look around the country, you'll see this is a movement,\" said Oakland City Council member Washington, referring to other Bay Area efforts and a proposal in Philadelphia. Advocates in Boulder, Colorado. \u003ca href=\"http://www.healthyfoodamerica.org/breaking_boulder_will_pursue_a_sugary_drinks_tax\" target=\"_blank\">are also working\u003c/a> to place a soda tax on the ballot.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think Oakland is a leader on this, with Berkeley,\" she said. \"Oakland is going to be an incredibly important city. If this passes, it really gives a boost to the entire movement.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Helps Keep Premiums in Check, UC Berkeley Study Finds",
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"content": "\u003cp>Covered California's Obamacare exchange has helped consumers get a better deal on health insurance in part because of its negotiating power -- power that other Affordable Care Act marketplaces don't have -- according to a \u003ca href=\"http://content.healthaffairs.org/content/35/5/880.abstract?rss=1&related-urls=yes&legid=healthaff;35/5/880\" target=\"_blank\">new analysis\u003c/a> published Monday.\u003c/p>\n\u003cp>California is one of the few states that created an \"active purchaser\" exchange, where the marketplace negotiates premiums and benefits with insurers. Most other states, as well as the federal healthcare.gov, accept any plan that seeks to participate.\u003c/p>\n\u003cp>Researchers compared California and New York and looked at the growth in premiums in 2014 and 2015 in the face of hospital competition and health plan competition.\u003c/p>\n\u003cp>While less hospital competition was associated with higher premium increases in both states, the effect of reduced insurance plan competition played out differently.\u003c/p>\n\u003cp>In New York, less competition in insurance resulted in higher premium growth. But in California, similar \"low competition\" areas had a slower rise in premiums.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Richard Scheffler, a health economist at UC Berkeley and lead author of the study, said one reason for the slower growth is California's negotiating power.\u003c/p>\n\u003cp>\"What happens here is an exchange that's competitive, but is helped by regulation,\" Scheffler said, \"that clears up the market in the sense that consumers can make apples-to-apples choices.\"\u003c/p>\n\u003cp>Scheffler called it \"a problem\" that in New York, there were so many plans available \"that it became very difficult, if not impossible, for a lot of consumers to be able to make good choices.\"\u003c/p>\n\u003cp>The two states' experiences highlight a division in the two visions in running an exchange, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>\"The approach of not negotiating, of just letting any insurer sell its wares, some would call it 'the free market,' \" Wright said. \"We call it the 'flea market' approach.\"\u003c/p>\n\u003cp>He likened Covered California to a human resources department for the \"rest of us that don't work at Google.\"\u003c/p>\n\u003cp>Covered California plans \u003ca href=\"https://www.coveredca.com/PDFs/2016-Health-Benefits-table.pdf\" target=\"_blank\">all have identical benefits\u003c/a>. The only difference between plans are price and the hospital and physician networks, making comparison straightforward.\u003c/p>\n\u003cp>\"We create a marketplace where consumers are in the driving seat,\" said Covered California executive director Peter Lee. \"[In] New York City, the consumers would be picking between 50 different products. What's the difference between them? Tweaks on co-insurance and insurance babble that most consumers don't understand.\"\u003c/p>\n\u003cp>\"The folklore in economics is that more choice is better,\" economist Scheffler said. If offered too many choices in health insurance, \"it becomes too much for consumers to look at and analyze and really absorb. So you're better off having a smaller number of choices to plan on and pick from.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scheffler and his co-authors say that the Affordable Care Act marketplaces provide a \"natural laboratory\" to continue studying the effects of competition among hospitals and insurers.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Covered California's Obamacare exchange has helped consumers get a better deal on health insurance in part because of its negotiating power -- power that other Affordable Care Act marketplaces don't have -- according to a \u003ca href=\"http://content.healthaffairs.org/content/35/5/880.abstract?rss=1&related-urls=yes&legid=healthaff;35/5/880\" target=\"_blank\">new analysis\u003c/a> published Monday.\u003c/p>\n\u003cp>California is one of the few states that created an \"active purchaser\" exchange, where the marketplace negotiates premiums and benefits with insurers. Most other states, as well as the federal healthcare.gov, accept any plan that seeks to participate.\u003c/p>\n\u003cp>Researchers compared California and New York and looked at the growth in premiums in 2014 and 2015 in the face of hospital competition and health plan competition.\u003c/p>\n\u003cp>While less hospital competition was associated with higher premium increases in both states, the effect of reduced insurance plan competition played out differently.\u003c/p>\n\u003cp>In New York, less competition in insurance resulted in higher premium growth. But in California, similar \"low competition\" areas had a slower rise in premiums.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Richard Scheffler, a health economist at UC Berkeley and lead author of the study, said one reason for the slower growth is California's negotiating power.\u003c/p>\n\u003cp>\"What happens here is an exchange that's competitive, but is helped by regulation,\" Scheffler said, \"that clears up the market in the sense that consumers can make apples-to-apples choices.\"\u003c/p>\n\u003cp>Scheffler called it \"a problem\" that in New York, there were so many plans available \"that it became very difficult, if not impossible, for a lot of consumers to be able to make good choices.\"\u003c/p>\n\u003cp>The two states' experiences highlight a division in the two visions in running an exchange, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>\"The approach of not negotiating, of just letting any insurer sell its wares, some would call it 'the free market,' \" Wright said. \"We call it the 'flea market' approach.\"\u003c/p>\n\u003cp>He likened Covered California to a human resources department for the \"rest of us that don't work at Google.\"\u003c/p>\n\u003cp>Covered California plans \u003ca href=\"https://www.coveredca.com/PDFs/2016-Health-Benefits-table.pdf\" target=\"_blank\">all have identical benefits\u003c/a>. The only difference between plans are price and the hospital and physician networks, making comparison straightforward.\u003c/p>\n\u003cp>\"We create a marketplace where consumers are in the driving seat,\" said Covered California executive director Peter Lee. \"[In] New York City, the consumers would be picking between 50 different products. What's the difference between them? Tweaks on co-insurance and insurance babble that most consumers don't understand.\"\u003c/p>\n\u003cp>\"The folklore in economics is that more choice is better,\" economist Scheffler said. If offered too many choices in health insurance, \"it becomes too much for consumers to look at and analyze and really absorb. So you're better off having a smaller number of choices to plan on and pick from.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scheffler and his co-authors say that the Affordable Care Act marketplaces provide a \"natural laboratory\" to continue studying the effects of competition among hospitals and insurers.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "how-fresno-man-started-biking-and-reversed-type-2-diabetes",
"title": "How Fresno Man Started Biking and Reversed Type 2 Diabetes",
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"content": "\u003cp>FRESNO — Jaime Rangel holds a bike tire and begins checking with his hands for thorns and other sharp objects that might be puncturing the tire’s rubber tread. His fingers, stained with black patches of oil, move quickly and seamlessly. He’s done this type of work dozens of times before.\u003c/p>\n\u003cp>All around him, a steady stream of kids line up to get their bikes’ flat tires and faulty brakes fixed at this free event at a park in southeast Fresno.\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/261604685″ 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>The free bike repairs are a preamble to the Cumbia Ride, a group bike ride with Latin American dance music started last year by Fresno’s \u003ca href=\"http://www.cultivalasalud.org/news-and-media/\" target=\"_blank\" rel=\"noopener\">Cultiva la Salud\u003c/a> to promote biking and a healthier lifestyle among Latino families.\u003c/p>\n\u003cp>Rangel, 26, says he’s here fixing bikes because he relates to many of the young riders at the event — kids who can’t afford to have their bikes repaired.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When I was a kid, no one showed me how to fix a bike,” he says. “My mom never took me to a bike shop because we grew up low income, so everything I had to learn from scratch.”\u003c/p>\n\u003cfigure id=\"attachment_177121\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177121 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg\" alt=\"Eloise Betancourt, 37, chats with Jaime Rangel as her son Lorenzo, 11, works on his bike with mechanic Chris Eacock. Betancourt lost her kids' bikes and most of the family's belongings after she couldn't afford to pay for storage, but Lorenzo saved money from running errands and bought three beat up bikes at a garage sale for him and his sisters.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eloise Betancourt, 37, brought her son, Lorenzo, 11 (R) to repair his bike. Biking is a main mode of transportation for the Betancourt family, but they lost their bikes and most of their belongings after they couldn’t afford to pay for storage. Lorenzo worked mowing lawns and saved $25 to buy bikes in need of repairs at a garage sale for himself and his sisters. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rangel makes a point of showing those skills to the kids and parents lingering by their bikes. He wants young people and adults, especially in working-class neighborhoods like southeast Fresno, to be able to bike more to fend off chronic illnesses such as diabetes.\u003c/p>\n\u003cp>Rangel speaks from personal experience.\u003c/p>\n\u003cp>\u003cstrong>Facing Type 2 Diabetes as a Teen\u003c/strong>\u003c/p>\n\u003cp>Rangel was just 14 and living with his family in Los Angeles when he was diagnosed with Type 2 diabetes. Obesity and a sedentary lifestyle are risk factors for the illness. While he was tall — 6-foot-1 — he weighed 260 pounds.\u003c/p>\n\u003cp>It’s been a dozen years since he was diagnosed, but he clearly recalls how frightened he was. The disease had already transformed the lives of his mother, two sets of grandparents and other relatives. He knew what he was facing.\u003c/p>\n\u003cp>“I was really scared,” says Rangel. “I was seeing there were only certain foods they would eat, taking their insulin shots. And I was like, ‘Nah, that can’t happen. I’m too young!'”\u003c/p>\n\u003cp>Until about two decades ago, Type 2 diabetes in children and teens was practically unheard of. But the number of adolescents living with the disease has\u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\" target=\"_blank\" rel=\"noopener\"> gone up in recent years,\u003c/a> in large part because of the \u003ca href=\"http://care.diabetesjournals.org/content/34/Supplement_2/S161.full#ref-8\" target=\"_blank\" rel=\"noopener\">obesity epidemic\u003c/a>.\u003c/p>\n\u003cp>As with adults, rates of Type 2 diabetes are higher among Hispanic, African-American and Asian-Pacific Islander youth than non-Hispanic whites, \u003ca href=\"http://templatelab.com/national-diabetes-report-2014/\" target=\"_blank\" rel=\"noopener\">according to data from the Centers for Disease Control and Prevention\u003c/a>. Uncontrolled diabetes can lead to blindness, heart disease, amputations, kidney failure and other serious complications.\u003c/p>\n\u003cp>Rangel’s doctor had said he needed to lose weight and give up foods he loved. But he didn’t know how to start. He loved the idea of biking, but his family couldn’t afford to buy him one.\u003c/p>\n\u003cp>Instead, a close friend stepped in with a gift of a BMX bike. He didn’t know how to ride and at first it was scary. He fell a lot the first couple of times he tried.\u003c/p>\n\u003cp>“I was a big dude riding a really small bike, so I didn’t know how to balance my weight,” Rangel says. “But I just kept going. I didn’t want to stop, and I just kept doing it so I could get better.”\u003c/p>\n\u003cp>With each trip he took, he ventured longer distances. Rangel says he enjoyed the independence he felt while crossing large swaths of the traffic-jammed city. Under the power of his own legs pushing down on his bike’s pedals, he would travel from his home in the Lincoln Heights neighborhood to the beach at Santa Monica — 20 miles away.\u003c/p>\n\u003cp>Within a year, Rangel had reversed his Type 2 diabetes. His blood sugar levels returned to a normal range. It’s surprising to many, but children and young adults can beat the disease through exercise, say medical experts.\u003c/p>\n\u003cfigure id=\"attachment_177119\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177119 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg\" alt=\"Jaime Rangel, 26, helps Gustavo Ruiz, 12, fix the flat tire on his bike at the Mosqueda Community Center park. Rangel says he makes a point of showing kids and adults who may not have funds to repair their bikes at a shop, how to fix their bikes on their own. \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jaime Rangel helps Gustavo Ruiz, 12, align a tire on his bike at the Mosqueda Community Center park in southeast Fresno. As manager for Bici Projects, Rangel teaches kids and adults ‘in the barrio’ how to repair bikes, part of a larger effort to promote biking among local Latino families. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience marked Rangel deeply. He had managed to rid himself of the illness without taking medication while having fun, too.\u003c/p>\n\u003cp>“Biking changed my life. I lost a lot of weight,” says Rangel, who now weighs about 220 pounds.\u003c/p>\n\u003cp>Rangel’s family noticed the change in the way he looked and the dramatic improvement in his health. At Rangel’s insistence, his mom, cousins and uncles began biking — a dramatic change for his family, he says.\u003c/p>\n\u003cp>“We all got rid of our diabetes, pretty much,” says Rangel, who recently moved to Fresno. “Now when I’m in L.A., about 20 of us go bike riding together. So it changed not just me, but my whole family at the same time.”\u003c/p>\n\u003cp>Rangel wants to promote biking and a more active lifestyle to create positive change in his new home in Fresno. The most recent \u003ca href=\"http://www.cdph.ca.gov/programs/ohir/Documents/OHIRProfiles2016.pdf\" target=\"_blank\" rel=\"noopener\">state data\u003c/a> show the county had the fourth-highest death rate from diabetes. Central Valley counties Kern and Kings also top the list.\u003c/p>\n\u003cp>Using his personal experience and love for biking as a mantra, Rangel coordinates youth engagement for the San Joaquin Valley Latino Environmental Advancement & Policy Project and manages the group’s Bici Projects (short for “bicicleta” — bicycle in Spanish).\u003c/p>\n\u003cp>\u003cstrong>How Can Type 2 Diabetes Disappear?\u003c/strong>\u003c/p>\n\u003cp>Type 2 diabetes is an illness affecting a person’s ability to use insulin, and not everyone can beat the disease through exercise and weight loss. But there’s “tremendous hope” for young people and others diagnosed with the disease early on, says Dr. Saleh Adi, medical director of the Madison Clinic for Pediatric Diabetes at UCSF.\u003c/p>\n\u003cp>Insulin is a hormone that allows the body to use sugars from carbohydrates. Patients with Type 1 diabetes, an irreversible autoimmune disorder, must take insulin medication for life because their bodies are no longer able to produce it.\u003c/p>\n\u003cp>In contrast, people with Type 2 diabetes are still able to make insulin for the most part, but their bodies don’t respond to it properly, and they develop what’s called insulin resistance. Exercise can change that because active muscle “is the biggest site of insulin action,” says Adi.\u003c/p>\n\u003cp>“Exercising increases your sensitivity to insulin, and that’s true in everybody,” says Adi, whose pediatric clinic tries to get patients to engage in physical activity for six months before prescribing them medication.\u003c/p>\n\u003cp>“We’ve seen quite a few cases where the disease disappears,” he says. “If you catch it early enough and do what it takes, which is exercising and losing the weight.”\u003c/p>\n\u003cp>Adi readily acknowledges squeezing more exercise into daily routines is not easy, but he says even 10 more minutes of walking can begin to make a difference.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Don’t give up. You can really get rid of Type 2 diabetes if you change your lifestyle,” says Adi. “I’m talking about moderate exercise, that will really help.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>FRESNO — Jaime Rangel holds a bike tire and begins checking with his hands for thorns and other sharp objects that might be puncturing the tire’s rubber tread. His fingers, stained with black patches of oil, move quickly and seamlessly. He’s done this type of work dozens of times before.\u003c/p>\n\u003cp>All around him, a steady stream of kids line up to get their bikes’ flat tires and faulty brakes fixed at this free event at a park in southeast Fresno.\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/261604685″&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/261604685″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The free bike repairs are a preamble to the Cumbia Ride, a group bike ride with Latin American dance music started last year by Fresno’s \u003ca href=\"http://www.cultivalasalud.org/news-and-media/\" target=\"_blank\" rel=\"noopener\">Cultiva la Salud\u003c/a> to promote biking and a healthier lifestyle among Latino families.\u003c/p>\n\u003cp>Rangel, 26, says he’s here fixing bikes because he relates to many of the young riders at the event — kids who can’t afford to have their bikes repaired.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When I was a kid, no one showed me how to fix a bike,” he says. “My mom never took me to a bike shop because we grew up low income, so everything I had to learn from scratch.”\u003c/p>\n\u003cfigure id=\"attachment_177121\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177121 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg\" alt=\"Eloise Betancourt, 37, chats with Jaime Rangel as her son Lorenzo, 11, works on his bike with mechanic Chris Eacock. Betancourt lost her kids' bikes and most of the family's belongings after she couldn't afford to pay for storage, but Lorenzo saved money from running errands and bought three beat up bikes at a garage sale for him and his sisters.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eloise Betancourt, 37, brought her son, Lorenzo, 11 (R) to repair his bike. Biking is a main mode of transportation for the Betancourt family, but they lost their bikes and most of their belongings after they couldn’t afford to pay for storage. Lorenzo worked mowing lawns and saved $25 to buy bikes in need of repairs at a garage sale for himself and his sisters. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rangel makes a point of showing those skills to the kids and parents lingering by their bikes. He wants young people and adults, especially in working-class neighborhoods like southeast Fresno, to be able to bike more to fend off chronic illnesses such as diabetes.\u003c/p>\n\u003cp>Rangel speaks from personal experience.\u003c/p>\n\u003cp>\u003cstrong>Facing Type 2 Diabetes as a Teen\u003c/strong>\u003c/p>\n\u003cp>Rangel was just 14 and living with his family in Los Angeles when he was diagnosed with Type 2 diabetes. Obesity and a sedentary lifestyle are risk factors for the illness. While he was tall — 6-foot-1 — he weighed 260 pounds.\u003c/p>\n\u003cp>It’s been a dozen years since he was diagnosed, but he clearly recalls how frightened he was. The disease had already transformed the lives of his mother, two sets of grandparents and other relatives. He knew what he was facing.\u003c/p>\n\u003cp>“I was really scared,” says Rangel. “I was seeing there were only certain foods they would eat, taking their insulin shots. And I was like, ‘Nah, that can’t happen. I’m too young!'”\u003c/p>\n\u003cp>Until about two decades ago, Type 2 diabetes in children and teens was practically unheard of. But the number of adolescents living with the disease has\u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\" target=\"_blank\" rel=\"noopener\"> gone up in recent years,\u003c/a> in large part because of the \u003ca href=\"http://care.diabetesjournals.org/content/34/Supplement_2/S161.full#ref-8\" target=\"_blank\" rel=\"noopener\">obesity epidemic\u003c/a>.\u003c/p>\n\u003cp>As with adults, rates of Type 2 diabetes are higher among Hispanic, African-American and Asian-Pacific Islander youth than non-Hispanic whites, \u003ca href=\"http://templatelab.com/national-diabetes-report-2014/\" target=\"_blank\" rel=\"noopener\">according to data from the Centers for Disease Control and Prevention\u003c/a>. Uncontrolled diabetes can lead to blindness, heart disease, amputations, kidney failure and other serious complications.\u003c/p>\n\u003cp>Rangel’s doctor had said he needed to lose weight and give up foods he loved. But he didn’t know how to start. He loved the idea of biking, but his family couldn’t afford to buy him one.\u003c/p>\n\u003cp>Instead, a close friend stepped in with a gift of a BMX bike. He didn’t know how to ride and at first it was scary. He fell a lot the first couple of times he tried.\u003c/p>\n\u003cp>“I was a big dude riding a really small bike, so I didn’t know how to balance my weight,” Rangel says. “But I just kept going. I didn’t want to stop, and I just kept doing it so I could get better.”\u003c/p>\n\u003cp>With each trip he took, he ventured longer distances. Rangel says he enjoyed the independence he felt while crossing large swaths of the traffic-jammed city. Under the power of his own legs pushing down on his bike’s pedals, he would travel from his home in the Lincoln Heights neighborhood to the beach at Santa Monica — 20 miles away.\u003c/p>\n\u003cp>Within a year, Rangel had reversed his Type 2 diabetes. His blood sugar levels returned to a normal range. It’s surprising to many, but children and young adults can beat the disease through exercise, say medical experts.\u003c/p>\n\u003cfigure id=\"attachment_177119\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177119 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg\" alt=\"Jaime Rangel, 26, helps Gustavo Ruiz, 12, fix the flat tire on his bike at the Mosqueda Community Center park. Rangel says he makes a point of showing kids and adults who may not have funds to repair their bikes at a shop, how to fix their bikes on their own. \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jaime Rangel helps Gustavo Ruiz, 12, align a tire on his bike at the Mosqueda Community Center park in southeast Fresno. As manager for Bici Projects, Rangel teaches kids and adults ‘in the barrio’ how to repair bikes, part of a larger effort to promote biking among local Latino families. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience marked Rangel deeply. He had managed to rid himself of the illness without taking medication while having fun, too.\u003c/p>\n\u003cp>“Biking changed my life. I lost a lot of weight,” says Rangel, who now weighs about 220 pounds.\u003c/p>\n\u003cp>Rangel’s family noticed the change in the way he looked and the dramatic improvement in his health. At Rangel’s insistence, his mom, cousins and uncles began biking — a dramatic change for his family, he says.\u003c/p>\n\u003cp>“We all got rid of our diabetes, pretty much,” says Rangel, who recently moved to Fresno. “Now when I’m in L.A., about 20 of us go bike riding together. So it changed not just me, but my whole family at the same time.”\u003c/p>\n\u003cp>Rangel wants to promote biking and a more active lifestyle to create positive change in his new home in Fresno. The most recent \u003ca href=\"http://www.cdph.ca.gov/programs/ohir/Documents/OHIRProfiles2016.pdf\" target=\"_blank\" rel=\"noopener\">state data\u003c/a> show the county had the fourth-highest death rate from diabetes. Central Valley counties Kern and Kings also top the list.\u003c/p>\n\u003cp>Using his personal experience and love for biking as a mantra, Rangel coordinates youth engagement for the San Joaquin Valley Latino Environmental Advancement & Policy Project and manages the group’s Bici Projects (short for “bicicleta” — bicycle in Spanish).\u003c/p>\n\u003cp>\u003cstrong>How Can Type 2 Diabetes Disappear?\u003c/strong>\u003c/p>\n\u003cp>Type 2 diabetes is an illness affecting a person’s ability to use insulin, and not everyone can beat the disease through exercise and weight loss. But there’s “tremendous hope” for young people and others diagnosed with the disease early on, says Dr. Saleh Adi, medical director of the Madison Clinic for Pediatric Diabetes at UCSF.\u003c/p>\n\u003cp>Insulin is a hormone that allows the body to use sugars from carbohydrates. Patients with Type 1 diabetes, an irreversible autoimmune disorder, must take insulin medication for life because their bodies are no longer able to produce it.\u003c/p>\n\u003cp>In contrast, people with Type 2 diabetes are still able to make insulin for the most part, but their bodies don’t respond to it properly, and they develop what’s called insulin resistance. Exercise can change that because active muscle “is the biggest site of insulin action,” says Adi.\u003c/p>\n\u003cp>“Exercising increases your sensitivity to insulin, and that’s true in everybody,” says Adi, whose pediatric clinic tries to get patients to engage in physical activity for six months before prescribing them medication.\u003c/p>\n\u003cp>“We’ve seen quite a few cases where the disease disappears,” he says. “If you catch it early enough and do what it takes, which is exercising and losing the weight.”\u003c/p>\n\u003cp>Adi readily acknowledges squeezing more exercise into daily routines is not easy, but he says even 10 more minutes of walking can begin to make a difference.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Don’t give up. You can really get rid of Type 2 diabetes if you change your lifestyle,” says Adi. “I’m talking about moderate exercise, that will really help.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Finally, Long Overdue Progress in Hospital Seismic Safety",
"title": "Finally, Long Overdue Progress in Hospital Seismic Safety",
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"content": "\u003cp>After years of delay, retrofitting and rebuilding, more than 90 percent of California’s acute care hospital buildings are no longer at risk of collapse during an earthquake, according to the most recent data from the state’s Office of Statewide Health Planning and Development (OSHPD).\u003c/p>\n\u003cp>But the remaining hospitals \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SeisPerfRatings-v3-2.html\" target=\"_blank\">still need to meet\u003c/a> the state’s tough seismic safety requirements, or close buildings that are not up to standard by 2030. Buildings at six rural “critical access” hospitals remain on the state’s list of structures most likely to collapse in an earthquake, and their administrators face challenges keeping them open.\u003c/p>\n\u003cp>“I am very pleased with the progress that has been made,” said Robert David, director of OSHPD, which oversees hospital earthquake safety. “Based on information and schedules provided by the hospitals … the remaining acute care buildings appear to be on track to meet the state deadline to withstand a major earthquake or be removed from service.”\u003c/p>\n\u003cp>An estimated 251 buildings are still rated “SPC-1,” the highest risk category — down from more than 1,000 in 2001, according to OSPHD spokesman David Byrnes.\u003c/p>\n\u003cp>Another 629 buildings are rated “SPC-2,” the second highest risk. Not all of those buildings house patients; some may hold administrative offices, for example. But state law requires all buildings in the top two risk categories to close by 2030 unless they have been repaired or replaced. In addition, all SPC-1 buildings must be retrofitted to meet at least SPC-2 requirements by 2020 unless a hospital has received a specific deadline extension from OSPHD.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It has taken years for hospitals to get this far.\u003c/p>\n\u003cp>After the magnitude 6.7 Northridge earthquake crippled local hospitals in 1994, state lawmakers toughened up 1973 legislation that required hospitals in danger of collapse or significant damage in an earthquake to make repairs or rebuild -- or face closure.\u003c/p>\n\u003cp>At the time, the new deadline was set for 2008. But the state’s hospital industry group, citing high construction costs, successfully pushed back many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.\u003c/p>\n\u003cp>There’s a 93 percent chance that a 7.0 magnitude earthquake could strike the Bay Area in the next 30 years, according to the most recent \u003ca href=\"http://pubs.usgs.gov/fs/2015/3009/pdf/fs2015-3009.pdf\" target=\"_blank\">estimate\u003c/a> by the U.S. Geological Survey.\u003c/p>\n\u003cp>While many hospitals around the state have spent millions on retrofitting or replacing unsafe buildings, some have chosen to shut down non-compliant facilities before the final 2030 deadline. Sutter-owned Alta Bates Hospital \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">recently determined\u003c/a> that it plans to close acute care and emergency services in Berkeley before 2030 because of the earthquake safety requirements. Some critics say Sutter is using those requirements \u003ca href=\"http://www.eastbaytimes.com/breaking-news/ci_29811598/sutter-plans-future-closing-berkeley-emergency-services\" target=\"_blank\">as an excuse\u003c/a> to consolidate some of its services.\u003c/p>\n\u003cp>A number of hospitals still face difficulty getting the money they need to replace aging buildings, and they’re hoping to get the needed capital through bond measures, tax hikes and other means.\u003c/p>\n\u003cp>In Fort Bragg, the Mendocino County District Hospital is trying to figure how best to keep its main hospital open. It’s \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SPCNPCList.pdf\" target=\"_blank\">got the second highest risk rating\u003c/a> and would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/11/06/the-mendocino-coast-fears-losing-its-only-hospital/\" target=\"_blank\">need to close\u003c/a> by 2030 unless improved or replaced. But the 25-bed critical access hospital declared bankruptcy in 2012, and amid staff turmoil, its financing options are limited.\u003c/p>\n\u003cp>The hospital’s board is considering a parcel tax, and its CEO has floated the idea of \u003ca href=\"http://www.advocate-news.com/general-news/20160407/private-non-profit-option-considered\" target=\"_blank\">converting the public hospital to private nonprofit status\u003c/a> to draw more funds.\u003c/p>\n\u003cp>Wade Sturgeon, the hospital district’s chief financial officer, said that reports of the hospital’s potential demise have been exaggerated. “We’ve been able to improve a lot of things. We are having conversations about what do we do going forward,” Sturgeon said. He added that \u003ca href=\"http://www.oshpd.ca.gov/FDD/seismic_compliance/SB1953/SPC-4D_Regulations.html\" target=\"_blank\">new state building regulations\u003c/a> taking effect in 2017 may allow his hospital to stay open past 2030 with some retrofits.\u003c/p>\n\u003cp>While hospitals are finally making progress since the tighter earthquake safety regulations took effect more than 20 years ago, the delays haven’t been good for patients or hospital staff, said Stephanie Roberson, legislative advocate for the California Nurses Association. The association is a persistent critic of what it has seen as hospital foot-dragging.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We need to make sure these hospitals are held accountable,” Roberson said. “We saw what happened in Northridge – the loss of life and property to the tune of billions of dollars. Hospitals are supposed to be that beacon of light in the community, and if we have a seismic catastrophe they are centers for the public to take refuge.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of delay, retrofitting and rebuilding, more than 90 percent of California’s acute care hospital buildings are no longer at risk of collapse during an earthquake, according to the most recent data from the state’s Office of Statewide Health Planning and Development (OSHPD).\u003c/p>\n\u003cp>But the remaining hospitals \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SeisPerfRatings-v3-2.html\" target=\"_blank\">still need to meet\u003c/a> the state’s tough seismic safety requirements, or close buildings that are not up to standard by 2030. Buildings at six rural “critical access” hospitals remain on the state’s list of structures most likely to collapse in an earthquake, and their administrators face challenges keeping them open.\u003c/p>\n\u003cp>“I am very pleased with the progress that has been made,” said Robert David, director of OSHPD, which oversees hospital earthquake safety. “Based on information and schedules provided by the hospitals … the remaining acute care buildings appear to be on track to meet the state deadline to withstand a major earthquake or be removed from service.”\u003c/p>\n\u003cp>An estimated 251 buildings are still rated “SPC-1,” the highest risk category — down from more than 1,000 in 2001, according to OSPHD spokesman David Byrnes.\u003c/p>\n\u003cp>Another 629 buildings are rated “SPC-2,” the second highest risk. Not all of those buildings house patients; some may hold administrative offices, for example. But state law requires all buildings in the top two risk categories to close by 2030 unless they have been repaired or replaced. In addition, all SPC-1 buildings must be retrofitted to meet at least SPC-2 requirements by 2020 unless a hospital has received a specific deadline extension from OSPHD.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It has taken years for hospitals to get this far.\u003c/p>\n\u003cp>After the magnitude 6.7 Northridge earthquake crippled local hospitals in 1994, state lawmakers toughened up 1973 legislation that required hospitals in danger of collapse or significant damage in an earthquake to make repairs or rebuild -- or face closure.\u003c/p>\n\u003cp>At the time, the new deadline was set for 2008. But the state’s hospital industry group, citing high construction costs, successfully pushed back many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.\u003c/p>\n\u003cp>There’s a 93 percent chance that a 7.0 magnitude earthquake could strike the Bay Area in the next 30 years, according to the most recent \u003ca href=\"http://pubs.usgs.gov/fs/2015/3009/pdf/fs2015-3009.pdf\" target=\"_blank\">estimate\u003c/a> by the U.S. Geological Survey.\u003c/p>\n\u003cp>While many hospitals around the state have spent millions on retrofitting or replacing unsafe buildings, some have chosen to shut down non-compliant facilities before the final 2030 deadline. Sutter-owned Alta Bates Hospital \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">recently determined\u003c/a> that it plans to close acute care and emergency services in Berkeley before 2030 because of the earthquake safety requirements. Some critics say Sutter is using those requirements \u003ca href=\"http://www.eastbaytimes.com/breaking-news/ci_29811598/sutter-plans-future-closing-berkeley-emergency-services\" target=\"_blank\">as an excuse\u003c/a> to consolidate some of its services.\u003c/p>\n\u003cp>A number of hospitals still face difficulty getting the money they need to replace aging buildings, and they’re hoping to get the needed capital through bond measures, tax hikes and other means.\u003c/p>\n\u003cp>In Fort Bragg, the Mendocino County District Hospital is trying to figure how best to keep its main hospital open. It’s \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SPCNPCList.pdf\" target=\"_blank\">got the second highest risk rating\u003c/a> and would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/11/06/the-mendocino-coast-fears-losing-its-only-hospital/\" target=\"_blank\">need to close\u003c/a> by 2030 unless improved or replaced. But the 25-bed critical access hospital declared bankruptcy in 2012, and amid staff turmoil, its financing options are limited.\u003c/p>\n\u003cp>The hospital’s board is considering a parcel tax, and its CEO has floated the idea of \u003ca href=\"http://www.advocate-news.com/general-news/20160407/private-non-profit-option-considered\" target=\"_blank\">converting the public hospital to private nonprofit status\u003c/a> to draw more funds.\u003c/p>\n\u003cp>Wade Sturgeon, the hospital district’s chief financial officer, said that reports of the hospital’s potential demise have been exaggerated. “We’ve been able to improve a lot of things. We are having conversations about what do we do going forward,” Sturgeon said. He added that \u003ca href=\"http://www.oshpd.ca.gov/FDD/seismic_compliance/SB1953/SPC-4D_Regulations.html\" target=\"_blank\">new state building regulations\u003c/a> taking effect in 2017 may allow his hospital to stay open past 2030 with some retrofits.\u003c/p>\n\u003cp>While hospitals are finally making progress since the tighter earthquake safety regulations took effect more than 20 years ago, the delays haven’t been good for patients or hospital staff, said Stephanie Roberson, legislative advocate for the California Nurses Association. The association is a persistent critic of what it has seen as hospital foot-dragging.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We need to make sure these hospitals are held accountable,” Roberson said. “We saw what happened in Northridge – the loss of life and property to the tune of billions of dollars. Hospitals are supposed to be that beacon of light in the community, and if we have a seismic catastrophe they are centers for the public to take refuge.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>After years of speculation in Berkeley, the future closure of Alta Bates Hospital appears to be certain.\u003c/p>\n\u003cp>Sutter Health, owner of Alta Bates, said it will close the inpatient hospital and its emergency department sometime in advance of 2030, when state seismic standards kick in. Those standards require that all inpatient hospitals are built both to withstand a major quake and to remain fully operational after the event.\u003c/p>\n\u003cp>In a statement, Sutter said that Alta Bates is \"not seismically compliant\" with the law, \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/\" target=\"_blank\">SB1953\u003c/a>. It plans to consolidate inpatient and emergency facilities at its Summit campus in Oakland.\u003c/p>\n\u003cp>Berkeley officials are concerned about the closure of its only emergency department. The Berkeley Fire Department and paramedics transported more than 5,000 patients to Alta Bates in the last year. Taking them to Summit in Oakland, 3 miles away, is expected to add 24 minutes to calls, fire officials say.\u003c/p>\n\u003cp>\"It increases the amount of time that (paramedics) have to spend transporting patients to the hospital,\" said Berkeley City Councilman Jesse Arreguin. \"It potentially puts people's lives at risk.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sutter Health, a nonprofit based in Sacramento, runs more than 25 hospitals across Northern California. The 110-year-old Alta Bates Hospital merged with Summit, part of Sutter Health's chain, in 1999.\u003c/p>\n\u003cp>Many hospital systems are choosing to completely rebuild their inpatient facilities to be compliant with state seismic standards. But Alta Bates is in a residential neighborhood in south Berkeley, and Sutter said that the hospital can't be rebuilt at its current location because \"the existing facility would need to be closed and demolished to make room for a replacement, which would result in loss of care to the community for a decade.\"\u003c/p>\n\u003cp>Instead, Sutter says it plans to make the Alta Bates campus a hub for outpatient services, which are not subject to the strict seismic standards that inpatient facilities are.\u003c/p>\n\u003cp>The ramifications of Alta Bates' closure will be felt well beyond Berkeley and Alameda County. Last year at this time in the Contra Costa County city of San Pablo,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\"> Doctors Medical Center closed\u003c/a> and took more than 20 emergency department beds with it. People north of Berkeley from Richmond to Vallejo had relied on the safety-net hospital.\u003c/p>\n\u003cp>One of the hospitals that absorbed patients after the shutdown was Alta Bates, already a distance for people who live in heavily trafficked communities on the Interstate 80 corridor.\u003c/p>\n\u003cp>Contra Costa Supervisor John Gioia echoed Arreguin's concerns about timely care.\u003c/p>\n\u003cp>\"It basically will mean for some patients, it will take longer to receive hospital care,\" he says. \"It could have negative outcomes in the case of those who need to be in the hospital quicker. Every minute counts, right?\"\u003c/p>\n\u003cp>In its statement, Sutter pointed out that Summit was \"less than 3 miles away\" from Alta Bates. But Alta Bates is on Berkeley's southern edge -- easily a 20-minute drive for people who live on the north side, much farther still for people coming from 10 miles north in Richmond.\u003c/p>\n\u003cp>\"(Sutter) is looking at this from the standpoint of those two hospitals alone,\" Gioia says, \"but the emergency medical system is just that, a system, and this closure will definitely impact the emergency medical systems in Alameda County and also West Contra Costa County.\"\u003c/p>\n\u003cp>Over the last several years, Sutter has moved Alta Bates' cardiac, stroke and rehabilitation services to its Summit Oakland campus.\u003c/p>\n\u003cp>The Berkeley City Council has directed both its Community Health Commission and the Disaster and Fire Safety Commission to assess the impact of Alta Bates' closure and make recommendations to the council.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Amy Mostafa contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of speculation in Berkeley, the future closure of Alta Bates Hospital appears to be certain.\u003c/p>\n\u003cp>Sutter Health, owner of Alta Bates, said it will close the inpatient hospital and its emergency department sometime in advance of 2030, when state seismic standards kick in. Those standards require that all inpatient hospitals are built both to withstand a major quake and to remain fully operational after the event.\u003c/p>\n\u003cp>In a statement, Sutter said that Alta Bates is \"not seismically compliant\" with the law, \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/\" target=\"_blank\">SB1953\u003c/a>. It plans to consolidate inpatient and emergency facilities at its Summit campus in Oakland.\u003c/p>\n\u003cp>Berkeley officials are concerned about the closure of its only emergency department. The Berkeley Fire Department and paramedics transported more than 5,000 patients to Alta Bates in the last year. Taking them to Summit in Oakland, 3 miles away, is expected to add 24 minutes to calls, fire officials say.\u003c/p>\n\u003cp>\"It increases the amount of time that (paramedics) have to spend transporting patients to the hospital,\" said Berkeley City Councilman Jesse Arreguin. \"It potentially puts people's lives at risk.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sutter Health, a nonprofit based in Sacramento, runs more than 25 hospitals across Northern California. The 110-year-old Alta Bates Hospital merged with Summit, part of Sutter Health's chain, in 1999.\u003c/p>\n\u003cp>Many hospital systems are choosing to completely rebuild their inpatient facilities to be compliant with state seismic standards. But Alta Bates is in a residential neighborhood in south Berkeley, and Sutter said that the hospital can't be rebuilt at its current location because \"the existing facility would need to be closed and demolished to make room for a replacement, which would result in loss of care to the community for a decade.\"\u003c/p>\n\u003cp>Instead, Sutter says it plans to make the Alta Bates campus a hub for outpatient services, which are not subject to the strict seismic standards that inpatient facilities are.\u003c/p>\n\u003cp>The ramifications of Alta Bates' closure will be felt well beyond Berkeley and Alameda County. Last year at this time in the Contra Costa County city of San Pablo,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\"> Doctors Medical Center closed\u003c/a> and took more than 20 emergency department beds with it. People north of Berkeley from Richmond to Vallejo had relied on the safety-net hospital.\u003c/p>\n\u003cp>One of the hospitals that absorbed patients after the shutdown was Alta Bates, already a distance for people who live in heavily trafficked communities on the Interstate 80 corridor.\u003c/p>\n\u003cp>Contra Costa Supervisor John Gioia echoed Arreguin's concerns about timely care.\u003c/p>\n\u003cp>\"It basically will mean for some patients, it will take longer to receive hospital care,\" he says. \"It could have negative outcomes in the case of those who need to be in the hospital quicker. Every minute counts, right?\"\u003c/p>\n\u003cp>In its statement, Sutter pointed out that Summit was \"less than 3 miles away\" from Alta Bates. But Alta Bates is on Berkeley's southern edge -- easily a 20-minute drive for people who live on the north side, much farther still for people coming from 10 miles north in Richmond.\u003c/p>\n\u003cp>\"(Sutter) is looking at this from the standpoint of those two hospitals alone,\" Gioia says, \"but the emergency medical system is just that, a system, and this closure will definitely impact the emergency medical systems in Alameda County and also West Contra Costa County.\"\u003c/p>\n\u003cp>Over the last several years, Sutter has moved Alta Bates' cardiac, stroke and rehabilitation services to its Summit Oakland campus.\u003c/p>\n\u003cp>The Berkeley City Council has directed both its Community Health Commission and the Disaster and Fire Safety Commission to assess the impact of Alta Bates' closure and make recommendations to the council.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Amy Mostafa contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Tiny Central Valley Community Tests California's Clean-Water Law",
"title": "Tiny Central Valley Community Tests California's Clean-Water Law",
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"content": "\u003cp>Here’s a statistic that, no matter how many times we report about it, still sounds shocking: \u003ca href=\"http://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/documents/dwdocuments/2014/2014_acr_final.pdf\" target=\"_blank\">More than a million Californians \u003c/a>lack access to safe, clean drinking water.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"When the doctor told me that I had high arsenic contamination in my body, I thought, 'If this is happening to me, then this must be happening to everyone.'\"\u003ccite>Reinelda Palma, resident Matheny Tract\u003c/cite>\u003c/aside>\n\u003cp>The crisis is particularly acute in the rural Central Valley, where some communities -- like tiny Matheny Tract outside Tulare -- have struggled with unsafe drinking water.\u003c/p>\n\u003cp>In Matheny Tract, the community's two wells are contaminated with arsenic. Reinelda Palma knows about it firsthand. She drank the tap water until a few years ago, when a doctor told her that she had been exposed to arsenic.\u003c/p>\n\u003cp>\"It was very traumatic when the doctor told me that I had high arsenic contamination in my body,\" she says in Spanish. \"And I thought, if this is happening to me, then this must be happening to everyone, including the children.\"\u003c/p>\n\u003cp>That’s when she became an advocate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Matheny Tract is not a city or a town. It’s unincorporated, which means it has no elected government, and it’s hard to get services like sidewalks or streetlights. About 1,200 people live here, and almost a third of them live below the federal poverty line. Like Palma, most are Latino.\u003c/p>\n\u003cfigure id=\"attachment_177434\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-177434 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/IMG_0977_0-e1461788970527.jpg\" alt=\"This hydrant, installed over a year ago, is still not hooked up to running water.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">This hydrant, installed over a year ago, is still not hooked up to running water. \u003ccite>(Kerry Klein/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Palma and her neighbor Javier Medina, took me on a tour of the neighborhood. We saw a lot of bright yellow fire hydrants that looked brand-new, but Palma and Medina said they didn't work.\u003c/p>\n\u003cp>That’s because they are waiting to be hooked up to water.\u003c/p>\n\u003cp>Ashley Werner of the nonprofit advocacy group the \u003ca href=\"http://www.leadershipcounsel.org/#!about/cjn9\">Leadership Counsel for Justice and Accountability\u003c/a> says people in unincorporated communities like Matheny Tract have been fighting for clean water for years.\u003c/p>\n\u003cp>\"Effectively in local government, often there’s no elected representatives claiming to have any responsibility to ensure that people have access to clean water,\" she says.\u003c/p>\n\u003cp>In Matheny’s case, getting water from the nearby city of Tulare seemed like an obvious solution. The city is so close, Palma can point to it from her backyard.\u003c/p>\n\u003cp>In 2009, Matheny and Tulare signed a contract to connect their water systems. Roads were dug up and hydrants put in place. But in 2014, the city sued to re-evaluate the contract. Construction stopped.\u003c/p>\n\u003cfigure id=\"attachment_177435\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-177435 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/IMG_1009_0-e1461789066582.jpg\" alt=\"Scars of dark pavement in Matheny Tract's roads remind residents of the water mains that are still not hooked up to water.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Scars of dark pavement in Matheny Tract's roads remind residents of the water mains that are still not hooked up to water. \u003ccite>(Kerry Klein/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"We did not have capacity to serve 300 homes at a turn of the switch, \" says Martin Koczanowicz, Tulare's city attorney. \"We spent over half a million dollars in short-term fixes to our infrastructure, and we had jurisdictional issues which were a barrier.\"\u003c/p>\n\u003cp>But Ashley Werner says the community’s residents -- mostly immigrants, farmworkers, and minorities -- felt discriminated against. With the help of Werner’s group, Matheny countersued.\u003c/p>\n\u003cp>\"It was a lack of responsibility on the part of elected officials to the residents of Matheny Tract,\" says Werner. \"In a sense, by everybody involved, that they had no duty and no commitment to this community.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"3syvmgeeaRwdP3TVOQNBOwaofFQPiC0D\"]Matheny and Tulare remained in a legal stalemate until March of this year, when the state intervened under a new law. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB88\">Senate Bill 88\u003c/a> allows the state to order a city to share its water with communities that need it. Matheny Tract is the law’s first success. By June, Tulare will be forced to share its drinking water.\u003c/p>\n\u003cp>Getting clean water is a huge relief for Javier Medina. He’s a dairy worker, and his family of six has been using bottled water. He’s glad that the state stepped in. But he wishes it hadn’t been necessary.\u003c/p>\n\u003cp>\"We live in the best country in the world and everyone should be looking out for everyone’s well-being,\" says Medina. \"Everyone should try to find a way to help their neighbor.\"\u003c/p>\n\u003cp>Matheny Tract should have safe drinking water soon, but hundreds of California communities still don’t. Maybe some of them are your neighbors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/261171293\" 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\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here’s a statistic that, no matter how many times we report about it, still sounds shocking: \u003ca href=\"http://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/documents/dwdocuments/2014/2014_acr_final.pdf\" target=\"_blank\">More than a million Californians \u003c/a>lack access to safe, clean drinking water.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"When the doctor told me that I had high arsenic contamination in my body, I thought, 'If this is happening to me, then this must be happening to everyone.'\"\u003ccite>Reinelda Palma, resident Matheny Tract\u003c/cite>\u003c/aside>\n\u003cp>The crisis is particularly acute in the rural Central Valley, where some communities -- like tiny Matheny Tract outside Tulare -- have struggled with unsafe drinking water.\u003c/p>\n\u003cp>In Matheny Tract, the community's two wells are contaminated with arsenic. Reinelda Palma knows about it firsthand. She drank the tap water until a few years ago, when a doctor told her that she had been exposed to arsenic.\u003c/p>\n\u003cp>\"It was very traumatic when the doctor told me that I had high arsenic contamination in my body,\" she says in Spanish. \"And I thought, if this is happening to me, then this must be happening to everyone, including the children.\"\u003c/p>\n\u003cp>That’s when she became an advocate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Matheny Tract is not a city or a town. It’s unincorporated, which means it has no elected government, and it’s hard to get services like sidewalks or streetlights. About 1,200 people live here, and almost a third of them live below the federal poverty line. Like Palma, most are Latino.\u003c/p>\n\u003cfigure id=\"attachment_177434\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-177434 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/IMG_0977_0-e1461788970527.jpg\" alt=\"This hydrant, installed over a year ago, is still not hooked up to running water.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">This hydrant, installed over a year ago, is still not hooked up to running water. \u003ccite>(Kerry Klein/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Palma and her neighbor Javier Medina, took me on a tour of the neighborhood. We saw a lot of bright yellow fire hydrants that looked brand-new, but Palma and Medina said they didn't work.\u003c/p>\n\u003cp>That’s because they are waiting to be hooked up to water.\u003c/p>\n\u003cp>Ashley Werner of the nonprofit advocacy group the \u003ca href=\"http://www.leadershipcounsel.org/#!about/cjn9\">Leadership Counsel for Justice and Accountability\u003c/a> says people in unincorporated communities like Matheny Tract have been fighting for clean water for years.\u003c/p>\n\u003cp>\"Effectively in local government, often there’s no elected representatives claiming to have any responsibility to ensure that people have access to clean water,\" she says.\u003c/p>\n\u003cp>In Matheny’s case, getting water from the nearby city of Tulare seemed like an obvious solution. The city is so close, Palma can point to it from her backyard.\u003c/p>\n\u003cp>In 2009, Matheny and Tulare signed a contract to connect their water systems. Roads were dug up and hydrants put in place. But in 2014, the city sued to re-evaluate the contract. Construction stopped.\u003c/p>\n\u003cfigure id=\"attachment_177435\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-177435 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/IMG_1009_0-e1461789066582.jpg\" alt=\"Scars of dark pavement in Matheny Tract's roads remind residents of the water mains that are still not hooked up to water.\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Scars of dark pavement in Matheny Tract's roads remind residents of the water mains that are still not hooked up to water. \u003ccite>(Kerry Klein/KVPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"We did not have capacity to serve 300 homes at a turn of the switch, \" says Martin Koczanowicz, Tulare's city attorney. \"We spent over half a million dollars in short-term fixes to our infrastructure, and we had jurisdictional issues which were a barrier.\"\u003c/p>\n\u003cp>But Ashley Werner says the community’s residents -- mostly immigrants, farmworkers, and minorities -- felt discriminated against. With the help of Werner’s group, Matheny countersued.\u003c/p>\n\u003cp>\"It was a lack of responsibility on the part of elected officials to the residents of Matheny Tract,\" says Werner. \"In a sense, by everybody involved, that they had no duty and no commitment to this community.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Matheny and Tulare remained in a legal stalemate until March of this year, when the state intervened under a new law. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB88\">Senate Bill 88\u003c/a> allows the state to order a city to share its water with communities that need it. Matheny Tract is the law’s first success. By June, Tulare will be forced to share its drinking water.\u003c/p>\n\u003cp>Getting clean water is a huge relief for Javier Medina. He’s a dairy worker, and his family of six has been using bottled water. He’s glad that the state stepped in. But he wishes it hadn’t been necessary.\u003c/p>\n\u003cp>\"We live in the best country in the world and everyone should be looking out for everyone’s well-being,\" says Medina. \"Everyone should try to find a way to help their neighbor.\"\u003c/p>\n\u003cp>Matheny Tract should have safe drinking water soon, but hundreds of California communities still don’t. Maybe some of them are your neighbors.\u003c/p>\n\u003cp>\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/261171293&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/261171293'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Fentanyl Overdoses in Bay Area Linked to Counterfeit Painkiller",
"title": "Fentanyl Overdoses in Bay Area Linked to Counterfeit Painkiller",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>An outbreak of poisonings linked to a counterfeit prescription painkiller — previously seen in the Sacramento region — has reached the Bay Area, according to the U.S. Centers for Disease Control.\u003c/p>\n\u003cp>The CDC \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6516e1.htm?s_cid=mm6516e1_e#T1_down\" target=\"_blank\">reported Tuesday\u003c/a> that seven patients were treated for overdoses in Bay Area hospitals in late March and early April after taking what they thought were tablets of Norco, a brand-name painkiller that combines acetaminophen and hydrocodone.\u003c/p>\n\u003cp>But the counterfeit Norco, which the patients bought off the street, mostly contained the opiate fentanyl, which is 100 times more powerful than morphine, according to the CDC.\u003c/p>\n\u003cp>In addition to the fentanyl, the pills contained promethazine, an allergy drug that’s believed to intensify the effects of fentanyl.\u003c/p>\n\u003cp>None of the patients died, but they suffered nausea, vomiting, breathing problems, lethargy and unconsciousness. Some needed treatment with naloxone, an antidote medication that can reverse the effects of an opioid overdose.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sacramento County health officials in late March \u003ca href=\"http://www.dhhs.saccounty.net/PUB/Documents/AZ-Health-Info/ME-Fentanyl+Alert_20160401.pdf#search=norco\" target=\"_blank\">reported\u003c/a> at least 36 overdoses related to similar counterfeit Norco tablets laced with fentanyl. Nine of those 36 patients died.\u003c/p>\n\u003cp>Since then, another 16 overdoses, three fatal, \u003ca href=\"http://www.dhhs.saccounty.net/Pages/NR---Update-on-opioid-related-overdoses-(April-25,-2016).aspx\" target=\"_blank\">have been reported\u003c/a> in the county.\u003c/p>\n\u003cp>The California Poison Control System has been on alert for new cases but has not received any reports of counterfeit Norco overdoses elsewhere in the state, said Stuart Heard, the system’s executive director and a clinical professor at the University of California-San Francisco School of Pharmacy. Some of the pills analyzed by experts contained as much as 3.5 milligrams of fentanyl, a potentially lethal dose, he said.\u003c/p>\n\u003cp>“The only safe prescription to take is prescribed to you by your doctor and received from a legitimate pharmacy – not from a coworker, a friend or off the street,” said Casey Rettig, a spokeswoman for the Drug Enforcement Administration’s San Francisco division, which is investigating the counterfeit Norco.\u003c/p>\n\u003cp>Drug enforcement and health officials are increasingly concerned about fentanyl making its way into counterfeit versions of common prescription drugs.\u003c/p>\n\u003cp>Last year in California, seven people took fentanyl-contaminated counterfeit Xanax, an anti-anxiety drug; two of them died, according to the CDC. The addition of the booster promethazine — seen in the Bay Area but not Sacramento overdose cases — additionally worries public health officials, because it strengthens the effects of already powerful fentanyl.\u003c/p>\n\u003cp>The recent Bay Area cases may strengthen the arguments of some California lawmakers trying to pass a bill, SB 1323, which would increase prison sentences and fines for major traffickers of fentanyl. The bill remains in committee.\u003c/p>\n\u003cp>To aid its investigation, the DEA’s San Francisco division recently set up an anonymous tip line at 530-722-7577.\u003c/p>\n\u003cp>“Fentanyl is available, it’s relatively cheap, a little goes a long way and it’s very profitable,” the DEA’s Rettig said. She said could not comment on the progress of the DEA’s investigation. But typically, she said, fentanyl is purchased from China, shipped to Mexico and transported into the United States across its southwest border.\u003c/p>\n\u003cp>At some point in Mexico or in the U.S., the fentanyl is processed into counterfeit tablets that carry the markings of legitimate prescription medications, including hydrocodone drugs like Norco, Rettig said.\u003c/p>\n\u003cp>“Why these manufacturers are making it so potent and doing in their own customers is very puzzling,” Heard said. “To me, it speaks to amateurs doing this, or people who just don’t care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n",
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"excerpt": "Authorities believe a painkiller was adulterated with a powerful opioid, similar to street drugs that have killed 12 in Sacramento. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>An outbreak of poisonings linked to a counterfeit prescription painkiller — previously seen in the Sacramento region — has reached the Bay Area, according to the U.S. Centers for Disease Control.\u003c/p>\n\u003cp>The CDC \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6516e1.htm?s_cid=mm6516e1_e#T1_down\" target=\"_blank\">reported Tuesday\u003c/a> that seven patients were treated for overdoses in Bay Area hospitals in late March and early April after taking what they thought were tablets of Norco, a brand-name painkiller that combines acetaminophen and hydrocodone.\u003c/p>\n\u003cp>But the counterfeit Norco, which the patients bought off the street, mostly contained the opiate fentanyl, which is 100 times more powerful than morphine, according to the CDC.\u003c/p>\n\u003cp>In addition to the fentanyl, the pills contained promethazine, an allergy drug that’s believed to intensify the effects of fentanyl.\u003c/p>\n\u003cp>None of the patients died, but they suffered nausea, vomiting, breathing problems, lethargy and unconsciousness. Some needed treatment with naloxone, an antidote medication that can reverse the effects of an opioid overdose.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sacramento County health officials in late March \u003ca href=\"http://www.dhhs.saccounty.net/PUB/Documents/AZ-Health-Info/ME-Fentanyl+Alert_20160401.pdf#search=norco\" target=\"_blank\">reported\u003c/a> at least 36 overdoses related to similar counterfeit Norco tablets laced with fentanyl. Nine of those 36 patients died.\u003c/p>\n\u003cp>Since then, another 16 overdoses, three fatal, \u003ca href=\"http://www.dhhs.saccounty.net/Pages/NR---Update-on-opioid-related-overdoses-(April-25,-2016).aspx\" target=\"_blank\">have been reported\u003c/a> in the county.\u003c/p>\n\u003cp>The California Poison Control System has been on alert for new cases but has not received any reports of counterfeit Norco overdoses elsewhere in the state, said Stuart Heard, the system’s executive director and a clinical professor at the University of California-San Francisco School of Pharmacy. Some of the pills analyzed by experts contained as much as 3.5 milligrams of fentanyl, a potentially lethal dose, he said.\u003c/p>\n\u003cp>“The only safe prescription to take is prescribed to you by your doctor and received from a legitimate pharmacy – not from a coworker, a friend or off the street,” said Casey Rettig, a spokeswoman for the Drug Enforcement Administration’s San Francisco division, which is investigating the counterfeit Norco.\u003c/p>\n\u003cp>Drug enforcement and health officials are increasingly concerned about fentanyl making its way into counterfeit versions of common prescription drugs.\u003c/p>\n\u003cp>Last year in California, seven people took fentanyl-contaminated counterfeit Xanax, an anti-anxiety drug; two of them died, according to the CDC. The addition of the booster promethazine — seen in the Bay Area but not Sacramento overdose cases — additionally worries public health officials, because it strengthens the effects of already powerful fentanyl.\u003c/p>\n\u003cp>The recent Bay Area cases may strengthen the arguments of some California lawmakers trying to pass a bill, SB 1323, which would increase prison sentences and fines for major traffickers of fentanyl. The bill remains in committee.\u003c/p>\n\u003cp>To aid its investigation, the DEA’s San Francisco division recently set up an anonymous tip line at 530-722-7577.\u003c/p>\n\u003cp>“Fentanyl is available, it’s relatively cheap, a little goes a long way and it’s very profitable,” the DEA’s Rettig said. She said could not comment on the progress of the DEA’s investigation. But typically, she said, fentanyl is purchased from China, shipped to Mexico and transported into the United States across its southwest border.\u003c/p>\n\u003cp>At some point in Mexico or in the U.S., the fentanyl is processed into counterfeit tablets that carry the markings of legitimate prescription medications, including hydrocodone drugs like Norco, Rettig said.\u003c/p>\n\u003cp>“Why these manufacturers are making it so potent and doing in their own customers is very puzzling,” Heard said. “To me, it speaks to amateurs doing this, or people who just don’t care.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How A Birth at Stanford 50 Years Ago Launched Search for Down Syndrome Test",
"title": "How A Birth at Stanford 50 Years Ago Launched Search for Down Syndrome Test",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cem>This story comes to us via\u003c/em> Only Human, \u003cem>a new podcast from WNYC Studios. Hosted by Mary Harris, \u003c/em>\u003ca href=\"http://www.wnyc.org/shows/onlyhuman/\" target=\"_blank\">Only Human\u003c/a>\u003cem> tells stories we all can relate to. Because every body has a story. Subscribe to \u003c/em>Only Human\u003cem> on iTunes or wherever you like to get your podcasts. \u003c/em>\u003c/p>\n\u003chr>\n\u003cp>When Lee Herzenberg remembers the day her son Michael was born, she laughs and calls it a \"cool birth.\" Her obstetrician was a friend, and she describes it almost like a party — \"a little bit painful, but that you forget very quickly.\" Lee even got a kick out of the fact that a resident learned to do an episiotomy on her.\u003c/p>\n\u003cp>It was November 1961, and she was at the newly christened Palo Alto-Stanford Hospital Center; her husband, Len, was a biology professor on campus. Like most fathers at the time, he didn't attend the birth, which meant he wasn't there when Michael started turning blue.\u003c/p>\n\u003cp>The nurses whisked the newborn off to the nursery without telling Lee anything was wrong.\u003c/p>\n\u003cp>It was then that a doctor noticed the characteristic features of Down syndrome: floppy muscles, eyes that slanted upward. They got Michael breathing again, but doctors thought his prognosis was grim. They gave Michael just a few months to live. A daisy chain of physicians was called, and Lee says it was a pediatrics professor who told her husband what had happened. Then Len was dispatched to tell Lee.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She remembers the moment with uncharacteristic emotion. \"We hugged each other, and it was a terrible conversation to realize that you'd lost the baby, but the baby was lost,\" Lee says now. \"We knew immediately what we'd do. We had already made the decision that it was not a good thing to take the baby home, and so we didn't.\"\u003c/p>\n\u003cp>In the 1960s — an era before neurodiversity movements and early intervention programs — many people still called people with Down syndrome \"mongoloids.\" Playwright Arthur Miller institutionalized his son, Daniel, in 1966. A few years later, \u003ca href=\"https://repository.library.georgetown.edu/handle/10822/1031271\" target=\"_blank\">an article\u003c/a> in \u003cem>The Atlantic Monthly\u003c/em> argued that \"a Down's is not a person.\"\u003c/p>\n\u003cp>Lee and Len Herzenberg had seen friends struggle with the birth of a child with Down syndrome and had even gone with a colleague to an institution, where he dropped off his own infant daughter.\u003c/p>\n\u003cp>So, they decided Michael would never come home.\u003c/p>\n\u003cp>But Michael wasn't absolutely lost to them. Michael's birth sparked their search for a blood test that has revolutionized prenatal care in this country.\u003c/p>\n\u003cp>I made the mistake of telling one scientist I was reporting about \"Len Herzenberg's lab.\" He corrected me instantly: \"Len \u003cem>and Lee's\u003c/em> lab.\" Because Lee Herzenberg was \"leaning in\" decades before Sheryl Sandberg coined the phrase. At 81, Lee, a professor of genetics, is still running the lab she and her husband founded more than 50 years ago. Len died in 2013.\u003c/p>\n\u003cp>The lab is a quirky place, even by Stanford standards. Lee rarely sits on chairs, preferring cushions on the floor. She's often accompanied by her bichon frise, Gigi. Researchers can often be found working in this basement office well into the night.\u003c/p>\n\u003cp>But Lee Herzenberg isn't just quirky. She is one of the few professors at Stanford — possibly the only one — never to have officially graduated from college. Instead, she trained by her husband's side, auditing courses while he got his Ph.D. at Caltech (women weren't allowed to attend at the time) and working at his labs at the Pasteur Institute in Paris and the National Institutes of Health.\u003c/p>\n\u003cp>And the science that's been done here has changed the course of medicine.\u003c/p>\n\u003cp>The Herzenbergs are best known as the creators of the modern-day \u003ca href=\"http://www.bio.umass.edu/micro/immunology/facs542/facswhat.htm\" target=\"_blank\">fluorescence-activated flow cytometer\u003c/a>, or FACS. It was a machine born out of frustration: Len couldn't stand squinting down a microscope looking at cells.\u003c/p>\n\u003cp>Before the FACS, a biologist peering at slides could feel like he was playing a really intense round of \"Where's Waldo,\" staring at crowds of all kinds of cells, trying to pinpoint the exact ones he was looking for. Not only was it annoying — Len Herzenberg worried it wasn't particularly scientific. He wanted a way to find and describe cells that didn't rely on his worn-out eyes.\u003c/p>\n\u003cp>The FACS allows you to pour cells in, program the machine to find whatever it is you're looking for, and then it will spit out a little tube of just those cells alone. And the FACS gives you all kinds of information, too: how big the cells are and how much DNA they have inside.\u003c/p>\n\u003cp>The FACS was used to diagnose AIDS because the technology can quickly and easily sort out T cells. The FACS was used to find the first stem cells. When Len Herzenberg died, one colleague \u003ca href=\"http://www.nytimes.com/2013/11/11/us/leonard-herzenberg-immunologist-who-revolutionized-research-dies-at-81.html?_r=0\" target=\"_blank\">told\u003c/a> \u003cem>T\u003c/em>\u003cem>he New York Times\u003c/em> that \"without Len, tens of thousands of people now alive would not be.\"\u003c/p>\n\u003cp>But in the 1970s, the Herzenbergs were still proving the value of this machine. That's when they started thinking about using it to create a blood test for Down syndrome.\u003c/p>\n\u003cfigure id=\"attachment_177037\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-177037\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85.jpg\" alt=\"One of Michael's albums, with a photo of his birth parents, Lee and Len Herzenberg. \" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85-768x575.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">One of Michael's albums, with a photo of his birth parents, Lee and Len Herzenberg. \u003ccite>(Mary Harris/WNYC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Len had seen research from Finland claiming it was possible to see a fetus's cells in a mother's blood. It was hard to believe. But he figured that FACS, with its nearly magical sorting capabilities, could figure it out. So he took on a medical student named Diana Bianchi as a research associate and made sorting out these cells her project.\u003c/p>\n\u003cp>If they could isolate these cells, he could learn a lot about the developing fetus, including whether the fetus had chromosomal abnormalities.\u003c/p>\n\u003cp>\"They had a very personal reason for doing this, because of their son Michael,\" Bianchi says now. \"They wanted to have a test that could be offered to any pregnant woman — that would be noninvasive and would allow them to know if a child had Down syndrome. The first step, however, was to show that you could pull out fetal cells.\"\u003c/p>\n\u003cp>Scientists now estimate that for every 200 billion cells in a mother's bloodstream, about 10 of those are fetal cells. Bianchi was one of the first people to see them.\u003c/p>\n\u003cp>\u003cem>The New York Times\u003c/em> quoted Len saying the work was a \"first step\" toward a blood test for Down syndrome for all pregnant women. But it would take 30 years for a practical test to become a reality.\u003c/p>\n\u003cp>As it turned out, Len's FACS wasn't the right tool for prenatal diagnosis. There weren't very many fetal cells to be sorted, and if a pregnant woman already had children, scientists couldn't be sure if the cells in her blood came from the current fetus or one of her older kids.\u003c/p>\n\u003cp>But in 2008, Len helped ensure the right tool was found.\u003c/p>\n\u003cp>A researcher named Stephen Quake had discovered a way to sequence chunks of fetal DNA floating in expectant mothers' blood. As a member of the National Academy of Sciences, Len made sure the \u003ca href=\"http://www.pnas.org/content/early/2008/10/03/0808319105\" target=\"_blank\">paper was published\u003c/a> in the academy's journal. Another researcher, Dennis Lo, confirmed Quake's findings. Three years later, the tests were on the market.\u003c/p>\n\u003cp>Now, at just 10 weeks into a pregnancy, a whole range of things can be revealed with this test. Not just Down syndrome, but a host of other chromosomal abnormalities as well as the sex of the child to be.\u003c/p>\n\u003cp>Until this test, doctors had to rely on amniocentesis, an invasive procedure that involves inserting a needle in the womb to sample amniotic fluid, or biopsying the placenta, to tell them with any reliability whether a fetus had a chromosomal abnormality. These tests aren't just uncomfortable; they come with a risk of miscarriage. By some estimates, in the past five years the number of these procedures performed in this country \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/26/368449371/dna-blood-test-gives-women-a-new-option-for-prenatal-screening\" target=\"_blank\">has plummeted\u003c/a> by more than 50 percent.\u003c/p>\n\u003cp>To some parents, this knowledge can be alarming. Advocates in Ohio are trying to pass a law preventing abortions if Down syndrome is the reason (North Dakota and \u003ca href=\"http://www.npr.org/sections/thetwo-way/2016/03/25/471842196/indiana-governor-signs-new-abortion-restrictions-into-law\" target=\"_blank\">Indiana\u003c/a> have already passed similar laws).\u003c/p>\n\u003cp>Lee Herzenberg is honest about what she would have done if she'd known early on in her pregnancy that Michael had Down syndrome.\u003c/p>\n\u003cp>\"I'd say if I had the choice of not pushing Michael into this life — if I at that time would know I was carrying a Down syndrome child — I would have aborted the child,\" she says. \"I see no reason Michael has to live the life he leads. The fact that we've made it very happy for him or that he's made it very happy for us — all of that is adapting to a situation, but I don't think it's fair or proper.\"\u003c/p>\n\u003cp>But Lee is alarmed that these tests are now being used to determine the sex of unborn babies. She worries about parents choosing to abort girls.\u003c/p>\n\u003cp>Diana Bianchi, that medical student from the Herzenberg lab, is now a professor at Tufts, where she founded the \u003ca href=\"https://www.tuftsmedicalcenter.org/Research-Clinical-Trials/Institutes-Centers-Labs/Mother-Infant-Research-Institute/Laboratories/Bianchi-Laboratory.aspx\" target=\"_blank\">Mother Infant Research Institute\u003c/a>. She's still working in prenatal testing. In fact, perfecting these tests has become her life's work.\u003c/p>\n\u003cp>But her focus has shifted. Now that she can detect Down syndrome so early, she wants to treat it early, too — in the womb. Because finding this chromosomal abnormality at 10 weeks means there's a window of opportunity: The brain changes associated with Down syndrome don't occur until a month or so later. Theoretically, you could treat a fetus before some brain changes occur at all.\u003c/p>\n\u003cp>Bianchi's work is still early. She's experimenting with mice, giving them existing drugs in utero to see if she can forestall brain damage.\u003c/p>\n\u003cp>There's an often-quoted statistic, that 90 percent of parents who find out that their fetus has Down syndrome will abort. But that statistic is from a study done in the United Kingdom. In the U.S., far fewer women terminate.\u003c/p>\n\u003cp>\"We have to unpack this connection between prenatal testing and abortion,\" she says. \"We have good data to suggest that approximately 40 plus percent of women who know their fetus has Down syndrome continue their pregnancy. There are many women who speak very highly of the fact that this allows them to prepare.\"\u003c/p>\n\u003cp>The Down syndrome baby who kicked off the search for this blood test is now a 54-year-old man. He lives in a squat house in Redwood City, Calif., just a 30-minute drive from his birth mother's home.\u003c/p>\n\u003cp>For years, Michael lived with a local woman named Barbara Jennings, who raised a number of children with developmental challenges. The Herzenbergs' pediatrician helped them find her when Michael was a newborn. The Herzenbergs would visit Michael every month or so, but they never felt they should bring him home. When Barbara died, Michael moved to this group home.\u003c/p>\n\u003cp>It's hard to know how much Michael understands when I speak to him, though he has learned to read and use a cellphone. And he's stubborn. A lot like his mother, actually. \"Michael has the hardest head in the whole world,\" says Janet Thomas, the caretaker who runs this house. \"He does whatever he wants to do. He does not care whatever you say. He's going to do whatever it is he wants to do — that's Michael.\"\u003c/p>\n\u003cp>I asked Lee if she ever regretted not raising Michael, and she said no. \"It was a decision that was selfish, if you like, because we had things we wanted to do. In retrospect, a lot of things would never have gotten done. There would be no FACS had we decided to do this. Because it would have been a very intensive kind of upbringing.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As for Michael, he clearly loves his mother, no matter what she decided. In Michael's room, there are photos on almost every surface, with snapshots of his biological and adopted families. In the corner is a huge poster of his father, celebrating when \u003ca href=\"//www.the-scientist.com/?articles.view/articleNo/24076/title/Herzenberg-wins-Kyoto-Prize/\" target=\"_blank\">he won the Kyoto Prize\u003c/a> for his contributions to biotechnology. And deep in one album, there's a picture of Len and Lee together. The caption reads: \"Michael's Other Mom + Dad.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 WNYC Radio. To see more, visit \u003ca href=\"http://www.wnyc.org/\" target=\"_blank\">WNYC Radio\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Only+Human%3A+A+Birth+That+Launched+The+Search+For+A+Down+Syndrome+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story comes to us via\u003c/em> Only Human, \u003cem>a new podcast from WNYC Studios. Hosted by Mary Harris, \u003c/em>\u003ca href=\"http://www.wnyc.org/shows/onlyhuman/\" target=\"_blank\">Only Human\u003c/a>\u003cem> tells stories we all can relate to. Because every body has a story. Subscribe to \u003c/em>Only Human\u003cem> on iTunes or wherever you like to get your podcasts. \u003c/em>\u003c/p>\n\u003chr>\n\u003cp>When Lee Herzenberg remembers the day her son Michael was born, she laughs and calls it a \"cool birth.\" Her obstetrician was a friend, and she describes it almost like a party — \"a little bit painful, but that you forget very quickly.\" Lee even got a kick out of the fact that a resident learned to do an episiotomy on her.\u003c/p>\n\u003cp>It was November 1961, and she was at the newly christened Palo Alto-Stanford Hospital Center; her husband, Len, was a biology professor on campus. Like most fathers at the time, he didn't attend the birth, which meant he wasn't there when Michael started turning blue.\u003c/p>\n\u003cp>The nurses whisked the newborn off to the nursery without telling Lee anything was wrong.\u003c/p>\n\u003cp>It was then that a doctor noticed the characteristic features of Down syndrome: floppy muscles, eyes that slanted upward. They got Michael breathing again, but doctors thought his prognosis was grim. They gave Michael just a few months to live. A daisy chain of physicians was called, and Lee says it was a pediatrics professor who told her husband what had happened. Then Len was dispatched to tell Lee.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She remembers the moment with uncharacteristic emotion. \"We hugged each other, and it was a terrible conversation to realize that you'd lost the baby, but the baby was lost,\" Lee says now. \"We knew immediately what we'd do. We had already made the decision that it was not a good thing to take the baby home, and so we didn't.\"\u003c/p>\n\u003cp>In the 1960s — an era before neurodiversity movements and early intervention programs — many people still called people with Down syndrome \"mongoloids.\" Playwright Arthur Miller institutionalized his son, Daniel, in 1966. A few years later, \u003ca href=\"https://repository.library.georgetown.edu/handle/10822/1031271\" target=\"_blank\">an article\u003c/a> in \u003cem>The Atlantic Monthly\u003c/em> argued that \"a Down's is not a person.\"\u003c/p>\n\u003cp>Lee and Len Herzenberg had seen friends struggle with the birth of a child with Down syndrome and had even gone with a colleague to an institution, where he dropped off his own infant daughter.\u003c/p>\n\u003cp>So, they decided Michael would never come home.\u003c/p>\n\u003cp>But Michael wasn't absolutely lost to them. Michael's birth sparked their search for a blood test that has revolutionized prenatal care in this country.\u003c/p>\n\u003cp>I made the mistake of telling one scientist I was reporting about \"Len Herzenberg's lab.\" He corrected me instantly: \"Len \u003cem>and Lee's\u003c/em> lab.\" Because Lee Herzenberg was \"leaning in\" decades before Sheryl Sandberg coined the phrase. At 81, Lee, a professor of genetics, is still running the lab she and her husband founded more than 50 years ago. Len died in 2013.\u003c/p>\n\u003cp>The lab is a quirky place, even by Stanford standards. Lee rarely sits on chairs, preferring cushions on the floor. She's often accompanied by her bichon frise, Gigi. Researchers can often be found working in this basement office well into the night.\u003c/p>\n\u003cp>But Lee Herzenberg isn't just quirky. She is one of the few professors at Stanford — possibly the only one — never to have officially graduated from college. Instead, she trained by her husband's side, auditing courses while he got his Ph.D. at Caltech (women weren't allowed to attend at the time) and working at his labs at the Pasteur Institute in Paris and the National Institutes of Health.\u003c/p>\n\u003cp>And the science that's been done here has changed the course of medicine.\u003c/p>\n\u003cp>The Herzenbergs are best known as the creators of the modern-day \u003ca href=\"http://www.bio.umass.edu/micro/immunology/facs542/facswhat.htm\" target=\"_blank\">fluorescence-activated flow cytometer\u003c/a>, or FACS. It was a machine born out of frustration: Len couldn't stand squinting down a microscope looking at cells.\u003c/p>\n\u003cp>Before the FACS, a biologist peering at slides could feel like he was playing a really intense round of \"Where's Waldo,\" staring at crowds of all kinds of cells, trying to pinpoint the exact ones he was looking for. Not only was it annoying — Len Herzenberg worried it wasn't particularly scientific. He wanted a way to find and describe cells that didn't rely on his worn-out eyes.\u003c/p>\n\u003cp>The FACS allows you to pour cells in, program the machine to find whatever it is you're looking for, and then it will spit out a little tube of just those cells alone. And the FACS gives you all kinds of information, too: how big the cells are and how much DNA they have inside.\u003c/p>\n\u003cp>The FACS was used to diagnose AIDS because the technology can quickly and easily sort out T cells. The FACS was used to find the first stem cells. When Len Herzenberg died, one colleague \u003ca href=\"http://www.nytimes.com/2013/11/11/us/leonard-herzenberg-immunologist-who-revolutionized-research-dies-at-81.html?_r=0\" target=\"_blank\">told\u003c/a> \u003cem>T\u003c/em>\u003cem>he New York Times\u003c/em> that \"without Len, tens of thousands of people now alive would not be.\"\u003c/p>\n\u003cp>But in the 1970s, the Herzenbergs were still proving the value of this machine. That's when they started thinking about using it to create a blood test for Down syndrome.\u003c/p>\n\u003cfigure id=\"attachment_177037\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-177037\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85.jpg\" alt=\"One of Michael's albums, with a photo of his birth parents, Lee and Len Herzenberg. \" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/herzenberg-2-8b2c93f342bef3820866b27fb8d5fb69f300d149-s800-c85-768x575.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">One of Michael's albums, with a photo of his birth parents, Lee and Len Herzenberg. \u003ccite>(Mary Harris/WNYC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Len had seen research from Finland claiming it was possible to see a fetus's cells in a mother's blood. It was hard to believe. But he figured that FACS, with its nearly magical sorting capabilities, could figure it out. So he took on a medical student named Diana Bianchi as a research associate and made sorting out these cells her project.\u003c/p>\n\u003cp>If they could isolate these cells, he could learn a lot about the developing fetus, including whether the fetus had chromosomal abnormalities.\u003c/p>\n\u003cp>\"They had a very personal reason for doing this, because of their son Michael,\" Bianchi says now. \"They wanted to have a test that could be offered to any pregnant woman — that would be noninvasive and would allow them to know if a child had Down syndrome. The first step, however, was to show that you could pull out fetal cells.\"\u003c/p>\n\u003cp>Scientists now estimate that for every 200 billion cells in a mother's bloodstream, about 10 of those are fetal cells. Bianchi was one of the first people to see them.\u003c/p>\n\u003cp>\u003cem>The New York Times\u003c/em> quoted Len saying the work was a \"first step\" toward a blood test for Down syndrome for all pregnant women. But it would take 30 years for a practical test to become a reality.\u003c/p>\n\u003cp>As it turned out, Len's FACS wasn't the right tool for prenatal diagnosis. There weren't very many fetal cells to be sorted, and if a pregnant woman already had children, scientists couldn't be sure if the cells in her blood came from the current fetus or one of her older kids.\u003c/p>\n\u003cp>But in 2008, Len helped ensure the right tool was found.\u003c/p>\n\u003cp>A researcher named Stephen Quake had discovered a way to sequence chunks of fetal DNA floating in expectant mothers' blood. As a member of the National Academy of Sciences, Len made sure the \u003ca href=\"http://www.pnas.org/content/early/2008/10/03/0808319105\" target=\"_blank\">paper was published\u003c/a> in the academy's journal. Another researcher, Dennis Lo, confirmed Quake's findings. Three years later, the tests were on the market.\u003c/p>\n\u003cp>Now, at just 10 weeks into a pregnancy, a whole range of things can be revealed with this test. Not just Down syndrome, but a host of other chromosomal abnormalities as well as the sex of the child to be.\u003c/p>\n\u003cp>Until this test, doctors had to rely on amniocentesis, an invasive procedure that involves inserting a needle in the womb to sample amniotic fluid, or biopsying the placenta, to tell them with any reliability whether a fetus had a chromosomal abnormality. These tests aren't just uncomfortable; they come with a risk of miscarriage. By some estimates, in the past five years the number of these procedures performed in this country \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/26/368449371/dna-blood-test-gives-women-a-new-option-for-prenatal-screening\" target=\"_blank\">has plummeted\u003c/a> by more than 50 percent.\u003c/p>\n\u003cp>To some parents, this knowledge can be alarming. Advocates in Ohio are trying to pass a law preventing abortions if Down syndrome is the reason (North Dakota and \u003ca href=\"http://www.npr.org/sections/thetwo-way/2016/03/25/471842196/indiana-governor-signs-new-abortion-restrictions-into-law\" target=\"_blank\">Indiana\u003c/a> have already passed similar laws).\u003c/p>\n\u003cp>Lee Herzenberg is honest about what she would have done if she'd known early on in her pregnancy that Michael had Down syndrome.\u003c/p>\n\u003cp>\"I'd say if I had the choice of not pushing Michael into this life — if I at that time would know I was carrying a Down syndrome child — I would have aborted the child,\" she says. \"I see no reason Michael has to live the life he leads. The fact that we've made it very happy for him or that he's made it very happy for us — all of that is adapting to a situation, but I don't think it's fair or proper.\"\u003c/p>\n\u003cp>But Lee is alarmed that these tests are now being used to determine the sex of unborn babies. She worries about parents choosing to abort girls.\u003c/p>\n\u003cp>Diana Bianchi, that medical student from the Herzenberg lab, is now a professor at Tufts, where she founded the \u003ca href=\"https://www.tuftsmedicalcenter.org/Research-Clinical-Trials/Institutes-Centers-Labs/Mother-Infant-Research-Institute/Laboratories/Bianchi-Laboratory.aspx\" target=\"_blank\">Mother Infant Research Institute\u003c/a>. She's still working in prenatal testing. In fact, perfecting these tests has become her life's work.\u003c/p>\n\u003cp>But her focus has shifted. Now that she can detect Down syndrome so early, she wants to treat it early, too — in the womb. Because finding this chromosomal abnormality at 10 weeks means there's a window of opportunity: The brain changes associated with Down syndrome don't occur until a month or so later. Theoretically, you could treat a fetus before some brain changes occur at all.\u003c/p>\n\u003cp>Bianchi's work is still early. She's experimenting with mice, giving them existing drugs in utero to see if she can forestall brain damage.\u003c/p>\n\u003cp>There's an often-quoted statistic, that 90 percent of parents who find out that their fetus has Down syndrome will abort. But that statistic is from a study done in the United Kingdom. In the U.S., far fewer women terminate.\u003c/p>\n\u003cp>\"We have to unpack this connection between prenatal testing and abortion,\" she says. \"We have good data to suggest that approximately 40 plus percent of women who know their fetus has Down syndrome continue their pregnancy. There are many women who speak very highly of the fact that this allows them to prepare.\"\u003c/p>\n\u003cp>The Down syndrome baby who kicked off the search for this blood test is now a 54-year-old man. He lives in a squat house in Redwood City, Calif., just a 30-minute drive from his birth mother's home.\u003c/p>\n\u003cp>For years, Michael lived with a local woman named Barbara Jennings, who raised a number of children with developmental challenges. The Herzenbergs' pediatrician helped them find her when Michael was a newborn. The Herzenbergs would visit Michael every month or so, but they never felt they should bring him home. When Barbara died, Michael moved to this group home.\u003c/p>\n\u003cp>It's hard to know how much Michael understands when I speak to him, though he has learned to read and use a cellphone. And he's stubborn. A lot like his mother, actually. \"Michael has the hardest head in the whole world,\" says Janet Thomas, the caretaker who runs this house. \"He does whatever he wants to do. He does not care whatever you say. He's going to do whatever it is he wants to do — that's Michael.\"\u003c/p>\n\u003cp>I asked Lee if she ever regretted not raising Michael, and she said no. \"It was a decision that was selfish, if you like, because we had things we wanted to do. In retrospect, a lot of things would never have gotten done. There would be no FACS had we decided to do this. Because it would have been a very intensive kind of upbringing.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As for Michael, he clearly loves his mother, no matter what she decided. In Michael's room, there are photos on almost every surface, with snapshots of his biological and adopted families. In the corner is a huge poster of his father, celebrating when \u003ca href=\"//www.the-scientist.com/?articles.view/articleNo/24076/title/Herzenberg-wins-Kyoto-Prize/\" target=\"_blank\">he won the Kyoto Prize\u003c/a> for his contributions to biotechnology. And deep in one album, there's a picture of Len and Lee together. The caption reads: \"Michael's Other Mom + Dad.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 WNYC Radio. To see more, visit \u003ca href=\"http://www.wnyc.org/\" target=\"_blank\">WNYC Radio\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Only+Human%3A+A+Birth+That+Launched+The+Search+For+A+Down+Syndrome+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Medi-Cal se expande para los niños inmigrantes. Así es como funciona",
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"content": "\u003cp>\u003cem>Read this story in English: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/09/medi-cal-expands-to-undocumented-children-heres-how-it-works/\" target=\"_blank\">Medi-Cal Expands to Undocumented Children. Here's How It Works\u003c/a>\u003c/em>\u003c/p>\n\u003cp>En poco tiempo, California comenzará a proveer cobertura completa de Medi-Cal para los niños de familias de bajos ingresos, independientemente de su status migratorio.\u003c/p>\n\u003cp>Dependiendo de a quien le pregunte, un número de entre 170.000 y 250.000 niños que viven en California, y están en el país indocumentados, calificarán.\u003c/p>\n\u003cp>Si piensa que su hijo calificará, o conoce a un padre cuyo hijo pueda ser elegible, oficiales de salud y defensores del cuidado de salud tienen un simple mensaje para usted: tome medidas ya. “Regístrese ahora”, dice Rachel Vizcarra, asistente de programa de la UFW Foundation en Bakersfield, que está ayudando a familias a pre registrarse. “Si lo hace, sus niños serán registrados automáticamente en el programa”.\u003c/p>\n\u003cp>Oficiales del estado esperan que la cobertura comience el 16 de mayo. Pero como el cambio de política requiere de ajustes de programación complejos en los sistemas informáticos de los condados y del estado, puede ocurrir que la implementación se atrase, dice Tony Cava, del Departamento de Servicios de Salud estatal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No importa cuándo ocurra, los niños elegibles tendrán cobertura retroactiva al primer día de ese mes, dice. Por ejemplo, si el cambio entra en vigencia el 16 de mayo, la cobertura estará vigente desde el 1 de mayo.\u003c/p>\n\u003cp>Carolina Moran, de Canoga Park, espera con ansiedad para llevar a Lizeth, su hija de 14 años, al médico una vez que ella se convierta en elegible para los beneficios completos de Medi-Cal.\u003c/p>\n\u003cp>Lizeth tuvo que ir a una sala de emergencias en enero, a causa de un fuerte golpe en la cabeza en una cancha de fútbol, pero no pudo ver al doctor para una cita de seguimiento porque “no podemos pagarla. Deberíamos haber pagado de nuestro bolsillo”, dice Moran.\u003c/p>\n\u003cp>Lo primero que hará Moran será llevar a Lizeth para un examen físico “y estar segura que sus vacunas están al día”, dice. “También necesita el relleno para cinco caries”.\u003c/p>\n\u003cp>La elegibilidad para el Medi-Cal se basa en el ingreso familiar, y niños menores de 19 años califican a un nivel de ingresos más alto que los adultos. Son elegibles para Medi-Cal si el ingreso de la familia es menos del 266 por ciento del Nivel Federal de Pobreza, o alrededor de $53.600 para una familia de tres y $75.650 para una familia de cinco.\u003c/p>\n\u003cp>Actualmente, los niños y adultos que están en el país indocumentados califican para una cobertura de Medi-Cal limitada, llamada de alcance restringido, que cubre emergencias y servicios relacionados con el embarazo.\u003c/p>\n\u003cp>Aunque esto pueda parecer contrario a la intuición, defensores del cuidado de salud y el estado quieren que usted registre a sus niños para el Medi-Cal restringido ahora, en preparación para la disponibilidad de los beneficios completos del Medi-Cal.\u003c/p>\n\u003cp>La idea es que, cuando ocurra el cambio, los niños que califican serán automáticamente transferidos a la cobertura completa del Medi-Cal “en pocos días” y sin una aplicación adicional, dice Cava.\u003c/p>\n\u003cp>El estado estima que hay alrededor de 115.000 niños inmigrantes sin papeles que ya tienen Medi-Cal restringido.\u003c/p>\n\u003cp>Si su niño no tiene seguro, regístrelo en el Medi-Cal restringido ahora. Incluso si su hijo tiene cobertura a través de otro programa existente —como el Programa de Salud Infantil de Kaiser Permanente o cobertura de salud del condado— todavía debería registrarlo para el Medi-Cal restringido ahora, dice Mark Diel, CEO de California Coverage & Health Initiatives (CCHI), una red de inscripción y difusión en todo el estado.\u003c/p>\n\u003cp>Esto se debe a que esos niños eventualmente se convertirán en no elegibles para esos programas después de que sean elegibles para el Medi-Cal completo. (No saque a su niño de otro programa hasta que no confirme si es elegible para el Medi-Cal de alcance completo, y que haya sido aprobado, dice Cava).\u003c/p>\n\u003cp>Pero advierte: la aplicación del Medi-Cal es larga y complicada. Para completarla, necesitará proveer un certificado de nacimiento, prueba de una dirección local, prueba de identidad e información sobre ingresos, dice Vizcarra. Se pueden usar pasaportes y partidas de nacimiento de otros países.\u003c/p>\n\u003cp>“Hágalo con un reclutador local en vez de tratar de hacerlo por su cuenta,” dice Diel. “Es mucho más probable que aprueben su aplicación”.\u003c/p>\n\u003cp>La ayuda de clínicas locales de salud y grupos comunitarios es gratis. En internet, visite www.cchi4families.org/find-help para recursos locales.\u003c/p>\n\u003cp>Defensores y oficiales del estado también quieren que usted sepa que inscribir a sus hijos no debería dar lugar a consecuencias negativas de inmigración para usted —o para otros miembros de su familia— que pueden no tener un estatus legal.\u003c/p>\n\u003cp>“Nada de la información que se recoge es compartida con autoridades de inmigración”, dice María Romero-Mora, de CCHI.\u003c/p>\n\u003cp>Una vez que sus niños están en el Medi-Cal de alcance restringido, y eventualmente dentro del Medi-Cal completo, necesitará actuar. Revise las cartas que lleguen por correo antes y después de la transición, explicando sus opciones.\u003c/p>\n\u003cp>\u003cstrong>ELIJA UN PLAN\u003c/strong>: una vez que ocurra la transición al Medi-Cal completo, tendrá 60 días para elegir un plan de cuidado de salud gerenciado para niños que ya están inscriptos en el Medi-Cal restringido. Si no elige un plan, el estado le asignará uno, dice Cava.\u003c/p>\n\u003cp>Los padres de niños que no están en el Medi-Cal restringido al momento del cambio, y que los inscribieron después, tendrán 30 días para elegir un plan, agrega.\u003c/p>\n\u003cp>Si vive en uno de los 22 condados en donde el cuidado de Medi-Cal es operado por un único County Organized Health System, los niños serán registrados automáticamente en ese plan, dice Cava.\u003c/p>\n\u003cp>En todos los casos, hasta que se elige un plan —o se asigna uno— los niños recibirán cobertura a través del programa de pago por servicio (fee-for-service) del Medi-Cal.\u003c/p>\n\u003cp>\u003cstrong>PAGUE LAS PRIMAS\u003c/strong>: Medi-Cal es gratuito (libre de prima, es decir de una cuota mensual) para los niños hasta 160 por ciento del Nivel Federal de Pobreza, pero deberá pagar una prima si el ingreso familiar se encuentra entre 160 por ciento y 266 por ciento. La prima es de $13 por mes por cada niño, con un máximo de $39 por familia.\u003c/p>\n\u003cp>Los niños en los planes del Medi-Cal no tienen co pagos por cuidado médico.\u003c/p>\n\u003cp>\u003cstrong>RENUEVE\u003c/strong>: usted tendrá que participar en el proceso de renovación anual de Medi-Cal para asegurar que sus hijos sigan siendo elegibles y se mantengan inscriptos.\u003c/p>\n\u003cp>Finalmente, si usted no inscribe a su hijo en el Medi-Cal restringido antes del cambio, puede aplicar para beneficios completos después —en cualquier momento del año— en la oficina de servicios humanos de su condado, a través de una organización comunitaria o en el sitio de internet de Covered California, \u003ca href=\"http://www.CoveredCa.com\">www.CoveredCa.com\u003c/a>\u003c/p>\n\u003cp>En Canoga Park, Moran dice que tener a Lizeth en el Medi-Cal le dará a la familia una gran seguridad financiera. Lizeth está de acuerdo.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Me preocupa si tengo que ir a un chequeo, porque le va a costar dinero a mis padres, y a veces no tienen el dinero para pagarlo\", dice la estudiante de noveno grado.\u003c/p>\n\n",
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"excerpt": "Entrará en vigencia una nueva ley del programa estatal de cuidado de salud de bajos ingresos para los niños en EE.UU. sin papeles. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Read this story in English: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/09/medi-cal-expands-to-undocumented-children-heres-how-it-works/\" target=\"_blank\">Medi-Cal Expands to Undocumented Children. Here's How It Works\u003c/a>\u003c/em>\u003c/p>\n\u003cp>En poco tiempo, California comenzará a proveer cobertura completa de Medi-Cal para los niños de familias de bajos ingresos, independientemente de su status migratorio.\u003c/p>\n\u003cp>Dependiendo de a quien le pregunte, un número de entre 170.000 y 250.000 niños que viven en California, y están en el país indocumentados, calificarán.\u003c/p>\n\u003cp>Si piensa que su hijo calificará, o conoce a un padre cuyo hijo pueda ser elegible, oficiales de salud y defensores del cuidado de salud tienen un simple mensaje para usted: tome medidas ya. “Regístrese ahora”, dice Rachel Vizcarra, asistente de programa de la UFW Foundation en Bakersfield, que está ayudando a familias a pre registrarse. “Si lo hace, sus niños serán registrados automáticamente en el programa”.\u003c/p>\n\u003cp>Oficiales del estado esperan que la cobertura comience el 16 de mayo. Pero como el cambio de política requiere de ajustes de programación complejos en los sistemas informáticos de los condados y del estado, puede ocurrir que la implementación se atrase, dice Tony Cava, del Departamento de Servicios de Salud estatal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No importa cuándo ocurra, los niños elegibles tendrán cobertura retroactiva al primer día de ese mes, dice. Por ejemplo, si el cambio entra en vigencia el 16 de mayo, la cobertura estará vigente desde el 1 de mayo.\u003c/p>\n\u003cp>Carolina Moran, de Canoga Park, espera con ansiedad para llevar a Lizeth, su hija de 14 años, al médico una vez que ella se convierta en elegible para los beneficios completos de Medi-Cal.\u003c/p>\n\u003cp>Lizeth tuvo que ir a una sala de emergencias en enero, a causa de un fuerte golpe en la cabeza en una cancha de fútbol, pero no pudo ver al doctor para una cita de seguimiento porque “no podemos pagarla. Deberíamos haber pagado de nuestro bolsillo”, dice Moran.\u003c/p>\n\u003cp>Lo primero que hará Moran será llevar a Lizeth para un examen físico “y estar segura que sus vacunas están al día”, dice. “También necesita el relleno para cinco caries”.\u003c/p>\n\u003cp>La elegibilidad para el Medi-Cal se basa en el ingreso familiar, y niños menores de 19 años califican a un nivel de ingresos más alto que los adultos. Son elegibles para Medi-Cal si el ingreso de la familia es menos del 266 por ciento del Nivel Federal de Pobreza, o alrededor de $53.600 para una familia de tres y $75.650 para una familia de cinco.\u003c/p>\n\u003cp>Actualmente, los niños y adultos que están en el país indocumentados califican para una cobertura de Medi-Cal limitada, llamada de alcance restringido, que cubre emergencias y servicios relacionados con el embarazo.\u003c/p>\n\u003cp>Aunque esto pueda parecer contrario a la intuición, defensores del cuidado de salud y el estado quieren que usted registre a sus niños para el Medi-Cal restringido ahora, en preparación para la disponibilidad de los beneficios completos del Medi-Cal.\u003c/p>\n\u003cp>La idea es que, cuando ocurra el cambio, los niños que califican serán automáticamente transferidos a la cobertura completa del Medi-Cal “en pocos días” y sin una aplicación adicional, dice Cava.\u003c/p>\n\u003cp>El estado estima que hay alrededor de 115.000 niños inmigrantes sin papeles que ya tienen Medi-Cal restringido.\u003c/p>\n\u003cp>Si su niño no tiene seguro, regístrelo en el Medi-Cal restringido ahora. Incluso si su hijo tiene cobertura a través de otro programa existente —como el Programa de Salud Infantil de Kaiser Permanente o cobertura de salud del condado— todavía debería registrarlo para el Medi-Cal restringido ahora, dice Mark Diel, CEO de California Coverage & Health Initiatives (CCHI), una red de inscripción y difusión en todo el estado.\u003c/p>\n\u003cp>Esto se debe a que esos niños eventualmente se convertirán en no elegibles para esos programas después de que sean elegibles para el Medi-Cal completo. (No saque a su niño de otro programa hasta que no confirme si es elegible para el Medi-Cal de alcance completo, y que haya sido aprobado, dice Cava).\u003c/p>\n\u003cp>Pero advierte: la aplicación del Medi-Cal es larga y complicada. Para completarla, necesitará proveer un certificado de nacimiento, prueba de una dirección local, prueba de identidad e información sobre ingresos, dice Vizcarra. Se pueden usar pasaportes y partidas de nacimiento de otros países.\u003c/p>\n\u003cp>“Hágalo con un reclutador local en vez de tratar de hacerlo por su cuenta,” dice Diel. “Es mucho más probable que aprueben su aplicación”.\u003c/p>\n\u003cp>La ayuda de clínicas locales de salud y grupos comunitarios es gratis. En internet, visite www.cchi4families.org/find-help para recursos locales.\u003c/p>\n\u003cp>Defensores y oficiales del estado también quieren que usted sepa que inscribir a sus hijos no debería dar lugar a consecuencias negativas de inmigración para usted —o para otros miembros de su familia— que pueden no tener un estatus legal.\u003c/p>\n\u003cp>“Nada de la información que se recoge es compartida con autoridades de inmigración”, dice María Romero-Mora, de CCHI.\u003c/p>\n\u003cp>Una vez que sus niños están en el Medi-Cal de alcance restringido, y eventualmente dentro del Medi-Cal completo, necesitará actuar. Revise las cartas que lleguen por correo antes y después de la transición, explicando sus opciones.\u003c/p>\n\u003cp>\u003cstrong>ELIJA UN PLAN\u003c/strong>: una vez que ocurra la transición al Medi-Cal completo, tendrá 60 días para elegir un plan de cuidado de salud gerenciado para niños que ya están inscriptos en el Medi-Cal restringido. Si no elige un plan, el estado le asignará uno, dice Cava.\u003c/p>\n\u003cp>Los padres de niños que no están en el Medi-Cal restringido al momento del cambio, y que los inscribieron después, tendrán 30 días para elegir un plan, agrega.\u003c/p>\n\u003cp>Si vive en uno de los 22 condados en donde el cuidado de Medi-Cal es operado por un único County Organized Health System, los niños serán registrados automáticamente en ese plan, dice Cava.\u003c/p>\n\u003cp>En todos los casos, hasta que se elige un plan —o se asigna uno— los niños recibirán cobertura a través del programa de pago por servicio (fee-for-service) del Medi-Cal.\u003c/p>\n\u003cp>\u003cstrong>PAGUE LAS PRIMAS\u003c/strong>: Medi-Cal es gratuito (libre de prima, es decir de una cuota mensual) para los niños hasta 160 por ciento del Nivel Federal de Pobreza, pero deberá pagar una prima si el ingreso familiar se encuentra entre 160 por ciento y 266 por ciento. La prima es de $13 por mes por cada niño, con un máximo de $39 por familia.\u003c/p>\n\u003cp>Los niños en los planes del Medi-Cal no tienen co pagos por cuidado médico.\u003c/p>\n\u003cp>\u003cstrong>RENUEVE\u003c/strong>: usted tendrá que participar en el proceso de renovación anual de Medi-Cal para asegurar que sus hijos sigan siendo elegibles y se mantengan inscriptos.\u003c/p>\n\u003cp>Finalmente, si usted no inscribe a su hijo en el Medi-Cal restringido antes del cambio, puede aplicar para beneficios completos después —en cualquier momento del año— en la oficina de servicios humanos de su condado, a través de una organización comunitaria o en el sitio de internet de Covered California, \u003ca href=\"http://www.CoveredCa.com\">www.CoveredCa.com\u003c/a>\u003c/p>\n\u003cp>En Canoga Park, Moran dice que tener a Lizeth en el Medi-Cal le dará a la familia una gran seguridad financiera. Lizeth está de acuerdo.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Budget Cuts Threaten UC Berkeley's Medical Program",
"title": "Budget Cuts Threaten UC Berkeley's Medical Program",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Budget woes at UC Berkeley could force the shut down of a program many people are unaware of -- its medical program.\u003c/p>\n\u003cp>The Joint Medical Program (JMP), part of Berkeley's School of Public Health, is small. Just 16 students a year are admitted. Under a \u003ca href=\"http://budget.berkeley.edu/budgetprocess\" target=\"_blank\">budget restructuring\u003c/a> process\u003ca href=\"http://ww2.kqed.org/news/2016/02/10/uc-berkeley-chancellor-says-big-deficit-will-lead-to-painful-changes\" target=\"_blank\"> initiated in February\u003c/a> by Berkeley's Chancellor Nicholas Dirks, the School of Public Health must cut expenses by roughly three percent -- or about $900,000.\u003c/p>\n\u003cp>One of the items on the list to meet that target is closure of the JMP. Losing 16 new doctors a year may not sound dramatic, but this particular population is unusual in medicine. While most medical students head into lucrative specialties, the majority of JMP graduates go into primary care.\u003c/p>\n\u003cp>John Balmes, acting director of the program, says California needs these doctors. \"(California) is 43rd in the nation in terms of primary care physicians,\" he said, \"and with the Affordable Care Act increasing the number of insured Californians, we need more primary care physicians, not less.\"\u003c/p>\n\u003cp>In 2014, just \u003ca href=\"http://www.theatlantic.com/health/archive/2014/09/why-im-becoming-a-primary-care-doctor/379231/\" target=\"_blank\">12 percent of medical students\u003c/a> nationally went into primary care residencies. The JMP was above\u003ca href=\"http://sph.berkeley.edu/jmp/residency-matches\" target=\"_blank\"> 50 percent\u003c/a> 1997-2014. It's unclear exactly why so many students go into primary care. One clue lies in the program's unusual approach to curriculum.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The program, established in 1971, prides itself on avoiding lecture halls and instead focusing on what it calls \"problem-based learning,\" where students review cases as a group. In addition, the medical program is one of few nationally, says second-year student Josh Pepper, that is housed within a school of public health, and that gives a broader focus to patients' lives.\u003c/p>\n\u003cp>\"We're constantly having to question how things like socio-economic status, insurance, housing and culture and addiction play a role in patients' health outcomes,\" Pepper said.\u003c/p>\n\u003cp>It gives a more holistic perspective, he said. \"We develop a whole skill set you don't normally get at a traditional medical school.\" Pepper has helped launch an \u003ca href=\"http://www.ipetitions.com/petition/savethejmp\" target=\"_blank\">online petition\u003c/a> in support of the program.\u003c/p>\n\u003cp>It's called a joint medical program because students do three years at Berkeley's School of Public Health, during which they complete an original research project and the first two years of medical school curriculum. They then head to UC San Francisco for two years of clinical rotation. They graduate with a master's in science from Cal and an M.D. from UCSF.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cpca.org/cpca2013/assets/File/Policy-and-Advocacy/Health%20Care%20Reform/2016-02-01-Horizon2030-PR.pdf\" target=\"_blank\">report earlier this year\u003c/a> commissioned by the California Primary Care Association detailed the shortfall in primary care providers in California. The state's ratio of primary care physicians in its Medicaid program, called Medi-Cal, is roughly half the federal recommendation, it said. By 2030, the analysis predicted a shortage of more than 8,000 primary care doctors.\u003c/p>\n\u003cp>Carmela Castellano-Garcia is the association's president and bemoaned the possible closure of Cal's medical program.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KH05iLE8gCziGB39qVZNvU5QcFzHysTq\"]\"Certainly with the shortage we are facing, we should not eliminate any existing programs that we know have successful track records into funneling people into primary care,\" she said. \"We cannot afford that at this time.\"\u003c/p>\n\u003cp>All of Cal's professional schools, including the School of Public Health, must trim expenses by the same rate, said Dan Mogulof, a spokesman for the university, and it's up to the schools themselves to determine how to meet the target.\u003c/p>\n\u003cp>Linda Anderberg, director of communications for the School of Public Health, said it is considering several options to achieve the budget cuts. \"The school does not want to lose the (medical) program,\" she said.\u003c/p>\n\u003cp>She stressed that no decisions have been made and that the process would be completed during the summer. Most of the cuts would not go into effect until 2018, she said.\u003c/p>\n\u003cp>Meanwhile, staff and students are speaking out to try to save the program.\u003c/p>\n\u003cp>\"If I had to go to medical school all over again, I'd want to do it in the Joint Medical Program,\" said acting director Balmes. He said there's an advantage to being in a small, supportive environment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think that translates into very fine doctors, because they're good human beings as well as good doctors,\" he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Budget woes at UC Berkeley could force the shut down of a program many people are unaware of -- its medical program.\u003c/p>\n\u003cp>The Joint Medical Program (JMP), part of Berkeley's School of Public Health, is small. Just 16 students a year are admitted. Under a \u003ca href=\"http://budget.berkeley.edu/budgetprocess\" target=\"_blank\">budget restructuring\u003c/a> process\u003ca href=\"http://ww2.kqed.org/news/2016/02/10/uc-berkeley-chancellor-says-big-deficit-will-lead-to-painful-changes\" target=\"_blank\"> initiated in February\u003c/a> by Berkeley's Chancellor Nicholas Dirks, the School of Public Health must cut expenses by roughly three percent -- or about $900,000.\u003c/p>\n\u003cp>One of the items on the list to meet that target is closure of the JMP. Losing 16 new doctors a year may not sound dramatic, but this particular population is unusual in medicine. While most medical students head into lucrative specialties, the majority of JMP graduates go into primary care.\u003c/p>\n\u003cp>John Balmes, acting director of the program, says California needs these doctors. \"(California) is 43rd in the nation in terms of primary care physicians,\" he said, \"and with the Affordable Care Act increasing the number of insured Californians, we need more primary care physicians, not less.\"\u003c/p>\n\u003cp>In 2014, just \u003ca href=\"http://www.theatlantic.com/health/archive/2014/09/why-im-becoming-a-primary-care-doctor/379231/\" target=\"_blank\">12 percent of medical students\u003c/a> nationally went into primary care residencies. The JMP was above\u003ca href=\"http://sph.berkeley.edu/jmp/residency-matches\" target=\"_blank\"> 50 percent\u003c/a> 1997-2014. It's unclear exactly why so many students go into primary care. One clue lies in the program's unusual approach to curriculum.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The program, established in 1971, prides itself on avoiding lecture halls and instead focusing on what it calls \"problem-based learning,\" where students review cases as a group. In addition, the medical program is one of few nationally, says second-year student Josh Pepper, that is housed within a school of public health, and that gives a broader focus to patients' lives.\u003c/p>\n\u003cp>\"We're constantly having to question how things like socio-economic status, insurance, housing and culture and addiction play a role in patients' health outcomes,\" Pepper said.\u003c/p>\n\u003cp>It gives a more holistic perspective, he said. \"We develop a whole skill set you don't normally get at a traditional medical school.\" Pepper has helped launch an \u003ca href=\"http://www.ipetitions.com/petition/savethejmp\" target=\"_blank\">online petition\u003c/a> in support of the program.\u003c/p>\n\u003cp>It's called a joint medical program because students do three years at Berkeley's School of Public Health, during which they complete an original research project and the first two years of medical school curriculum. They then head to UC San Francisco for two years of clinical rotation. They graduate with a master's in science from Cal and an M.D. from UCSF.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cpca.org/cpca2013/assets/File/Policy-and-Advocacy/Health%20Care%20Reform/2016-02-01-Horizon2030-PR.pdf\" target=\"_blank\">report earlier this year\u003c/a> commissioned by the California Primary Care Association detailed the shortfall in primary care providers in California. The state's ratio of primary care physicians in its Medicaid program, called Medi-Cal, is roughly half the federal recommendation, it said. By 2030, the analysis predicted a shortage of more than 8,000 primary care doctors.\u003c/p>\n\u003cp>Carmela Castellano-Garcia is the association's president and bemoaned the possible closure of Cal's medical program.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Certainly with the shortage we are facing, we should not eliminate any existing programs that we know have successful track records into funneling people into primary care,\" she said. \"We cannot afford that at this time.\"\u003c/p>\n\u003cp>All of Cal's professional schools, including the School of Public Health, must trim expenses by the same rate, said Dan Mogulof, a spokesman for the university, and it's up to the schools themselves to determine how to meet the target.\u003c/p>\n\u003cp>Linda Anderberg, director of communications for the School of Public Health, said it is considering several options to achieve the budget cuts. \"The school does not want to lose the (medical) program,\" she said.\u003c/p>\n\u003cp>She stressed that no decisions have been made and that the process would be completed during the summer. Most of the cuts would not go into effect until 2018, she said.\u003c/p>\n\u003cp>Meanwhile, staff and students are speaking out to try to save the program.\u003c/p>\n\u003cp>\"If I had to go to medical school all over again, I'd want to do it in the Joint Medical Program,\" said acting director Balmes. He said there's an advantage to being in a small, supportive environment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think that translates into very fine doctors, because they're good human beings as well as good doctors,\" he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"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.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"source": "npr"
},
"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
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