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"content": "\u003cp>For the first time since the U.S. government began keeping records, the life expectancy for white women has declined, according to a \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db244.htm\" target=\"_blank\">report\u003c/a> from the Centers for Disease Control and Prevention's National Center for Health Statistics. The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n",
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"headline": "Life Expectancy Down for White Women, Up for Black Men",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time since the U.S. government began keeping records, the life expectancy for white women has declined, according to a \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db244.htm\" target=\"_blank\">report\u003c/a> from the Centers for Disease Control and Prevention's National Center for Health Statistics. The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Newly Pregnant? You May Not Want to Tell Covered California",
"title": "Newly Pregnant? You May Not Want to Tell Covered California",
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"content": "\u003cp>Lynn Kersey has some advice for pregnant women who bought health insurance policies from Covered California and want to keep them: Don’t report your pregnancy to the agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">1,900 pregnant women across the state were automatically transferred from the exchange to Medi-Cal since October, even though they were supposed to have the option to stay with Covered California\u003c/aside>\n\u003cp>“It’s not a requirement ... and it’s actually worse to do so,” said Kersey, executive director of Maternal and Child Health Access, an advocacy group based in Los Angeles County.\u003c/p>\n\u003cp>Why? Two of Kersey’s clients with Covered California health plans recently were thrown into Medi-Cal -- the state’s health program for low-income residents -- without their consent or prior notice after they reported their pregnancies to the state’s health insurance exchange.\u003c/p>\n\u003cp>The two women are among about 1,900 across the state who were automatically transferred from the exchange to Medi-Cal since October, even though they were supposed to have the option to stay with Covered California. The snafu was triggered by a recent policy change in Medi-Cal eligibility.\u003c/p>\n\u003cp>“One of the women missed a month of prenatal care,” Kersey said. “She was told she couldn’t be seen when she went to see her doctor.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Covered California acknowledged the problem, casting part of the blame on its computer system.\u003c/p>\n\u003cp>\u003cstrong>Similar Problem with Healthcare.gov\u003c/strong>\u003c/p>\n\u003cp>“We didn’t implement this as well as it should have been implemented,” said Amy Palmer, the agency’s director of communications.\u003c/p>\n\u003cp>That computer glitch will be fixed, but not until September, Palmer said.\u003c/p>\n\u003cp>A similar problem is affecting some pregnant women who purchased their plans through \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov\u003c/a>, the federal health insurance exchange that serves people in 38 states, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities in Washington, D.C.\u003c/p>\n\u003cp>“The computer system was basically immediately transitioning them to Medicaid when they reported their pregnancies to HealthCare.gov,\" Solomon said. “They should have the choice and they’re not getting it.”\u003c/p>\n\u003cp>Plan cancellations without notice or consent have been a persistent problem for some Covered California enrollees since 2014. In some cases, people are terminated from their plans unexpectedly. In others, they are transferred to Medi-Cal without prior notice. It’s unclear -- even to Covered California -- how widespread the problem is.\u003c/p>\n\u003cp>The situation for the pregnant California women can be traced to a recent policy change.\u003c/p>\n\u003cp>Usually, consumers are placed in either Covered California or Medi-Cal based on their income, with no choice in the matter, even though they can enroll in Medi-Cal via the Covered California website.\u003c/p>\n\u003cp>But the rules are different for some pregnant women whose household income falls between 138 percent and 213 percent of the federal poverty level, or roughly $22,100 to $34,100 for a family of two.\u003c/p>\n\u003cp>Before last October pregnant women in that income range technically had a choice between Medi-Cal and Covered California, though often they were not informed of the choice, said Lucy Quacinella, a San Francisco attorney and health care advocate for working families.\u003c/p>\n\u003cp>Now, under an October 2015 policy change, \u003cem>women who are pregnant at the time they apply\u003c/em> for health coverage and fall into this income bracket will automatically be placed into Medi-Cal, she said.\u003c/p>\n\u003cp>Women in the income range who already have Covered California plans \u003cem>before they become pregnant\u003c/em> are now supposed to be given the choice to remain in their subsidized plans -- which have out-of-pocket costs such as co-pays and deductibles -- or move to Medi-Cal, which is free.\u003c/p>\n\u003cp>The idea is to allow them to keep their existing Covered California providers if they want, Quacinella said.\u003c/p>\n\u003cp>But the Covered California computer system wasn’t programmed to give them the choice, and some pregnant women were moved immediately into Medi-Cal.\u003c/p>\n\u003cp>“They didn’t receive notice. They just knew from one day to the next that their Covered California insurance didn’t work anymore,” Quacinella said. “It’s very stressful, very confusing.”\u003c/p>\n\u003cp>\u003cstrong>May Be Easier to Find a Doctor with Covered California...\u003c/strong>\u003c/p>\n\u003cp>Although Medi-Cal is free, some women find it’s easier to get a doctor if they have private insurance. And because Covered California and Medi-Cal provider networks don’t always overlap, some of the women could no longer see the doctors with whom they had established relationships, Quacinella said.\u003c/p>\n\u003cp>“For some women, continuity of care is critical,” she said. “They don’t want to lose their providers.”\u003c/p>\n\u003cp>\u003cstrong>... But Medi-Cal is Free to Consumers\u003c/strong>\u003c/p>\n\u003cp>But after the initial shock, some women will consider the move to Medi-Cal a “blessing” because it’s cheaper, Quacinella said.\u003c/p>\n\u003cp>“Even with tax credits and cost-sharing reductions, it’s really hard for some families to afford the Covered California premiums or for pregnant women to afford a hospital’s labor and delivery charge,” she said.\u003c/p>\n\u003cp>That was the case for Kersey’s clients, who initially were distressed by the sudden loss of their Covered California plans but later decided to stay in Medi-Cal.\u003c/p>\n\u003cp>“One of our clients desperately wanted to get back into Covered California, but ultimately was fine with Medi-Cal, knowing there’s no delivery cost,” Kersey said.\u003c/p>\n\u003cp>Covered California has trained its customer service reps, insurance agents and other enrollers to explain to pregnant consumers that reporting a pregnancy could trigger a switch to Medi-Cal, Palmer said.\u003c/p>\n\u003cp>However, until the computer fix later this year, some women who report their pregnancy through the Covered California website still will be moved without a choice, she confirmed. These women can get their Covered California plans back, retroactive to the date they reported their pregnancies by calling Covered California’s customer service center at 800-300-1506.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Consumers should feel confident that their coverage continues,” Palmer said. “No consumer should be concerned about accessing care while they are pregnant for fear they do not have health coverage. They do.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lynn Kersey has some advice for pregnant women who bought health insurance policies from Covered California and want to keep them: Don’t report your pregnancy to the agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">1,900 pregnant women across the state were automatically transferred from the exchange to Medi-Cal since October, even though they were supposed to have the option to stay with Covered California\u003c/aside>\n\u003cp>“It’s not a requirement ... and it’s actually worse to do so,” said Kersey, executive director of Maternal and Child Health Access, an advocacy group based in Los Angeles County.\u003c/p>\n\u003cp>Why? Two of Kersey’s clients with Covered California health plans recently were thrown into Medi-Cal -- the state’s health program for low-income residents -- without their consent or prior notice after they reported their pregnancies to the state’s health insurance exchange.\u003c/p>\n\u003cp>The two women are among about 1,900 across the state who were automatically transferred from the exchange to Medi-Cal since October, even though they were supposed to have the option to stay with Covered California. The snafu was triggered by a recent policy change in Medi-Cal eligibility.\u003c/p>\n\u003cp>“One of the women missed a month of prenatal care,” Kersey said. “She was told she couldn’t be seen when she went to see her doctor.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Covered California acknowledged the problem, casting part of the blame on its computer system.\u003c/p>\n\u003cp>\u003cstrong>Similar Problem with Healthcare.gov\u003c/strong>\u003c/p>\n\u003cp>“We didn’t implement this as well as it should have been implemented,” said Amy Palmer, the agency’s director of communications.\u003c/p>\n\u003cp>That computer glitch will be fixed, but not until September, Palmer said.\u003c/p>\n\u003cp>A similar problem is affecting some pregnant women who purchased their plans through \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov\u003c/a>, the federal health insurance exchange that serves people in 38 states, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities in Washington, D.C.\u003c/p>\n\u003cp>“The computer system was basically immediately transitioning them to Medicaid when they reported their pregnancies to HealthCare.gov,\" Solomon said. “They should have the choice and they’re not getting it.”\u003c/p>\n\u003cp>Plan cancellations without notice or consent have been a persistent problem for some Covered California enrollees since 2014. In some cases, people are terminated from their plans unexpectedly. In others, they are transferred to Medi-Cal without prior notice. It’s unclear -- even to Covered California -- how widespread the problem is.\u003c/p>\n\u003cp>The situation for the pregnant California women can be traced to a recent policy change.\u003c/p>\n\u003cp>Usually, consumers are placed in either Covered California or Medi-Cal based on their income, with no choice in the matter, even though they can enroll in Medi-Cal via the Covered California website.\u003c/p>\n\u003cp>But the rules are different for some pregnant women whose household income falls between 138 percent and 213 percent of the federal poverty level, or roughly $22,100 to $34,100 for a family of two.\u003c/p>\n\u003cp>Before last October pregnant women in that income range technically had a choice between Medi-Cal and Covered California, though often they were not informed of the choice, said Lucy Quacinella, a San Francisco attorney and health care advocate for working families.\u003c/p>\n\u003cp>Now, under an October 2015 policy change, \u003cem>women who are pregnant at the time they apply\u003c/em> for health coverage and fall into this income bracket will automatically be placed into Medi-Cal, she said.\u003c/p>\n\u003cp>Women in the income range who already have Covered California plans \u003cem>before they become pregnant\u003c/em> are now supposed to be given the choice to remain in their subsidized plans -- which have out-of-pocket costs such as co-pays and deductibles -- or move to Medi-Cal, which is free.\u003c/p>\n\u003cp>The idea is to allow them to keep their existing Covered California providers if they want, Quacinella said.\u003c/p>\n\u003cp>But the Covered California computer system wasn’t programmed to give them the choice, and some pregnant women were moved immediately into Medi-Cal.\u003c/p>\n\u003cp>“They didn’t receive notice. They just knew from one day to the next that their Covered California insurance didn’t work anymore,” Quacinella said. “It’s very stressful, very confusing.”\u003c/p>\n\u003cp>\u003cstrong>May Be Easier to Find a Doctor with Covered California...\u003c/strong>\u003c/p>\n\u003cp>Although Medi-Cal is free, some women find it’s easier to get a doctor if they have private insurance. And because Covered California and Medi-Cal provider networks don’t always overlap, some of the women could no longer see the doctors with whom they had established relationships, Quacinella said.\u003c/p>\n\u003cp>“For some women, continuity of care is critical,” she said. “They don’t want to lose their providers.”\u003c/p>\n\u003cp>\u003cstrong>... But Medi-Cal is Free to Consumers\u003c/strong>\u003c/p>\n\u003cp>But after the initial shock, some women will consider the move to Medi-Cal a “blessing” because it’s cheaper, Quacinella said.\u003c/p>\n\u003cp>“Even with tax credits and cost-sharing reductions, it’s really hard for some families to afford the Covered California premiums or for pregnant women to afford a hospital’s labor and delivery charge,” she said.\u003c/p>\n\u003cp>That was the case for Kersey’s clients, who initially were distressed by the sudden loss of their Covered California plans but later decided to stay in Medi-Cal.\u003c/p>\n\u003cp>“One of our clients desperately wanted to get back into Covered California, but ultimately was fine with Medi-Cal, knowing there’s no delivery cost,” Kersey said.\u003c/p>\n\u003cp>Covered California has trained its customer service reps, insurance agents and other enrollers to explain to pregnant consumers that reporting a pregnancy could trigger a switch to Medi-Cal, Palmer said.\u003c/p>\n\u003cp>However, until the computer fix later this year, some women who report their pregnancy through the Covered California website still will be moved without a choice, she confirmed. These women can get their Covered California plans back, retroactive to the date they reported their pregnancies by calling Covered California’s customer service center at 800-300-1506.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Consumers should feel confident that their coverage continues,” Palmer said. “No consumer should be concerned about accessing care while they are pregnant for fear they do not have health coverage. They do.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "An East Bay Child’s Death and the Power of the Dental Lobby",
"title": "An East Bay Child’s Death and the Power of the Dental Lobby",
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"content": "\u003cp>After their 6-year-old son died following a dental procedure, a Bay Area couple went to the California Legislature, hoping a new law could prevent other families from experiencing similar tragedy.\u003c/p>\n\u003cp>What they’ve found, so far, is that dentists hold surprising sway in Sacramento. More, it seems, than grieving parents making a plea for change.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The (dental) association is an influential group. I knew this would be a hard bill.' \u003ccite> Assemblyman Tony Thurmond, D-Richmond\u003c/cite>\u003c/aside>\n\u003cp>The California Dental Association spent about $664,000 lobbying in California last year – more than the pharmaceutical industry trade group or the association for Hollywood movie studios.\u003c/p>\n\u003cp>Dentists and related professional organizations are also big political donors, pouring at least $12 million over the last five years into California races. They spend millions on super-PAC style \u003ca href=\"https://calmatters.org/articles/money-talks-candidates-listen/\" target=\"_blank\">independent campaigns\u003c/a> and have given donations to every lawmaker on the committee that recently watered down the Bay Area couple’s bill.\u003c/p>\n\u003cp>“The (dental) association is an influential group,” said Assemblyman Tony Thurmond, D-Richmond, who is carrying the legislation. “I knew this would be a hard bill.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In March 2015, Tim and Eliza Sears brought their son to an oral surgeon in Albany to remove a tooth that was growing in the wrong spot in his mouth. Caleb Sears, a kindergartener, was under general anesthesia because the procedure involved cutting into the bone on the roof of his mouth, his father said. The family now believes the anesthesia ended Caleb’s life.\u003c/p>\n\u003cp>“We had a whole conversation about the risks of general anesthesia versus the trauma of doing it without anesthesia,” Tim Sears said. “But we had no clue that the method … would be different than it would be in any other medical setting. And that’s what we’re trying to push for, for parents to be given that information.”\u003c/p>\n\u003cp>Since Caleb’s death, the family has learned that oral surgeons are the only medical professionals allowed to both administer anesthesia and perform surgery. Those duties are separated in hospitals.\u003c/p>\n\u003cp>The executive officer of the state’s Dental Board, which is responsible for disciplinary actions, \u003ca href=\"https://app.box.com/s/pr2ceu8e5mrn988n66uk22ol5064v1t3/1/7419303397/60859030597/1\" target=\"_blank\">accused\u003c/a> Dr. Michael Doucet in February of “gross negligence” in Caleb’s treatment. Doucet \u003ca href=\"https://app.box.com/s/pr2ceu8e5mrn988n66uk22ol5064v1t3/1/7419303397/60859034461/1\" target=\"_blank\">denied\u003c/a> it and is allowed to continue practicing while the case to revoke his license is pending.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no evidence that dental anesthesia under this model of care carries a greater risk than dental care with a second anesthesiologist present.' \u003ccite> Alicia Malaby, California Dental Association\u003c/cite>\u003c/aside>\n\u003cp>As they dealt with their loss, the Sears family tried to learn how many other children had died during dental anesthesia, but found a lack of reliable data. They asked Thurmond, their assemblyman, for a bill to require two providers during oral surgery – one to perform and monitor anesthesia, and another to operate. Thurmond said dentists and oral surgeons pushed back, arguing it would make it harder for poor people to get care.\u003c/p>\n\u003cp>So with the family’s support, Thurmond crafted \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2235\" target=\"_blank\">Assembly Bill 2235\u003c/a> to require notifying parents before their children’s oral surgeries that there is a greater risk of death when a dentist both administers anesthesia and operates.\u003c/p>\n\u003cp>Lobbyists for dentists and oral surgeons opposed that, too.\u003c/p>\n\u003cp>“There is no evidence that dental anesthesia under this model of care carries a greater risk than dental care with a second anesthesiologist present,” Alicia Malaby, spokeswoman for the California Dental Association, wrote in an email.\u003c/p>\n\u003cp>Dental groups convinced a key lawmaker to block the bill: Assemblyman Rudy Salas (D-Bakersfield), who chairs the committee that oversees professional licensing.\u003c/p>\n\u003cp>Salas won re-election in 2014 with significant help from independent expenditure campaigns funded, in part, by the California Dental Association. The association has also made donations to each of the 16 members of his Assembly Business and Professions Committee.\u003c/p>\n\u003cp>When the committee heard Thurmond’s bill earlier this month, Salas insisted on amendments the dental lobby wanted. They removed the requirement to notify parents about the risks of a single provider doing anesthesia and surgery, replacing it with a more general warning in pre-surgery paperwork about the risks of anesthesia.\u003c/p>\n\u003cp>Thurmond said he didn’t like the change but would accept it because he thought the dentists’ opposition would doom the tougher version of the bill.\u003c/p>\n\u003cp>“We’ve negotiated around the clock up until late last night and sadly… the oral surgeons and (the dental association) have rejected (a) compromise,” Thurmond said at the hearing.\u003c/p>\n\u003cp>Above the lawmakers on the dais hung a portrait of former Assembly speaker Jesse Unruh, famous for saying that “money is the mother’s milk of politics.” In the audience, Eliza Sears -- wearing wristbands embroidered with the word “Caleb” -- cuddled her one-month old baby. Caleb’s grandparents held up photos of Caleb’s smiling face.\u003c/p>\n\u003cp>The weakened bill passed unanimously out of committee. Salas said later that the dentists’ campaign spending had no influence on the way he handled the bill. The committee did, he said, “what we think is fair and balanced.”\u003c/p>\n\u003cp>“We’re not changing an entire system if it doesn’t need to be changed or if this was a bad actor or an outlier,” Salas said.\u003c/p>\n\u003cp>The Sears family has sued Doucet for malpractice. The Dental Board’s case says that after Doucet administered anesthesia, Caleb stopped breathing and went into cardiac arrest. Doucet’s “response and actions during this emergency incident were inadequate and constituted incompetence, gross negligence and repeated acts of negligence,” the Feb. 24, 2016, accusation says.\u003c/p>\n\u003cp>Doucet denied the accusation on March 8, 2016, arguing that it was made too late and that the investigation violated his due process rights. His lawyer, Arthur Curley, declined to comment for this story.\u003c/p>\n\u003cp>The Sears family sees the approval of their bill as a first step in a long fight. It will require the Dental Board to study anesthesia incidents and publicly report the findings. They hope to make the bill stronger as it advances, and want to call it “\u003ca href=\"http://www.calebslaw.org/\" target=\"_blank\">Caleb’s law\u003c/a>.”\u003c/p>\n\u003cp>“We cry a lot,” Sears said.\u003c/p>\n\u003cp>“But this is our life now and we have to figure out what to do with it… Trying to make sure this won’t happen to other families is one thing we can do.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CALmatters is a nonprofit journalism venture dedicated to explaining state policies and politics.For more news analysis by Laurel Rosenhall, visit \u003ca href=\"https://calmatters.org/newsanalysis/.\" target=\"_blank\">CALmatters\u003c/a>. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After their 6-year-old son died following a dental procedure, a Bay Area couple went to the California Legislature, hoping a new law could prevent other families from experiencing similar tragedy.\u003c/p>\n\u003cp>What they’ve found, so far, is that dentists hold surprising sway in Sacramento. More, it seems, than grieving parents making a plea for change.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The (dental) association is an influential group. I knew this would be a hard bill.' \u003ccite> Assemblyman Tony Thurmond, D-Richmond\u003c/cite>\u003c/aside>\n\u003cp>The California Dental Association spent about $664,000 lobbying in California last year – more than the pharmaceutical industry trade group or the association for Hollywood movie studios.\u003c/p>\n\u003cp>Dentists and related professional organizations are also big political donors, pouring at least $12 million over the last five years into California races. They spend millions on super-PAC style \u003ca href=\"https://calmatters.org/articles/money-talks-candidates-listen/\" target=\"_blank\">independent campaigns\u003c/a> and have given donations to every lawmaker on the committee that recently watered down the Bay Area couple’s bill.\u003c/p>\n\u003cp>“The (dental) association is an influential group,” said Assemblyman Tony Thurmond, D-Richmond, who is carrying the legislation. “I knew this would be a hard bill.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In March 2015, Tim and Eliza Sears brought their son to an oral surgeon in Albany to remove a tooth that was growing in the wrong spot in his mouth. Caleb Sears, a kindergartener, was under general anesthesia because the procedure involved cutting into the bone on the roof of his mouth, his father said. The family now believes the anesthesia ended Caleb’s life.\u003c/p>\n\u003cp>“We had a whole conversation about the risks of general anesthesia versus the trauma of doing it without anesthesia,” Tim Sears said. “But we had no clue that the method … would be different than it would be in any other medical setting. And that’s what we’re trying to push for, for parents to be given that information.”\u003c/p>\n\u003cp>Since Caleb’s death, the family has learned that oral surgeons are the only medical professionals allowed to both administer anesthesia and perform surgery. Those duties are separated in hospitals.\u003c/p>\n\u003cp>The executive officer of the state’s Dental Board, which is responsible for disciplinary actions, \u003ca href=\"https://app.box.com/s/pr2ceu8e5mrn988n66uk22ol5064v1t3/1/7419303397/60859030597/1\" target=\"_blank\">accused\u003c/a> Dr. Michael Doucet in February of “gross negligence” in Caleb’s treatment. Doucet \u003ca href=\"https://app.box.com/s/pr2ceu8e5mrn988n66uk22ol5064v1t3/1/7419303397/60859034461/1\" target=\"_blank\">denied\u003c/a> it and is allowed to continue practicing while the case to revoke his license is pending.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no evidence that dental anesthesia under this model of care carries a greater risk than dental care with a second anesthesiologist present.' \u003ccite> Alicia Malaby, California Dental Association\u003c/cite>\u003c/aside>\n\u003cp>As they dealt with their loss, the Sears family tried to learn how many other children had died during dental anesthesia, but found a lack of reliable data. They asked Thurmond, their assemblyman, for a bill to require two providers during oral surgery – one to perform and monitor anesthesia, and another to operate. Thurmond said dentists and oral surgeons pushed back, arguing it would make it harder for poor people to get care.\u003c/p>\n\u003cp>So with the family’s support, Thurmond crafted \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2235\" target=\"_blank\">Assembly Bill 2235\u003c/a> to require notifying parents before their children’s oral surgeries that there is a greater risk of death when a dentist both administers anesthesia and operates.\u003c/p>\n\u003cp>Lobbyists for dentists and oral surgeons opposed that, too.\u003c/p>\n\u003cp>“There is no evidence that dental anesthesia under this model of care carries a greater risk than dental care with a second anesthesiologist present,” Alicia Malaby, spokeswoman for the California Dental Association, wrote in an email.\u003c/p>\n\u003cp>Dental groups convinced a key lawmaker to block the bill: Assemblyman Rudy Salas (D-Bakersfield), who chairs the committee that oversees professional licensing.\u003c/p>\n\u003cp>Salas won re-election in 2014 with significant help from independent expenditure campaigns funded, in part, by the California Dental Association. The association has also made donations to each of the 16 members of his Assembly Business and Professions Committee.\u003c/p>\n\u003cp>When the committee heard Thurmond’s bill earlier this month, Salas insisted on amendments the dental lobby wanted. They removed the requirement to notify parents about the risks of a single provider doing anesthesia and surgery, replacing it with a more general warning in pre-surgery paperwork about the risks of anesthesia.\u003c/p>\n\u003cp>Thurmond said he didn’t like the change but would accept it because he thought the dentists’ opposition would doom the tougher version of the bill.\u003c/p>\n\u003cp>“We’ve negotiated around the clock up until late last night and sadly… the oral surgeons and (the dental association) have rejected (a) compromise,” Thurmond said at the hearing.\u003c/p>\n\u003cp>Above the lawmakers on the dais hung a portrait of former Assembly speaker Jesse Unruh, famous for saying that “money is the mother’s milk of politics.” In the audience, Eliza Sears -- wearing wristbands embroidered with the word “Caleb” -- cuddled her one-month old baby. Caleb’s grandparents held up photos of Caleb’s smiling face.\u003c/p>\n\u003cp>The weakened bill passed unanimously out of committee. Salas said later that the dentists’ campaign spending had no influence on the way he handled the bill. The committee did, he said, “what we think is fair and balanced.”\u003c/p>\n\u003cp>“We’re not changing an entire system if it doesn’t need to be changed or if this was a bad actor or an outlier,” Salas said.\u003c/p>\n\u003cp>The Sears family has sued Doucet for malpractice. The Dental Board’s case says that after Doucet administered anesthesia, Caleb stopped breathing and went into cardiac arrest. Doucet’s “response and actions during this emergency incident were inadequate and constituted incompetence, gross negligence and repeated acts of negligence,” the Feb. 24, 2016, accusation says.\u003c/p>\n\u003cp>Doucet denied the accusation on March 8, 2016, arguing that it was made too late and that the investigation violated his due process rights. His lawyer, Arthur Curley, declined to comment for this story.\u003c/p>\n\u003cp>The Sears family sees the approval of their bill as a first step in a long fight. It will require the Dental Board to study anesthesia incidents and publicly report the findings. They hope to make the bill stronger as it advances, and want to call it “\u003ca href=\"http://www.calebslaw.org/\" target=\"_blank\">Caleb’s law\u003c/a>.”\u003c/p>\n\u003cp>“We cry a lot,” Sears said.\u003c/p>\n\u003cp>“But this is our life now and we have to figure out what to do with it… Trying to make sure this won’t happen to other families is one thing we can do.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Democratic lawmakers' \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">eighth attempt\u003c/a> in six years to change Californians' sugar habits has stalled in the state Legislature.\u003c/p>\n\u003cp>Assemblyman Richard Bloom of Santa Monica put the brakes on his latest proposal for a soda tax before lawmakers on a health panel had a chance to vote it down Tuesday.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2782\" target=\"_blank\">AB2782\u003c/a> would have imposed a 2-cent-per-ounce fee on sugary drinks. The money would have benefited clinics that address obesity, diabetes and oral health.\u003c/p>\n\u003cp>Spokesman Sean MacNeil says Bloom did not have enough support from members of the Assembly Health Committee to ensure the bill's passage.\u003c/p>\n\u003cp>MacNeil says there are no plans to amend or revive the measure.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article71436032.html\" target=\"_blank\">Sacramento Bee reports \u003c/a>that supporters of the tax have faced heavy opposition from the beverage industry:\u003c/p>\n\u003cblockquote>\u003cp>The California Nevada Beverage Association, PepsiCo and Coca-Cola have spent at least $413,000 on lobbying since the start of 2015, according to records filed with the California secretary of state. The industry spent nearly $500,000 on campaign contributions during the last election cycle.\u003c/p>\n\u003cp>The California Chamber of Commerce also attacked AB 2782 on the grounds that it “threatens jobs in the beverage, retail and restaurant industries,” joining the California Restaurant Association in criticizing the bill.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, California cities are pressing ahead. In 2014, Berkeley became the\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\"> first city in the country\u003c/a> to pass a soda tax. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/04/san-francisco-oakland-working-to-put-soda-tax-before-voters/\" target=\"_blank\">San Francisco and Oakland\u003c/a> are moving toward putting a soda tax on their November ballots.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.nbcphiladelphia.com/news/politics/Mayor-Jim-Kenney-Philadelphia-Soda-Tax-371956832.html\" target=\"_blank\">Philadelphia's mayor\u003c/a> has proposed a three-cents-per-ounce tax on sugary beverages.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Democratic lawmakers' \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">eighth attempt\u003c/a> in six years to change Californians' sugar habits has stalled in the state Legislature.\u003c/p>\n\u003cp>Assemblyman Richard Bloom of Santa Monica put the brakes on his latest proposal for a soda tax before lawmakers on a health panel had a chance to vote it down Tuesday.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2782\" target=\"_blank\">AB2782\u003c/a> would have imposed a 2-cent-per-ounce fee on sugary drinks. The money would have benefited clinics that address obesity, diabetes and oral health.\u003c/p>\n\u003cp>Spokesman Sean MacNeil says Bloom did not have enough support from members of the Assembly Health Committee to ensure the bill's passage.\u003c/p>\n\u003cp>MacNeil says there are no plans to amend or revive the measure.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.sacbee.com/news/politics-government/capitol-alert/article71436032.html\" target=\"_blank\">Sacramento Bee reports \u003c/a>that supporters of the tax have faced heavy opposition from the beverage industry:\u003c/p>\n\u003cblockquote>\u003cp>The California Nevada Beverage Association, PepsiCo and Coca-Cola have spent at least $413,000 on lobbying since the start of 2015, according to records filed with the California secretary of state. The industry spent nearly $500,000 on campaign contributions during the last election cycle.\u003c/p>\n\u003cp>The California Chamber of Commerce also attacked AB 2782 on the grounds that it “threatens jobs in the beverage, retail and restaurant industries,” joining the California Restaurant Association in criticizing the bill.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, California cities are pressing ahead. In 2014, Berkeley became the\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\"> first city in the country\u003c/a> to pass a soda tax. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/04/san-francisco-oakland-working-to-put-soda-tax-before-voters/\" target=\"_blank\">San Francisco and Oakland\u003c/a> are moving toward putting a soda tax on their November ballots.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.nbcphiladelphia.com/news/politics/Mayor-Jim-Kenney-Philadelphia-Soda-Tax-371956832.html\" target=\"_blank\">Philadelphia's mayor\u003c/a> has proposed a three-cents-per-ounce tax on sugary beverages.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Doctors who are on probation after being disciplined by state regulators would have to share that information with patients before providing care under a bill making its way through the state Senate.\u003c/p>\n\u003cp>The measure, which would apply to physicians, podiatrists, acupuncturists and chiropractors, was passed by the Senate Business, Professions and Economic Development Committee this week.\u003c/p>\n\u003cp>About 600 of the 137,000 licensed physicians in California are on probation for serious offenses, including sexual misconduct involving patients or treatment and prescription errors that harmed patients.\u003c/p>\n\u003cp>The Medical Board of California in November voted down \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/29/in-california-doctors-on-probation-not-required-to-tell-you-should-they/\" target=\"_blank\">a similar proposal\u003c/a> that would have required doctors on probation to tell their patients verbally and in writing, saying it was too onerous and unnecessary because the information is posted on the board’s website.\u003c/p>\n\u003cp>In California, physicians on probation are already required to report the disciplinary status to their malpractice insurers and hospitals where they work, yet there is no rule requiring proactive notifications of patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Doctors on probation are not necessarily admitting they violated ethics rules. Some do it to avoid lengthy and costly legal battles.\u003c/p>\n\u003cp>While on probation, they may be temporarily barred from performing specific procedures or prescribing certain medicines. They might have to take classes or be supervised. In some cases it means a physician disciplined for sexual misconduct must be chaperoned in the exam room.\u003c/p>\n\u003cp>Patient advocate Tina Minasian, of Roseville, Calif., said such a law would have prevented her much pain and misery.\u003c/p>\n\u003cp>“Nearly 14 years after my botched surgery, I still suffer from the lingering effects with excruciating pain, spitting sutures, gaping holes, disfigurement and a mutilated body,” she said in written testimony to the committee. “I will be forever reminded of the harm this doctor caused me and how the Medical Board of California allowed him to destroy my body, my self-confidence and my womanhood. I know many patients who were victims of this same physician while he was on probation, in fact, some have died.”\u003c/p>\n\u003cp>Minasian, who works as an advocate with Consumer’s Union California Safe Patient Project, told the committee that, unbeknownst to her, Brian West, operated on her while on probation for alcohol abuse. She said his license was revoked seven years after her surgery.\u003c/p>\n\u003cp>The California Medical Association, which opposes the bill, said requiring doctors to inform patients directly would take up valuable time in which care could be provided, in a letter filed with the committee.\u003c/p>\n\u003cp>But advocacy groups like Consumers Union and Consumer Watchdog say it’s important for doctors to tell patients about their disciplinary status so patients can make informed choices about their own care.\u003c/p>\n\u003cp>“This is the kind of information every patient deserves to know about their doctor before they receive medical care,” Consumer Watchdog wrote in a letter to the committee. “The patients of these doctors deserve to be notified proactively.”\u003c/p>\n\u003cp>The bill needs to be passed by the appropriations committee and then by the full state Senate by June 3 in order to proceed to the Assembly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors who are on probation after being disciplined by state regulators would have to share that information with patients before providing care under a bill making its way through the state Senate.\u003c/p>\n\u003cp>The measure, which would apply to physicians, podiatrists, acupuncturists and chiropractors, was passed by the Senate Business, Professions and Economic Development Committee this week.\u003c/p>\n\u003cp>About 600 of the 137,000 licensed physicians in California are on probation for serious offenses, including sexual misconduct involving patients or treatment and prescription errors that harmed patients.\u003c/p>\n\u003cp>The Medical Board of California in November voted down \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/29/in-california-doctors-on-probation-not-required-to-tell-you-should-they/\" target=\"_blank\">a similar proposal\u003c/a> that would have required doctors on probation to tell their patients verbally and in writing, saying it was too onerous and unnecessary because the information is posted on the board’s website.\u003c/p>\n\u003cp>In California, physicians on probation are already required to report the disciplinary status to their malpractice insurers and hospitals where they work, yet there is no rule requiring proactive notifications of patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Doctors on probation are not necessarily admitting they violated ethics rules. Some do it to avoid lengthy and costly legal battles.\u003c/p>\n\u003cp>While on probation, they may be temporarily barred from performing specific procedures or prescribing certain medicines. They might have to take classes or be supervised. In some cases it means a physician disciplined for sexual misconduct must be chaperoned in the exam room.\u003c/p>\n\u003cp>Patient advocate Tina Minasian, of Roseville, Calif., said such a law would have prevented her much pain and misery.\u003c/p>\n\u003cp>“Nearly 14 years after my botched surgery, I still suffer from the lingering effects with excruciating pain, spitting sutures, gaping holes, disfigurement and a mutilated body,” she said in written testimony to the committee. “I will be forever reminded of the harm this doctor caused me and how the Medical Board of California allowed him to destroy my body, my self-confidence and my womanhood. I know many patients who were victims of this same physician while he was on probation, in fact, some have died.”\u003c/p>\n\u003cp>Minasian, who works as an advocate with Consumer’s Union California Safe Patient Project, told the committee that, unbeknownst to her, Brian West, operated on her while on probation for alcohol abuse. She said his license was revoked seven years after her surgery.\u003c/p>\n\u003cp>The California Medical Association, which opposes the bill, said requiring doctors to inform patients directly would take up valuable time in which care could be provided, in a letter filed with the committee.\u003c/p>\n\u003cp>But advocacy groups like Consumers Union and Consumer Watchdog say it’s important for doctors to tell patients about their disciplinary status so patients can make informed choices about their own care.\u003c/p>\n\u003cp>“This is the kind of information every patient deserves to know about their doctor before they receive medical care,” Consumer Watchdog wrote in a letter to the committee. “The patients of these doctors deserve to be notified proactively.”\u003c/p>\n\u003cp>The bill needs to be passed by the appropriations committee and then by the full state Senate by June 3 in order to proceed to the Assembly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Combine years of delay, ever-changing rules and requirements, state and federal red tape, and a once mighty company now in deep financial trouble, and what do you get?\u003c/p>\n\u003cp>In California’s case, the junking of a $179 million computer modernization project to process claims for Medi-Cal, the state’s health-payment program for low-income residents.\u003c/p>\n\u003cp>The project, put out to bid in 2007 and still far from completion, was finally put to rest on Monday when the state Department of Health Care Services announced a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Settlement%20Agreement%2003212016%201930%20FINAL%20web.pdf\" target=\"_blank\">legal settlement\u003c/a> with Xerox Corp., the project contractor, under which Xerox will pay the state approximately $120 million.\u003c/p>\n\u003cp>That means Medi-Cal’s existing computer system – creaky, patched-together, and decades old - will continue to operate for however long it takes the state to contract out and build a replacement.\u003c/p>\n\u003cp>According to the settlement, Xerox will continue to run the existing system until 2019.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The DHCS is putting a bright face on the project’s demise, calling it, in a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/Xerox_Settlement.aspx\" target=\"_blank\">press release\u003c/a> issued Monday, an “opportunity” to reevaluate current needs. A fresh start, it went on, will ensure “modern, robust and sustainable system.”\u003c/p>\n\u003cp>DHCS noted it's not the only state with such problems: “Many other states … have adjusted their strategies” toward their Medicaid computer systems, the release said. (Medi-Cal is California’s version of Medicaid.)\u003c/p>\n\u003cp>Indeed, several parties in Texas and Alaska, both public and private, have sued the Xerox subsidiary Xerox State Healthcare over contract problems.\u003c/p>\n\u003cp>The department declined to comment beyond the press release. The settlement requires that DHCS and Xerox both approve in advance any public statement for the next 30 days.\u003c/p>\n\u003cp>In a statement, Xerox said the settlement agreement finalizes the announcement it made last fall \"that it did not expect to complete implementation of the Health Enterprise Platform in California.\" Xerox added that it is \"pleased to work with DHCS to continue processing Medi-Cal claims through September 2019.\"\u003c/p>\n\u003cp>California’s drawn-out competition for the project began in 2007. Xerox won the contract in 2010. By 2012, the project was already in trouble. Delays caused the state to impose on Xerox a “\u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/CAMMIS_Quarterly_July-2012.pdf\" target=\"_blank\">corrective action plan\u003c/a>.”\u003c/p>\n\u003cp>Originally scheduled for completion by the end of this year, the project isn’t close to done, the settlement indicates.\u003c/p>\n\u003cp>Whenever government computer systems fall behind schedule, which is common, critics blame red tape. In this case, the massive Medi-Cal replacement contract with Xerox was inked just five days before President Obama signed the Affordable Care Act into law. As new regulations under the law worked their way through the health care system, requirements for the Medi-Cal project continued to change.\u003c/p>\n\u003cp>Compounding matters, Xerox fell into deep trouble. Its stock has lagged far behind the market in general. The company is under pressure from investor activist Carl Icahn. Late last year, Xerox said it would wind down its Medicaid computer systems business in California and Montana, take a $385 million charge against earnings, and “focus on profitable market segments.” That meant the end of the California project.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/downloads/mmisfacsr.pdf\" target=\"_blank\">Several companies \u003c/a>compete in the Medicaid system market. As of February, Xerox was the number-two provider, covering 11 states. The leader, HP Enterprise Systems, covers 18.\u003c/p>\n\u003cp>Xerox will pay about $103 million in cash, provide computer hardware and software worth $15 million, and abandon payment claims worth roughly $5 million more.\u003c/p>\n\u003cp>DHCS has reported it had paid Xerox $9 million for the replacement system, $8.1 million of that with federal funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Combine years of delay, ever-changing rules and requirements, state and federal red tape, and a once mighty company now in deep financial trouble, and what do you get?\u003c/p>\n\u003cp>In California’s case, the junking of a $179 million computer modernization project to process claims for Medi-Cal, the state’s health-payment program for low-income residents.\u003c/p>\n\u003cp>The project, put out to bid in 2007 and still far from completion, was finally put to rest on Monday when the state Department of Health Care Services announced a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Settlement%20Agreement%2003212016%201930%20FINAL%20web.pdf\" target=\"_blank\">legal settlement\u003c/a> with Xerox Corp., the project contractor, under which Xerox will pay the state approximately $120 million.\u003c/p>\n\u003cp>That means Medi-Cal’s existing computer system – creaky, patched-together, and decades old - will continue to operate for however long it takes the state to contract out and build a replacement.\u003c/p>\n\u003cp>According to the settlement, Xerox will continue to run the existing system until 2019.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The DHCS is putting a bright face on the project’s demise, calling it, in a \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/Xerox_Settlement.aspx\" target=\"_blank\">press release\u003c/a> issued Monday, an “opportunity” to reevaluate current needs. A fresh start, it went on, will ensure “modern, robust and sustainable system.”\u003c/p>\n\u003cp>DHCS noted it's not the only state with such problems: “Many other states … have adjusted their strategies” toward their Medicaid computer systems, the release said. (Medi-Cal is California’s version of Medicaid.)\u003c/p>\n\u003cp>Indeed, several parties in Texas and Alaska, both public and private, have sued the Xerox subsidiary Xerox State Healthcare over contract problems.\u003c/p>\n\u003cp>The department declined to comment beyond the press release. The settlement requires that DHCS and Xerox both approve in advance any public statement for the next 30 days.\u003c/p>\n\u003cp>In a statement, Xerox said the settlement agreement finalizes the announcement it made last fall \"that it did not expect to complete implementation of the Health Enterprise Platform in California.\" Xerox added that it is \"pleased to work with DHCS to continue processing Medi-Cal claims through September 2019.\"\u003c/p>\n\u003cp>California’s drawn-out competition for the project began in 2007. Xerox won the contract in 2010. By 2012, the project was already in trouble. Delays caused the state to impose on Xerox a “\u003ca href=\"http://www.dhcs.ca.gov/formsandpubs/Documents/Legislative%20Reports/CAMMIS_Quarterly_July-2012.pdf\" target=\"_blank\">corrective action plan\u003c/a>.”\u003c/p>\n\u003cp>Originally scheduled for completion by the end of this year, the project isn’t close to done, the settlement indicates.\u003c/p>\n\u003cp>Whenever government computer systems fall behind schedule, which is common, critics blame red tape. In this case, the massive Medi-Cal replacement contract with Xerox was inked just five days before President Obama signed the Affordable Care Act into law. As new regulations under the law worked their way through the health care system, requirements for the Medi-Cal project continued to change.\u003c/p>\n\u003cp>Compounding matters, Xerox fell into deep trouble. Its stock has lagged far behind the market in general. The company is under pressure from investor activist Carl Icahn. Late last year, Xerox said it would wind down its Medicaid computer systems business in California and Montana, take a $385 million charge against earnings, and “focus on profitable market segments.” That meant the end of the California project.\u003c/p>\n\u003cp>\u003ca href=\"https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/downloads/mmisfacsr.pdf\" target=\"_blank\">Several companies \u003c/a>compete in the Medicaid system market. As of February, Xerox was the number-two provider, covering 11 states. The leader, HP Enterprise Systems, covers 18.\u003c/p>\n\u003cp>Xerox will pay about $103 million in cash, provide computer hardware and software worth $15 million, and abandon payment claims worth roughly $5 million more.\u003c/p>\n\u003cp>DHCS has reported it had paid Xerox $9 million for the replacement system, $8.1 million of that with federal funds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, which publishes California Healthline, a service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Poor people who reside in expensive, well-educated cities such as San Francisco tend to live longer than low-income people in less affluent places, according to a study of more than a billion Social Security and tax records.\u003c/p>\n\u003cp>\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2513561\">The study\u003c/a>, published in \u003cem>JAMA\u003c/em>, the Journal of the American Medical Association, bolsters what was already well known — the poor tend to have shorter lifespans than those with more money. But it also says that among low-income people, big disparities exist in life expectancy from place to place, said Raj Chetty, professor of economics at Stanford University.\u003c/p>\n\u003cp>\"There are some places where the poor are doing quite well, gaining just as much in terms of life span as the rich, but there are other places where they're actually going in the other direction, where the poor are living shorter lives today than they did in the past,\" Chetty said, in an interview with NPR.\u003c/p>\n\u003cp>For example, low-income people in Birmingham, Ala., live about as long as the rich, but in Tampa, Fla., the poor have actually lost ground.\u003c/p>\n\u003cp>Chetty and his co-authors collected more than 1.4 billion records from the Social Security Administration and the Internal Revenue Service to try to measure the relationship between income and life expectancy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There are vast gaps in life expectancy between the richest and poorest Americans,\" Chetty said. \"Men in the top 1 percent distribution level live about 15 years longer than men in the bottom 1 percent on the income distribution in the United States.\u003c/p>\n\u003cp>\"To give you a sense of the magnitude, men in the bottom 1 percent have life expectancy comparable to the average life expectancy in Pakistan or Sudan.\"\u003c/p>\n\u003cp>And where life spans are concerned, the rich are getting richer.\u003c/p>\n\u003cp>Since 2001, life expectancy has increased by 2.3 years for the wealthiest 5 percent of American men and by nearly 3 years for similarly situated women. Meanwhile, life expectancy has increased barely at all for the poorest 5 percent.\u003c/p>\n\u003cp>Among the study's findings was that poor people in affluent cities such as San Francisco and New York tend to live longer than people of similar income levels in rust belt cities such as Detroit, he said.\u003c/p>\n\u003cp>What accounts for the disparity isn't clear, Chetty says.\u003c/p>\n\u003cp>It may be that some cities such as San Francisco may be better at promoting healthier lifestyles, with smoking bans, for example, or perhaps people tend to adopt healthier habits if they live in a place where everyone else is doing it, he says.\u003c/p>\n\u003cp>The study suggests that the relationship between life expectancy and income is not ironclad, and changes at the local level can make a big difference.\u003c/p>\n\u003cp>\"What our study shows is that thinking about these issues of inequality and health and life expectancy at a local level is very fruitful, and thinking about policies that change health behaviors at a local level is likely to be important,\" he says.\u003c/p>\n\u003cp>Chetty notes that the study has clear implications for Social Security and Medicare. The fact that poor people don't live as long means they are paying into the system without getting the same benefits, a fact that needs to be considered in any discussion about raising the retirement age, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was co-authored by Michael Stepner and Sarah Abraham of the Massachusetts Institute of Technology; Benjamin Scuderi, David Cutler and Augustin Bergeron of Harvard University; Shelby Lin of McKinsey and Co.; and Nicholas Turner of the U.S. Treasury Department's Office of Tax Analysis.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Life+Expectancy+Study%3A+It%27s+Not+Just+What+You+Make%2C+It%27s+Where+You+Live&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Poor people who reside in expensive, well-educated cities such as San Francisco tend to live longer than low-income people in less affluent places, according to a study of more than a billion Social Security and tax records.\u003c/p>\n\u003cp>\u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2513561\">The study\u003c/a>, published in \u003cem>JAMA\u003c/em>, the Journal of the American Medical Association, bolsters what was already well known — the poor tend to have shorter lifespans than those with more money. But it also says that among low-income people, big disparities exist in life expectancy from place to place, said Raj Chetty, professor of economics at Stanford University.\u003c/p>\n\u003cp>\"There are some places where the poor are doing quite well, gaining just as much in terms of life span as the rich, but there are other places where they're actually going in the other direction, where the poor are living shorter lives today than they did in the past,\" Chetty said, in an interview with NPR.\u003c/p>\n\u003cp>For example, low-income people in Birmingham, Ala., live about as long as the rich, but in Tampa, Fla., the poor have actually lost ground.\u003c/p>\n\u003cp>Chetty and his co-authors collected more than 1.4 billion records from the Social Security Administration and the Internal Revenue Service to try to measure the relationship between income and life expectancy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There are vast gaps in life expectancy between the richest and poorest Americans,\" Chetty said. \"Men in the top 1 percent distribution level live about 15 years longer than men in the bottom 1 percent on the income distribution in the United States.\u003c/p>\n\u003cp>\"To give you a sense of the magnitude, men in the bottom 1 percent have life expectancy comparable to the average life expectancy in Pakistan or Sudan.\"\u003c/p>\n\u003cp>And where life spans are concerned, the rich are getting richer.\u003c/p>\n\u003cp>Since 2001, life expectancy has increased by 2.3 years for the wealthiest 5 percent of American men and by nearly 3 years for similarly situated women. Meanwhile, life expectancy has increased barely at all for the poorest 5 percent.\u003c/p>\n\u003cp>Among the study's findings was that poor people in affluent cities such as San Francisco and New York tend to live longer than people of similar income levels in rust belt cities such as Detroit, he said.\u003c/p>\n\u003cp>What accounts for the disparity isn't clear, Chetty says.\u003c/p>\n\u003cp>It may be that some cities such as San Francisco may be better at promoting healthier lifestyles, with smoking bans, for example, or perhaps people tend to adopt healthier habits if they live in a place where everyone else is doing it, he says.\u003c/p>\n\u003cp>The study suggests that the relationship between life expectancy and income is not ironclad, and changes at the local level can make a big difference.\u003c/p>\n\u003cp>\"What our study shows is that thinking about these issues of inequality and health and life expectancy at a local level is very fruitful, and thinking about policies that change health behaviors at a local level is likely to be important,\" he says.\u003c/p>\n\u003cp>Chetty notes that the study has clear implications for Social Security and Medicare. The fact that poor people don't live as long means they are paying into the system without getting the same benefits, a fact that needs to be considered in any discussion about raising the retirement age, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was co-authored by Michael Stepner and Sarah Abraham of the Massachusetts Institute of Technology; Benjamin Scuderi, David Cutler and Augustin Bergeron of Harvard University; Shelby Lin of McKinsey and Co.; and Nicholas Turner of the U.S. Treasury Department's Office of Tax Analysis.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Life+Expectancy+Study%3A+It%27s+Not+Just+What+You+Make%2C+It%27s+Where+You+Live&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When \u003ca href=\"http://californiahealthline.org/news/saving-amanda-one-familys-struggle-to-deal-with-a-daughters-mental-illness/\" target=\"_blank\">Pam Lipp’s 18-year-old daughter Amanda\u003c/a> needed to be admitted to a psychiatric hospital in 2010, she thought it would be easy to find her a bed.\u003c/p>\n\u003cp>Instead, Lipp says, “It was a nightmare.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go.'\u003cbr>\n\u003ccite> Pam Lipp\u003c/cite>\u003c/aside>\n\u003cp>Her daughter had been admitted to a psychiatric crisis center during an episode of psychosis but she could only stay there for 72 hours. Lipp asked the crisis center for help finding her a bed and was told she was on her own.\u003c/p>\n\u003cp>So Lipp plugged her phone into the wall in the waiting room and started calling one hospital after the next. They were all full. They wouldn’t reserve a spot when a bed opened, nor would they call to let her know. So she called each one every half hour to check. After eight hours, she found her daughter an open bed near their home in Fair Oaks, California.\u003c/p>\n\u003cp>Usually, it’s an emergency room staff or medical providers making such calls, rather than a patient or caregiver. The result, however, is the same: Finding an available inpatient psychiatric bed in the state of California can be extremely difficult. Many patients with acute psychiatric conditions spend days \u003ca href=\"http://www.npr.org/2011/04/13/135351760/mentally-ill-languish-in-hospital-emergency-rooms\" target=\"_blank\">deteriorating in hospital emergency departments\u003c/a> while they wait.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But how exactly to solve the problem has become a controversy in Sacramento.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2743\" target=\"_blank\">An Assembly bill \u003c/a>backed by the California Psychiatric Association and the Steinberg Institute, a mental health policy organization, seeks to improve the process by establishing an online registry to collect and display information to help medical providers find psychiatric beds. But the California Hospital Association is staunchly opposed, saying that finding the right placement for a patient is much more complex than identifying an empty bed, and a registry could actually hinder efforts to get patients appropriate treatment.\u003c/p>\n\u003cp>The Assembly’s Committee on Health plans to hold the first hearing on the bill on April 12.\u003c/p>\n\u003cp>[contextly_sidebar id=\"3DVVdSD0eUzVhPbKvw2SFfjlfM0rBqT8\"]Under the proposed legislation, AB2743, facilities with psychiatric beds would be required to update the registry as the beds became available, and emergency medical providers would be able to log on to search for openings.\u003c/p>\n\u003cp>“A bed registry would eliminate the need for rounds and rounds of calls over hours and hours. Why not just cut that time out and go straight to the source?” asks Anna Hasselblad, public policy director at the Steinberg Institute.\u003c/p>\n\u003cp>California is facing a serious shortage of psychiatric beds, said Randall Hagar, director of government affairs for the California Psychiatric Association. As of 2013, there were 6,680 beds in the state — about 17 per 100,000 residents, according to a \u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">report from the hospital association\u003c/a>. Psychiatric experts recommend a minimum of 50 beds per 100,000. In 25 counties in the state, there were no psychiatric beds at all.\u003c/p>\n\u003cp>Adding beds is a long-term goal for many mental health advocates, but it’s a huge task that could take years.\u003c/p>\n\u003cp>“We have to use the beds we do have and we have to know where they are. It can be a hit or miss process. It needs to be more reliable,” said Hagar. “We’ve heard instances where people were told there were no beds when in fact it turns out later that there were. An online registry would fix that issue.”\u003c/p>\n\u003cp>It would also provide data on exactly what types of additional beds are needed and where, he said.\u003c/p>\n\u003cp>The hospital association is not convinced it would work.\u003c/p>\n\u003cp>“On first blush, if you are not in the trenches, it seems like the best and easiest solution in the entire world. But the reality is that the bill will really increase the amount of time and the frustration people have trying to locate psychiatric acute-levels of care in our state,” said Sheree Lowe, the hospital association’s vice president of behavioral health.\u003c/p>\n\u003cp>Beyond finding an open bed, staffers must also factor in the age, gender, illness and acuity of the patient.\u003c/p>\n\u003cp>“You have to take under consideration your staffing needs, the needs of the other patients, and the therapeutic milieu for the safety of all patients and all staff. And that’s not something you can put into a drop-down menu,” said Lowe.\u003c/p>\n\u003cp>Requiring hospital staffers to report all those changing dynamics in an online registry, she added, would be yet another administrative burden that could cut into hands-on patient care.\u003c/p>\n\u003cp>\u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">Many states \u003c/a>have some sort of computerized tracking system for psychiatric beds, but few are mandatory. Lowe points to a recent effort in Virginia to create a mandatory registry similar to the one being proposed in California as evidence that they don’t work.\u003c/p>\n\u003cp>In January, the \u003ca href=\"https://osig.virginia.gov/media/5277/2016-bhds-001-acute-psychiatric-and-community-services-board-bed-registry.pdf\" target=\"_blank\">Virginia state inspector general reported \u003c/a>that more than half of users of the online registry said it takes longer to find a bed for a patient than it did before the registry was established, in part because hospitals were not accurately updating information about their beds.\u003c/p>\n\u003cp>Hasselblad of the Steinberg Institute, however, said the issues with the Virginia system “is a little bit of a self-fulfilling prophesy. We have to get the buy-in from the people who will be updating the registry, because if you don’t believe it’s going to be useful to you, it’s not going to be useful to you.”\u003c/p>\n\u003cp>One solution, she said, would be to include a fine in the bill for hospitals that do not keep the registry updated. “Hospitals aren’t going to do this unless they’re absolutely mandated to.”\u003c/p>\n\u003cp>Despite the opposition of the hospital association, the emergency room doctors who staff their facilities are generally supportive of the bill. Holding psychiatric patients for days in the emergency department is “a worst case scenario for everyone involved,” said Elena Lopez-Gusman, executive director of the California chapter of the American College of Emergency Physicians.\u003c/p>\n\u003cp>And she said the hospitals with psychiatric beds may be making the problem worse by trying to reserve beds for patients with private insurance.\u003c/p>\n\u003cp>“Our physician members have reported a significant level of difficulty in getting what they feel is an accurate assessment of bed availability,” said Lopez-Gusman. “They might call the same facility in a short time for two different patients with different types of insurance, and get different answers on whether or not there’s a bed available. So our thought is that more transparency reduces the hospitals’ ability to hide available beds.”\u003c/p>\n\u003cp>Lowe of the hospital association denies that psychiatric hospitals are holding beds, which would be a violation of federal law.\u003c/p>\n\u003cp>Assemblymember Susan Talamantes Eggman, the Stockton Democrat who wrote the bill, said she believes the bill has a good chance of passing.\u003c/p>\n\u003cp>“We are very hopeful. There’s a good coalition, and everyone is talking about mental health these days,” she said. “This is a practical, small step we can take. It’s hard to argue against it.”\u003c/p>\n\u003cp>Pam Lipp, who struggled to find a bed for her daughter, said the idea of establishing a registry is “absolutely phenomenal.”\u003c/p>\n\u003cp>“Our situation is exactly the kind of situation that hopefully this bill will help,” she said.\u003c/p>\n\u003cp>“If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go, and we would have just repeated the cycle again. Maybe she wouldn’t have survived.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But how exactly to solve the problem has become a controversy in Sacramento.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2743\" target=\"_blank\">An Assembly bill \u003c/a>backed by the California Psychiatric Association and the Steinberg Institute, a mental health policy organization, seeks to improve the process by establishing an online registry to collect and display information to help medical providers find psychiatric beds. But the California Hospital Association is staunchly opposed, saying that finding the right placement for a patient is much more complex than identifying an empty bed, and a registry could actually hinder efforts to get patients appropriate treatment.\u003c/p>\n\u003cp>The Assembly’s Committee on Health plans to hold the first hearing on the bill on April 12.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Under the proposed legislation, AB2743, facilities with psychiatric beds would be required to update the registry as the beds became available, and emergency medical providers would be able to log on to search for openings.\u003c/p>\n\u003cp>“A bed registry would eliminate the need for rounds and rounds of calls over hours and hours. Why not just cut that time out and go straight to the source?” asks Anna Hasselblad, public policy director at the Steinberg Institute.\u003c/p>\n\u003cp>California is facing a serious shortage of psychiatric beds, said Randall Hagar, director of government affairs for the California Psychiatric Association. As of 2013, there were 6,680 beds in the state — about 17 per 100,000 residents, according to a \u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">report from the hospital association\u003c/a>. Psychiatric experts recommend a minimum of 50 beds per 100,000. In 25 counties in the state, there were no psychiatric beds at all.\u003c/p>\n\u003cp>Adding beds is a long-term goal for many mental health advocates, but it’s a huge task that could take years.\u003c/p>\n\u003cp>“We have to use the beds we do have and we have to know where they are. It can be a hit or miss process. It needs to be more reliable,” said Hagar. “We’ve heard instances where people were told there were no beds when in fact it turns out later that there were. An online registry would fix that issue.”\u003c/p>\n\u003cp>It would also provide data on exactly what types of additional beds are needed and where, he said.\u003c/p>\n\u003cp>The hospital association is not convinced it would work.\u003c/p>\n\u003cp>“On first blush, if you are not in the trenches, it seems like the best and easiest solution in the entire world. But the reality is that the bill will really increase the amount of time and the frustration people have trying to locate psychiatric acute-levels of care in our state,” said Sheree Lowe, the hospital association’s vice president of behavioral health.\u003c/p>\n\u003cp>Beyond finding an open bed, staffers must also factor in the age, gender, illness and acuity of the patient.\u003c/p>\n\u003cp>“You have to take under consideration your staffing needs, the needs of the other patients, and the therapeutic milieu for the safety of all patients and all staff. And that’s not something you can put into a drop-down menu,” said Lowe.\u003c/p>\n\u003cp>Requiring hospital staffers to report all those changing dynamics in an online registry, she added, would be yet another administrative burden that could cut into hands-on patient care.\u003c/p>\n\u003cp>\u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">Many states \u003c/a>have some sort of computerized tracking system for psychiatric beds, but few are mandatory. Lowe points to a recent effort in Virginia to create a mandatory registry similar to the one being proposed in California as evidence that they don’t work.\u003c/p>\n\u003cp>In January, the \u003ca href=\"https://osig.virginia.gov/media/5277/2016-bhds-001-acute-psychiatric-and-community-services-board-bed-registry.pdf\" target=\"_blank\">Virginia state inspector general reported \u003c/a>that more than half of users of the online registry said it takes longer to find a bed for a patient than it did before the registry was established, in part because hospitals were not accurately updating information about their beds.\u003c/p>\n\u003cp>Hasselblad of the Steinberg Institute, however, said the issues with the Virginia system “is a little bit of a self-fulfilling prophesy. We have to get the buy-in from the people who will be updating the registry, because if you don’t believe it’s going to be useful to you, it’s not going to be useful to you.”\u003c/p>\n\u003cp>One solution, she said, would be to include a fine in the bill for hospitals that do not keep the registry updated. “Hospitals aren’t going to do this unless they’re absolutely mandated to.”\u003c/p>\n\u003cp>Despite the opposition of the hospital association, the emergency room doctors who staff their facilities are generally supportive of the bill. Holding psychiatric patients for days in the emergency department is “a worst case scenario for everyone involved,” said Elena Lopez-Gusman, executive director of the California chapter of the American College of Emergency Physicians.\u003c/p>\n\u003cp>And she said the hospitals with psychiatric beds may be making the problem worse by trying to reserve beds for patients with private insurance.\u003c/p>\n\u003cp>“Our physician members have reported a significant level of difficulty in getting what they feel is an accurate assessment of bed availability,” said Lopez-Gusman. “They might call the same facility in a short time for two different patients with different types of insurance, and get different answers on whether or not there’s a bed available. So our thought is that more transparency reduces the hospitals’ ability to hide available beds.”\u003c/p>\n\u003cp>Lowe of the hospital association denies that psychiatric hospitals are holding beds, which would be a violation of federal law.\u003c/p>\n\u003cp>Assemblymember Susan Talamantes Eggman, the Stockton Democrat who wrote the bill, said she believes the bill has a good chance of passing.\u003c/p>\n\u003cp>“We are very hopeful. There’s a good coalition, and everyone is talking about mental health these days,” she said. “This is a practical, small step we can take. It’s hard to argue against it.”\u003c/p>\n\u003cp>Pam Lipp, who struggled to find a bed for her daughter, said the idea of establishing a registry is “absolutely phenomenal.”\u003c/p>\n\u003cp>“Our situation is exactly the kind of situation that hopefully this bill will help,” she said.\u003c/p>\n\u003cp>“If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go, and we would have just repeated the cycle again. Maybe she wouldn’t have survived.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In a small room at a neighborhood clinic in Sacramento, a handful of hepatitis C patients wait to see their physician, hoping they’ll be found sick enough to be approved for a cure.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There are very few tools in our toolbox” to control pharmaceutical spending\u003ccite>Diana Dooley, secretary of California’s Health and Human Services\u003c/cite>\u003c/aside>\n\u003cp>The low-income patients hope to be prescribed new breakthrough drugs, such as Sovaldi or Harvoni, which offer cures with almost no side effects. But treating the virus comes with a high price tag: at least $84,000 for a course of treatment. Getting Medi-Cal to pay for such drugs can involve a long, arduous process of tests and paperwork to prove infection has progressed to liver damage.\u003c/p>\n\u003cp>“If you’re practically dead … they’ll approve you,” said Laura Castillo, 54, who has been navigating the Medi-Cal system for four months to get Sovaldi. The former legal clerk said she contracted the virus from a blood transfusion in the early 1980s. Patients can live for years symptom free with hepatitis C, but left untreated, it can eventually lead to liver disease and death. Castillo has waited for treatment with substantial liver damage, which burdens her with overwhelming fatigue, depression and what she describes as a “brain fog.”\u003c/p>\n\u003cp>“It’s very, very frustrating, knowing that you have an illness and there is a cure, and you can’t do anything about it,” Castillo said.\u003c/p>\n\u003cp>Castillo’s physician, Dr. Catherine Moizeau, says she treats hundreds of Medi-Cal patients who wait months to get approval for the hepatitis C drugs. Moizeau says health plans, under state guidelines, are rationing the drugs because of the high cost. But Medi-Cal officials say patients receive the treatments based on medical necessity, not on cost.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hepatitis C drugs are not the only part of California’s troubling drug spending picture. Despite recent cost-cutting measures, such as putting tighter controls on which patients get coverage for which drugs and when, California’s spending on pharmaceuticals has gone up, and so has the number of pricey drugs it is covering. It’s not clear state agencies have the means to balance drug cost pressures in a way that serves the best interests of patients, taxpayers and public health.\u003c/p>\n\u003cp>“There are very few tools in our toolbox” to control pharmaceutical spending, said Diana Dooley, secretary of California’s Health and Human Services. She says high prescription drug costs are a problem across California’s public and private health insurance, and should be addressed on a national level.\u003c/p>\n\u003cp>Drug price concerns will also be a matter of public policy debate this year. California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs, and lawmakers have proposed drug price transparency requirements on pharmaceutical manufacturers and health insurers.\u003c/p>\n\u003cp>“We all have to do everything we can to try to control these drug costs,” Dooley said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"kO3lkbe6TLc7SIMiuJ3FinItNEnjyfYz\"]A CALmatters analysis found that state prisons, a California public pension system, and one subset of the Medi-Cal program spent $600 million more on pharmaceuticals in 2014 than in 2012. That does not include the Medi-Cal population in a health plan, nor does it account for discounts the state may have received from drugmakers.\u003c/p>\n\u003cp>Over the past decade, Medi-Cal has seen a 57 percent increase in the drugs it covers that cost $600 or more per prescription. And when it comes to hepatitis C drugs alone, Medi-Cal estimates it will spend almost $482 million over this fiscal year and last. As of September 2015, only 4,200 Medi-Cal patients had received the drugs in that time period, out of 237,000 who are estimated to have the disease.\u003c/p>\n\u003cp>These cost trends exist despite new protocols various state agencies have introduced to tamp down on pharmaceutical spending, which include stricter controls on which patients get which prescription drugs and how.\u003c/p>\n\u003cp>“The people that pay for health care, be it the government or employers, are asking for more prior authorization because we’re having to scrutinize every penny we spend now,” said Steve Miller, chief medical officer at Express Scripts, which manages pharmacy benefits for health plans nationally, including 7.5 million Californians.\u003c/p>\n\u003cp>Miller said involvement from the payer is meant to get “the right patient, the right drug, at the right dose.” But the process, can be “clunky” and cause delays and frustrations for patients like Castillo.\u003c/p>\n\u003cp>Drugmakers say the value of the new hepatitis C drugs, the first of which hit the market at the end of 2013, is worth the cost, and in the long term, may eventually even bring savings to the health system.\u003c/p>\n\u003cp>The new hepatitis C drugs involve only a few months of treatment, and produce a cure in about 90 percent of patients. The older generation of treatments are cheaper, but are also about half as effective, and have side-effects that resemble the flu.\u003c/p>\n\u003cp>“These patients are now healthier. They’re more productive. They’re functioning,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA).\u003c/p>\n\u003cp>“You’re going to have less people who need long-term medication therapy for their hep C, they’re not going to need liver transplants, they’re not going to need significant hospitalizations,” VanderVeer said.\u003c/p>\n\u003cp>Health consumer advocates and economists argue that paying a lot for some drugs that only treat a limited population may not serve larger public health interests, or be the best use of taxpayer dollars.\u003c/p>\n\u003cp>For example, if the cost of the new hepatitis C drugs were cheaper, the hundreds of millions of dollars spent on treating just a few thousand patients could have been spent to help eradicate the disease, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>“You could imagine a strategy to provide this cure in a much more broad population strategy,” Wright said.\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-170763 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/DrugsOver600-400x828.png\" alt=\"DrugsOver600\" width=\"400\" height=\"828\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600-400x828.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600.png 550w\" sizes=\"(max-width: 400px) 100vw, 400px\">Specialty drugs, which the federal government defines as costing $600 or more a month, are raising concern among health insurers and state agencies. In CalPERS, for instance, specialty drugs are taking up a larger share of total drug expenditures, despite the fact that they account for a small percentage of prescriptions.\u003c/p>\n\u003cp>Drugmakers are investing more in these types of drugs, said Joel Hay, a pharmaceutical economist at the University of Southern California, because “the profits are very high.”\u003c/p>\n\u003cp>But paying a high price for drugs that treat a small number of patients raises an equity question, Hay said. It may not be fair to the larger patient population for a health system to pay a high price for cancer drugs that extend a patient’s life by three weeks.\u003c/p>\n\u003cp>“You can get a lot more lives saved if you take that budget and put it into colon cancer screening or any number of other more efficient, more effective interventions,” Hay said.\u003c/p>\n\u003cp>The cost pressure from specialty drugs may not go away soon. Pharmaceutical benefits manager Express Scripts estimates that this class of drugs will continue to grow in Medicaid programs by 13.6 percent over the next three years.\u003c/p>\n\u003cp>“Are we going to have a sustainable (pharmaceutical) industry where we are making sure the drug companies make enough money where they can bring great new products to the marketplace, yet we control cost well enough that people –- all people, even the most vulnerable -- have access to the drugs they need?” asked Miller.\u003c/p>\n\u003cp>State Medi-Cal administrators say it’s too soon to assess the sustainability of current prescription drug spending trends. Meantime, their guidelines about which patients can get covered by new hepatitis C drugs has recently loosened up. As of July 2015, patients with a less advanced stage of liver disease can get covered for the drugs, as well as IV drug users and women who want to get pregnant.\u003c/p>\n\u003cp>Castillo got her medication in March, after an attorney helped her challenge denied coverage for Sovaldi through a health insurance regulator. Castillo says she’s glad she’s in treatment now, but she doesn’t know why her Medi-Cal health plan made it so hard for her to get the medicine.\u003c/p>\n\u003cp>“They need to get it together,” she said. “It’s our health and our life that they’re messing with.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CALmatters data reporter Matt Levin contributed to this article. \u003c/em>\u003ca href=\"https://calmatters.org/\" target=\"_blank\">\u003cem>CALmatters\u003c/em>\u003c/a>\u003cem> is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\">\u003cem>California Data\u003c/em>\u003c/a> \u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" target=\"_blank\">\u003cem>Fellowship,\u003c/em>\u003c/a>\u003cem> a program of the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/\" target=\"_blank\">\u003cem>Center for Health Journalism\u003c/em>\u003c/a>\u003cem> at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a small room at a neighborhood clinic in Sacramento, a handful of hepatitis C patients wait to see their physician, hoping they’ll be found sick enough to be approved for a cure.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There are very few tools in our toolbox” to control pharmaceutical spending\u003ccite>Diana Dooley, secretary of California’s Health and Human Services\u003c/cite>\u003c/aside>\n\u003cp>The low-income patients hope to be prescribed new breakthrough drugs, such as Sovaldi or Harvoni, which offer cures with almost no side effects. But treating the virus comes with a high price tag: at least $84,000 for a course of treatment. Getting Medi-Cal to pay for such drugs can involve a long, arduous process of tests and paperwork to prove infection has progressed to liver damage.\u003c/p>\n\u003cp>“If you’re practically dead … they’ll approve you,” said Laura Castillo, 54, who has been navigating the Medi-Cal system for four months to get Sovaldi. The former legal clerk said she contracted the virus from a blood transfusion in the early 1980s. Patients can live for years symptom free with hepatitis C, but left untreated, it can eventually lead to liver disease and death. Castillo has waited for treatment with substantial liver damage, which burdens her with overwhelming fatigue, depression and what she describes as a “brain fog.”\u003c/p>\n\u003cp>“It’s very, very frustrating, knowing that you have an illness and there is a cure, and you can’t do anything about it,” Castillo said.\u003c/p>\n\u003cp>Castillo’s physician, Dr. Catherine Moizeau, says she treats hundreds of Medi-Cal patients who wait months to get approval for the hepatitis C drugs. Moizeau says health plans, under state guidelines, are rationing the drugs because of the high cost. But Medi-Cal officials say patients receive the treatments based on medical necessity, not on cost.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hepatitis C drugs are not the only part of California’s troubling drug spending picture. Despite recent cost-cutting measures, such as putting tighter controls on which patients get coverage for which drugs and when, California’s spending on pharmaceuticals has gone up, and so has the number of pricey drugs it is covering. It’s not clear state agencies have the means to balance drug cost pressures in a way that serves the best interests of patients, taxpayers and public health.\u003c/p>\n\u003cp>“There are very few tools in our toolbox” to control pharmaceutical spending, said Diana Dooley, secretary of California’s Health and Human Services. She says high prescription drug costs are a problem across California’s public and private health insurance, and should be addressed on a national level.\u003c/p>\n\u003cp>Drug price concerns will also be a matter of public policy debate this year. California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs, and lawmakers have proposed drug price transparency requirements on pharmaceutical manufacturers and health insurers.\u003c/p>\n\u003cp>“We all have to do everything we can to try to control these drug costs,” Dooley said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A CALmatters analysis found that state prisons, a California public pension system, and one subset of the Medi-Cal program spent $600 million more on pharmaceuticals in 2014 than in 2012. That does not include the Medi-Cal population in a health plan, nor does it account for discounts the state may have received from drugmakers.\u003c/p>\n\u003cp>Over the past decade, Medi-Cal has seen a 57 percent increase in the drugs it covers that cost $600 or more per prescription. And when it comes to hepatitis C drugs alone, Medi-Cal estimates it will spend almost $482 million over this fiscal year and last. As of September 2015, only 4,200 Medi-Cal patients had received the drugs in that time period, out of 237,000 who are estimated to have the disease.\u003c/p>\n\u003cp>These cost trends exist despite new protocols various state agencies have introduced to tamp down on pharmaceutical spending, which include stricter controls on which patients get which prescription drugs and how.\u003c/p>\n\u003cp>“The people that pay for health care, be it the government or employers, are asking for more prior authorization because we’re having to scrutinize every penny we spend now,” said Steve Miller, chief medical officer at Express Scripts, which manages pharmacy benefits for health plans nationally, including 7.5 million Californians.\u003c/p>\n\u003cp>Miller said involvement from the payer is meant to get “the right patient, the right drug, at the right dose.” But the process, can be “clunky” and cause delays and frustrations for patients like Castillo.\u003c/p>\n\u003cp>Drugmakers say the value of the new hepatitis C drugs, the first of which hit the market at the end of 2013, is worth the cost, and in the long term, may eventually even bring savings to the health system.\u003c/p>\n\u003cp>The new hepatitis C drugs involve only a few months of treatment, and produce a cure in about 90 percent of patients. The older generation of treatments are cheaper, but are also about half as effective, and have side-effects that resemble the flu.\u003c/p>\n\u003cp>“These patients are now healthier. They’re more productive. They’re functioning,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA).\u003c/p>\n\u003cp>“You’re going to have less people who need long-term medication therapy for their hep C, they’re not going to need liver transplants, they’re not going to need significant hospitalizations,” VanderVeer said.\u003c/p>\n\u003cp>Health consumer advocates and economists argue that paying a lot for some drugs that only treat a limited population may not serve larger public health interests, or be the best use of taxpayer dollars.\u003c/p>\n\u003cp>For example, if the cost of the new hepatitis C drugs were cheaper, the hundreds of millions of dollars spent on treating just a few thousand patients could have been spent to help eradicate the disease, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>“You could imagine a strategy to provide this cure in a much more broad population strategy,” Wright said.\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-170763 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/DrugsOver600-400x828.png\" alt=\"DrugsOver600\" width=\"400\" height=\"828\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600-400x828.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600.png 550w\" sizes=\"(max-width: 400px) 100vw, 400px\">Specialty drugs, which the federal government defines as costing $600 or more a month, are raising concern among health insurers and state agencies. In CalPERS, for instance, specialty drugs are taking up a larger share of total drug expenditures, despite the fact that they account for a small percentage of prescriptions.\u003c/p>\n\u003cp>Drugmakers are investing more in these types of drugs, said Joel Hay, a pharmaceutical economist at the University of Southern California, because “the profits are very high.”\u003c/p>\n\u003cp>But paying a high price for drugs that treat a small number of patients raises an equity question, Hay said. It may not be fair to the larger patient population for a health system to pay a high price for cancer drugs that extend a patient’s life by three weeks.\u003c/p>\n\u003cp>“You can get a lot more lives saved if you take that budget and put it into colon cancer screening or any number of other more efficient, more effective interventions,” Hay said.\u003c/p>\n\u003cp>The cost pressure from specialty drugs may not go away soon. Pharmaceutical benefits manager Express Scripts estimates that this class of drugs will continue to grow in Medicaid programs by 13.6 percent over the next three years.\u003c/p>\n\u003cp>“Are we going to have a sustainable (pharmaceutical) industry where we are making sure the drug companies make enough money where they can bring great new products to the marketplace, yet we control cost well enough that people –- all people, even the most vulnerable -- have access to the drugs they need?” asked Miller.\u003c/p>\n\u003cp>State Medi-Cal administrators say it’s too soon to assess the sustainability of current prescription drug spending trends. Meantime, their guidelines about which patients can get covered by new hepatitis C drugs has recently loosened up. As of July 2015, patients with a less advanced stage of liver disease can get covered for the drugs, as well as IV drug users and women who want to get pregnant.\u003c/p>\n\u003cp>Castillo got her medication in March, after an attorney helped her challenge denied coverage for Sovaldi through a health insurance regulator. Castillo says she’s glad she’s in treatment now, but she doesn’t know why her Medi-Cal health plan made it so hard for her to get the medicine.\u003c/p>\n\u003cp>“They need to get it together,” she said. “It’s our health and our life that they’re messing with.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters data reporter Matt Levin contributed to this article. \u003c/em>\u003ca href=\"https://calmatters.org/\" target=\"_blank\">\u003cem>CALmatters\u003c/em>\u003c/a>\u003cem> is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\">\u003cem>California Data\u003c/em>\u003c/a> \u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" target=\"_blank\">\u003cem>Fellowship,\u003c/em>\u003c/a>\u003cem> a program of the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/\" target=\"_blank\">\u003cem>Center for Health Journalism\u003c/em>\u003c/a>\u003cem> at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Lea este artículo en español : \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/22/medi-cal-se-expande-para-los-ninos-inmigrantes-asi-es-como-funciona/\" target=\"_blank\">“Medi-Cal se expande para los niños inmigrantes. Así es como funciona”\u003c/a>\u003c/em>\u003c/p>\n\u003cp>In a few months, California will begin providing full Medi-Cal coverage to all low-income children — regardless of their immigration status.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/02/09/states-medi-cal-bill-for-undocumented-children-could-go-up/\" target=\"_blank\">Depending on whom you ask\u003c/a>, anywhere from 170,000 to \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/covers/undocumented%20children%20transition%20memo%20final%20101615.pdf\" target=\"_blank\">250,000\u003c/a> children who live in California and are in the country illegally will qualify.\u003c/p>\n\u003caside class=\"pullquote alignright\">Take action now, sign up today, say health advocates\u003c/aside>\n\u003cp>If you think your child will, or know a parent whose child will, state officials and health care advocates have a simple message for you: Take action now. “Sign up today,” says Rachel Vizcarra, a program assistant with the \u003ca href=\"http://www.ufwfoundation.org/\" target=\"_blank\">UFW Foundation\u003c/a> in Bakersfield, which is helping families pre-enroll. “If you do, your kids will be automatically enrolled into the program.”\u003c/p>\n\u003cp>State officials expect coverage to start May 16. But because the policy shift requires complex programming changes to state and county computer systems, implementation may be delayed, says Tony Cava of the \u003ca href=\"http://www.dhcs.ca.gov/Pages/default.aspx\" target=\"_blank\">state Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>No matter when it occurs, eligible children will gain coverage retroactive to the first day of that month, he says. For example, if the change takes place on May 16, coverage will extend back to May 1.\u003c/p>\n\u003cp>Carolina Moran of Canoga Park looks forward to taking her 14-year-old daughter Lizeth to the doctor once she becomes eligible for full Medi-Cal benefits.\u003c/p>\n\u003cp>A concussion on the soccer field sent Lizeth to the emergency room in January, but she couldn’t see a doctor for a follow-up visit because “we couldn’t afford it. We would have to pay out of pocket,” Moran says.\u003c/p>\n\u003cp>The first thing Moran will do is take Lizeth for a physical “and make sure her vaccinations are up to date,” she says. “She also needs fillings for five cavities.”\u003c/p>\n\u003cp>Medi-Cal eligibility is based on household income, and children under the age of 19 qualify at a higher income level than adults. They’re eligible for Medi-Cal if the family’s household income is less than 266 percent of the \u003ca href=\"https://aspe.hhs.gov/poverty-guidelines\" target=\"_blank\">Federal Poverty Level\u003c/a>, or about $53,600 for a family of three and $75,650 for a family of five.\u003c/p>\n\u003cp>Currently, children and adults in the country illegally qualify for limited Medi-Cal coverage, called restricted-scope, which covers emergency and pregnancy-related services.\u003c/p>\n\u003cp>Though this may sound counter-intuitive, health care advocates and the state want you to sign your kids up for restricted Medi-Cal now in preparation for the availability of full Medi-Cal benefits.\u003c/p>\n\u003caside class=\"pullquote alignright\">Be warned: the Medi-Cal application is long and complicated, but free help is available to help with enrollment\u003c/aside>\n\u003cp>The idea is that when the change occurs, qualified children \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/SB75/SB75_EE_Plan_032116_Final.PDF\" target=\"_blank\">will automatically transition\u003c/a> into full-scope Medi-Cal “within a few days” and without an additional application, Cava says.\u003c/p>\n\u003cp>The state estimates that there are about 115,000 unauthorized immigrant children who already have restricted Medi-Cal.\u003c/p>\n\u003cp>If your child is uninsured, sign up for restricted-scope Medi-Cal now. Even if your child has coverage through another existing program — such as Kaiser Permanente’s \u003ca href=\"http://info.kaiserpermanente.org/html/child_health_plan/index.html\" target=\"_blank\">Child Health Program\u003c/a> or county-based health coverage — you should still sign your child up for restricted Medi-Cal now, says Mark Diel, CEO of \u003ca href=\"http://cchi4families.org/\" target=\"_blank\">California Coverage & Health Initiatives\u003c/a> (CCHI), a statewide outreach and enrollment network.\u003c/p>\n\u003cp>That’s because those kids will eventually become ineligible for those programs after they become eligible for full Medi-Cal, he says. (Don’t drop out of another program until you confirm that your child’s full-scope Medi-Cal has been approved, he says.)\u003c/p>\n\u003cp>But be warned: The Medi-Cal application is long and complicated. To complete it, you’ll need to provide a birth certificate, proof of local address, proof of identity and income information, Vizcarra says. Foreign passports and birth certificates can be used.\u003c/p>\n\u003cp>“Work with a local enroller instead of trying to do it on your own,” Diel says. “You’re much more likely to get the application approved.”\u003c/p>\n\u003cp>Help from local health clinics and community groups is free. Online, visit \u003ca href=\"http://www.cchi4families.org/find-help\" target=\"_blank\">www.cchi4families.org/find-help\u003c/a> for local resources.\u003c/p>\n\u003cp>Advocates and state officials also want you to know that enrolling your kids shouldn’t lead to negative immigration consequences for you — or other members of your family — who may not have legal status.\u003c/p>\n\u003cp>“None of the information being collected is shared with immigration authorities,” says Maria Romero-Mora of CCHI.\u003c/p>\n\u003cp>Once you get your kids into restricted-scope Medi-Cal, and eventually into full Medi-Cal, you’ll need to take action.\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75_FAQ_1.aspx\" target=\"_blank\"> Look for letters in the mail\u003c/a> before and after the transition explaining your options.\u003c/p>\n\u003cp>\u003cstrong>CHOOSE A PLAN\u003c/strong>: Once the transition to full Medi-Cal occurs, you will have 60 days to choose a managed care health plan for children already enrolled in restricted-scope Medi-Cal. If you don’t choose a plan, the state will assign one, Cava says.\u003c/p>\n\u003cp>Parents of kids who are not in restricted-scope Medi-Cal at the time of the change and who enroll them afterward will have 30 days to choose a plan, he says.\u003c/p>\n\u003cp>If you live in one of 22 counties where Medi-Cal managed care is operated by a single \u003ca href=\"http://www.healthconsumer.org/092914-ManagedCareinCaliforniaSeries-3-COHSMediCalPlans.pdf\" target=\"_blank\">County Organized Health System\u003c/a>, children will be automatically enrolled in that plan, Cava says.\u003c/p>\n\u003cp>In all cases, until a plan is chosen — or assigned — children will receive coverage through Medi-Cal’s fee-for-service program.\u003c/p>\n\u003cp>\u003cstrong>PAY PREMIUMS\u003c/strong>: Medi-Cal is premium-free for kids up to 160 percent of the Federal Poverty Level, but you will owe a premium if your family income falls between 160 percent and 266 percent. The premium is $13 a month for each child, with a $39 family maximum.\u003c/p>\n\u003cp>Children in Medi-Cal plans don’t have co-payments for medical care.\u003c/p>\n\u003cp>\u003cstrong>RENEW\u003c/strong>: You will need to participate in Medi-Cal’s annual renewal process to ensure your children remain eligible and enrolled.\u003c/p>\n\u003cp>Finally, if you don’t sign your child up for restricted Medi-Cal before the change, you can apply for full benefits afterward — anytime of year — at your county human services office, through a community organization or via the \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> website, \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>In Canoga Park, Moran says getting Lizeth on Medi-Cal will give her family greater financial security. Lizeth agrees.\u003c/p>\n\u003cp>“I worry that if I have to go to a checkup, it’s going to cost my parents money, and sometimes they don’t have the money to pay for it,” the ninth-grader says.\u003c/p>\n\u003cp>\u003cem>This story is part of California Healthline's \u003ca href=\"http://californiahealthline.org/news/author/emily-bazar/\" target=\"_blank\">Ask Emily\u003c/a>, a series of Q&A columns answering consumers’ questions about California’s new medical world. It was produced by Kaiser Health News which publishes California Healthline, a service of the California Health Care Foundation.”\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Send questions for Emily to AskEmily@kff.org\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Moving into a realm usually reserved for health care regulators, \u003ca href=\"http://www.coveredca.com/news/\" target=\"_blank\">the California health marketplace Thursday unveiled sweeping reforms\u003c/a> to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers.\u003c/p>\n\u003cp>The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation.\u003c/p>\n\u003cp>Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards.\u003c/p>\n\u003cp>The plan, to be implemented over seven years, is based on a \u003ca href=\"http://khn.org/news/hhs-pledges-to-quicken-pace-toward-quality-based-medicare-payments/\" target=\"_blank\">similar strategy pursued by the federal agency\u003c/a> that oversees the government-run Medicaid and Medicare health insurance programs.\u003c/p>\n\u003cp>The California Hospital Association, in a statement issued late Thursday, said it supported the exchange’s decision to phase in the plan incrementally.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The exchange, known as Covered California, will also \u003ca href=\"http://californiahealthline.org/news/california-insurance-marketplace-wants-to-kick-out-poor-performing-hospitals/\" target=\"_blank\">require health plans to identify hospitals and doctors that are performing poorly\u003c/a> on a variety of quality metrics or charging too much for care. The plans must dump the providers from their networks as early as 2019 if they don’t mend their ways. The plans could choose not to cut the hospitals or doctors, but they would have to explain in writing why, and detail what the providers are doing to address their deficiencies.\u003c/p>\n\u003cp>“Covered California’s mission is not just getting patients health insurance; it’s about improving the quality of the health care delivery system,” Peter V. Lee, the exchange’s executive, said in a written statement. “We are creating a market that rewards quality over quantity.”\u003c/p>\n\u003cp>Some doctors have noted that provider networks in many of the health plans sold by Covered California are already thin and warned that cutting the networks even more would only exacerbate the problem. And, they say, some hospitals and physicians might balk at the stringent new requirements and decline to participate in Covered California networks.\u003c/p>\n\u003cp>The insurers are not happy about transparency provisions that involve disclosing the rates they negotiate with their providers. Health plans have long resisted efforts that would let competitors or the public see the deals they make with doctors and hospitals.\u003c/p>\n\u003cp>But Covered California officials believe that scrutinizing the negotiated rates will help the exchange identify high-cost providers and allow policyholders with high deductibles to see the differences in price before undergoing a medical procedure.\u003c/p>\n\u003cp>Nicole Evans, spokeswoman for the California Association of Health Plans, said that in some rural areas, where hospitals are few and far between, eliminating even one that is deemed to be underperforming might seriously compromise access to medical care.\u003c/p>\n\u003cp>“Or maybe one of them didn’t score as well on one quality measure but other quality measures are higher,” she said.\u003c/p>\n\u003cp>Evans added, though, that she was pleased Covered California would at least allow exceptions to this rule.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Among other elements of Covered California’s contract overhaul:\u003c/p>\n\u003cul>\n\u003cli>Health plans must assign a primary care doctor to enrollees within 30 days of coverage.\u003c/li>\n\u003cli>Health plans and doctors must share data to better track and treat patients with chronic conditions such as diabetes.\u003c/li>\n\u003cli>Plans are obliged to monitor and reduce health disparities among all their patients, starting with four major conditions: diabetes, hypertension, asthma and depression.\u003c/li>\n\u003cli>They also are required to better manage the price of high-end pharmaceuticals and aid consumers in reducing the cost of expensive drug treatments.\u003c/li>\n\u003cli>The health plans must help consumers better understand their diseases and treatment choices — and their share of the costs for those treatments.\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Moving into a realm usually reserved for health care regulators, \u003ca href=\"http://www.coveredca.com/news/\" target=\"_blank\">the California health marketplace Thursday unveiled sweeping reforms\u003c/a> to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers.\u003c/p>\n\u003cp>The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation.\u003c/p>\n\u003cp>Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards.\u003c/p>\n\u003cp>The plan, to be implemented over seven years, is based on a \u003ca href=\"http://khn.org/news/hhs-pledges-to-quicken-pace-toward-quality-based-medicare-payments/\" target=\"_blank\">similar strategy pursued by the federal agency\u003c/a> that oversees the government-run Medicaid and Medicare health insurance programs.\u003c/p>\n\u003cp>The California Hospital Association, in a statement issued late Thursday, said it supported the exchange’s decision to phase in the plan incrementally.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The exchange, known as Covered California, will also \u003ca href=\"http://californiahealthline.org/news/california-insurance-marketplace-wants-to-kick-out-poor-performing-hospitals/\" target=\"_blank\">require health plans to identify hospitals and doctors that are performing poorly\u003c/a> on a variety of quality metrics or charging too much for care. The plans must dump the providers from their networks as early as 2019 if they don’t mend their ways. The plans could choose not to cut the hospitals or doctors, but they would have to explain in writing why, and detail what the providers are doing to address their deficiencies.\u003c/p>\n\u003cp>“Covered California’s mission is not just getting patients health insurance; it’s about improving the quality of the health care delivery system,” Peter V. Lee, the exchange’s executive, said in a written statement. “We are creating a market that rewards quality over quantity.”\u003c/p>\n\u003cp>Some doctors have noted that provider networks in many of the health plans sold by Covered California are already thin and warned that cutting the networks even more would only exacerbate the problem. And, they say, some hospitals and physicians might balk at the stringent new requirements and decline to participate in Covered California networks.\u003c/p>\n\u003cp>The insurers are not happy about transparency provisions that involve disclosing the rates they negotiate with their providers. Health plans have long resisted efforts that would let competitors or the public see the deals they make with doctors and hospitals.\u003c/p>\n\u003cp>But Covered California officials believe that scrutinizing the negotiated rates will help the exchange identify high-cost providers and allow policyholders with high deductibles to see the differences in price before undergoing a medical procedure.\u003c/p>\n\u003cp>Nicole Evans, spokeswoman for the California Association of Health Plans, said that in some rural areas, where hospitals are few and far between, eliminating even one that is deemed to be underperforming might seriously compromise access to medical care.\u003c/p>\n\u003cp>“Or maybe one of them didn’t score as well on one quality measure but other quality measures are higher,” she said.\u003c/p>\n\u003cp>Evans added, though, that she was pleased Covered California would at least allow exceptions to this rule.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Among other elements of Covered California’s contract overhaul:\u003c/p>\n\u003cul>\n\u003cli>Health plans must assign a primary care doctor to enrollees within 30 days of coverage.\u003c/li>\n\u003cli>Health plans and doctors must share data to better track and treat patients with chronic conditions such as diabetes.\u003c/li>\n\u003cli>Plans are obliged to monitor and reduce health disparities among all their patients, starting with four major conditions: diabetes, hypertension, asthma and depression.\u003c/li>\n\u003cli>They also are required to better manage the price of high-end pharmaceuticals and aid consumers in reducing the cost of expensive drug treatments.\u003c/li>\n\u003cli>The health plans must help consumers better understand their diseases and treatment choices — and their share of the costs for those treatments.\u003c/li>\n\u003c/ul>\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": "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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"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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"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.",
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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.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
},
"link": "/podcasts/rightnowish",
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