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"disqusTitle": "More Bay Area Kids Getting Vaccinated, Preliminary Numbers Show",
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"content": "\u003cp>In the face of a measles outbreak tied to Disneyland and the heated debate around a legislative move to end parents' option not to vaccinate their children, vaccination rates are increasing across the Bay Area, a KQED analysis of preliminary state data shows.\u003c/p>\n\u003cp>All incoming California kindergarteners are required to be vaccinated against a range of diseases, unless the child has a medical exemption or a personal belief exemption (PBE) on file with their school. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">A new state law\u003c/a>, known as \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB 277\u003c/a>, will end the PBE in July, but during the current school year, the exemption is still permitted.\u003c/p>\n\u003caside class=\"pullquote align right\">'The outbreak of measles was a real wake up call for all of us.' \u003ccite>Dr. Matt Willis, Marin County public health officer \u003c/cite>\u003c/aside>\n\u003cp>Statewide, the PBE rate declined from 2.54 percent of incoming kindergartners to 2.33 percent. In addition, the percent of children receiving both doses of the measles, mumps, rubella -- or \"MMR\" -- vaccine increased from 92.55 percent to 94.59 percent statewide.\u003c/p>\n\u003cp>\"I can only assume that this is in part a response to ... the measles outbreak and the publicity that that received,\" said Art Reingold, head of epidemiology at the UC Berkeley School of Public Health. \"It's unfortunate that fear or outbreaks of disease are necessary to get people to do what we'd like them to do, but I think that's human nature.\"\u003c/p>\n\u003cp>The California Department of Public Health collects vaccination rates from every kindergarten, public or private, with more than 10 students. It then \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Pages/ImmunizationLevels.aspx\" target=\"_blank\">publishes \u003c/a>a downloadable data set and a separate summary document. This year, CDPH published the data set on its site last Thursday, Dec. 24. The summary document was not published.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>KQED downloaded the data and calculated a PBE rate and an MMR rate for nine Bay Area counties and a statewide average. We contacted CDPH to request an interview about our analysis.\u003c/p>\n\u003cp>But late Monday, after calls from reporters, CDPH deleted the data set from its site, saying it was preliminary and incomplete, and said final data would be published by mid-January.\u003c/p>\n\u003cp>According to the KQED analysis, across the Bay Area, most counties saw a decline in the PBE rate when compared to last year, with the exceptions of Contra Costa and Santa Clara counties, where the rates are already below the statewide average.\u003c/p>\n\u003cp>Last year, Contra Costa's PBE rate was 1.90 percent; this year it increased slightly to 1.97 percent. Santa Clara's rate was 1.57 percent last year; this year it also increased slightly to 1.62 percent.\u003c/p>\n\u003cp>The PBE rates for other Bay Area counties declined, as follows:\u003c/p>\n\u003cul>\n\u003cli>Alameda: 1.54 percent last year to 1.20 percent this year\u003c/li>\n\u003cli>Marin: from 6.45 to 5.97 percent this year\u003c/li>\n\u003cli>Napa: from 3.18 to 3.15 percent\u003c/li>\n\u003cli>San Francisco: from 1.80 to 1.46 percent\u003c/li>\n\u003cli>San Mateo: from 1.85 to 1.62 percent\u003c/li>\n\u003cli>Solano: from 1.80 to 1.50 percent\u003c/li>\n\u003cli>Sonoma: from 5.54 to 4.69 percent\u003c/li>\n\u003c/ul>\n\u003cp>Marin County has long had the highest PBE rate in the Bay Area, but county public health officer Dr. Matt Willis called the decline in Marin's PBE rate this year \"great news\" and said it was the third year in a row of increasing vaccination rates. \"We haven't seen this many children vaccinated in Marin County since 2007,\" he said.\u003c/p>\n\u003cp>Bay Area counties saw a corresponding increase in rates of the MMR vaccine, with the exception of Napa County, where there was a small decrease. Last year, Napa's MMR rate was 94.74 percent; this year it declined slightly to 94.51 percent.\u003c/p>\n\u003cp>Here are the MMR vaccination rates for the other Bay Area counties:\u003c/p>\n\u003cul>\n\u003cli>Alameda: from 91.40 percent last year to 97.11 percent this year\u003c/li>\n\u003cli>Contra Costa: from 95.52 percent to 96.34 percent\u003c/li>\n\u003cli>Marin: 88.03 percent to 90.97 percent\u003c/li>\n\u003cli>San Francisco: from 89.63 percent to 94.45 percent\u003c/li>\n\u003cli>San Mateo: from 94.83 percent to 96.57 percent\u003c/li>\n\u003cli>Santa Clara: from 95.33 percent to 96.29 percent\u003c/li>\n\u003cli>Solano: from 95.41 percent to 95.99 percent\u003c/li>\n\u003cli>Sonoma: from 91.48 percent to 93.70 percent\u003c/li>\n\u003c/ul>\n\u003cp>Alameda County had the most dramatic increase in the Bay Area in its MMR rate, more than 5.5 percentage points. Erica Pan, deputy health officer with the Alameda County Public Health Department, said that staff had noticed more than a year ago that there were many children who were not up to date on immunizations. The health department launched an outreach effort to help get children vaccinated.\u003c/p>\n\u003cp>[contextly_sidebar id=\"ZugDxUbK78gNenbhpe38Q9Te7QQc793p\"]The work has paid off. Over the past few years, kindergarteners up to date on vaccines had ranged from 86 to 89 percent. This year it's more than 96 percent, Pan said.\u003c/p>\n\u003cp>\"Between our work with the staff and various leadership, and public awareness,\" she said, \"that's how we made some really dramatic improvement. We're really excited to see the huge change in Alameda County.\"\u003c/p>\n\u003cp>Willis, Pan and Reingold all said that a driver of the increase in vaccination rates was the widespread news coverage of the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">measles outbreak earlier this year\u003c/a> and the vocal debate around SB277, the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">law signed by Gov. Jerry Brown in June\u003c/a> that ends a parent's option to refuse vaccination for their children for personal reasons.\u003c/p>\n\u003cp>\"The outbreak of measles was a real wake up call for all of us around this issue,\" Willis said. \"It gave us a chance to speak openly as a community about what vaccination does for us, it gave us a chance to understand vaccination as a matter of community responsibility.\"\u003c/p>\n\u003cp>Berkeley pediatrician Olivia Lang said she's seen a change among families in her practice. \"There were a lot of families who had been waffling on vaccines, but perhaps were not strong believers in anti-vaccination ideals,\" she said. \"But now they're saying, 'Well, I guess we're going to have to do it,'\" and so they are having their children vaccinated.\u003c/p>\n\u003cp>SB 277 takes effect July 1. Starting with the 2016-2017 school year, all kindergarteners and 7th graders in California will need to be up to date on vaccines to enter school. Only those children who cannot be vaccinated for medical reasons will be exempt.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, was co-author of the new law. In an interview Monday, he said that the vocal debate around the passage of the bill helped many parents to learn more about vaccines.\u003c/p>\n\u003cp>\"This is part of the momentum where people realize there’s a lot of misinformation about vaccines,\" he said. \"During the 277 debate they saw in the news that vaccines are important, that diseases have not gone away. People became educated and more aware of the importance of vaccinations.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>In an emailed statement late Monday afternoon, state epidemiologist Dr. Gil Chavez said, \"The summary reports and [final] immunization status data are anticipated to be posted by Jan. 15, 2016.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the face of a measles outbreak tied to Disneyland and the heated debate around a legislative move to end parents' option not to vaccinate their children, vaccination rates are increasing across the Bay Area, a KQED analysis of preliminary state data shows.\u003c/p>\n\u003cp>All incoming California kindergarteners are required to be vaccinated against a range of diseases, unless the child has a medical exemption or a personal belief exemption (PBE) on file with their school. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">A new state law\u003c/a>, known as \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB 277\u003c/a>, will end the PBE in July, but during the current school year, the exemption is still permitted.\u003c/p>\n\u003caside class=\"pullquote align right\">'The outbreak of measles was a real wake up call for all of us.' \u003ccite>Dr. Matt Willis, Marin County public health officer \u003c/cite>\u003c/aside>\n\u003cp>Statewide, the PBE rate declined from 2.54 percent of incoming kindergartners to 2.33 percent. In addition, the percent of children receiving both doses of the measles, mumps, rubella -- or \"MMR\" -- vaccine increased from 92.55 percent to 94.59 percent statewide.\u003c/p>\n\u003cp>\"I can only assume that this is in part a response to ... the measles outbreak and the publicity that that received,\" said Art Reingold, head of epidemiology at the UC Berkeley School of Public Health. \"It's unfortunate that fear or outbreaks of disease are necessary to get people to do what we'd like them to do, but I think that's human nature.\"\u003c/p>\n\u003cp>The California Department of Public Health collects vaccination rates from every kindergarten, public or private, with more than 10 students. It then \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Pages/ImmunizationLevels.aspx\" target=\"_blank\">publishes \u003c/a>a downloadable data set and a separate summary document. This year, CDPH published the data set on its site last Thursday, Dec. 24. The summary document was not published.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>KQED downloaded the data and calculated a PBE rate and an MMR rate for nine Bay Area counties and a statewide average. We contacted CDPH to request an interview about our analysis.\u003c/p>\n\u003cp>But late Monday, after calls from reporters, CDPH deleted the data set from its site, saying it was preliminary and incomplete, and said final data would be published by mid-January.\u003c/p>\n\u003cp>According to the KQED analysis, across the Bay Area, most counties saw a decline in the PBE rate when compared to last year, with the exceptions of Contra Costa and Santa Clara counties, where the rates are already below the statewide average.\u003c/p>\n\u003cp>Last year, Contra Costa's PBE rate was 1.90 percent; this year it increased slightly to 1.97 percent. Santa Clara's rate was 1.57 percent last year; this year it also increased slightly to 1.62 percent.\u003c/p>\n\u003cp>The PBE rates for other Bay Area counties declined, as follows:\u003c/p>\n\u003cul>\n\u003cli>Alameda: 1.54 percent last year to 1.20 percent this year\u003c/li>\n\u003cli>Marin: from 6.45 to 5.97 percent this year\u003c/li>\n\u003cli>Napa: from 3.18 to 3.15 percent\u003c/li>\n\u003cli>San Francisco: from 1.80 to 1.46 percent\u003c/li>\n\u003cli>San Mateo: from 1.85 to 1.62 percent\u003c/li>\n\u003cli>Solano: from 1.80 to 1.50 percent\u003c/li>\n\u003cli>Sonoma: from 5.54 to 4.69 percent\u003c/li>\n\u003c/ul>\n\u003cp>Marin County has long had the highest PBE rate in the Bay Area, but county public health officer Dr. Matt Willis called the decline in Marin's PBE rate this year \"great news\" and said it was the third year in a row of increasing vaccination rates. \"We haven't seen this many children vaccinated in Marin County since 2007,\" he said.\u003c/p>\n\u003cp>Bay Area counties saw a corresponding increase in rates of the MMR vaccine, with the exception of Napa County, where there was a small decrease. Last year, Napa's MMR rate was 94.74 percent; this year it declined slightly to 94.51 percent.\u003c/p>\n\u003cp>Here are the MMR vaccination rates for the other Bay Area counties:\u003c/p>\n\u003cul>\n\u003cli>Alameda: from 91.40 percent last year to 97.11 percent this year\u003c/li>\n\u003cli>Contra Costa: from 95.52 percent to 96.34 percent\u003c/li>\n\u003cli>Marin: 88.03 percent to 90.97 percent\u003c/li>\n\u003cli>San Francisco: from 89.63 percent to 94.45 percent\u003c/li>\n\u003cli>San Mateo: from 94.83 percent to 96.57 percent\u003c/li>\n\u003cli>Santa Clara: from 95.33 percent to 96.29 percent\u003c/li>\n\u003cli>Solano: from 95.41 percent to 95.99 percent\u003c/li>\n\u003cli>Sonoma: from 91.48 percent to 93.70 percent\u003c/li>\n\u003c/ul>\n\u003cp>Alameda County had the most dramatic increase in the Bay Area in its MMR rate, more than 5.5 percentage points. Erica Pan, deputy health officer with the Alameda County Public Health Department, said that staff had noticed more than a year ago that there were many children who were not up to date on immunizations. The health department launched an outreach effort to help get children vaccinated.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The work has paid off. Over the past few years, kindergarteners up to date on vaccines had ranged from 86 to 89 percent. This year it's more than 96 percent, Pan said.\u003c/p>\n\u003cp>\"Between our work with the staff and various leadership, and public awareness,\" she said, \"that's how we made some really dramatic improvement. We're really excited to see the huge change in Alameda County.\"\u003c/p>\n\u003cp>Willis, Pan and Reingold all said that a driver of the increase in vaccination rates was the widespread news coverage of the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">measles outbreak earlier this year\u003c/a> and the vocal debate around SB277, the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">law signed by Gov. Jerry Brown in June\u003c/a> that ends a parent's option to refuse vaccination for their children for personal reasons.\u003c/p>\n\u003cp>\"The outbreak of measles was a real wake up call for all of us around this issue,\" Willis said. \"It gave us a chance to speak openly as a community about what vaccination does for us, it gave us a chance to understand vaccination as a matter of community responsibility.\"\u003c/p>\n\u003cp>Berkeley pediatrician Olivia Lang said she's seen a change among families in her practice. \"There were a lot of families who had been waffling on vaccines, but perhaps were not strong believers in anti-vaccination ideals,\" she said. \"But now they're saying, 'Well, I guess we're going to have to do it,'\" and so they are having their children vaccinated.\u003c/p>\n\u003cp>SB 277 takes effect July 1. Starting with the 2016-2017 school year, all kindergarteners and 7th graders in California will need to be up to date on vaccines to enter school. Only those children who cannot be vaccinated for medical reasons will be exempt.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, was co-author of the new law. In an interview Monday, he said that the vocal debate around the passage of the bill helped many parents to learn more about vaccines.\u003c/p>\n\u003cp>\"This is part of the momentum where people realize there’s a lot of misinformation about vaccines,\" he said. \"During the 277 debate they saw in the news that vaccines are important, that diseases have not gone away. People became educated and more aware of the importance of vaccinations.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In an emailed statement late Monday afternoon, state epidemiologist Dr. Gil Chavez said, \"The summary reports and [final] immunization status data are anticipated to be posted by Jan. 15, 2016.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "It's Not Hard to Treat HIV -- Unless You're Poor",
"title": "It's Not Hard to Treat HIV -- Unless You're Poor",
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"content": "\u003cp>A major insurer said recently it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/12/01/major-insurer-says-it-will-offer-individual-life-insurance-to-people-with-hiv/\" target=\"_blank\">offer life insurance\u003c/a> to HIV-positive people because of their rising life expectancies, prompting cheers from AIDS activists. But on the very same day, the nation’s top disease control official described an America \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMms1513641\" target=\"_blank\">falling far short in its fight against AIDS.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">“It’s very hard to talk about HIV prevention with someone who is homeless or someone who isn’t sure where they’re going to find their next meal.”\u003ccite> Anthony Hayes, GMHC\u003c/cite>\u003c/aside>\n\u003cp>It might seem a jarring disconnect — but it reflects very different realities dividing the estimated 1.2 million Americans living with the human immunodeficiency virus that causes AIDS.\u003c/p>\n\u003cp>While life expectancies are approaching the national norm among white, affluent gay men, about 66 percent of the 1.2 million people living with HIV/AIDS in the United States \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6347a5.htm?s_cid=mm6347a5_w\" target=\"_blank\">are not in treatment\u003c/a>, imperiling their health and putting them at risk for infecting others.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMms1513641\" target=\"_blank\">Nearly half\u003c/a> of the approximately 45,000 Americans infected with HIV each year are African-Americans, mostly they are gay or bisexual men. Both African-Americans and Latinos are \u003ca href=\"http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf\" target=\"_blank\">less likely to remain in treatment\u003c/a> than whites. Compared to white men, African American men were more than seven times and Latino men were almost twice as likely to die from HIV-related complications.\u003c/p>\n\u003cp>HIV/AIDS activists and physicians say that despite the significant medical advances in treating the disease, many patients are being left behind because of their life circumstances. Groups that once held angry demonstrations against government agencies and pharmaceutical companies to speed access to affordable, life-saving HIV medications now emphasize the socioeconomic barriers that keep some people living with HIV from consistently obtaining and using those drugs to remain healthy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There is an extreme disparity when it comes to treating HIV and AIDS,” said Anthony Hayes, managing director of public affairs and policy for GMHC, formerly Gay Men’s Health Crisis.\u003c/p>\n\u003cp>“It’s critical, when we talk about ending the epidemic, to not just talk about the science. These are people who are incredibly vulnerable as it relates to all aspects of society. In contrast, more affluent HIV positive people — specifically gay white men — are able to access care, they have jobs, they have homes, they have access to life’s basic necessities that many do not.\u003c/p>\n\u003cp>“It’s very hard to talk about HIV prevention with someone who is homeless or someone who isn’t sure where they’re going to find their next meal.”\u003c/p>\n\u003cp>It’s not a simple matter of financing care for those who can’t afford it. Treatment and social services are currently available for low-income and uninsured or underinsured patients under the \u003ca href=\"http://www.hhs.gov/about/news/2015/08/18/ryan-white-care-act-celebrates-25th-anniversary.html\">Ryan White Act\u003c/a>. Once long waiting lists for free HIV medications \u003ca href=\"https://www.nastad.org/sites/default/files/ADAP-Watch-July-2014.pdf\">have virtually been eliminated\u003c/a>. But basic survival – money to live, a place to sleep — often takes precedence over seeking help and closely managing a disease that can be symptom-free in its early stages, doctors say.\u003c/p>\n\u003cp>Loren Jones, 63, of Berkeley, was homeless when she was first diagnosed with HIV about 30 years ago. And for many years she wasn’t symptomatic, so her diagnosis was rarely at the top of her list of worries, Jones said. “It actually sinks to the bottom. HIV becomes another thing on your, like, to-do list.”\u003c/p>\n\u003cfigure id=\"attachment_131140\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-131140\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/loren-jones-4-400x267.jpg\" alt=\"Loren Jones takes antiretroviral drugs to suppress her HIV viral load. “You have to be a hustler for your own health,” she said.\" width=\"400\" height=\"267\">\u003cfigcaption class=\"wp-caption-text\">Loren Jones takes antiretroviral drugs to suppress her HIV viral load. “You have to be a hustler for your own health,” she said. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jones eventually was able to find a government-subsidized studio apartment in Berkeley and qualify for Social Security disability benefits. She recently had a bout with eczema, a serious skin rash that can be a marker for the progression of HIV-related disease. Her blood pressure spiked, leading to discovery of kidney disease, a common complication of HIV.\u003c/p>\n\u003cp>Newer approaches to controlling HIV/AIDS focus on a \u003ca href=\"http://www.cdc.gov/hiv/pdf/dhap_continuum.pdf\">“continuum of care,”\u003c/a> from the very beginning. Federal health official are trying to track improvements or setbacks at every stage: testing, linking the newly diagnosed to care within three months, getting HIV-positive people to remain in treatment, prescribing them antiretroviral drugs, and suppressing HIV viral load – the amount of HIV in the blood – to a very low level.\u003c/p>\n\u003cp>People fall out of care at every stage, with \u003ca href=\"http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf\" target=\"_blank\">minorities generally faring worse\u003c/a> than whites. The the goal is to keep them in treatment, not only for their sake but because research has shown that people with low or undetectable viral loads are far less likely to transmit the disease to others.\u003c/p>\n\u003cp>Dr. Edward Machtinger, director of the Women’s HIV Program at the UC, San Francisco, said his clinic has been able to achieve viral suppression in up to 80 percent of its patients. But the focus on biomedical treatment of their HIV obscures the deep challenges many of his patients face: poverty, domestic abuse, addiction, mental illness, he noted.\u003c/p>\n\u003cp>“Complex trauma is what led many of my patients to get HIV in first place and gets them to remain depressed, stay addicted and have trouble adhering to their meds,” Machtinger said. “Medicine and HIV primary care has not considered these health issues to be in their domain and their responsibility. I’ve heard many clinicians brag about having patients on crack be undetectable in their viral load, as if HIV was going to kill them in the first place. It’s not. Crack is going to kill them.”\u003c/p>\n\u003cp>Addressing HIV patients’ social and economic challenges — often referred to as “social determinants of health” — is complicated and not reimbursable, Machtinger said. “What we really need to do is find a way for patients to be safer, more empowered and healthy.”\u003c/p>\n\u003cp>Dr. William Cunningham, a UCLA medicine and public health professor, is researching ways to help marginalized HIV-positive people stay in treatment and avoid infecting others. He’s co-directing a $4.6 million, five-year \u003ca href=\"http://newsroom.ucla.edu/releases/ucla-researchers-get-4-6-million-176799\" target=\"_blank\">study\u003c/a> that pairs recently released Los Angeles County jail inmates who are HIV-positive with peer navigators who help them find medical care and new prescriptions of antiretroviral medications they received while incarcerated.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“They’re trying to survive outside — to get housing, to get a job. We just don’t have a system that’s designed for people who have those kinds of issues. It’s designed for well-educated, well-informed consumers in a market type system,” Cunningham said. “It’s the context of people’s lives that is just so difficult that HIV is not their biggest problem. We haven’t come up with any kind of magic bullet, but at the very least, we need to focus on these social barriers to a greater extent.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A major insurer said recently it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/12/01/major-insurer-says-it-will-offer-individual-life-insurance-to-people-with-hiv/\" target=\"_blank\">offer life insurance\u003c/a> to HIV-positive people because of their rising life expectancies, prompting cheers from AIDS activists. But on the very same day, the nation’s top disease control official described an America \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMms1513641\" target=\"_blank\">falling far short in its fight against AIDS.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">“It’s very hard to talk about HIV prevention with someone who is homeless or someone who isn’t sure where they’re going to find their next meal.”\u003ccite> Anthony Hayes, GMHC\u003c/cite>\u003c/aside>\n\u003cp>It might seem a jarring disconnect — but it reflects very different realities dividing the estimated 1.2 million Americans living with the human immunodeficiency virus that causes AIDS.\u003c/p>\n\u003cp>While life expectancies are approaching the national norm among white, affluent gay men, about 66 percent of the 1.2 million people living with HIV/AIDS in the United States \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6347a5.htm?s_cid=mm6347a5_w\" target=\"_blank\">are not in treatment\u003c/a>, imperiling their health and putting them at risk for infecting others.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMms1513641\" target=\"_blank\">Nearly half\u003c/a> of the approximately 45,000 Americans infected with HIV each year are African-Americans, mostly they are gay or bisexual men. Both African-Americans and Latinos are \u003ca href=\"http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf\" target=\"_blank\">less likely to remain in treatment\u003c/a> than whites. Compared to white men, African American men were more than seven times and Latino men were almost twice as likely to die from HIV-related complications.\u003c/p>\n\u003cp>HIV/AIDS activists and physicians say that despite the significant medical advances in treating the disease, many patients are being left behind because of their life circumstances. Groups that once held angry demonstrations against government agencies and pharmaceutical companies to speed access to affordable, life-saving HIV medications now emphasize the socioeconomic barriers that keep some people living with HIV from consistently obtaining and using those drugs to remain healthy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There is an extreme disparity when it comes to treating HIV and AIDS,” said Anthony Hayes, managing director of public affairs and policy for GMHC, formerly Gay Men’s Health Crisis.\u003c/p>\n\u003cp>“It’s critical, when we talk about ending the epidemic, to not just talk about the science. These are people who are incredibly vulnerable as it relates to all aspects of society. In contrast, more affluent HIV positive people — specifically gay white men — are able to access care, they have jobs, they have homes, they have access to life’s basic necessities that many do not.\u003c/p>\n\u003cp>“It’s very hard to talk about HIV prevention with someone who is homeless or someone who isn’t sure where they’re going to find their next meal.”\u003c/p>\n\u003cp>It’s not a simple matter of financing care for those who can’t afford it. Treatment and social services are currently available for low-income and uninsured or underinsured patients under the \u003ca href=\"http://www.hhs.gov/about/news/2015/08/18/ryan-white-care-act-celebrates-25th-anniversary.html\">Ryan White Act\u003c/a>. Once long waiting lists for free HIV medications \u003ca href=\"https://www.nastad.org/sites/default/files/ADAP-Watch-July-2014.pdf\">have virtually been eliminated\u003c/a>. But basic survival – money to live, a place to sleep — often takes precedence over seeking help and closely managing a disease that can be symptom-free in its early stages, doctors say.\u003c/p>\n\u003cp>Loren Jones, 63, of Berkeley, was homeless when she was first diagnosed with HIV about 30 years ago. And for many years she wasn’t symptomatic, so her diagnosis was rarely at the top of her list of worries, Jones said. “It actually sinks to the bottom. HIV becomes another thing on your, like, to-do list.”\u003c/p>\n\u003cfigure id=\"attachment_131140\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-131140\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/loren-jones-4-400x267.jpg\" alt=\"Loren Jones takes antiretroviral drugs to suppress her HIV viral load. “You have to be a hustler for your own health,” she said.\" width=\"400\" height=\"267\">\u003cfigcaption class=\"wp-caption-text\">Loren Jones takes antiretroviral drugs to suppress her HIV viral load. “You have to be a hustler for your own health,” she said. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jones eventually was able to find a government-subsidized studio apartment in Berkeley and qualify for Social Security disability benefits. She recently had a bout with eczema, a serious skin rash that can be a marker for the progression of HIV-related disease. Her blood pressure spiked, leading to discovery of kidney disease, a common complication of HIV.\u003c/p>\n\u003cp>Newer approaches to controlling HIV/AIDS focus on a \u003ca href=\"http://www.cdc.gov/hiv/pdf/dhap_continuum.pdf\">“continuum of care,”\u003c/a> from the very beginning. Federal health official are trying to track improvements or setbacks at every stage: testing, linking the newly diagnosed to care within three months, getting HIV-positive people to remain in treatment, prescribing them antiretroviral drugs, and suppressing HIV viral load – the amount of HIV in the blood – to a very low level.\u003c/p>\n\u003cp>People fall out of care at every stage, with \u003ca href=\"http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf\" target=\"_blank\">minorities generally faring worse\u003c/a> than whites. The the goal is to keep them in treatment, not only for their sake but because research has shown that people with low or undetectable viral loads are far less likely to transmit the disease to others.\u003c/p>\n\u003cp>Dr. Edward Machtinger, director of the Women’s HIV Program at the UC, San Francisco, said his clinic has been able to achieve viral suppression in up to 80 percent of its patients. But the focus on biomedical treatment of their HIV obscures the deep challenges many of his patients face: poverty, domestic abuse, addiction, mental illness, he noted.\u003c/p>\n\u003cp>“Complex trauma is what led many of my patients to get HIV in first place and gets them to remain depressed, stay addicted and have trouble adhering to their meds,” Machtinger said. “Medicine and HIV primary care has not considered these health issues to be in their domain and their responsibility. I’ve heard many clinicians brag about having patients on crack be undetectable in their viral load, as if HIV was going to kill them in the first place. It’s not. Crack is going to kill them.”\u003c/p>\n\u003cp>Addressing HIV patients’ social and economic challenges — often referred to as “social determinants of health” — is complicated and not reimbursable, Machtinger said. “What we really need to do is find a way for patients to be safer, more empowered and healthy.”\u003c/p>\n\u003cp>Dr. William Cunningham, a UCLA medicine and public health professor, is researching ways to help marginalized HIV-positive people stay in treatment and avoid infecting others. He’s co-directing a $4.6 million, five-year \u003ca href=\"http://newsroom.ucla.edu/releases/ucla-researchers-get-4-6-million-176799\" target=\"_blank\">study\u003c/a> that pairs recently released Los Angeles County jail inmates who are HIV-positive with peer navigators who help them find medical care and new prescriptions of antiretroviral medications they received while incarcerated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Jahi McMath's Mother Files Federal Suit to Have Brain-Dead Girl Declared Alive",
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"content": "\u003cp>A Northern California mother's two-year quest to have her brain-dead daughter declared legally alive moved to federal court Wednesday after attempts to secure an order from a state judge ended in failure.\u003c/p>\n\u003cp>Lawyers for the mother of 13-year-old Jahi McMath filed a lawsuit in San Francisco federal court asking that the girl be declared alive after state courts have refused to rescind the teen's death certificate. McMath suffered cardiac arrest in December 2013 after a routine operation to remove her tonsils to cure her sleep apnea. Doctors say she suffered irreversible brain damage from lack of oxygen and declared her brain dead.\u003c/p>\n\u003cp>The Alameda County coroner in Oakland signed Jahi McMath's death certificate a few weeks later, but McMath's family sought a state court ruling declaring the teen is still alive. A state court judge earlier this year refused the family's request and upheld the death certificate after a respected Stanford University neurologist and two other medical experts concluded the girl was dead.\u003c/p>\n\u003cp>Jahi's family is now asking a federal judge to declare Jahi alive and invalidate the death certificate. If that happens, insurance companies will be required to pay for her medical treatment, says lawyer Chris Dolan, who represents Jahi's family.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Sou5GFuQYfFOdAGSMnnhPr7CTm8oRgvR\"]Dolan says insurance companies are paying for Jahi's nursing care and around-the-clock treatment with a ventilator in New Jersey, the only state in the country that requires medical treatment of patients like McMath who are declared dead but show minimal brain function.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>McMath's family, led by her mother Nailah Winkfield, want a federal court to invalidate the death certificate so they can care for the in their home in Oakland.\u003c/p>\n\u003cp>\"I want her to have the same rights as any other disabled kid,\" Winkfield said.\u003c/p>\n\u003cp>McMath's mother says her daughter show some signs of life, including the twitching of fingers and toes.\u003c/p>\n\u003cp>Medical experts said those movements could be spasms and reflexes commonly seen in corpses. They say McMath shows hardly any brain activity and is clinically dead.\u003c/p>\n\u003cp>But her mother isn't ready to give up. Winfield said she recently sold her Oakland home and is living off those rapidly dwindling proceeds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I won't give up on Jahi, because I'm her mother,\" Winkfield said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A Northern California mother's two-year quest to have her brain-dead daughter declared legally alive moved to federal court Wednesday after attempts to secure an order from a state judge ended in failure.\u003c/p>\n\u003cp>Lawyers for the mother of 13-year-old Jahi McMath filed a lawsuit in San Francisco federal court asking that the girl be declared alive after state courts have refused to rescind the teen's death certificate. McMath suffered cardiac arrest in December 2013 after a routine operation to remove her tonsils to cure her sleep apnea. Doctors say she suffered irreversible brain damage from lack of oxygen and declared her brain dead.\u003c/p>\n\u003cp>The Alameda County coroner in Oakland signed Jahi McMath's death certificate a few weeks later, but McMath's family sought a state court ruling declaring the teen is still alive. A state court judge earlier this year refused the family's request and upheld the death certificate after a respected Stanford University neurologist and two other medical experts concluded the girl was dead.\u003c/p>\n\u003cp>Jahi's family is now asking a federal judge to declare Jahi alive and invalidate the death certificate. If that happens, insurance companies will be required to pay for her medical treatment, says lawyer Chris Dolan, who represents Jahi's family.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Dolan says insurance companies are paying for Jahi's nursing care and around-the-clock treatment with a ventilator in New Jersey, the only state in the country that requires medical treatment of patients like McMath who are declared dead but show minimal brain function.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>McMath's family, led by her mother Nailah Winkfield, want a federal court to invalidate the death certificate so they can care for the in their home in Oakland.\u003c/p>\n\u003cp>\"I want her to have the same rights as any other disabled kid,\" Winkfield said.\u003c/p>\n\u003cp>McMath's mother says her daughter show some signs of life, including the twitching of fingers and toes.\u003c/p>\n\u003cp>Medical experts said those movements could be spasms and reflexes commonly seen in corpses. They say McMath shows hardly any brain activity and is clinically dead.\u003c/p>\n\u003cp>But her mother isn't ready to give up. Winfield said she recently sold her Oakland home and is living off those rapidly dwindling proceeds.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I won't give up on Jahi, because I'm her mother,\" Winkfield said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A quartet of Western states and the District of Columbia have legalized recreational marijuana, and voters in a half-dozen more states may vote on pot legalization in 2016. That's leading law enforcement officials and entrepreneurs to try to come up with better ways of testing for driving while stoned.\u003c/p>\n\u003cp>Police usually spot impaired drivers by noting driving behavior, coordination, mannerisms and physical cues. But while a handheld breath test can quickly determine whether someone is legally drunk based on ethanol in the breath, there's no instant test for marijuana intoxication.\u003c/p>\n\u003cp>In Washington state, which is one of 18 states that has \u003ca href=\"http://ghsa.org/html/stateinfo/laws/dre_perse_laws.html\">set limits on marijuana intoxication\u003c/a> while driving, law enforcement can seek a warrant for a blood draw to test for THC, the main active ingredient in marijuana. But it can take weeks for results to come back from the toxicology lab.\u003c/p>\n\u003cp>With more Washington state \u003ca href=\"http://www.npr.org/2015/08/19/432896393/more-washington-drivers-use-and-drive\">drivers being arrested\u003c/a> with marijuana in their systems since the state legalized recreational marijuana, there's growing need for a fast way to identify impaired drivers and get them off the road.\u003c/p>\n\u003cp>Herb Hill, a chemistry professor at Washington State University in Pullman, heard about the challenges of nailing drug-impaired drivers from a colleague who was a political science professor. \"I said, 'Why don't we have a Breathalyzer for that?' He said none exists,\" Hill said. \"I said, 'We can probably make one.' \"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So Hill and his colleagues are trying to develop a hand-held device that police officers can use to detect THC in breath. Preliminary field testing with 30 human subjects this spring established that the device can detect THC in breath, Hill said. Much more testing is ahead to look at potential variations among gender, race, body types and amount of use.\u003c/p>\n\u003cfigure id=\"attachment_128451\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-128451\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/breathalyzer-2_enl-462f4f6e28abeed88d820d946baf930178915e07-400x279.jpg\" alt=\"Research professor Wenjie Liu works with graduate student Jennifer Tufariello and professor Herb Hill to develop a marijuana breath test at Washington State University\" width=\"400\" height=\"279\">\u003cfigcaption class=\"wp-caption-text\">Research professor Wenjie Liu works with graduate student Jennifer Tufariello and professor Herb Hill to develop a marijuana breath test at Washington State University \u003ccite>(Tom Banse/KUOW)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hill's team recruits volunteers who buy their own weed, smoke it at their homes and then blow into the prototype.\u003c/p>\n\u003cp>\"We had to go through institutional board review,\" Hill said, referring to federal restrictions on research involving marijuana. \"It took us almost a year to get permission to do this.\"\u003c/p>\n\u003cp>\"It wasn't very hard to find the volunteers,\" Hill added. \"We have a waiting list of volunteers.\"\u003c/p>\n\u003cp>The human guinea pigs get paid just over minimum wage to smoke their pot.\u003c/p>\n\u003cp>Hill said the portable device may look like an alcohol Breathalyzer but works differently inside. His team is modifying existing sniffers used at airports to detect explosives and by the military to alert to the presence of chemical warfare agents. The technology is called ion mobility spectrometry.\u003c/p>\n\u003cp>\"In the beginning at least this would not be used as evidential information,\" Hill explained. \"It would be used as screening information to help the officer say he should take a blood sample now.\"\u003c/p>\n\u003cp>Jake Yancey, a police officer in Tumwater, Wash., said he would be \"super excited\" to get a detector that he hopes could \"drastically speed up\" the process of confirming or ruling out a person's possible marijuana impairment. But a pot breath test must prove itself highly accurate before Washington state would adopt it, according to Lt. Rob Sharpe, head of the impaired driving section at the Washington State Patrol.\u003c/p>\n\u003cp>\"Even if it is a preliminary device, we still need that level of accuracy and reliability for trust and confidence,\" Sharpe said. \"Regardless where it comes into play in that arrest decision, we're talking about people's rights, their liberties and freedoms. We need to be accurate.\"\u003c/p>\n\u003cp>All of which points to it being several years at the earliest before you'd see a roadside breath test to identify stoned drivers.\u003c/p>\n\u003cp>Sharpe said a pot breath test might not even be the chosen answer. He said other companies and research teams are working on alternatives, including cheek swabs or a saliva test, a smartphone-based eye scan, or analyzing sweat on a person's skin.\u003c/p>\n\u003cp>Since legalizing marijuana use for adults, \u003ca href=\"http://apps.leg.wa.gov/rcw/default.aspx?cite=46.61.502\">Washington\u003c/a> and \u003ca href=\"https://www.codot.gov/safety/alcohol-and-impaired-driving/druggeddriving\">Colorado\u003c/a> have both set \u003ca href=\"http://ghsa.org/html/stateinfo/laws/dre_perse_laws.html\">legal limits\u003c/a> for THC intoxication at 5 nanograms per milliliter of blood. Oregon and Alaska have not established a legal THC limit beyond which a driver is presumed to be impaired.\u003c/p>\n\u003cp>Some marijuana activists have expressed fears that this technology could lead to unimpaired drivers getting unfairly arrested. They point out that THC persists in the body long after the high has worn off. The effects of weed are also different in different people, including between infrequent versus chronic smokers.\u003c/p>\n\u003cfigure id=\"attachment_128452\" class=\"wp-caption alignright\" style=\"max-width: 200px\">\u003cimg class=\"size-full wp-image-128452\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/cannabix_custom-092914e5da1d62af2355eabd189651cf841e272c.jpg\" alt=\"This prototype of a marijuana breath tester was developed by Vancouver, British Columbia-based Cannabix Technologies\" width=\"200\" height=\"178\">\u003cfigcaption class=\"wp-caption-text\">This prototype of a marijuana breath tester was developed by Vancouver, British Columbia-based Cannabix Technologies \u003ccite>(Courtesy of Cannabix Technologies)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Indeed, there is no universal agreement on how much THC is impairing — countries in Europe have set legal limits at 2 to 7 nanograms.\u003c/p>\n\u003cp>As part of the next rounds of human testing of the marijuana breath tester, the Washington state researchers want to correlate breath readings of THC with simultaneous blood draws and measurements. This could help to establish how long THC lingers in the breath after initial consumption.\u003c/p>\n\u003cp>Early on, the WSU professors took their idea to \u003ca href=\"http://www.chemringnorthamerica.com/business-groups/sensors-and-electronics.aspx\">Chemring\u003c/a>, a Falls Church, Va., instrument maker that agreed to pay for the R&D and will have the commercialization rights.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Chemring-WSU team is by no means alone in trying to perfect a marijuana breath test. Competitors include Lifeloc Technologies of Colorado, which already makes alcohol testers, and \u003ca href=\"http://www.cannabixtechnologies.com/\">Cannabix Technologies Inc.\u003c/a> of Vancouver, British Columbia, has shown off an initial prototype at conferences. There are reportedly several research teams at work in Europe as well.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NWNews. To see more, visit \u003ca href=\"http://www.nwnewsnetwork.org/\">NWNews\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=High+On+The+Highway%3A+Scientists+Try+To+Build+A+Marijuana+Breath+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"excerpt": "Now that recreational marijuana is legal in four states, police are looking for quicker ways to test drivers for excessive pot use.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A quartet of Western states and the District of Columbia have legalized recreational marijuana, and voters in a half-dozen more states may vote on pot legalization in 2016. That's leading law enforcement officials and entrepreneurs to try to come up with better ways of testing for driving while stoned.\u003c/p>\n\u003cp>Police usually spot impaired drivers by noting driving behavior, coordination, mannerisms and physical cues. But while a handheld breath test can quickly determine whether someone is legally drunk based on ethanol in the breath, there's no instant test for marijuana intoxication.\u003c/p>\n\u003cp>In Washington state, which is one of 18 states that has \u003ca href=\"http://ghsa.org/html/stateinfo/laws/dre_perse_laws.html\">set limits on marijuana intoxication\u003c/a> while driving, law enforcement can seek a warrant for a blood draw to test for THC, the main active ingredient in marijuana. But it can take weeks for results to come back from the toxicology lab.\u003c/p>\n\u003cp>With more Washington state \u003ca href=\"http://www.npr.org/2015/08/19/432896393/more-washington-drivers-use-and-drive\">drivers being arrested\u003c/a> with marijuana in their systems since the state legalized recreational marijuana, there's growing need for a fast way to identify impaired drivers and get them off the road.\u003c/p>\n\u003cp>Herb Hill, a chemistry professor at Washington State University in Pullman, heard about the challenges of nailing drug-impaired drivers from a colleague who was a political science professor. \"I said, 'Why don't we have a Breathalyzer for that?' He said none exists,\" Hill said. \"I said, 'We can probably make one.' \"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So Hill and his colleagues are trying to develop a hand-held device that police officers can use to detect THC in breath. Preliminary field testing with 30 human subjects this spring established that the device can detect THC in breath, Hill said. Much more testing is ahead to look at potential variations among gender, race, body types and amount of use.\u003c/p>\n\u003cfigure id=\"attachment_128451\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-128451\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/breathalyzer-2_enl-462f4f6e28abeed88d820d946baf930178915e07-400x279.jpg\" alt=\"Research professor Wenjie Liu works with graduate student Jennifer Tufariello and professor Herb Hill to develop a marijuana breath test at Washington State University\" width=\"400\" height=\"279\">\u003cfigcaption class=\"wp-caption-text\">Research professor Wenjie Liu works with graduate student Jennifer Tufariello and professor Herb Hill to develop a marijuana breath test at Washington State University \u003ccite>(Tom Banse/KUOW)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hill's team recruits volunteers who buy their own weed, smoke it at their homes and then blow into the prototype.\u003c/p>\n\u003cp>\"We had to go through institutional board review,\" Hill said, referring to federal restrictions on research involving marijuana. \"It took us almost a year to get permission to do this.\"\u003c/p>\n\u003cp>\"It wasn't very hard to find the volunteers,\" Hill added. \"We have a waiting list of volunteers.\"\u003c/p>\n\u003cp>The human guinea pigs get paid just over minimum wage to smoke their pot.\u003c/p>\n\u003cp>Hill said the portable device may look like an alcohol Breathalyzer but works differently inside. His team is modifying existing sniffers used at airports to detect explosives and by the military to alert to the presence of chemical warfare agents. The technology is called ion mobility spectrometry.\u003c/p>\n\u003cp>\"In the beginning at least this would not be used as evidential information,\" Hill explained. \"It would be used as screening information to help the officer say he should take a blood sample now.\"\u003c/p>\n\u003cp>Jake Yancey, a police officer in Tumwater, Wash., said he would be \"super excited\" to get a detector that he hopes could \"drastically speed up\" the process of confirming or ruling out a person's possible marijuana impairment. But a pot breath test must prove itself highly accurate before Washington state would adopt it, according to Lt. Rob Sharpe, head of the impaired driving section at the Washington State Patrol.\u003c/p>\n\u003cp>\"Even if it is a preliminary device, we still need that level of accuracy and reliability for trust and confidence,\" Sharpe said. \"Regardless where it comes into play in that arrest decision, we're talking about people's rights, their liberties and freedoms. We need to be accurate.\"\u003c/p>\n\u003cp>All of which points to it being several years at the earliest before you'd see a roadside breath test to identify stoned drivers.\u003c/p>\n\u003cp>Sharpe said a pot breath test might not even be the chosen answer. He said other companies and research teams are working on alternatives, including cheek swabs or a saliva test, a smartphone-based eye scan, or analyzing sweat on a person's skin.\u003c/p>\n\u003cp>Since legalizing marijuana use for adults, \u003ca href=\"http://apps.leg.wa.gov/rcw/default.aspx?cite=46.61.502\">Washington\u003c/a> and \u003ca href=\"https://www.codot.gov/safety/alcohol-and-impaired-driving/druggeddriving\">Colorado\u003c/a> have both set \u003ca href=\"http://ghsa.org/html/stateinfo/laws/dre_perse_laws.html\">legal limits\u003c/a> for THC intoxication at 5 nanograms per milliliter of blood. Oregon and Alaska have not established a legal THC limit beyond which a driver is presumed to be impaired.\u003c/p>\n\u003cp>Some marijuana activists have expressed fears that this technology could lead to unimpaired drivers getting unfairly arrested. They point out that THC persists in the body long after the high has worn off. The effects of weed are also different in different people, including between infrequent versus chronic smokers.\u003c/p>\n\u003cfigure id=\"attachment_128452\" class=\"wp-caption alignright\" style=\"max-width: 200px\">\u003cimg class=\"size-full wp-image-128452\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/cannabix_custom-092914e5da1d62af2355eabd189651cf841e272c.jpg\" alt=\"This prototype of a marijuana breath tester was developed by Vancouver, British Columbia-based Cannabix Technologies\" width=\"200\" height=\"178\">\u003cfigcaption class=\"wp-caption-text\">This prototype of a marijuana breath tester was developed by Vancouver, British Columbia-based Cannabix Technologies \u003ccite>(Courtesy of Cannabix Technologies)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Indeed, there is no universal agreement on how much THC is impairing — countries in Europe have set legal limits at 2 to 7 nanograms.\u003c/p>\n\u003cp>As part of the next rounds of human testing of the marijuana breath tester, the Washington state researchers want to correlate breath readings of THC with simultaneous blood draws and measurements. This could help to establish how long THC lingers in the breath after initial consumption.\u003c/p>\n\u003cp>Early on, the WSU professors took their idea to \u003ca href=\"http://www.chemringnorthamerica.com/business-groups/sensors-and-electronics.aspx\">Chemring\u003c/a>, a Falls Church, Va., instrument maker that agreed to pay for the R&D and will have the commercialization rights.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Chemring-WSU team is by no means alone in trying to perfect a marijuana breath test. Competitors include Lifeloc Technologies of Colorado, which already makes alcohol testers, and \u003ca href=\"http://www.cannabixtechnologies.com/\">Cannabix Technologies Inc.\u003c/a> of Vancouver, British Columbia, has shown off an initial prototype at conferences. There are reportedly several research teams at work in Europe as well.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NWNews. To see more, visit \u003ca href=\"http://www.nwnewsnetwork.org/\">NWNews\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=High+On+The+Highway%3A+Scientists+Try+To+Build+A+Marijuana+Breath+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Teledentistry Could Boost Access to California's Poor Kids But Is Little Used. Why?",
"title": "Teledentistry Could Boost Access to California's Poor Kids But Is Little Used. Why?",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cb>\u003c/b>At a Head Start center in San Mateo County, preschoolers are receiving their first-ever dental exam, but there’s not a dentist in sight.\u003c/p>\n\u003caside class=\"pullquote alignright\">The need is great: Millions of California's low-income children don't receive dental care.\u003c/aside>\n\u003cp>Instead, dental hygienists give each child a teeth cleaning, X-rays, and take pictures of their teeth. These images are transmitted via a Cloud-based server to Dr. Yogita Thakur, who reviews them from her office at \u003ca href=\"http://www.ravenswoodfhc.org/index.php/services/family_dentistry\" target=\"_blank\">Ravenswood Family Dentistry\u003c/a> in East Palo Alto, 6 miles away.\u003c/p>\n\u003cp>“This is how we reach children in areas where dental care is usually limited,” Thakur said.\u003c/p>\n\u003cp>This process, called \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/TelehealthFAQ.aspx\" target=\"_blank\">telehealth\u003c/a>, allows dentists to diagnose, treat and educate patients remotely, rather than in person. The primary aim is to bolster preventive care, but if the dentist sees that significant work is required, such as a root canal or crown, an in-person appointment can be scheduled\u003cb>.\u003c/b>\u003c/p>\n\u003cp>The need for such innovation seems readily apparent\u003cb>.\u003c/b>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Most people in our society are not getting dental care,” said Dr. Paul Glassman, director of the Pacific Center for Special Care at the University of the Pacific School of Dentistry.\u003c/p>\n\u003cp>Despite dental problems being the No. 1\u003ca href=\"http://dental.pacific.edu/Documents/community/special_care/acrobat/Pacific_VDH_FactSheet_2015_0903.pdf\" target=\"_blank\"> chronic disease\u003c/a> that children face, a\u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2013-125.pdf\" target=\"_blank\"> state audit of Medi-Cal’s dental program\u003c/a> last year found that less than half of the 5.1 million children enrolled in the federal-state health plan for the poor were receiving care.\u003c/p>\n\u003cp>With the goal of changing that statistic, \u003ca href=\"http://www.californiahealthline.org/articles/2014/9/30/medical-to-cover-teledentistry--services-beginning-in-2015\" target=\"_blank\">a law that went into effect this year \u003c/a>requires Medi-Cal providers to be reimbursed for dental services provided through telehealth.\u003c/p>\n\u003cp>But as of July, only seven dentists in the state had billed the dental arm of Medi-Cal, called Denti-Cal, for teledentistry services.\u003c/p>\n\u003cp>[contextly_sidebar id=\"UaYIgFWjlVQQHDuygF6hDc4LuQuWX50p\"]A number of factors may be contributing to the law’s ineffectiveness, but few doubt that the key reason is Medi-Cal’s remarkably low reimbursement rates.\u003c/p>\n\u003cp>A report \u003ca href=\"http://www.dhcs.ca.gov/Documents/2015_Dental-Services-Rate-Review.pdf\" target=\"_blank\">released by the Department of Health Care Services \u003c/a>in July showed that Denti-Cal reimbursements are less than one-third of the national average paid by commercial insurance.\u003c/p>\n\u003cp>Some providers have stopped accepting new Denti-Cal patients altogether.\u003c/p>\n\u003cp>“Increasing reimbursement rates so they are sufficient to cover the cost of care is important to ensuring providers can participate in the Denti-Cal program, and that applies to whatever delivery model is used,” said Alicia Malaby, a spokeswoman for the \u003ca href=\"http://www.cda.org\" target=\"_blank\">California Dental Association\u003c/a> (CDA).\u003c/p>\n\u003cp>In addition to the question of payment, providers may be wary of using teledentistry simply because “it’s a very different style of providing dental services,” Glassman said.\u003c/p>\n\u003cp>Some dentists worry that teledentistry will lead to increased competition for patients\u003cb>,\u003c/b> but “it’s actually a way of expanding dental practice,” he said.\u003c/p>\n\u003cp>Glassman began developing a teledentistry model of care, called the \u003ca href=\"http://dental.pacific.edu/Community_Involvement/Pacific_Center_for_Special_Care_(PCSC)/Innovations_Center/Virtual_Dental_Home_System_of_Care.html\" target=\"_blank\">Virtual Dental Home\u003c/a> (VDH), 10 years ago.\u003c/p>\n\u003cp>“The idea was to figure out how to get to where the vulnerable populations are,” Glassman said.\u003c/p>\n\u003cp>A six-year pilot project demonstrated that virtual dental care could not only work, but reduce the cost of care as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Getting the word out on this is going to be top priority.'\u003cbr>\n\u003ccite>Carmela Castellano-Garcia, California Primary Care Association\u003c/cite>\u003c/aside>\n\u003cp>“We’ve tested (the VDH model) in a number of different areas and populations. \u003ca href=\"http://www.benefits.gov/benefits/benefit-details/616\" target=\"_blank\">Head Start\u003c/a> schools, Early Head Start, adults in residential care, low-income community centers, all the way up to nursing homes,” Glassman said.\u003c/p>\n\u003cp>These populations are some of the estimated \u003ca href=\"http://dental.pacific.edu/Documents/community/special_care/acrobat/VirtualDentalHome_PolicyBrief_Aug_2014_HD_ForPrintOnly.pdf\" target=\"_blank\">30 percent of Californians\u003c/a> (about 11 million people) who face barriers to dental care.\u003c/p>\n\u003cp>One of the benefits of the VDH model is “its ability to facilitate patients’ access to the full dental team and comprehensive dental care,” Malaby said.\u003c/p>\n\u003cp>“I can sense the hesitancy because it’s so new,” Thakur said. “Providers think, ‘I did not really see and touch the patient, so how can I make a recommendation for their care?’ ”\u003c/p>\n\u003cp>Glassman understands the reluctance.\u003c/p>\n\u003cp>“I often joke when I’m speaking to dental hygienists, ‘How many of you remember the class you took on telehealth in dental school?’ ” Glassman said. “Because of course, there’s no such class.”\u003c/p>\n\u003cp>Providers need information and training to feel comfortable with teledentistry, said Carmela Castellano-Garcia, CEO of the \u003ca href=\"http://www.cpca.org\" target=\"_blank\">California Primary Care Association\u003c/a> (CPCA).\u003c/p>\n\u003cp>“Getting the word out on this is going to be top priority,” Castellano-Garcia said.\u003c/p>\n\u003cp>The CPCA is working with California’s new \u003ca href=\"http://www.cda.org/news-events/governor-announces-california-state-dental-director\" target=\"_blank\">dental director\u003c/a>, Dr. Jayanth Kumar, to provide new training programs.\u003c/p>\n\u003cp>Securing funding for teledentistry models is another challenge.\u003c/p>\n\u003cp>The CDA is co-sponsoring \u003ca href=\"http://www.childrenspartnership.org/storage/documents/OurWork/Dental/TCP_CDA_AB_648_Fact_Sheet_March_2015_Final.pdf\" target=\"_blank\">AB648\u003c/a>, which would provide funding for implementing the Virtual Dental Home in new areas.\u003c/p>\n\u003cp>“It’s always a long process,” Castellano-Garcia said. “But ultimately, this is going to expand dental care in the state.”\u003c/p>\n\u003cp>At Ravenswood, the dental team wants to continue using the VDH model to reach low-income children as early as possible. About 80 percent of pediatric dental disease is found in low-income populations, Thakur said.\u003c/p>\n\u003cp>“The idea here is to prevent dental disease from ever happening.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>Hellesen writes for the \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">California HealthCare Foundation Center for Health Reporting\u003c/a> at the USC Annenberg School for Communication and Journalism.\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>\u003c/b>At a Head Start center in San Mateo County, preschoolers are receiving their first-ever dental exam, but there’s not a dentist in sight.\u003c/p>\n\u003caside class=\"pullquote alignright\">The need is great: Millions of California's low-income children don't receive dental care.\u003c/aside>\n\u003cp>Instead, dental hygienists give each child a teeth cleaning, X-rays, and take pictures of their teeth. These images are transmitted via a Cloud-based server to Dr. Yogita Thakur, who reviews them from her office at \u003ca href=\"http://www.ravenswoodfhc.org/index.php/services/family_dentistry\" target=\"_blank\">Ravenswood Family Dentistry\u003c/a> in East Palo Alto, 6 miles away.\u003c/p>\n\u003cp>“This is how we reach children in areas where dental care is usually limited,” Thakur said.\u003c/p>\n\u003cp>This process, called \u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/TelehealthFAQ.aspx\" target=\"_blank\">telehealth\u003c/a>, allows dentists to diagnose, treat and educate patients remotely, rather than in person. The primary aim is to bolster preventive care, but if the dentist sees that significant work is required, such as a root canal or crown, an in-person appointment can be scheduled\u003cb>.\u003c/b>\u003c/p>\n\u003cp>The need for such innovation seems readily apparent\u003cb>.\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Most people in our society are not getting dental care,” said Dr. Paul Glassman, director of the Pacific Center for Special Care at the University of the Pacific School of Dentistry.\u003c/p>\n\u003cp>Despite dental problems being the No. 1\u003ca href=\"http://dental.pacific.edu/Documents/community/special_care/acrobat/Pacific_VDH_FactSheet_2015_0903.pdf\" target=\"_blank\"> chronic disease\u003c/a> that children face, a\u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2013-125.pdf\" target=\"_blank\"> state audit of Medi-Cal’s dental program\u003c/a> last year found that less than half of the 5.1 million children enrolled in the federal-state health plan for the poor were receiving care.\u003c/p>\n\u003cp>With the goal of changing that statistic, \u003ca href=\"http://www.californiahealthline.org/articles/2014/9/30/medical-to-cover-teledentistry--services-beginning-in-2015\" target=\"_blank\">a law that went into effect this year \u003c/a>requires Medi-Cal providers to be reimbursed for dental services provided through telehealth.\u003c/p>\n\u003cp>But as of July, only seven dentists in the state had billed the dental arm of Medi-Cal, called Denti-Cal, for teledentistry services.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A number of factors may be contributing to the law’s ineffectiveness, but few doubt that the key reason is Medi-Cal’s remarkably low reimbursement rates.\u003c/p>\n\u003cp>A report \u003ca href=\"http://www.dhcs.ca.gov/Documents/2015_Dental-Services-Rate-Review.pdf\" target=\"_blank\">released by the Department of Health Care Services \u003c/a>in July showed that Denti-Cal reimbursements are less than one-third of the national average paid by commercial insurance.\u003c/p>\n\u003cp>Some providers have stopped accepting new Denti-Cal patients altogether.\u003c/p>\n\u003cp>“Increasing reimbursement rates so they are sufficient to cover the cost of care is important to ensuring providers can participate in the Denti-Cal program, and that applies to whatever delivery model is used,” said Alicia Malaby, a spokeswoman for the \u003ca href=\"http://www.cda.org\" target=\"_blank\">California Dental Association\u003c/a> (CDA).\u003c/p>\n\u003cp>In addition to the question of payment, providers may be wary of using teledentistry simply because “it’s a very different style of providing dental services,” Glassman said.\u003c/p>\n\u003cp>Some dentists worry that teledentistry will lead to increased competition for patients\u003cb>,\u003c/b> but “it’s actually a way of expanding dental practice,” he said.\u003c/p>\n\u003cp>Glassman began developing a teledentistry model of care, called the \u003ca href=\"http://dental.pacific.edu/Community_Involvement/Pacific_Center_for_Special_Care_(PCSC)/Innovations_Center/Virtual_Dental_Home_System_of_Care.html\" target=\"_blank\">Virtual Dental Home\u003c/a> (VDH), 10 years ago.\u003c/p>\n\u003cp>“The idea was to figure out how to get to where the vulnerable populations are,” Glassman said.\u003c/p>\n\u003cp>A six-year pilot project demonstrated that virtual dental care could not only work, but reduce the cost of care as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Getting the word out on this is going to be top priority.'\u003cbr>\n\u003ccite>Carmela Castellano-Garcia, California Primary Care Association\u003c/cite>\u003c/aside>\n\u003cp>“We’ve tested (the VDH model) in a number of different areas and populations. \u003ca href=\"http://www.benefits.gov/benefits/benefit-details/616\" target=\"_blank\">Head Start\u003c/a> schools, Early Head Start, adults in residential care, low-income community centers, all the way up to nursing homes,” Glassman said.\u003c/p>\n\u003cp>These populations are some of the estimated \u003ca href=\"http://dental.pacific.edu/Documents/community/special_care/acrobat/VirtualDentalHome_PolicyBrief_Aug_2014_HD_ForPrintOnly.pdf\" target=\"_blank\">30 percent of Californians\u003c/a> (about 11 million people) who face barriers to dental care.\u003c/p>\n\u003cp>One of the benefits of the VDH model is “its ability to facilitate patients’ access to the full dental team and comprehensive dental care,” Malaby said.\u003c/p>\n\u003cp>“I can sense the hesitancy because it’s so new,” Thakur said. “Providers think, ‘I did not really see and touch the patient, so how can I make a recommendation for their care?’ ”\u003c/p>\n\u003cp>Glassman understands the reluctance.\u003c/p>\n\u003cp>“I often joke when I’m speaking to dental hygienists, ‘How many of you remember the class you took on telehealth in dental school?’ ” Glassman said. “Because of course, there’s no such class.”\u003c/p>\n\u003cp>Providers need information and training to feel comfortable with teledentistry, said Carmela Castellano-Garcia, CEO of the \u003ca href=\"http://www.cpca.org\" target=\"_blank\">California Primary Care Association\u003c/a> (CPCA).\u003c/p>\n\u003cp>“Getting the word out on this is going to be top priority,” Castellano-Garcia said.\u003c/p>\n\u003cp>The CPCA is working with California’s new \u003ca href=\"http://www.cda.org/news-events/governor-announces-california-state-dental-director\" target=\"_blank\">dental director\u003c/a>, Dr. Jayanth Kumar, to provide new training programs.\u003c/p>\n\u003cp>Securing funding for teledentistry models is another challenge.\u003c/p>\n\u003cp>The CDA is co-sponsoring \u003ca href=\"http://www.childrenspartnership.org/storage/documents/OurWork/Dental/TCP_CDA_AB_648_Fact_Sheet_March_2015_Final.pdf\" target=\"_blank\">AB648\u003c/a>, which would provide funding for implementing the Virtual Dental Home in new areas.\u003c/p>\n\u003cp>“It’s always a long process,” Castellano-Garcia said. “But ultimately, this is going to expand dental care in the state.”\u003c/p>\n\u003cp>At Ravenswood, the dental team wants to continue using the VDH model to reach low-income children as early as possible. About 80 percent of pediatric dental disease is found in low-income populations, Thakur said.\u003c/p>\n\u003cp>“The idea here is to prevent dental disease from ever happening.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>Hellesen writes for the \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">California HealthCare Foundation Center for Health Reporting\u003c/a> at the USC Annenberg School for Communication and Journalism.\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA Eases 30-Year Ban on Blood Donations from Gay Men",
"title": "FDA Eases 30-Year Ban on Blood Donations from Gay Men",
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"content": "\u003cp>The Food and Drug Administration \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm478031.htm\" target=\"_blank\">announced Monday \u003c/a>that it is easing the ban on blood donations from men who have sex with men.\u003c/p>\n\u003cp>The ban had been in place for more than 30 years, since the early days of the AIDS epidemic when little was known about AIDS or how it spread. But advocates had long argued that the policy was antiquated.\u003c/p>\n\u003cp>The new policy has been \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/12/23/fda-proposes-lifting-lifetime-ban-on-gay-blood-donors/\" target=\"_blank\">under review \u003c/a>for the last year and was issued today as a \"\u003ca href=\"http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM446580.pdf\" target=\"_blank\">final guidance\u003c/a>\" by the FDA. Under the revision, men who have sex with men may donate blood -- but only if they have not had sex with another man for the last year or more.\u003c/p>\n\u003cp>The policy matches that of many other countries, including the United Kingdom, Australia and Japan.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm478031.htm\" target=\"_blank\">a statement, \u003c/a>acting FDA Commissioner Dr. Stephen Ostroff said that the FDA's responsibility was to maintain a high level of safety in the nation's blood supply. “We have taken great care to ensure this policy revision is backed by sound science and continues to protect our blood supply.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But gay rights activists say the change doesn't go far enough.\u003c/p>\n\u003cp>\"It continues to stigmatize gay and bisexual men,\" David Stacy, of the Human Rights Campaign, \u003ca href=\"http://abcnews.go.com/Health/wireStory/fda-eases-restrictions-blood-donations-gay-men-35888660\" target=\"_blank\">told ABC News\u003c/a>. \"It simply cannot be justified in light of current scientific research and updated blood screening technology.\"\u003c/p>\n\u003cp>The National Gay Blood Drive said the change \"was a huge first step in the right direction,\" but also \u003ca href=\"http://www.gayblooddrive.com/#!updates/c1vwd\" target=\"_blank\">called on the FDA \u003c/a>to move toward a non-discriminatory policy and end discrimination based on sexual orientation.\u003c/p>\n\u003cp>Under the recommendations approved today, the FDA says the following donors should not be permitted to donate blood \"indefinitely\":\u003c/p>\n\u003cul>\n\u003cli>An individual who has ever had a positive test for HIV.\u003c/li>\n\u003cli>An individual who has ever exchanged sex for money or drugs.\u003c/li>\n\u003cli>An individual who has ever engaged in injection drug use that was not prescribed.\u003c/li>\n\u003c/ul>\n\u003cp>And these people should be deferred:\u003c/p>\n\u003cul>\n\u003cli>Defer for 12 months from the most recent contact any individual who has a history of sex with a person who: has ever had a positive test for HIV, ever exchanged sex for money or drugs, or ever engaged in non-prescription injection drug use.\u003c/li>\n\u003cli>Defer for 12 months from the most recent transfusion any individual who has a history of receiving a transfusion of Whole Blood or blood components donated by another person (allogeneic transfusion).\u003c/li>\n\u003cli>Defer for 12 months from the most recent exposure any individual who has a history of through-the-skin contact with the blood of another individual, such as a needle stick or blood contact with an open wound or mucous membrane.\u003c/li>\n\u003cli>Defer for 12 months from the most recent tattoo, ear or body piercing. However, individuals who have undergone tattooing within 12 months of donation are eligible to donate if the tattoo was applied by a state regulated entity with sterile needles and non-reused ink. Individuals who have undergone ear or body piercing within 12 months of donation are eligible to donate if the piercing was done using single-use equipment.\u003c/li>\n\u003cli>Defer for 12 months after completion of treatment any individual with a history of syphilis or gonorrhea or with a history of diagnosis or treatment for syphilis or gonorrhea in the past 12 months.\u003c/li>\n\u003cli>Defer for 12 months from the most recent contact a man who has had sex with another man during the past 12 months.\u003c/li>\n\u003cli>Defer for 12 months from the most recent contact a female who has had sex during the past 12 months with a man who has had sex with another man in the past 12 months.\u003c/li>\n\u003c/ul>\n\u003cp>The policy also addressed transgender donors, saying \"male or female gender should be self-identified and self-reported.\"\u003c/p>\n\u003cp>This does little to clarify \"a policy that some blood banks have interpreted as a ban on all transgender donors,\" \u003ca href=\"http://www.buzzfeed.com/dominicholden/new-fda-policy-relaxes-ban-on-gay-men-donating-blood#.djy8W0PPV\" target=\"_blank\">reports BuzzFeed News and continued\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>One national blood donation company — facing two discrimination lawsuits from transgender women who were allegedly turned away — has \u003ca href=\"http://www.buzzfeed.com/dominicholden/why-are-blood-banks-rejecting-transgender-women#.rf04yR9Z\">argued\u003c/a> in court records that previous FDA policy banned all transgender women. It is unclear that donors self-reporting their gender, as specified by the new guidance, clarifies that issue.\u003c/p>\n\u003cp>The FDA did not immediately reply to questions Monday from BuzzFeed News about whether all transgender people are banned from donating blood under the new guidelines.\u003c/p>\u003c/blockquote>\n\u003cp id=\"story-continues-4\" class=\"story-body-text story-content\">All U.S. blood donations are screened for HIV, the virus that causes AIDS. But there is a roughly 10-day window between initial infection and when the virus can be detected in the bloodstream. The American Red Cross estimates the risk of getting an HIV-positive blood donation is 1 in 1.5 million for U.S. patients. About 15.7 million blood donations are collected in the U.S. each year.\u003c/p>\n\u003cp class=\"story-body-text story-content\">In 2006 the Red Cross, the American Association of Blood Banks, and America's Blood Centers called the ban \"medically and scientifically unwarranted.\"\u003c/p>\n\u003cp class=\"story-body-text story-content\">The FDA concluded that moving to a one-year abstinence requirement would not change the safety of the U.S. blood supply, based on data from Australia and other sources.\u003c/p>\n\u003cp class=\"story-body-text story-content\">On the current blood donor questionnaire, men are asked if they have ever had sex with another man since 1977 -- the start of the AIDS epidemic in the U.S. Potential donors who answer positively are barred from donating blood. The new questionnaire, as outlined by the FDA, would ask men if they have had sex with another man in the last 12 months.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"story-body-text story-content\">\u003cem>This story includes reporting from the Associated Press.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm478031.htm\" target=\"_blank\">announced Monday \u003c/a>that it is easing the ban on blood donations from men who have sex with men.\u003c/p>\n\u003cp>The ban had been in place for more than 30 years, since the early days of the AIDS epidemic when little was known about AIDS or how it spread. But advocates had long argued that the policy was antiquated.\u003c/p>\n\u003cp>The new policy has been \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/12/23/fda-proposes-lifting-lifetime-ban-on-gay-blood-donors/\" target=\"_blank\">under review \u003c/a>for the last year and was issued today as a \"\u003ca href=\"http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM446580.pdf\" target=\"_blank\">final guidance\u003c/a>\" by the FDA. Under the revision, men who have sex with men may donate blood -- but only if they have not had sex with another man for the last year or more.\u003c/p>\n\u003cp>The policy matches that of many other countries, including the United Kingdom, Australia and Japan.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm478031.htm\" target=\"_blank\">a statement, \u003c/a>acting FDA Commissioner Dr. Stephen Ostroff said that the FDA's responsibility was to maintain a high level of safety in the nation's blood supply. “We have taken great care to ensure this policy revision is backed by sound science and continues to protect our blood supply.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But gay rights activists say the change doesn't go far enough.\u003c/p>\n\u003cp>\"It continues to stigmatize gay and bisexual men,\" David Stacy, of the Human Rights Campaign, \u003ca href=\"http://abcnews.go.com/Health/wireStory/fda-eases-restrictions-blood-donations-gay-men-35888660\" target=\"_blank\">told ABC News\u003c/a>. \"It simply cannot be justified in light of current scientific research and updated blood screening technology.\"\u003c/p>\n\u003cp>The National Gay Blood Drive said the change \"was a huge first step in the right direction,\" but also \u003ca href=\"http://www.gayblooddrive.com/#!updates/c1vwd\" target=\"_blank\">called on the FDA \u003c/a>to move toward a non-discriminatory policy and end discrimination based on sexual orientation.\u003c/p>\n\u003cp>Under the recommendations approved today, the FDA says the following donors should not be permitted to donate blood \"indefinitely\":\u003c/p>\n\u003cul>\n\u003cli>An individual who has ever had a positive test for HIV.\u003c/li>\n\u003cli>An individual who has ever exchanged sex for money or drugs.\u003c/li>\n\u003cli>An individual who has ever engaged in injection drug use that was not prescribed.\u003c/li>\n\u003c/ul>\n\u003cp>And these people should be deferred:\u003c/p>\n\u003cul>\n\u003cli>Defer for 12 months from the most recent contact any individual who has a history of sex with a person who: has ever had a positive test for HIV, ever exchanged sex for money or drugs, or ever engaged in non-prescription injection drug use.\u003c/li>\n\u003cli>Defer for 12 months from the most recent transfusion any individual who has a history of receiving a transfusion of Whole Blood or blood components donated by another person (allogeneic transfusion).\u003c/li>\n\u003cli>Defer for 12 months from the most recent exposure any individual who has a history of through-the-skin contact with the blood of another individual, such as a needle stick or blood contact with an open wound or mucous membrane.\u003c/li>\n\u003cli>Defer for 12 months from the most recent tattoo, ear or body piercing. However, individuals who have undergone tattooing within 12 months of donation are eligible to donate if the tattoo was applied by a state regulated entity with sterile needles and non-reused ink. Individuals who have undergone ear or body piercing within 12 months of donation are eligible to donate if the piercing was done using single-use equipment.\u003c/li>\n\u003cli>Defer for 12 months after completion of treatment any individual with a history of syphilis or gonorrhea or with a history of diagnosis or treatment for syphilis or gonorrhea in the past 12 months.\u003c/li>\n\u003cli>Defer for 12 months from the most recent contact a man who has had sex with another man during the past 12 months.\u003c/li>\n\u003cli>Defer for 12 months from the most recent contact a female who has had sex during the past 12 months with a man who has had sex with another man in the past 12 months.\u003c/li>\n\u003c/ul>\n\u003cp>The policy also addressed transgender donors, saying \"male or female gender should be self-identified and self-reported.\"\u003c/p>\n\u003cp>This does little to clarify \"a policy that some blood banks have interpreted as a ban on all transgender donors,\" \u003ca href=\"http://www.buzzfeed.com/dominicholden/new-fda-policy-relaxes-ban-on-gay-men-donating-blood#.djy8W0PPV\" target=\"_blank\">reports BuzzFeed News and continued\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>One national blood donation company — facing two discrimination lawsuits from transgender women who were allegedly turned away — has \u003ca href=\"http://www.buzzfeed.com/dominicholden/why-are-blood-banks-rejecting-transgender-women#.rf04yR9Z\">argued\u003c/a> in court records that previous FDA policy banned all transgender women. It is unclear that donors self-reporting their gender, as specified by the new guidance, clarifies that issue.\u003c/p>\n\u003cp>The FDA did not immediately reply to questions Monday from BuzzFeed News about whether all transgender people are banned from donating blood under the new guidelines.\u003c/p>\u003c/blockquote>\n\u003cp id=\"story-continues-4\" class=\"story-body-text story-content\">All U.S. blood donations are screened for HIV, the virus that causes AIDS. But there is a roughly 10-day window between initial infection and when the virus can be detected in the bloodstream. The American Red Cross estimates the risk of getting an HIV-positive blood donation is 1 in 1.5 million for U.S. patients. About 15.7 million blood donations are collected in the U.S. each year.\u003c/p>\n\u003cp class=\"story-body-text story-content\">In 2006 the Red Cross, the American Association of Blood Banks, and America's Blood Centers called the ban \"medically and scientifically unwarranted.\"\u003c/p>\n\u003cp class=\"story-body-text story-content\">The FDA concluded that moving to a one-year abstinence requirement would not change the safety of the U.S. blood supply, based on data from Australia and other sources.\u003c/p>\n\u003cp class=\"story-body-text story-content\">On the current blood donor questionnaire, men are asked if they have ever had sex with another man since 1977 -- the start of the AIDS epidemic in the U.S. Potential donors who answer positively are barred from donating blood. The new questionnaire, as outlined by the FDA, would ask men if they have had sex with another man in the last 12 months.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"story-body-text story-content\">\u003cem>This story includes reporting from the Associated Press.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Thursday’s \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/12/17/kaiser-permanente-to-open-a-medical-school-in-southern-california/\" target=\"_blank\">announcement\u003c/a> by Kaiser Permanente that it plans to open its own medical school in Southern California has attracted a lot of attention in the health care community.\u003c/p>\n\u003cp>But Kaiser is actually at the trailing edge of a medical school expansion that has been unmatched since the 1960s and 1970s, say medical education experts. In the past decade alone, according to the \u003ca href=\"https://www.aamc.org/newsroom/newsreleases/436326/20150630_threenewlyaccreditedmedschools.html\" target=\"_blank\">Association of American Medical Colleges\u003c/a>, 20 new medical schools have opened or been approved.\u003c/p>\n\u003cp>That’s no coincidence. In 2006, the AAMC called for a \u003ca href=\"https://www.aamc.org/download/82874/data/helpwanted.pdf\" target=\"_blank\">30 percent increase\u003c/a> in medical school graduates by 2015 to meet a growing demand, both through expanded class sizes and newly created medical schools.\u003c/p>\n\u003cp>“We’re on track to meet that 30 percent increase in the next three or four years,” said Atul Grover, AAMC’s chief public policy officer. “Enrollment is already up 25 percent since 2002.”\u003c/p>\n\u003cp>Many of the new schools focus on producing more \u003ca href=\"http://www.npr.org/sections/health-shots/2013/04/02/175945921/new-medical-school-wants-to-build-ranks-of-primary-care-doctors\" target=\"_blank\">primary care doctors\u003c/a> — those specializing in pediatrics, family medicine or general internal medicine. In fact, Kaiser Permanente already has a partnership with the UC Davis on a \u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/9071\" target=\"_blank\">fast-track training program\u003c/a> for primary care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Kaiser leaders say their new school (projected to enroll its first class in 2019) is about more than just primary care.\u003c/p>\n\u003cp>“We need to prepare physicians for the way health care is delivered in the future,” said Dr. Edward Ellison, executive medical director for the Southern California Permanente Medical Group. He said students need to learn not just medicine, but about integrated systems of care and how to work in a much different medical environment. “Our advantage is we can start from scratch,” he said.\u003c/p>\n\u003cp>Another advantage is the HMO’s deep pockets.\u003c/p>\n\u003cp>“They’ve got huge resources,” said George Thibault, president of the \u003ca href=\"http://macyfoundation.org/\" target=\"_blank\">Josiah Macy Jr. Foundation\u003c/a>, which focuses on medical education. “This is a grand experiment, but if anybody can do it, Kaiser can.”\u003c/p>\n\u003cp>Kaiser Permanente is far from the first health care provider to launch its own medical school — the \u003ca href=\"http://www.mayo.edu/mms/\" target=\"_blank\">Mayo Clinic\u003c/a> has had one since 1972 and is about to expand that school from its home base in Minnesota to its satellite campuses in Arizona and Florida.\u003c/p>\n\u003cp>Thibault said health-provider systems are already heavily involved in the new medical schools, often as partners with degree-granting universities, “which itself is a new trend.” For example, on Long Island, the North Shore-LIJ Health System \u003ca href=\"http://medicine.hofstra.edu/about/history/index.html\" target=\"_blank\">co-launched a medical school\u003c/a> with Hofstra University in 2011.\u003c/p>\n\u003cp>One big question is whether all these new schools will eventually produce more students than there are residency positions, which are necessary to complete the training. The federal government, which funds the majority of those residencies through the \u003ca href=\"http://economix.blogs.nytimes.com/2013/12/17/how-medicare-subsidizes-doctor-training/?_r=0\" target=\"_blank\">Medicare program\u003c/a>, capped the number of residencies it would fund in the \u003ca href=\"http://www.commonwealthfund.org/publications/fund-reports/1997/sep/an-examination-of-key-medicare-provisions-in-the-balanced-budget-act-of-1997\" target=\"_blank\">1997 Balanced Budget Act\u003c/a>.\u003c/p>\n\u003cp>Currently there are about 27,000 residency slots available each year, which are filled by students who have earned M.D. or D.O. degrees (doctors of osteopathy) in the U.S., as well as foreign medical school graduates and U.S. citizens who have graduated from medical schools overseas.\u003c/p>\n\u003cp>Between the new M.D.-granting schools and \u003ca href=\"http://www.osteopathic.org/inside-aoa/about/aoa-annual-statistics/Pages/growth-in-osteopathic-medical-students.aspx\" target=\"_blank\">a rapid expansion\u003c/a> of osteopathic medical schools, AAMC’s Grover said, demand will soon outstrip supply. Residency slots “are growing at about 1 percent per year,” he said (mostly funded by health systems themselves since Medicare will not), “while undergraduate medical education is growing about 3 percent per year.”\u003c/p>\n\u003cp>But Edward Salsberg of George Washington University, who has spent a career documenting health workforce trends, said any potential conflict is still a long way off.\u003c/p>\n\u003cp>“When you start with an excess of 7,000 slots” of residencies over graduating U.S. medical students, “it takes a very long time” to consume that excess, he said. By the year 2024, he and others concluded in a recent article in the \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1511707\" target=\"_blank\">New England Journal of Medicine\u003c/a>, there will still be 4,500 more slots than graduates.\u003c/p>\n\u003cp>“So yes, U.S. medical students will have a slightly more limited range of specialties to choose from,” said Salsberg, “but still plenty of room.”\u003c/p>\n\u003cp>There are also questions about whether there even is a \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/18/360145347/doctor-shortage-looming-maybe-not\" target=\"_blank\">doctor shortage\u003c/a> that all these new schools are aiming to alleviate.\u003c/p>\n\u003cp>Grover, whose organization has led the call for more doctors, said the anticipated shortage of primary care physicians might not be as acute as originally thought. That’s because the U.S. is producing dramatically more \u003ca href=\"http://healthaffairs.org/blog/2015/05/26/the-nurse-practitioner-physician-assistant-and-pharmacist-pipelines-continued-growth/\" target=\"_blank\">nurse practitioners and physician assistants\u003c/a>, who also provide primary care.\u003c/p>\n\u003cp>That’s probably a good thing, at least in supply terms, said Thibault of the Macy Foundation. Because it turns out that many students graduating from new primary care-focused school’s programs are in fact opting to become specialists instead.\u003c/p>\n\u003cp>“The career choices in the new schools look remarkably similar to career choices of more traditional schools,” he said. The graduating medical students “are responding to the same set of signals and stimuli” about prestige, income and lifestyle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Julie Rovner is a reporter with \u003c/em>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003cem>\u003ca href=\"http://www.kff.org/\">Kaiser Family Foundation\u003c/a>\u003c/em>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003cem>and is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Thursday’s \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/12/17/kaiser-permanente-to-open-a-medical-school-in-southern-california/\" target=\"_blank\">announcement\u003c/a> by Kaiser Permanente that it plans to open its own medical school in Southern California has attracted a lot of attention in the health care community.\u003c/p>\n\u003cp>But Kaiser is actually at the trailing edge of a medical school expansion that has been unmatched since the 1960s and 1970s, say medical education experts. In the past decade alone, according to the \u003ca href=\"https://www.aamc.org/newsroom/newsreleases/436326/20150630_threenewlyaccreditedmedschools.html\" target=\"_blank\">Association of American Medical Colleges\u003c/a>, 20 new medical schools have opened or been approved.\u003c/p>\n\u003cp>That’s no coincidence. In 2006, the AAMC called for a \u003ca href=\"https://www.aamc.org/download/82874/data/helpwanted.pdf\" target=\"_blank\">30 percent increase\u003c/a> in medical school graduates by 2015 to meet a growing demand, both through expanded class sizes and newly created medical schools.\u003c/p>\n\u003cp>“We’re on track to meet that 30 percent increase in the next three or four years,” said Atul Grover, AAMC’s chief public policy officer. “Enrollment is already up 25 percent since 2002.”\u003c/p>\n\u003cp>Many of the new schools focus on producing more \u003ca href=\"http://www.npr.org/sections/health-shots/2013/04/02/175945921/new-medical-school-wants-to-build-ranks-of-primary-care-doctors\" target=\"_blank\">primary care doctors\u003c/a> — those specializing in pediatrics, family medicine or general internal medicine. In fact, Kaiser Permanente already has a partnership with the UC Davis on a \u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/9071\" target=\"_blank\">fast-track training program\u003c/a> for primary care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Kaiser leaders say their new school (projected to enroll its first class in 2019) is about more than just primary care.\u003c/p>\n\u003cp>“We need to prepare physicians for the way health care is delivered in the future,” said Dr. Edward Ellison, executive medical director for the Southern California Permanente Medical Group. He said students need to learn not just medicine, but about integrated systems of care and how to work in a much different medical environment. “Our advantage is we can start from scratch,” he said.\u003c/p>\n\u003cp>Another advantage is the HMO’s deep pockets.\u003c/p>\n\u003cp>“They’ve got huge resources,” said George Thibault, president of the \u003ca href=\"http://macyfoundation.org/\" target=\"_blank\">Josiah Macy Jr. Foundation\u003c/a>, which focuses on medical education. “This is a grand experiment, but if anybody can do it, Kaiser can.”\u003c/p>\n\u003cp>Kaiser Permanente is far from the first health care provider to launch its own medical school — the \u003ca href=\"http://www.mayo.edu/mms/\" target=\"_blank\">Mayo Clinic\u003c/a> has had one since 1972 and is about to expand that school from its home base in Minnesota to its satellite campuses in Arizona and Florida.\u003c/p>\n\u003cp>Thibault said health-provider systems are already heavily involved in the new medical schools, often as partners with degree-granting universities, “which itself is a new trend.” For example, on Long Island, the North Shore-LIJ Health System \u003ca href=\"http://medicine.hofstra.edu/about/history/index.html\" target=\"_blank\">co-launched a medical school\u003c/a> with Hofstra University in 2011.\u003c/p>\n\u003cp>One big question is whether all these new schools will eventually produce more students than there are residency positions, which are necessary to complete the training. The federal government, which funds the majority of those residencies through the \u003ca href=\"http://economix.blogs.nytimes.com/2013/12/17/how-medicare-subsidizes-doctor-training/?_r=0\" target=\"_blank\">Medicare program\u003c/a>, capped the number of residencies it would fund in the \u003ca href=\"http://www.commonwealthfund.org/publications/fund-reports/1997/sep/an-examination-of-key-medicare-provisions-in-the-balanced-budget-act-of-1997\" target=\"_blank\">1997 Balanced Budget Act\u003c/a>.\u003c/p>\n\u003cp>Currently there are about 27,000 residency slots available each year, which are filled by students who have earned M.D. or D.O. degrees (doctors of osteopathy) in the U.S., as well as foreign medical school graduates and U.S. citizens who have graduated from medical schools overseas.\u003c/p>\n\u003cp>Between the new M.D.-granting schools and \u003ca href=\"http://www.osteopathic.org/inside-aoa/about/aoa-annual-statistics/Pages/growth-in-osteopathic-medical-students.aspx\" target=\"_blank\">a rapid expansion\u003c/a> of osteopathic medical schools, AAMC’s Grover said, demand will soon outstrip supply. Residency slots “are growing at about 1 percent per year,” he said (mostly funded by health systems themselves since Medicare will not), “while undergraduate medical education is growing about 3 percent per year.”\u003c/p>\n\u003cp>But Edward Salsberg of George Washington University, who has spent a career documenting health workforce trends, said any potential conflict is still a long way off.\u003c/p>\n\u003cp>“When you start with an excess of 7,000 slots” of residencies over graduating U.S. medical students, “it takes a very long time” to consume that excess, he said. By the year 2024, he and others concluded in a recent article in the \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1511707\" target=\"_blank\">New England Journal of Medicine\u003c/a>, there will still be 4,500 more slots than graduates.\u003c/p>\n\u003cp>“So yes, U.S. medical students will have a slightly more limited range of specialties to choose from,” said Salsberg, “but still plenty of room.”\u003c/p>\n\u003cp>There are also questions about whether there even is a \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/18/360145347/doctor-shortage-looming-maybe-not\" target=\"_blank\">doctor shortage\u003c/a> that all these new schools are aiming to alleviate.\u003c/p>\n\u003cp>Grover, whose organization has led the call for more doctors, said the anticipated shortage of primary care physicians might not be as acute as originally thought. That’s because the U.S. is producing dramatically more \u003ca href=\"http://healthaffairs.org/blog/2015/05/26/the-nurse-practitioner-physician-assistant-and-pharmacist-pipelines-continued-growth/\" target=\"_blank\">nurse practitioners and physician assistants\u003c/a>, who also provide primary care.\u003c/p>\n\u003cp>That’s probably a good thing, at least in supply terms, said Thibault of the Macy Foundation. Because it turns out that many students graduating from new primary care-focused school’s programs are in fact opting to become specialists instead.\u003c/p>\n\u003cp>“The career choices in the new schools look remarkably similar to career choices of more traditional schools,” he said. The graduating medical students “are responding to the same set of signals and stimuli” about prestige, income and lifestyle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Julie Rovner is a reporter with \u003c/em>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003cem>\u003ca href=\"http://www.kff.org/\">Kaiser Family Foundation\u003c/a>\u003c/em>\u003cstrong>\u003cem> \u003c/em>\u003c/strong>\u003cem>and is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Kaiser Permanente, the managed health care giant that now offers patients an integrated system combining insurance, hospitals and outpatient physicians, is adding a medical school to its portfolio, the company announced Thursday.\u003c/p>\n\u003cp>The nonprofit HMO, based in Oakland, will open the Kaiser Permanente School of Medicine in Southern California in 2019. No specific site has yet been selected.\u003c/p>\n\u003cp>\"This is a natural evolution for us,\" Kaiser's CEO Bernard Tyson said in an interview. \"We are very motivated in being part of the transformation of the entire health care ecosystem.\"\u003c/p>\n\u003cp>Kaiser says it will base physician training on \"strategic pillars\" including providing care beyond traditional medical settings, emphasizing collaboration and teamwork, and addressing health disparities.\u003c/p>\n\u003cp>Kaiser has long been lauded by health care experts as delivering high quality care to its population of 10.2 million patients. Kaiser is known for providing coordinated care in a technology-driven environment. It was an early adopter of electronic health records and uses its system to reach patients about basic and complex medical needs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We now want to take all of our learnings and understanding of how to care for population and individuals and teach it more upstream for the future physicians of the 21st century,\" Tyson said.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/238062573\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Kaiser says it is committed to attracting a diverse pool of students \"to better reflect the communities we serve,\" said Dr. Edward Ellison, executive director of the Southern California Permanente Medical Group. \"We've been able successfully to move, not completely, to closing the care gaps in health disequities for different populations, ... and we see that type of work in informing the medical students and how we educate them.\"\u003c/p>\n\u003cp>In a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/12/16/study-west-eliminates-race-gap-on-key-health-measures-disparities/\" target=\"_blank\">major analysis\u003c/a> last year, Kaiser was cited as closing the race gap in managing heart disease and diabetes, diseases which account for much of the reason African Americans have shorter life expectancies than caucasians.\u003c/p>\n\u003cp>The HMO has long been involved in medical education, but at the residency level, training more than 600 residents every year.\u003c/p>\n\u003cp>Kaiser's move is unusual. The nation's 145 medical schools are mostly affiliated with universities, although the Mayo Medical School campus operates within the Mayo Clinic in Rochester, Minnesota.\u003c/p>\n\u003cp>\"There are precedents, but this will be different,\" John Prescott, chief academic officer with the American Association of Medical Colleges, said of Kaiser's new school. \"It's an integrated health care system that's looking at developing a medical school. I think there will be some surprises as the school unfolds.\"\u003c/p>\n\u003cp>Prescott said the school will need to be accredited and that process could take several years. Twenty new medical schools have opened in the U.S. since 2002, he said, and many of them feature \"innovative models,\" he said.\u003c/p>\n\u003cp>Still, building a new medical school is \"fraught with risk,\" said John Deane, president of Advisory Board Consulting and Management. He said it could be a \"huge waste of money\" if Kaiser were to replicate the existing model of specialty-focused academic medical centers.\u003c/p>\n\u003cp>\"On the other hand,\" he said, \"they have an opportunity to do this in a new and different way that could be a form of disruptive innovation that could become a new standard for teaching doctors.\"\u003c/p>\n\u003cp>Tyson and Ellison both seemed focused on innovation as opposed to status quo.\u003c/p>\n\u003cp>\"We are excited to be on the frontier of creating a new medical school and thinking about how do we transform a medical education to meet the transformative needs of health care in this country, today, and into the future.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I'm as interested and motivated and part of the sponsorship of this 21st century new medical school if I were a physician myself,\" Tyson said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kaiser Permanente, the managed health care giant that now offers patients an integrated system combining insurance, hospitals and outpatient physicians, is adding a medical school to its portfolio, the company announced Thursday.\u003c/p>\n\u003cp>The nonprofit HMO, based in Oakland, will open the Kaiser Permanente School of Medicine in Southern California in 2019. No specific site has yet been selected.\u003c/p>\n\u003cp>\"This is a natural evolution for us,\" Kaiser's CEO Bernard Tyson said in an interview. \"We are very motivated in being part of the transformation of the entire health care ecosystem.\"\u003c/p>\n\u003cp>Kaiser says it will base physician training on \"strategic pillars\" including providing care beyond traditional medical settings, emphasizing collaboration and teamwork, and addressing health disparities.\u003c/p>\n\u003cp>Kaiser has long been lauded by health care experts as delivering high quality care to its population of 10.2 million patients. Kaiser is known for providing coordinated care in a technology-driven environment. It was an early adopter of electronic health records and uses its system to reach patients about basic and complex medical needs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We now want to take all of our learnings and understanding of how to care for population and individuals and teach it more upstream for the future physicians of the 21st century,\" Tyson said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/238062573&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/238062573'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Kaiser says it is committed to attracting a diverse pool of students \"to better reflect the communities we serve,\" said Dr. Edward Ellison, executive director of the Southern California Permanente Medical Group. \"We've been able successfully to move, not completely, to closing the care gaps in health disequities for different populations, ... and we see that type of work in informing the medical students and how we educate them.\"\u003c/p>\n\u003cp>In a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/12/16/study-west-eliminates-race-gap-on-key-health-measures-disparities/\" target=\"_blank\">major analysis\u003c/a> last year, Kaiser was cited as closing the race gap in managing heart disease and diabetes, diseases which account for much of the reason African Americans have shorter life expectancies than caucasians.\u003c/p>\n\u003cp>The HMO has long been involved in medical education, but at the residency level, training more than 600 residents every year.\u003c/p>\n\u003cp>Kaiser's move is unusual. The nation's 145 medical schools are mostly affiliated with universities, although the Mayo Medical School campus operates within the Mayo Clinic in Rochester, Minnesota.\u003c/p>\n\u003cp>\"There are precedents, but this will be different,\" John Prescott, chief academic officer with the American Association of Medical Colleges, said of Kaiser's new school. \"It's an integrated health care system that's looking at developing a medical school. I think there will be some surprises as the school unfolds.\"\u003c/p>\n\u003cp>Prescott said the school will need to be accredited and that process could take several years. Twenty new medical schools have opened in the U.S. since 2002, he said, and many of them feature \"innovative models,\" he said.\u003c/p>\n\u003cp>Still, building a new medical school is \"fraught with risk,\" said John Deane, president of Advisory Board Consulting and Management. He said it could be a \"huge waste of money\" if Kaiser were to replicate the existing model of specialty-focused academic medical centers.\u003c/p>\n\u003cp>\"On the other hand,\" he said, \"they have an opportunity to do this in a new and different way that could be a form of disruptive innovation that could become a new standard for teaching doctors.\"\u003c/p>\n\u003cp>Tyson and Ellison both seemed focused on innovation as opposed to status quo.\u003c/p>\n\u003cp>\"We are excited to be on the frontier of creating a new medical school and thinking about how do we transform a medical education to meet the transformative needs of health care in this country, today, and into the future.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I'm as interested and motivated and part of the sponsorship of this 21st century new medical school if I were a physician myself,\" Tyson said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Characters on television who consider or obtain abortions don't reflect the demographics of American women who choose them or their reasons for doing so, according to an \u003ca href=\"http://www.contraceptionjournal.org/article/S0010-7824%2815%2900675-7/abstract\" target=\"_blank\">analysis\u003c/a> from researchers at UC San Francisco.\u003c/p>\n\u003cp>The group looked at all depictions of abortion on U.S. television shows from 2005 to 2014. This included both network television shows and other distributors, including Netflix and Showtime. They found that women who had abortions were younger, whiter and better off financially than the average American woman who has an abortion.\u003c/p>\n\u003cp>\"It's not that these portrayals are inaccurate. They're going to represent someone's reality,\" said Gretchen Sisson, Ph.D., a research sociologist with the UCSF research group Advancing New Standards in Reproductive Health. \"But in aggregate, they're not reflecting what's really happening in the real world. So what we would like to see is a greater diversity of stories told on television\" about women who seek abortions.\u003c/p>\n\u003cp>Abortion is a common procedure in the United States. About \u003ca href=\"https://www.guttmacher.org/pubs/fb_induced_abortion.html\" target=\"_blank\">a million were performed in 2011,\u003c/a> the most recent year for which statistics were available. Three in 10 women have an abortion by age 45.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/237914010\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Specifically, about a third of the television characters having abortions were under age 20, about a third in their 20s and about a third in their 30s. In reality, nearly 60 percent of women who have abortions are in their 20s.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nearly nine in 10 of the fictional characters were white, versus 36 percent in real life. About 30 percent of American women who choose abortions are black and about 25 percent are Latino. Fictional characters were far less likely to be parents -- about 15 percent versus more than 60 percent in real life.\u003c/p>\n\u003cp>\"All these factors work together,\" Sisson said, \"to build an interesting social myth, which is that women who get abortions aren't mothers and they don't want to be mothers. Where we know that the majority of women getting abortions are already parenting and the vast majority intend to parent during their lives.\"\u003c/p>\n\u003cp>In addition to the demographics, dramatic depictions of the reasons for abortion were also not reflective of the reasons real women obtain the procedure. Women on television tended to say they were choosing abortion because having a child would interfere with educational or career plans, what Sisson called \"self-focused\" reasons. In reality, women in real life tend to cite \"other-focused\" reasons. In particular, women will often cite a need to take care of the children they have or that they can't afford another child, Sisson said.\u003c/p>\n\u003cp>\"Taken together, this pattern of reasons can contribute to the construction of abortion as a self-focused decision, and to the belief that abortions are 'wanted' because of personal desires rather than 'needed' because of circumstances such as poverty,\" the researchers wrote about the television characters.\u003c/p>\n\u003cp>Over 40 percent of U.S. women who have abortions are below the federal poverty level, the researchers noted, but on television, 82 percent of characters having abortions were upper or middle class.\u003c/p>\n\u003cp>Sisson said that abortion is a \"stigmatized procedure\" that few people discuss openly. \"So very few people have a context for the reality of abortion care ... so these fictional stories that happen on screen can have greater power to influence perceptions of what that care looks like in real life.\"\u003c/p>\n\u003cp>She cites the fictional character of Claire Underwood, deftly played by Robin Wright in the Emmy-winning \u003cem>House of Cards, \u003c/em>as one example that could mislead viewers about abortion. The affluent character \"lies about the number of and reasons for her abortions, and she has the abortions because she does not want children,\" Sisson points out. \"Additionally, her doctor implies that multiple abortions might lead to infertility — which they don't.\"\u003c/p>\n\u003cp>Depictions that are demographically more realistic, at least in some ways, may have other flaws, Sisson says, but they add some complexity as far as representation of the different kinds of women who choose abortion, and their motivation. Among these, she cites \u003cem>Shameless\u003c/em>, where one character has an abortion because she can't afford a child, or \u003cem>Grey's Anatomy\u003c/em>, which depicts a woman of color in her 30s choosing abortion.\u003c/p>\n\u003cp>In particular, the researchers found that the death rate for women on television who had abortions was about 10 percent. In reality, the actual death rate is merely a fraction of that, \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6108a1.htm\" target=\"_blank\">0.0015 percent according to data from the Centers for Disease Control and Prevention\u003c/a>, more than a 6,000-fold difference.\u003c/p>\n\u003cp>While the study did not look at audience impact -- that analysis is coming, Sisson said -- she theorized that depictions of women choosing abortion may influence policy.\u003c/p>\n\u003cp>\"It's easy to postulate,\" she said, \"if you see a lot of stories where women are changing their mind in the waiting room, then public policies such as waiting periods might make sense. ... If you see a lot of teenagers getting abortion on television, then policies such as parental consent or parental notification laws might make sense.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In addition to the analysis of audience impact, Sisson said a review in the coming months will look at television depictions of abortion providers.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Characters on television who consider or obtain abortions don't reflect the demographics of American women who choose them or their reasons for doing so, according to an \u003ca href=\"http://www.contraceptionjournal.org/article/S0010-7824%2815%2900675-7/abstract\" target=\"_blank\">analysis\u003c/a> from researchers at UC San Francisco.\u003c/p>\n\u003cp>The group looked at all depictions of abortion on U.S. television shows from 2005 to 2014. This included both network television shows and other distributors, including Netflix and Showtime. They found that women who had abortions were younger, whiter and better off financially than the average American woman who has an abortion.\u003c/p>\n\u003cp>\"It's not that these portrayals are inaccurate. They're going to represent someone's reality,\" said Gretchen Sisson, Ph.D., a research sociologist with the UCSF research group Advancing New Standards in Reproductive Health. \"But in aggregate, they're not reflecting what's really happening in the real world. So what we would like to see is a greater diversity of stories told on television\" about women who seek abortions.\u003c/p>\n\u003cp>Abortion is a common procedure in the United States. About \u003ca href=\"https://www.guttmacher.org/pubs/fb_induced_abortion.html\" target=\"_blank\">a million were performed in 2011,\u003c/a> the most recent year for which statistics were available. Three in 10 women have an abortion by age 45.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/237914010&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/237914010'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Specifically, about a third of the television characters having abortions were under age 20, about a third in their 20s and about a third in their 30s. In reality, nearly 60 percent of women who have abortions are in their 20s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nearly nine in 10 of the fictional characters were white, versus 36 percent in real life. About 30 percent of American women who choose abortions are black and about 25 percent are Latino. Fictional characters were far less likely to be parents -- about 15 percent versus more than 60 percent in real life.\u003c/p>\n\u003cp>\"All these factors work together,\" Sisson said, \"to build an interesting social myth, which is that women who get abortions aren't mothers and they don't want to be mothers. Where we know that the majority of women getting abortions are already parenting and the vast majority intend to parent during their lives.\"\u003c/p>\n\u003cp>In addition to the demographics, dramatic depictions of the reasons for abortion were also not reflective of the reasons real women obtain the procedure. Women on television tended to say they were choosing abortion because having a child would interfere with educational or career plans, what Sisson called \"self-focused\" reasons. In reality, women in real life tend to cite \"other-focused\" reasons. In particular, women will often cite a need to take care of the children they have or that they can't afford another child, Sisson said.\u003c/p>\n\u003cp>\"Taken together, this pattern of reasons can contribute to the construction of abortion as a self-focused decision, and to the belief that abortions are 'wanted' because of personal desires rather than 'needed' because of circumstances such as poverty,\" the researchers wrote about the television characters.\u003c/p>\n\u003cp>Over 40 percent of U.S. women who have abortions are below the federal poverty level, the researchers noted, but on television, 82 percent of characters having abortions were upper or middle class.\u003c/p>\n\u003cp>Sisson said that abortion is a \"stigmatized procedure\" that few people discuss openly. \"So very few people have a context for the reality of abortion care ... so these fictional stories that happen on screen can have greater power to influence perceptions of what that care looks like in real life.\"\u003c/p>\n\u003cp>She cites the fictional character of Claire Underwood, deftly played by Robin Wright in the Emmy-winning \u003cem>House of Cards, \u003c/em>as one example that could mislead viewers about abortion. The affluent character \"lies about the number of and reasons for her abortions, and she has the abortions because she does not want children,\" Sisson points out. \"Additionally, her doctor implies that multiple abortions might lead to infertility — which they don't.\"\u003c/p>\n\u003cp>Depictions that are demographically more realistic, at least in some ways, may have other flaws, Sisson says, but they add some complexity as far as representation of the different kinds of women who choose abortion, and their motivation. Among these, she cites \u003cem>Shameless\u003c/em>, where one character has an abortion because she can't afford a child, or \u003cem>Grey's Anatomy\u003c/em>, which depicts a woman of color in her 30s choosing abortion.\u003c/p>\n\u003cp>In particular, the researchers found that the death rate for women on television who had abortions was about 10 percent. In reality, the actual death rate is merely a fraction of that, \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6108a1.htm\" target=\"_blank\">0.0015 percent according to data from the Centers for Disease Control and Prevention\u003c/a>, more than a 6,000-fold difference.\u003c/p>\n\u003cp>While the study did not look at audience impact -- that analysis is coming, Sisson said -- she theorized that depictions of women choosing abortion may influence policy.\u003c/p>\n\u003cp>\"It's easy to postulate,\" she said, \"if you see a lot of stories where women are changing their mind in the waiting room, then public policies such as waiting periods might make sense. ... If you see a lot of teenagers getting abortion on television, then policies such as parental consent or parental notification laws might make sense.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In addition to the analysis of audience impact, Sisson said a review in the coming months will look at television depictions of abortion providers.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Most teenage girls who are prescribed drugs known to cause birth defects don’t receive adequate counseling about contraception, putting them at risk for negative pregnancy outcomes, according to a study published Wednesday in the \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/12/14/peds.2015-1454?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token\" target=\"_blank\">journal Pediatrics.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is room for great improvement.'\u003ccite>Stephani Stancil, lead author of study\u003c/cite>\u003c/aside>\n\u003cp>The medications are given to treat a wide range of conditions, including acne and anxiety.\u003c/p>\n\u003cp>More than 70 percent of female patients in the study who were prescribed such medications did not receive counseling about preventing pregnancy or given prescriptions for contraceptives or referral for such care.\u003c/p>\n\u003cp>“There is room for great improvement,” said lead author Stephani Stancil, a nurse practitioner in the division of adolescent medicine and clinical pharmacology at Children’s Mercy Hospital in Kansas City, Missouri. “We hope the study is a good first step to increase education to prescribers and patients and families to make healthier reproductive choices.”\u003c/p>\n\u003cp>The study examined electronic medical records from female patients between 14 and 25 years old who received the drug prescriptions during office visits between 2008 and 2012 at a major Midwestern academic pediatric medical center.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nearly 1,700 girls and women received 4,506 prescriptions for so-called teratogenic medications -- meaning those that can cause birth defects -- during 4,100 office visits.\u003c/p>\n\u003cp>The study found some disparities. White patients were more likely to receive contraception counseling than minority patients, the study said. The study did not suggest reasons for that, but doctors not involved in the research say it could be due to general health care disparities and a cultural or language gap between doctors and patients.\u003c/p>\n\u003cp>Older patients, those ages 16 to 25, in the study were more likely to receive counseling about contraception than the 14- and 15-year-olds, perhaps driven by doctors’ expectation that older teens were more likely to be sexually active, researchers wrote.\u003c/p>\n\u003cp>But statistics show this assumption about teenage sexual behavior may be off-base. The Centers for Disease Control and Prevention's 2013 \u003ca href=\"https://nccd.cdc.gov/youthonline/App/Results.aspx?TT=A&OUT=0&SID=HS&QID=QQ&LID=XX&YID=2013&LID2=&YID2=&COL=S&ROW1=N&ROW2=N&HT=QQ&LCT=LL&FS=S1&FR=R1&FG=G1&FSL=S1&FRL=R1&FGL=G1&PV=&TST=False&C1=&C2=&QP=G&DP=1&VA=CI&CS=Y&SYID=&EYID=&SC=DEFAULT&SO=ASC\" target=\"_blank\">Youth Risk Behavior Surveillance System\u003c/a> showed that 35 percent of adolescent females in grades 9 to 12, ages 14 to18, were classified as currently sexually active, having had sex in the previous three months, researchers said.\u003c/p>\n\u003cp>Young patients take drugs that can cause birth defects to treat all sorts of conditions, including common ones.\u003c/p>\n\u003cp>In the study, the most commonly prescribed were:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>isotretinoin\u003c/strong> -- used to treat severe acne\u003c/li>\n\u003cli>\u003cstrong>diazepam\u003c/strong> -- used to treat treat anxiety disorders or seizures\u003c/li>\n\u003cli>\u003cstrong>methotrexate\u003c/strong> -- used to treat certain cancers, arthritis and inflammatory bowel disease\u003c/li>\n\u003cli>\u003cstrong>topiramate\u003c/strong> -- used to treat seizures\u003c/li>\n\u003cli>\u003cstrong>enalapril\u003c/strong> -- used to treat high blood pressure and heart conditions.\u003c/li>\n\u003c/ul>\n\u003cp>The pediatricians who most frequently prescribe the drugs are from the neurology, hematology-oncology and dermatology specialties, the study said, but others use them to treat teens for other conditions as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">The drugs in question are given to treat a wide range of conditions, including acne and anxiety.\u003c/aside>\n\u003cp>\u003ca href=\"http://www.childrenshospitaloakland.org/main/find-a-doctor/gleghorn-elizabeth-md-118.aspx\" target=\"_blank\">Dr. Elizabeth Gleghorn\u003c/a>, a pediatric gastroenterologist and division chief at UCSF Benioff Children’s Hospital Oakland who was not involved in the study, said she counsels patients about the risk of birth defects when prescribing methotrexate to help treat inflammatory bowel disease.\u003c/p>\n\u003cp>“We are very aware of our drugs that are known or thought to cause birth defects,\" she said. “We talk about it to patients.”\u003c/p>\n\u003cp>But with adolescent patients, it can be a tricky situation to navigate with the whole family involved, she said.\u003c/p>\n\u003cp>“At what point do you unceremoniously kick the family out and find out if the patient is sexually active, counsel her, and bring her family back in?”\u003c/p>\n\u003cp>She said some parents feel they are the only ones who should be discussing sex with their children.\u003c/p>\n\u003cp>So Gleghorn will sometimes start out discussing the topic in a general way by saying, “In the case of women who are pregnant, this drug could be dangerous.”\u003c/p>\n\u003cp>She says the subject can be met with strong reactions from patients and families. She recalled that the mother of a teenage girl patient became hysterical when Gleghorn raised the issue of methotrexate causing birth defects.\u003c/p>\n\u003cp>“It raised fears of her daughter’s reproductive future, and went to the basis of her anxiety that her daughter wouldn’t have a normal life living with a chronic illness,” Gleghorn said.\u003c/p>\n\u003cp>But Gleghorn says she counsels patients that when a woman decides to become pregnant, she would go off methotrexate and perhaps use a different medication that poses less risk to a fetus.\u003c/p>\n\u003cp>One adolescent girl insisted she was never going to have sex and never going to have kids, so the risk of birth defects wasn’t a problem, Gleghorn said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So I told her, ‘It may not be an issue for you right now, but I am telling you so you know for the future.’ ”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most teenage girls who are prescribed drugs known to cause birth defects don’t receive adequate counseling about contraception, putting them at risk for negative pregnancy outcomes, according to a study published Wednesday in the \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/12/14/peds.2015-1454?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token\" target=\"_blank\">journal Pediatrics.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is room for great improvement.'\u003ccite>Stephani Stancil, lead author of study\u003c/cite>\u003c/aside>\n\u003cp>The medications are given to treat a wide range of conditions, including acne and anxiety.\u003c/p>\n\u003cp>More than 70 percent of female patients in the study who were prescribed such medications did not receive counseling about preventing pregnancy or given prescriptions for contraceptives or referral for such care.\u003c/p>\n\u003cp>“There is room for great improvement,” said lead author Stephani Stancil, a nurse practitioner in the division of adolescent medicine and clinical pharmacology at Children’s Mercy Hospital in Kansas City, Missouri. “We hope the study is a good first step to increase education to prescribers and patients and families to make healthier reproductive choices.”\u003c/p>\n\u003cp>The study examined electronic medical records from female patients between 14 and 25 years old who received the drug prescriptions during office visits between 2008 and 2012 at a major Midwestern academic pediatric medical center.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nearly 1,700 girls and women received 4,506 prescriptions for so-called teratogenic medications -- meaning those that can cause birth defects -- during 4,100 office visits.\u003c/p>\n\u003cp>The study found some disparities. White patients were more likely to receive contraception counseling than minority patients, the study said. The study did not suggest reasons for that, but doctors not involved in the research say it could be due to general health care disparities and a cultural or language gap between doctors and patients.\u003c/p>\n\u003cp>Older patients, those ages 16 to 25, in the study were more likely to receive counseling about contraception than the 14- and 15-year-olds, perhaps driven by doctors’ expectation that older teens were more likely to be sexually active, researchers wrote.\u003c/p>\n\u003cp>But statistics show this assumption about teenage sexual behavior may be off-base. The Centers for Disease Control and Prevention's 2013 \u003ca href=\"https://nccd.cdc.gov/youthonline/App/Results.aspx?TT=A&OUT=0&SID=HS&QID=QQ&LID=XX&YID=2013&LID2=&YID2=&COL=S&ROW1=N&ROW2=N&HT=QQ&LCT=LL&FS=S1&FR=R1&FG=G1&FSL=S1&FRL=R1&FGL=G1&PV=&TST=False&C1=&C2=&QP=G&DP=1&VA=CI&CS=Y&SYID=&EYID=&SC=DEFAULT&SO=ASC\" target=\"_blank\">Youth Risk Behavior Surveillance System\u003c/a> showed that 35 percent of adolescent females in grades 9 to 12, ages 14 to18, were classified as currently sexually active, having had sex in the previous three months, researchers said.\u003c/p>\n\u003cp>Young patients take drugs that can cause birth defects to treat all sorts of conditions, including common ones.\u003c/p>\n\u003cp>In the study, the most commonly prescribed were:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>isotretinoin\u003c/strong> -- used to treat severe acne\u003c/li>\n\u003cli>\u003cstrong>diazepam\u003c/strong> -- used to treat treat anxiety disorders or seizures\u003c/li>\n\u003cli>\u003cstrong>methotrexate\u003c/strong> -- used to treat certain cancers, arthritis and inflammatory bowel disease\u003c/li>\n\u003cli>\u003cstrong>topiramate\u003c/strong> -- used to treat seizures\u003c/li>\n\u003cli>\u003cstrong>enalapril\u003c/strong> -- used to treat high blood pressure and heart conditions.\u003c/li>\n\u003c/ul>\n\u003cp>The pediatricians who most frequently prescribe the drugs are from the neurology, hematology-oncology and dermatology specialties, the study said, but others use them to treat teens for other conditions as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">The drugs in question are given to treat a wide range of conditions, including acne and anxiety.\u003c/aside>\n\u003cp>\u003ca href=\"http://www.childrenshospitaloakland.org/main/find-a-doctor/gleghorn-elizabeth-md-118.aspx\" target=\"_blank\">Dr. Elizabeth Gleghorn\u003c/a>, a pediatric gastroenterologist and division chief at UCSF Benioff Children’s Hospital Oakland who was not involved in the study, said she counsels patients about the risk of birth defects when prescribing methotrexate to help treat inflammatory bowel disease.\u003c/p>\n\u003cp>“We are very aware of our drugs that are known or thought to cause birth defects,\" she said. “We talk about it to patients.”\u003c/p>\n\u003cp>But with adolescent patients, it can be a tricky situation to navigate with the whole family involved, she said.\u003c/p>\n\u003cp>“At what point do you unceremoniously kick the family out and find out if the patient is sexually active, counsel her, and bring her family back in?”\u003c/p>\n\u003cp>She said some parents feel they are the only ones who should be discussing sex with their children.\u003c/p>\n\u003cp>So Gleghorn will sometimes start out discussing the topic in a general way by saying, “In the case of women who are pregnant, this drug could be dangerous.”\u003c/p>\n\u003cp>She says the subject can be met with strong reactions from patients and families. She recalled that the mother of a teenage girl patient became hysterical when Gleghorn raised the issue of methotrexate causing birth defects.\u003c/p>\n\u003cp>“It raised fears of her daughter’s reproductive future, and went to the basis of her anxiety that her daughter wouldn’t have a normal life living with a chronic illness,” Gleghorn said.\u003c/p>\n\u003cp>But Gleghorn says she counsels patients that when a woman decides to become pregnant, she would go off methotrexate and perhaps use a different medication that poses less risk to a fetus.\u003c/p>\n\u003cp>One adolescent girl insisted she was never going to have sex and never going to have kids, so the risk of birth defects wasn’t a problem, Gleghorn said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So I told her, ‘It may not be an issue for you right now, but I am telling you so you know for the future.’ ”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Federal Complaint, Advocates Allege Medi-Cal Violates Latinos' Civil Rights",
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"content": "\u003cp>Health advocates are accusing state officials of discriminating against Latino patients in Medi-Cal, the state’s health insurance program for people who are low income.\u003c/p>\n\u003cp>They filed \u003ca href=\"http://www.seiu-uhw.org/wp-content/blogs.dir/166/files/2015/12/CivilRightsComplaint_Text_12.15.15.pdf\" target=\"_blank\">a complaint \u003c/a>with the U.S. Department of Health and Human Services Office for Civil Rights, arguing reimbursement rates are so low that doctors refuse to see Medi-Cal patients -- nearly two-thirds of whom are Latino. Many patients face long waits for care or outright denial, the complaint says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When I tell them I have Medi-Cal, they tell me they won't see me.'\u003ccite>Maria Barba, Medi-Cal patient \u003c/cite>\u003c/aside>\n\u003cp>One of them is Saul Jimenez, who has cerebral palsy and epilepsy. He gets terrible seizures that land him in the ER. His mother, Analilia Jimenez Perea, has been trying to get him to see a neurologist. But with Medi-Cal, she says the wait is a year and a half.\u003c/p>\n\u003cp>\"It’s very sad when I try to get an appointment for him at a special clinic,\" Jimenez Perea said in \u003ca href=\"https://www.youtube.com/watch?v=8GKAjo_W_p8&feature=youtu.be\" target=\"_blank\">videotaped remarks\u003c/a>. \"They so happy to answer me until they ask me what is insurance. And I say, 'Medi-Cal.' They say, 'We just don’t accepting Medi-Cal,' or, 'You have to be on the waiting list,' or, 'No thank you.'\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"Ufk3CCxjA2CAQFv3ZoqESkx0FSr4jgxy\"]Maria Barba has had similar difficulties getting treatment for kidney stones. She’s been to two different ER’s with incredible pain.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"They all tell me the same thing,\" Barba said in Spanish, through an interpreter, \"that I need a surgery and they won't do it. When I tell them I have Medi-Cal, they tell me they won't see me.\"\u003c/p>\n\u003cp>Lawyers from the Mexican American Legal Defense and Education Fund and the National Health Law Program say the state is abdicating its responsibility to provide equal access to health care. They allege that Medi-Cal reimbursement rates have fallen \"in tandem\" with the increasing proportion of Latinos in Medi-Cal.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/237879394\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>“By ensuring that reimbursement rates remain unduly low, the state of California has engaged in unlawful discrimination under both state and federal law,” said Thomas Saenz, president and general counsel for MALDEF.\u003c/p>\n\u003cp>Here's more from \u003ca href=\"http://www.seiu-uhw.org/wp-content/blogs.dir/166/files/2015/12/CivilRightsComplaint_Text_12.15.15.pdf\" target=\"_blank\">the complaint\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Today, no other type of health insurance in California covers a population that is so heavily Latino. The separate and unequal system of healthcare thus violates the protections of Title VI of the Civil Rights Act and the Department of Health and Human Services’ implementing regulations, as well as Section 1557 of the Affordable Care Act ...\u003c/p>\u003c/blockquote>\n\u003cp>State Medi-Cal officials said they would not comment on the specifics of the complaint, but insisted that they closely monitor access to all Medi-Cal programs.\u003c/p>\n\u003cp>“We work hard to serve all beneficiaries equally,” Jennifer Kent, director of the Department of Health Care Services, said in a statement. “We are committed to serving all vulnerable populations with vital health services.”\u003c/p>\n\u003cp>The statement cited a \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/publications/downloadable/BSCF%20Delivering%20Promise%20Full%20Report%20Web.pdf\" target=\"_blank\">January 2015 survey\u003c/a> by the Blue Shield of California Foundation that showed satisfaction gaps between whites and Latinos, identified in 2011, have been eliminated or dramatically narrowed. Overall satisfaction with Medi-Cal was 90 percent.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We are committed to serving all vulnerable populations with vital health services.'\u003ccite>Jennifer Kent, director, Dept. of Health Care Services \u003c/cite>\u003c/aside>\n\u003cp>Catha Worthman, an attorney with the Oakland law firm Feinberg, Jackson, Worthman and Wasow, says the Office of Civil Rights has a duty to investigate the claims, and, if they agree with the advocates that the law has been violated, they can negotiate a solution with California health officials. Advocates believe that solution should include raising reimbursement rates and better monitoring of access to doctors.\u003c/p>\n\u003cp>If no resolution is reached voluntarily, the Office of Civil Rights can ask the federal Department of Justice to bring a lawsuit or the complainants could file a class action lawsuit on behalf of all Latino Medi-Cal recipients.\u003c/p>\n\u003cp>H.D. Palmer, spokesman for the state Department of Finance, said Gov. Jerry Brown is currently working on a budget he will submit to the Legislature in January.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We have not said we’re opposed to rate increases, but if you’re going to have a rate increase, show us how that results in an expansion of care,” Palmer said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Health advocates are accusing state officials of discriminating against Latino patients in Medi-Cal, the state’s health insurance program for people who are low income.\u003c/p>\n\u003cp>They filed \u003ca href=\"http://www.seiu-uhw.org/wp-content/blogs.dir/166/files/2015/12/CivilRightsComplaint_Text_12.15.15.pdf\" target=\"_blank\">a complaint \u003c/a>with the U.S. Department of Health and Human Services Office for Civil Rights, arguing reimbursement rates are so low that doctors refuse to see Medi-Cal patients -- nearly two-thirds of whom are Latino. Many patients face long waits for care or outright denial, the complaint says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When I tell them I have Medi-Cal, they tell me they won't see me.'\u003ccite>Maria Barba, Medi-Cal patient \u003c/cite>\u003c/aside>\n\u003cp>One of them is Saul Jimenez, who has cerebral palsy and epilepsy. He gets terrible seizures that land him in the ER. His mother, Analilia Jimenez Perea, has been trying to get him to see a neurologist. But with Medi-Cal, she says the wait is a year and a half.\u003c/p>\n\u003cp>\"It’s very sad when I try to get an appointment for him at a special clinic,\" Jimenez Perea said in \u003ca href=\"https://www.youtube.com/watch?v=8GKAjo_W_p8&feature=youtu.be\" target=\"_blank\">videotaped remarks\u003c/a>. \"They so happy to answer me until they ask me what is insurance. And I say, 'Medi-Cal.' They say, 'We just don’t accepting Medi-Cal,' or, 'You have to be on the waiting list,' or, 'No thank you.'\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Maria Barba has had similar difficulties getting treatment for kidney stones. She’s been to two different ER’s with incredible pain.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"They all tell me the same thing,\" Barba said in Spanish, through an interpreter, \"that I need a surgery and they won't do it. When I tell them I have Medi-Cal, they tell me they won't see me.\"\u003c/p>\n\u003cp>Lawyers from the Mexican American Legal Defense and Education Fund and the National Health Law Program say the state is abdicating its responsibility to provide equal access to health care. They allege that Medi-Cal reimbursement rates have fallen \"in tandem\" with the increasing proportion of Latinos in Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/237879394&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/237879394'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“By ensuring that reimbursement rates remain unduly low, the state of California has engaged in unlawful discrimination under both state and federal law,” said Thomas Saenz, president and general counsel for MALDEF.\u003c/p>\n\u003cp>Here's more from \u003ca href=\"http://www.seiu-uhw.org/wp-content/blogs.dir/166/files/2015/12/CivilRightsComplaint_Text_12.15.15.pdf\" target=\"_blank\">the complaint\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Today, no other type of health insurance in California covers a population that is so heavily Latino. The separate and unequal system of healthcare thus violates the protections of Title VI of the Civil Rights Act and the Department of Health and Human Services’ implementing regulations, as well as Section 1557 of the Affordable Care Act ...\u003c/p>\u003c/blockquote>\n\u003cp>State Medi-Cal officials said they would not comment on the specifics of the complaint, but insisted that they closely monitor access to all Medi-Cal programs.\u003c/p>\n\u003cp>“We work hard to serve all beneficiaries equally,” Jennifer Kent, director of the Department of Health Care Services, said in a statement. “We are committed to serving all vulnerable populations with vital health services.”\u003c/p>\n\u003cp>The statement cited a \u003ca href=\"http://www.blueshieldcafoundation.org/sites/default/files/publications/downloadable/BSCF%20Delivering%20Promise%20Full%20Report%20Web.pdf\" target=\"_blank\">January 2015 survey\u003c/a> by the Blue Shield of California Foundation that showed satisfaction gaps between whites and Latinos, identified in 2011, have been eliminated or dramatically narrowed. Overall satisfaction with Medi-Cal was 90 percent.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We are committed to serving all vulnerable populations with vital health services.'\u003ccite>Jennifer Kent, director, Dept. of Health Care Services \u003c/cite>\u003c/aside>\n\u003cp>Catha Worthman, an attorney with the Oakland law firm Feinberg, Jackson, Worthman and Wasow, says the Office of Civil Rights has a duty to investigate the claims, and, if they agree with the advocates that the law has been violated, they can negotiate a solution with California health officials. Advocates believe that solution should include raising reimbursement rates and better monitoring of access to doctors.\u003c/p>\n\u003cp>If no resolution is reached voluntarily, the Office of Civil Rights can ask the federal Department of Justice to bring a lawsuit or the complainants could file a class action lawsuit on behalf of all Latino Medi-Cal recipients.\u003c/p>\n\u003cp>H.D. Palmer, spokesman for the state Department of Finance, said Gov. Jerry Brown is currently working on a budget he will submit to the Legislature in January.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We have not said we’re opposed to rate increases, but if you’re going to have a rate increase, show us how that results in an expansion of care,” Palmer said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Obamacare challenges aren’t over for businesses.\u003c/p>\n\u003cp>Starting in January, companies employing 50 to 100 workers face complicated and seemingly contradictory new rules that will affect what kind of insurance they offer and how much they and their workers will pay for it.\u003c/p>\n\u003cp>Wouldn’t you know it, one rule defines them as large businesses and another as small businesses.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These guys are great truck drivers and farm workers, but not human resources guys. Now they’re forced with paying a ton of money to outsource this or do it themselves.' \u003ccite> Adam Rochon, insurance agent \u003c/cite>\u003c/aside>\n\u003cp>“The Affordable Care Act has many different definitions of small business. They’re inconsistent with one another,” says David Chase, California director of the \u003ca href=\"http://www.smallbusinessmajority.org/\" target=\"_blank\">Small Business Majority\u003c/a> advocacy organization.\u003c/p>\n\u003cp>Many of the affected businesses are family-run establishments that don’t have human resources departments, says \u003ca href=\"https://wfis.wellsfargo.com/aboutus/bios/pages/lilianasalazar.aspx\" target=\"_blank\">Liliana Salazar\u003c/a>, a senior vice president at Wells Fargo Insurance who advises employers on their benefits packages.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Many are completely oblivious to what they’re facing,” she says.\u003c/p>\n\u003cp>Adam Rochon, an insurance agent in the Central Valley city of Exeter, confirms employers’ frustrations. Many of his small business clients are farmers and owners of blue-collar companies who are “scared and frustrated.”\u003c/p>\n\u003cp>“These guys are great truck drivers and farm workers, but not human resources guys,” he says. “Now they’re forced with paying a ton of money to outsource this or do it themselves.”\u003c/p>\n\u003cp>Unfortunately, the cost of not complying could also be dear.\u003c/p>\n\u003cp>\u003cstrong>Q: I am a business owner with 78 full-time workers. Is there anything I need to know about health insurance changes next year?\u003c/strong>\u003c/p>\n\u003cp>A: Oh yes.\u003c/p>\n\u003cp>I’m going to focus on two, and I’m going to simplify for your sanity – and mine.\u003c/p>\n\u003cp>If you think you might be subject to these changes, I highly recommend you seek expert guidance. More on that later.\u003c/p>\n\u003cp>\u003cstrong>EMPLOYER MANDATE\u003c/strong>\u003c/p>\n\u003cp>Obamacare’s \u003ca href=\"http://centerforhealthreporting.org/article/health-law-mandate-hits-employers-unevenly\" target=\"_blank\">employer mandate \u003c/a>requires “large” businesses to provide “affordable” health coverage to their employees or face financial penalties. (That’s affordable as defined by the law.)\u003c/p>\n\u003cp>Starting Jan. 1, the mandate will expand to include businesses with at least 50 full-time equivalent workers, compared with 100 this year.\u003c/p>\n\u003cp>In other words, businesses with 50 to 100 workers will be considered large and will be required to offer insurance to their employees.\u003c/p>\n\u003cp>This year, 89 percent of firms with between 50 and 99 workers offered benefits to at least some workers, \u003ca href=\"http://kff.org/report-section/ehbs-2015-section-two-health-benefits-offer-rates/\" target=\"_blank\">according to the nonprofit Kaiser Family Foundation\u003c/a> (KFF).\u003c/p>\n\u003caside class=\"pullquote align right\">'A small business can’t afford a penalty.'\u003ccite> Liliana Salazar, Wells Fargo Insurance\u003c/cite>\u003c/aside>\n\u003cp>Restaurants, retail establishments and construction firms are among the employers in this category that are least likely to offer insurance, says Larry Levitt, a senior vice president at KFF.\u003c/p>\n\u003cp>Next year, they’ll face a penalty if they don’t.\u003c/p>\n\u003cp>More specifically, a business will be dinged if it doesn’t offer insurance to at least 95 percent of its full-time employees and their children, or if the coverage it offers doesn’t meet Obamacare’s standards. (Businesses don’t necessarily have to provide coverage to spouses, Levitt says.)\u003c/p>\n\u003cp>Under the law, a full-time employee is someone who works an average of at least 30 hours a week.\u003c/p>\n\u003cp>The penalties kick in if at least one of the business’ employees signs up for a plan from a health insurance exchange such as Covered California and receives tax credits to reduce the cost of the plan.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/infographic/employer-responsibility-under-the-affordable-care-act/\" target=\"_blank\">The penalties\u003c/a> can easily climb into the tens of thousands of dollars.\u003c/p>\n\u003cp>“A small business can’t afford a penalty,” Salazar says.\u003c/p>\n\u003cp>Because this can be complicated, the federal government is giving businesses that are newly subject to the mandate until April 1, 2016 to comply, she says.\u003c/p>\n\u003cp>\u003cstrong>SMALL BUSINESS DEFINITION\u003c/strong>\u003c/p>\n\u003cp>In addition to the requirement that these business offer insurance, \u003ca href=\"http://healthaffairs.org/blog/2015/10/20/cms-allows-states-to-keep-original-aca-small-employer-definition-in-the-pace-act/\" target=\"_blank\">California is among a handful of states \u003c/a>that next year will change the definition of “small” business to include them.\u003c/p>\n\u003cp>This Obamacare-related change will define small businesses as those with up to 100 full-time equivalent employees, up from 50 now.\u003c/p>\n\u003cp>By being classified as small businesses instead of a large business, these employers must offer health insurance that complies with a different and expanded set of Obamacare rules.\u003c/p>\n\u003cp>As a result, most of these businesses will have to purchase new plans that meet the requirements.\u003c/p>\n\u003cp>“The insurance carriers and products are different,” Chase says. “The way they calculate the premiums is different.”\u003c/p>\n\u003cp>For instance, under the new rules, the health plans must contain standard designs – think of those bronze, silver, gold and platinum coverage tiers \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">offered by Covered California\u003c/a> – and cover specific medical benefits. They also limit how much more insurers can charge employers for older workers than younger ones.\u003c/p>\n\u003cp>“If you’ve got a young and healthy workforce, you might see a premium increase,” Levitt says. “If you’ve got an older, sicker workforce, you might see a premium decrease.”\u003c/p>\n\u003cp>Overall, Salazar predicts that both employers and workers will see higher premium costs.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange, is opening its small business exchange to businesses in this category and has “experienced a noticeable surge in enrollment” in the past few months, says spokesman Larry Hicks.\u003c/p>\n\u003cp>\u003ca href=\"https://www.calchoice.com\" target=\"_blank\">CaliforniaChoice\u003c/a>, a private health insurance exchange for small businesses, also is opening to these employers and has seen a jump in enrollments, says CEO Ron Goldstein.\u003c/p>\n\u003cp>Finally, you’ll recall from the “employer mandate” section that businesses with under 50 full-time equivalent employees are not required to offer insurance to their employees. However, if they do, their plans also must meet Obamacare requirements for small businesses.\u003c/p>\n\u003cp>\u003cstrong>GET HELP\u003c/strong>\u003c/p>\n\u003cp>If you’re a business in this category, seek guidance. The details are incredibly complex.\u003c/p>\n\u003cp>• Reach out to your local or state chamber of commerce, which can help you figure out where you stand.\u003cbr>\n• Consider hiring an employee benefits consultant, who can advise you on how to comply with Obamacare requirements.\u003cbr>\n• A licensed insurance broker can help you find the right health plan for your business, and there’s no extra cost for the help.\u003c/p>\n\u003cp>\u003cstrong>CHANGE FOR ASK EMILY\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Starting in January, Ask Emily is moving to a new home with \u003ca href=\"http://www.khn.org\" target=\"_blank\">Kaiser Health News.\u003c/a> Please start directing your questions to \u003ca href=\"mailto:AskEmily@kff.org\" target=\"_blank\">AskEmily@kff.org\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Obamacare challenges aren’t over for businesses.\u003c/p>\n\u003cp>Starting in January, companies employing 50 to 100 workers face complicated and seemingly contradictory new rules that will affect what kind of insurance they offer and how much they and their workers will pay for it.\u003c/p>\n\u003cp>Wouldn’t you know it, one rule defines them as large businesses and another as small businesses.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These guys are great truck drivers and farm workers, but not human resources guys. Now they’re forced with paying a ton of money to outsource this or do it themselves.' \u003ccite> Adam Rochon, insurance agent \u003c/cite>\u003c/aside>\n\u003cp>“The Affordable Care Act has many different definitions of small business. They’re inconsistent with one another,” says David Chase, California director of the \u003ca href=\"http://www.smallbusinessmajority.org/\" target=\"_blank\">Small Business Majority\u003c/a> advocacy organization.\u003c/p>\n\u003cp>Many of the affected businesses are family-run establishments that don’t have human resources departments, says \u003ca href=\"https://wfis.wellsfargo.com/aboutus/bios/pages/lilianasalazar.aspx\" target=\"_blank\">Liliana Salazar\u003c/a>, a senior vice president at Wells Fargo Insurance who advises employers on their benefits packages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Many are completely oblivious to what they’re facing,” she says.\u003c/p>\n\u003cp>Adam Rochon, an insurance agent in the Central Valley city of Exeter, confirms employers’ frustrations. Many of his small business clients are farmers and owners of blue-collar companies who are “scared and frustrated.”\u003c/p>\n\u003cp>“These guys are great truck drivers and farm workers, but not human resources guys,” he says. “Now they’re forced with paying a ton of money to outsource this or do it themselves.”\u003c/p>\n\u003cp>Unfortunately, the cost of not complying could also be dear.\u003c/p>\n\u003cp>\u003cstrong>Q: I am a business owner with 78 full-time workers. Is there anything I need to know about health insurance changes next year?\u003c/strong>\u003c/p>\n\u003cp>A: Oh yes.\u003c/p>\n\u003cp>I’m going to focus on two, and I’m going to simplify for your sanity – and mine.\u003c/p>\n\u003cp>If you think you might be subject to these changes, I highly recommend you seek expert guidance. More on that later.\u003c/p>\n\u003cp>\u003cstrong>EMPLOYER MANDATE\u003c/strong>\u003c/p>\n\u003cp>Obamacare’s \u003ca href=\"http://centerforhealthreporting.org/article/health-law-mandate-hits-employers-unevenly\" target=\"_blank\">employer mandate \u003c/a>requires “large” businesses to provide “affordable” health coverage to their employees or face financial penalties. (That’s affordable as defined by the law.)\u003c/p>\n\u003cp>Starting Jan. 1, the mandate will expand to include businesses with at least 50 full-time equivalent workers, compared with 100 this year.\u003c/p>\n\u003cp>In other words, businesses with 50 to 100 workers will be considered large and will be required to offer insurance to their employees.\u003c/p>\n\u003cp>This year, 89 percent of firms with between 50 and 99 workers offered benefits to at least some workers, \u003ca href=\"http://kff.org/report-section/ehbs-2015-section-two-health-benefits-offer-rates/\" target=\"_blank\">according to the nonprofit Kaiser Family Foundation\u003c/a> (KFF).\u003c/p>\n\u003caside class=\"pullquote align right\">'A small business can’t afford a penalty.'\u003ccite> Liliana Salazar, Wells Fargo Insurance\u003c/cite>\u003c/aside>\n\u003cp>Restaurants, retail establishments and construction firms are among the employers in this category that are least likely to offer insurance, says Larry Levitt, a senior vice president at KFF.\u003c/p>\n\u003cp>Next year, they’ll face a penalty if they don’t.\u003c/p>\n\u003cp>More specifically, a business will be dinged if it doesn’t offer insurance to at least 95 percent of its full-time employees and their children, or if the coverage it offers doesn’t meet Obamacare’s standards. (Businesses don’t necessarily have to provide coverage to spouses, Levitt says.)\u003c/p>\n\u003cp>Under the law, a full-time employee is someone who works an average of at least 30 hours a week.\u003c/p>\n\u003cp>The penalties kick in if at least one of the business’ employees signs up for a plan from a health insurance exchange such as Covered California and receives tax credits to reduce the cost of the plan.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/infographic/employer-responsibility-under-the-affordable-care-act/\" target=\"_blank\">The penalties\u003c/a> can easily climb into the tens of thousands of dollars.\u003c/p>\n\u003cp>“A small business can’t afford a penalty,” Salazar says.\u003c/p>\n\u003cp>Because this can be complicated, the federal government is giving businesses that are newly subject to the mandate until April 1, 2016 to comply, she says.\u003c/p>\n\u003cp>\u003cstrong>SMALL BUSINESS DEFINITION\u003c/strong>\u003c/p>\n\u003cp>In addition to the requirement that these business offer insurance, \u003ca href=\"http://healthaffairs.org/blog/2015/10/20/cms-allows-states-to-keep-original-aca-small-employer-definition-in-the-pace-act/\" target=\"_blank\">California is among a handful of states \u003c/a>that next year will change the definition of “small” business to include them.\u003c/p>\n\u003cp>This Obamacare-related change will define small businesses as those with up to 100 full-time equivalent employees, up from 50 now.\u003c/p>\n\u003cp>By being classified as small businesses instead of a large business, these employers must offer health insurance that complies with a different and expanded set of Obamacare rules.\u003c/p>\n\u003cp>As a result, most of these businesses will have to purchase new plans that meet the requirements.\u003c/p>\n\u003cp>“The insurance carriers and products are different,” Chase says. “The way they calculate the premiums is different.”\u003c/p>\n\u003cp>For instance, under the new rules, the health plans must contain standard designs – think of those bronze, silver, gold and platinum coverage tiers \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">offered by Covered California\u003c/a> – and cover specific medical benefits. They also limit how much more insurers can charge employers for older workers than younger ones.\u003c/p>\n\u003cp>“If you’ve got a young and healthy workforce, you might see a premium increase,” Levitt says. “If you’ve got an older, sicker workforce, you might see a premium decrease.”\u003c/p>\n\u003cp>Overall, Salazar predicts that both employers and workers will see higher premium costs.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange, is opening its small business exchange to businesses in this category and has “experienced a noticeable surge in enrollment” in the past few months, says spokesman Larry Hicks.\u003c/p>\n\u003cp>\u003ca href=\"https://www.calchoice.com\" target=\"_blank\">CaliforniaChoice\u003c/a>, a private health insurance exchange for small businesses, also is opening to these employers and has seen a jump in enrollments, says CEO Ron Goldstein.\u003c/p>\n\u003cp>Finally, you’ll recall from the “employer mandate” section that businesses with under 50 full-time equivalent employees are not required to offer insurance to their employees. However, if they do, their plans also must meet Obamacare requirements for small businesses.\u003c/p>\n\u003cp>\u003cstrong>GET HELP\u003c/strong>\u003c/p>\n\u003cp>If you’re a business in this category, seek guidance. The details are incredibly complex.\u003c/p>\n\u003cp>• Reach out to your local or state chamber of commerce, which can help you figure out where you stand.\u003cbr>\n• Consider hiring an employee benefits consultant, who can advise you on how to comply with Obamacare requirements.\u003cbr>\n• A licensed insurance broker can help you find the right health plan for your business, and there’s no extra cost for the help.\u003c/p>\n\u003cp>\u003cstrong>CHANGE FOR ASK EMILY\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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},
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
},
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"how-i-built-this": {
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
},
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
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