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"content": "\u003cp>Carmen Gonzalez combs through pictures of her youngest son, Jacob. She picks one that shows him in boxing gear, his gloved fists raised. He looks straight at the camera. In another, he’s more relaxed, with his long, wavy hair reaching down to his shoulders. His arm hangs around his mother.\u003c/p>\n\u003cp>“My son was a very charming, popular kid with girls,” says Gonzalez. “He was funny, and he always had a smiling face. No one could resist him.”\u003c/p>\n\u003cp>Two years ago, when Jacob was 17, he was accidentally killed by a friend who shot him in the back while they sat in a parking lot.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/230868753\" 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>“Instead of waiting for a kid to graduate from high school or drive his own car, we have nothing. He just left. And he left us with an empty heart, because we love him so much,” she says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Gonzalez felt a deep sense of injustice over her son’s sudden death. She became depressed and angry. That’s when she decided to look for help and came to a grief group at Oakland's La Clinica de la Raza. Participants meet weekly to talk about their emotions and learn different ways to cope. And today, that includes tapping into traditional medicine and art as \u003cem>Dia de los Muertos\u003c/em>, the Mexican celebration of loved ones who have died, approaches.\u003c/p>\n\u003cfigure id=\"attachment_100504\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg\">\u003cimg class=\"wp-image-100504 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg\" alt=\"Carmen Gonzalez (R) and other members of a grief group at La Clinica de la Raza in Oakland. Gonzalez’s son was accidentally killed two years ago at age 17. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Carmen Gonzalez (R) and other members of a grief group at La Clinica de la Raza in Oakland. Gonzalez’s son was accidentally killed two years ago at age 17. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gonzalez and her husband first made a nicho -- a small box decorated to honor someone who has died -- in their son's memory for \u003cem>Dia de los Muertos\u003c/em> last year. They decorated it with things Jacob loved, such as green apples, Cheetos, Star Wars figurines and chicken. She says the process of making the nicho brought a lot of tears.\u003c/p>\n\u003cp>“It's hard to think that our kid is not with us anymore,” she said.\u003c/p>\n\u003cp>The nicho that Gonzalez is making for her son this year is different. She glues red sequins onto the edge of the box and says she plans on adding a dancing \u003cem>calavera\u003c/em> or skeleton. The pain of losing her son hasn’t subsided, she says, but she feels less anger.\u003c/p>\n\u003cp>“The one I’m doing now is a little bit like resignation, because I know he is connected. Energy always transforms into something different,” Gonzalez says. “And that’s what I want to believe, that he is still with me.”\u003c/p>\n\u003cp>Everyone in the group is busily working on tables with fabrics and flowers. They take turns using a glue gun to paste tiny ceramic figurines of tamales and enchiladas onto their boxes.\u003c/p>\n\u003cp>Victor Perez, 14, has just put the first layer of paint on the nicho for his parents. They died in a car accident when he was just 3 years old. He made a nicho last year with pictures of them and other items.\u003c/p>\n\u003cfigure id=\"attachment_100505\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg\">\u003cimg class=\"size-full wp-image-100505\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg\" alt=\"Yolanda Tell shows off a nicho she made for her daughter, as grandson Victor Hugo Perez looks on. Tell’s daugher died in a car accident when Perez was 3 years old. Tell takes care of him and his brother. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Yolanda Tell shows off a nicho she made for her daughter, as grandson Victor Hugo Perez looks on. Tell’s daugher died in a car accident when Perez was 3 years old. Tell takes care of him and his brother. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My dad used to have his own workshop so I put cars, tools. And a hummingbird, because every time I used to see a hummingbird, that reminded me of (my mom),” says Perez.\u003c/p>\n\u003cp>Sometimes, he says, he kisses the nicho goodnight.\u003c/p>\n\u003cp>Psychologist Ricardo Carrillo leads the group, which is part of La Clinica’s \u003cem>Cultura y Bienestar\u003c/em> (Culture and Wellbeing) mental health program. He says that by making this art, people here are rerooting themselves in traditions that offer healthy approaches to life and death.\u003c/p>\n\u003cfigure id=\"attachment_100508\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut.jpg\">\u003cimg class=\"size-thumbnail wp-image-100508\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-400x267.jpg\" alt=\"A nicho at the Oakland Museum of California made in one of Alicia Diaz’s workshops. \" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nicho at the Oakland Museum of California made in one of Alicia Diaz’s workshops. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It strengthens our mental health in that we have a place to bring our grief, bring our loss in a celebratory way,” says Carrillo. “We accept the fact that we are going to die. The question is, what do we want to leave and what did our loved ones leave for us? And that’s what we try to celebrate in the artwork that we are doing.”\u003c/p>\n\u003cp>Carrillo is also working on a nicho for his sister, who died last year of complications from alcoholism. He paints it with bright pinks and purples.\u003c/p>\n\u003cp>“She was a really girly girl, but at the same time had the heart of a tough guy,” says Carrillo. “She was a beautiful person, but she suffered her entire life.”\u003c/p>\n\u003cp>Art therapist Alicia Diaz started the grief group nearly nine years ago. She recognized the natural fit of making nichos to help this community, and now is setting up an altar with nichos at the Oakland Museum of California.\u003c/p>\n\u003cfigure id=\"attachment_100506\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg\">\u003cimg class=\"size-full wp-image-100506\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg\" alt=\"Alicia Diaz, an art therapist, decorates an altar with nichos she helped others make at the Oakland Museum of California. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alicia Diaz, an art therapist, decorates an altar with nichos she helped others make at the Oakland Museum of California. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If people can make that connection to the person that's passed away, let that creativity just run from their heart to their hands and create without judgment, it shows,\" she says. \"People love it, and people love to look at them.”\u003c/p>\n\u003cp>Diaz didn’t grow up with the tradition -– this hybrid between popular and religious art. But she fell in love with it after learning about it when she was in graduate school. Now she has helped more than 100 people make nichos for loved ones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I look at every nicho and think, 'That’s a person. That was somebody’s life, and somebody is grieving them and missing them and this is real!' It’s not just a painting or a creation,” she says.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Carmen Gonzalez combs through pictures of her youngest son, Jacob. She picks one that shows him in boxing gear, his gloved fists raised. He looks straight at the camera. In another, he’s more relaxed, with his long, wavy hair reaching down to his shoulders. His arm hangs around his mother.\u003c/p>\n\u003cp>“My son was a very charming, popular kid with girls,” says Gonzalez. “He was funny, and he always had a smiling face. No one could resist him.”\u003c/p>\n\u003cp>Two years ago, when Jacob was 17, he was accidentally killed by a friend who shot him in the back while they sat in a parking lot.\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/230868753&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/230868753'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Instead of waiting for a kid to graduate from high school or drive his own car, we have nothing. He just left. And he left us with an empty heart, because we love him so much,” she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gonzalez felt a deep sense of injustice over her son’s sudden death. She became depressed and angry. That’s when she decided to look for help and came to a grief group at Oakland's La Clinica de la Raza. Participants meet weekly to talk about their emotions and learn different ways to cope. And today, that includes tapping into traditional medicine and art as \u003cem>Dia de los Muertos\u003c/em>, the Mexican celebration of loved ones who have died, approaches.\u003c/p>\n\u003cfigure id=\"attachment_100504\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg\">\u003cimg class=\"wp-image-100504 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg\" alt=\"Carmen Gonzalez (R) and other members of a grief group at La Clinica de la Raza in Oakland. Gonzalez’s son was accidentally killed two years ago at age 17. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17254_IMG_9960.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Carmen Gonzalez (R) and other members of a grief group at La Clinica de la Raza in Oakland. Gonzalez’s son was accidentally killed two years ago at age 17. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Gonzalez and her husband first made a nicho -- a small box decorated to honor someone who has died -- in their son's memory for \u003cem>Dia de los Muertos\u003c/em> last year. They decorated it with things Jacob loved, such as green apples, Cheetos, Star Wars figurines and chicken. She says the process of making the nicho brought a lot of tears.\u003c/p>\n\u003cp>“It's hard to think that our kid is not with us anymore,” she said.\u003c/p>\n\u003cp>The nicho that Gonzalez is making for her son this year is different. She glues red sequins onto the edge of the box and says she plans on adding a dancing \u003cem>calavera\u003c/em> or skeleton. The pain of losing her son hasn’t subsided, she says, but she feels less anger.\u003c/p>\n\u003cp>“The one I’m doing now is a little bit like resignation, because I know he is connected. Energy always transforms into something different,” Gonzalez says. “And that’s what I want to believe, that he is still with me.”\u003c/p>\n\u003cp>Everyone in the group is busily working on tables with fabrics and flowers. They take turns using a glue gun to paste tiny ceramic figurines of tamales and enchiladas onto their boxes.\u003c/p>\n\u003cp>Victor Perez, 14, has just put the first layer of paint on the nicho for his parents. They died in a car accident when he was just 3 years old. He made a nicho last year with pictures of them and other items.\u003c/p>\n\u003cfigure id=\"attachment_100505\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg\">\u003cimg class=\"size-full wp-image-100505\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg\" alt=\"Yolanda Tell shows off a nicho she made for her daughter, as grandson Victor Hugo Perez looks on. Tell’s daugher died in a car accident when Perez was 3 years old. Tell takes care of him and his brother. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17253_IMG_9948.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Yolanda Tell shows off a nicho she made for her daughter, as grandson Victor Hugo Perez looks on. Tell’s daugher died in a car accident when Perez was 3 years old. Tell takes care of him and his brother. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My dad used to have his own workshop so I put cars, tools. And a hummingbird, because every time I used to see a hummingbird, that reminded me of (my mom),” says Perez.\u003c/p>\n\u003cp>Sometimes, he says, he kisses the nicho goodnight.\u003c/p>\n\u003cp>Psychologist Ricardo Carrillo leads the group, which is part of La Clinica’s \u003cem>Cultura y Bienestar\u003c/em> (Culture and Wellbeing) mental health program. He says that by making this art, people here are rerooting themselves in traditions that offer healthy approaches to life and death.\u003c/p>\n\u003cfigure id=\"attachment_100508\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut.jpg\">\u003cimg class=\"size-thumbnail wp-image-100508\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-400x267.jpg\" alt=\"A nicho at the Oakland Museum of California made in one of Alicia Diaz’s workshops. \" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17250_IMG_9896.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nicho at the Oakland Museum of California made in one of Alicia Diaz’s workshops. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It strengthens our mental health in that we have a place to bring our grief, bring our loss in a celebratory way,” says Carrillo. “We accept the fact that we are going to die. The question is, what do we want to leave and what did our loved ones leave for us? And that’s what we try to celebrate in the artwork that we are doing.”\u003c/p>\n\u003cp>Carrillo is also working on a nicho for his sister, who died last year of complications from alcoholism. He paints it with bright pinks and purples.\u003c/p>\n\u003cp>“She was a really girly girl, but at the same time had the heart of a tough guy,” says Carrillo. “She was a beautiful person, but she suffered her entire life.”\u003c/p>\n\u003cp>Art therapist Alicia Diaz started the grief group nearly nine years ago. She recognized the natural fit of making nichos to help this community, and now is setting up an altar with nichos at the Oakland Museum of California.\u003c/p>\n\u003cfigure id=\"attachment_100506\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg\">\u003cimg class=\"size-full wp-image-100506\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg\" alt=\"Alicia Diaz, an art therapist, decorates an altar with nichos she helped others make at the Oakland Museum of California. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS17252_IMG_9931.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Alicia Diaz, an art therapist, decorates an altar with nichos she helped others make at the Oakland Museum of California. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If people can make that connection to the person that's passed away, let that creativity just run from their heart to their hands and create without judgment, it shows,\" she says. \"People love it, and people love to look at them.”\u003c/p>\n\u003cp>Diaz didn’t grow up with the tradition -– this hybrid between popular and religious art. But she fell in love with it after learning about it when she was in graduate school. Now she has helped more than 100 people make nichos for loved ones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I look at every nicho and think, 'That’s a person. That was somebody’s life, and somebody is grieving them and missing them and this is real!' It’s not just a painting or a creation,” she says.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "San Francisco Dedicates More Money to End HIV",
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"content": "\u003cp>San Francisco is putting up another $1.2 million in its fight against HIV and to further its goal of becoming the first city in the world to reduce its number of new HIV infections and deaths to zero.\u003c/p>\n\u003cp>Other cities have signed on to meet the challenge by 2030. But San Francisco believes it has the strategy to meet the goal before then.\u003c/p>\n\u003cp>“If anyone can do it, San Francisco can do it,” said Supervisor David Campos.\u003c/p>\n\u003cp>The city is relying heavily on two initiatives.\u003c/p>\n\u003cp>The first is getting people with HIV into antiretroviral treatment much faster, sometimes the same day they’re diagnosed. These medications reduce the level of HIV in the blood, making it harder to transmit.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The second is expanding use of the HIV prevention pill, Truvada. This has been somewhat controversial. \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract?sid=2f65f7e1-fee1-490a-adba-5b832bcc0b0e\">A recent Kaiser study\u003c/a> found that some men who took the drug used condoms less and contracted other sexually transmitted diseases.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\"> But none got HIV\u003c/a>.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/230815563\" 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>Other studies show the drug “could be over 90 percent effective in preventing new infections, if taken on a daily basis,” said Dr. Susan Buchbinder, director of HIV research at the city’s health department. She added there's no reason to withhold a lifesaving preventive drug for fear of promiscuity.\u003c/p>\n\u003cp>“I liken it to me telling my patients that I'm not going to give them a cholesterol-lowering drug because they might eat more ice cream,” she said. “I would never do that.\"\u003c/p>\n\u003cp>San Francisco participated in the first pilot studies for the preventive therapy, also known as Pre-Exposure Prophylaxis (PrEP), and is now a leader in its use, Buchbinder said.\u003c/p>\n\u003cp>Health officials from Paris and Amsterdam visited San Francisco recently to study the city’s program, in anticipation of the drug getting licensed in Europe.\u003c/p>\n\u003cp>[contextly_sidebar id=\"cFp5wV3hR1Hh2hpqoQnSTiU5ZVhdnzSx\"]“Of course, we were a city where HIV started and was discovered, and reached epidemic levels,” said Mayor Ed Lee, “but we're also a city at the forefront of the appropriate response.”\u003c/p>\n\u003cp>At a time when the federal government continues to cut HIV/AIDS funding, San Francisco consistently backfills the loss, Lee said.\u003c/p>\n\u003cp>But other counties in California haven’t. \u003ca href=\"http://kvpr.org/post/hiv-infections-fresno-county-increase-especially-among-youth\">In Fresno\u003c/a>, for example, HIV infection rates have gone up as funding has been cut. In 2011, new cases of HIV \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/CH/content/CD/content/Epidemiology/content/At%20a%20glance%20HIV.pdf\" target=\"_blank\">spiked 73 percent \u003c/a>over the county’s previous five-year average. Annual rates dipped slightly after that, then went up again last year.\u003c/p>\n\u003cp>In total, San Francisco spends $54 million on HIV prevention and care each year. In addition to the $1.2 million the city dedicated to the effort from its own coffers this week, the MAC AIDS Fund, a philanthropic arm of the MAC cosmetics company, gave another $500,000 to the city.\u003c/p>\n\u003cp>Most of the new funding will go toward hiring more patient navigators, who will help patients sign up for health insurance, find a clinic to get care or find resources to help pay for the prevention drugs -- the Truvada daily pill can cost more than $1,000 a month.\u003c/p>\n\u003cp>The city will focus a lot of its outreach on young men and men of color, who are disproportionately affected by HIV. African-American gay men have the highest rate of new diagnoses.\u003c/p>\n\u003cp>Johanna Brown, a black transgender woman living with AIDS, remembers how difficult life was after she got her diagnosis.\u003c/p>\n\u003cp>“I lost my job, I lost my apartment, I got on drugs real heavy,” she said. “I lost my self-esteem, got disconnected from my family.”\u003c/p>\n\u003cp>She came to San Francisco in 2011 and found the \u003ca href=\"http://apiwellness.org/site/\" target=\"_blank\">API Wellness Center\u003c/a>, where she got a new doctor, therapist and case manager. They helped her get treatment, housing and a job. They also have a special support program for transgender people living with HIV and AIDS.\u003c/p>\n\u003cp>“There, we as girls get to come together, we get to socialize within ourselves, but we get to learn about our disease,” she said. “We don’t have to be worried about stigma, being judged, people pointing fingers at us. So we live a healthier life.”\u003c/p>\n\u003cp>Today, Brown’s T-cell count is good, and the virus is undetectable in her blood.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I'm not dying,” she said. “I'm going to live a long life.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco is putting up another $1.2 million in its fight against HIV and to further its goal of becoming the first city in the world to reduce its number of new HIV infections and deaths to zero.\u003c/p>\n\u003cp>Other cities have signed on to meet the challenge by 2030. But San Francisco believes it has the strategy to meet the goal before then.\u003c/p>\n\u003cp>“If anyone can do it, San Francisco can do it,” said Supervisor David Campos.\u003c/p>\n\u003cp>The city is relying heavily on two initiatives.\u003c/p>\n\u003cp>The first is getting people with HIV into antiretroviral treatment much faster, sometimes the same day they’re diagnosed. These medications reduce the level of HIV in the blood, making it harder to transmit.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The second is expanding use of the HIV prevention pill, Truvada. This has been somewhat controversial. \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/09/01/cid.civ778.abstract?sid=2f65f7e1-fee1-490a-adba-5b832bcc0b0e\">A recent Kaiser study\u003c/a> found that some men who took the drug used condoms less and contracted other sexually transmitted diseases.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\"> But none got HIV\u003c/a>.\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/230815563&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/230815563'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Other studies show the drug “could be over 90 percent effective in preventing new infections, if taken on a daily basis,” said Dr. Susan Buchbinder, director of HIV research at the city’s health department. She added there's no reason to withhold a lifesaving preventive drug for fear of promiscuity.\u003c/p>\n\u003cp>“I liken it to me telling my patients that I'm not going to give them a cholesterol-lowering drug because they might eat more ice cream,” she said. “I would never do that.\"\u003c/p>\n\u003cp>San Francisco participated in the first pilot studies for the preventive therapy, also known as Pre-Exposure Prophylaxis (PrEP), and is now a leader in its use, Buchbinder said.\u003c/p>\n\u003cp>Health officials from Paris and Amsterdam visited San Francisco recently to study the city’s program, in anticipation of the drug getting licensed in Europe.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“Of course, we were a city where HIV started and was discovered, and reached epidemic levels,” said Mayor Ed Lee, “but we're also a city at the forefront of the appropriate response.”\u003c/p>\n\u003cp>At a time when the federal government continues to cut HIV/AIDS funding, San Francisco consistently backfills the loss, Lee said.\u003c/p>\n\u003cp>But other counties in California haven’t. \u003ca href=\"http://kvpr.org/post/hiv-infections-fresno-county-increase-especially-among-youth\">In Fresno\u003c/a>, for example, HIV infection rates have gone up as funding has been cut. In 2011, new cases of HIV \u003ca href=\"http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/CH/content/CD/content/Epidemiology/content/At%20a%20glance%20HIV.pdf\" target=\"_blank\">spiked 73 percent \u003c/a>over the county’s previous five-year average. Annual rates dipped slightly after that, then went up again last year.\u003c/p>\n\u003cp>In total, San Francisco spends $54 million on HIV prevention and care each year. In addition to the $1.2 million the city dedicated to the effort from its own coffers this week, the MAC AIDS Fund, a philanthropic arm of the MAC cosmetics company, gave another $500,000 to the city.\u003c/p>\n\u003cp>Most of the new funding will go toward hiring more patient navigators, who will help patients sign up for health insurance, find a clinic to get care or find resources to help pay for the prevention drugs -- the Truvada daily pill can cost more than $1,000 a month.\u003c/p>\n\u003cp>The city will focus a lot of its outreach on young men and men of color, who are disproportionately affected by HIV. African-American gay men have the highest rate of new diagnoses.\u003c/p>\n\u003cp>Johanna Brown, a black transgender woman living with AIDS, remembers how difficult life was after she got her diagnosis.\u003c/p>\n\u003cp>“I lost my job, I lost my apartment, I got on drugs real heavy,” she said. “I lost my self-esteem, got disconnected from my family.”\u003c/p>\n\u003cp>She came to San Francisco in 2011 and found the \u003ca href=\"http://apiwellness.org/site/\" target=\"_blank\">API Wellness Center\u003c/a>, where she got a new doctor, therapist and case manager. They helped her get treatment, housing and a job. They also have a special support program for transgender people living with HIV and AIDS.\u003c/p>\n\u003cp>“There, we as girls get to come together, we get to socialize within ourselves, but we get to learn about our disease,” she said. “We don’t have to be worried about stigma, being judged, people pointing fingers at us. So we live a healthier life.”\u003c/p>\n\u003cp>Today, Brown’s T-cell count is good, and the virus is undetectable in her blood.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I'm not dying,” she said. “I'm going to live a long life.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In California, Doctors on Probation Not Required to Tell You. Should They?",
"title": "In California, Doctors on Probation Not Required to Tell You. Should They?",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>When you call to set up your next check-up, you may be unknowingly arranging for care from a physician in trouble for drug abuse, sexual misconduct, patient negligence or harm.\u003c/p>\n\u003cp>In California, physicians on probation for such punishments are already required to report them to their malpractice insurers and hospitals where they work, yet there is no rule requiring similar pro-active notifications of patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">“I was stunned to learn that the doctor I had been referred to had a long history of substance abuse and DUIs.\"\u003ccite>Marian Hollingsworth, Consumers Union\u003c/cite>\u003c/aside>\n\u003cp>The advocacy group Consumers Union wants that to change. They are calling for the Medical Board of California to make doctors on probation responsible for informing their patients. The board is \u003ca href=\"http://www.mbc.ca.gov/About_Us/Meetings/2015/Agendas/agenda_20151029_brd.pdf\" target=\"_blank\">scheduled to consider the idea\u003c/a> on Friday at its quarterly meeting in San Diego. But it is unlikely to win approval.\u003c/p>\n\u003cp>“Maybe if patients knew, they wouldn’t see the doctor,” said Lisa McGiffert, Director of the Safe Patient Project at Consumers Union. “Maybe they still would. But they are doing it with their eyes open.”\u003c/p>\n\u003cp>Under the proposed rule, doctors on probation would have to alert their patients when they call for an appointment as well as verbally and in writing during the visit. Consumers Union filed a \u003ca href=\"http://safepatientproject.org/wordpress/wp-content/uploads/2015/10/Administrative-petition-probation-disclosure-FINAL-CUSPP-as-sent-to-MBC-October-8-2015.pdf\" target=\"_blank\">9-page petition\u003c/a> with the board outlining its proposal. The petition was signed by more than 5,000 Californians.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Doctors' Group Resistant\u003c/strong>\u003c/p>\n\u003cp>Since the disciplinary actions against doctors \u003ca href=\"http://www.mbc.ca.gov/Breeze/License_Verification.aspx\" target=\"_blank\">are posted\u003c/a> on the board’s website, the state’s biggest physician group, the California Medical Association, says the proposed changes of the notification requirements would go too far.\u003c/p>\n\u003cp>In a statement Paul Hegyi, a spokesman for the association, said they worry this type of rule would “put a burden on the physician-patient relationship,\" especially when appointment time is already limited. “This information is already public and available online and can be accessed by anyone,\" he said. \"This is a duplicative burden that will interfere with patient care.”\u003c/p>\n\u003cp>The board rejected a similar measure when it was proposed by board staff in 2012. In fact, the board has just begun \u003ca href=\"http://www.mbc.ca.gov/About_Us/Media_Room/2015/news_releases_20151020_verify.pdf\" target=\"_blank\">a public relations effort\u003c/a> to encourage patients to take it upon themselves to research the disciplinary actions against their doctors.\u003c/p>\n\u003cp>Board officials even held a tutorial to show people how to use their website at a mall in Sacramento last week. Those who don’t have access to computers can call the board’s office for assistance, a statement from the board said.\u003c/p>\n\u003cp>Advocates see the board’s outreach as a response to their efforts but say it doesn’t go far enough. The burden to find the information shouldn’t be placed on patients, who may not think to look it up, know how to do so, or have access to the Internet, McGiffert said.\u003c/p>\n\u003cp>Other patients may not be able to research the information due to mental or physical impairments. They could be missing out on important information about the doctors they have trusted with their care, she said.\u003c/p>\n\u003cp>Of the approximately \u003ca href=\"http://www.oshpd.ca.gov/HWDD/HWC/FactSheets/MD-2014.pdf\" target=\"_blank\">137,000 licensed medical doctors\u003c/a> in California, nearly 500 are on probation for offenses including sexual misconduct, gross negligence, substance abuse, inappropriate prescribing, and conviction of a felony, Consumers Union said. The group \u003ca href=\"http://safepatientproject.org/wordpress/wp-content/uploads/2015/10/MBC-list-of-docs-on-probation-as-of-9-29-15-as-of-10-8-15.pdf\" target=\"_blank\">compiled a list of doctors on probation\u003c/a>.\u003c/p>\n\u003cp>Patient advocate Marian Hollingsworth, who works for Consumers Union, \u003ca href=\"http://www.sacbee.com/opinion/op-ed/soapbox/article27279535.html#storylink=cpy\" target=\"_blank\">described in a Sacramento Bee\u003c/a> opinion piece how she felt when she discovered her doctor’s probation.\u003c/p>\n\u003cp>“I was stunned to learn that the doctor I had been referred to for a routine colonoscopy was about to start a 30-day suspension and seven-year probation,” she wrote. “He had a long history of substance abuse and DUIs, but what finally got the board’s attention is that he went after a patient with a hatchet in an alcohol-fueled rage.”\u003c/p>\n\u003cp>The doctors who got into trouble are from all over the state -- in big cities like Los Angeles and rural areas like Humboldt County. In some areas with doctor shortages, if a doctor is on probation it may present an even bigger dilemma for patients. Those patients should be able to decide whether they still want to see the doctor even if it’s their only option for miles, McGiffert said\u003c/p>\n\u003cp>By agreeing to go on probation, doctors are not necessarily admitting they violated ethics rules. Some do it to avoid lengthy and costly legal battles, McGiffert said.\u003c/p>\n\u003cp>Physicians on probation may be barred from performing specific procedures, or prescribing certain medicines for a period of time. They might have to take classes or be supervised. In some cases it means a physician disciplined for sexual misconduct must be chaperoned in the exam room.\u003c/p>\n\u003cp>The issue of physician discipline has been difficult for the board. It has come under fire in recent years for failing to hold problem doctors accountable. Some legislators in 2013\u003ca href=\"http://articles.latimes.com/2013/apr/25/local/la-me-rx-medical-board-20130426\" target=\"_blank\"> called for stripping the board\u003c/a> of its investigative powers. This issue will draw renewed public attention to whether the board is aggressive enough in protecting the public from dangerous doctors.\u003c/p>\n\u003cp>McGiffert said there is concern in the medical field that requiring doctors to tell patients about their probationary status is too awkward.\u003c/p>\n\u003cp>“The objection is that, gee, this would be very uncomfortable for doctors,” McGiffert said. “What does that tell you? Sometimes you need that kind of pressure.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Update:\u003c/strong> In its meeting on Friday, the Medical Board of California voted to deny the petition that would have required doctors on probation to notify their patients. But it did agree to form a committee to review the petition more closely and potentially develop a plan to improve notification to patients of doctors on probation.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Advocacy group says Medical Board of California should require doctors it places on probation to notify patients. The board has refused in the past.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When you call to set up your next check-up, you may be unknowingly arranging for care from a physician in trouble for drug abuse, sexual misconduct, patient negligence or harm.\u003c/p>\n\u003cp>In California, physicians on probation for such punishments are already required to report them to their malpractice insurers and hospitals where they work, yet there is no rule requiring similar pro-active notifications of patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">“I was stunned to learn that the doctor I had been referred to had a long history of substance abuse and DUIs.\"\u003ccite>Marian Hollingsworth, Consumers Union\u003c/cite>\u003c/aside>\n\u003cp>The advocacy group Consumers Union wants that to change. They are calling for the Medical Board of California to make doctors on probation responsible for informing their patients. The board is \u003ca href=\"http://www.mbc.ca.gov/About_Us/Meetings/2015/Agendas/agenda_20151029_brd.pdf\" target=\"_blank\">scheduled to consider the idea\u003c/a> on Friday at its quarterly meeting in San Diego. But it is unlikely to win approval.\u003c/p>\n\u003cp>“Maybe if patients knew, they wouldn’t see the doctor,” said Lisa McGiffert, Director of the Safe Patient Project at Consumers Union. “Maybe they still would. But they are doing it with their eyes open.”\u003c/p>\n\u003cp>Under the proposed rule, doctors on probation would have to alert their patients when they call for an appointment as well as verbally and in writing during the visit. Consumers Union filed a \u003ca href=\"http://safepatientproject.org/wordpress/wp-content/uploads/2015/10/Administrative-petition-probation-disclosure-FINAL-CUSPP-as-sent-to-MBC-October-8-2015.pdf\" target=\"_blank\">9-page petition\u003c/a> with the board outlining its proposal. The petition was signed by more than 5,000 Californians.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Doctors' Group Resistant\u003c/strong>\u003c/p>\n\u003cp>Since the disciplinary actions against doctors \u003ca href=\"http://www.mbc.ca.gov/Breeze/License_Verification.aspx\" target=\"_blank\">are posted\u003c/a> on the board’s website, the state’s biggest physician group, the California Medical Association, says the proposed changes of the notification requirements would go too far.\u003c/p>\n\u003cp>In a statement Paul Hegyi, a spokesman for the association, said they worry this type of rule would “put a burden on the physician-patient relationship,\" especially when appointment time is already limited. “This information is already public and available online and can be accessed by anyone,\" he said. \"This is a duplicative burden that will interfere with patient care.”\u003c/p>\n\u003cp>The board rejected a similar measure when it was proposed by board staff in 2012. In fact, the board has just begun \u003ca href=\"http://www.mbc.ca.gov/About_Us/Media_Room/2015/news_releases_20151020_verify.pdf\" target=\"_blank\">a public relations effort\u003c/a> to encourage patients to take it upon themselves to research the disciplinary actions against their doctors.\u003c/p>\n\u003cp>Board officials even held a tutorial to show people how to use their website at a mall in Sacramento last week. Those who don’t have access to computers can call the board’s office for assistance, a statement from the board said.\u003c/p>\n\u003cp>Advocates see the board’s outreach as a response to their efforts but say it doesn’t go far enough. The burden to find the information shouldn’t be placed on patients, who may not think to look it up, know how to do so, or have access to the Internet, McGiffert said.\u003c/p>\n\u003cp>Other patients may not be able to research the information due to mental or physical impairments. They could be missing out on important information about the doctors they have trusted with their care, she said.\u003c/p>\n\u003cp>Of the approximately \u003ca href=\"http://www.oshpd.ca.gov/HWDD/HWC/FactSheets/MD-2014.pdf\" target=\"_blank\">137,000 licensed medical doctors\u003c/a> in California, nearly 500 are on probation for offenses including sexual misconduct, gross negligence, substance abuse, inappropriate prescribing, and conviction of a felony, Consumers Union said. The group \u003ca href=\"http://safepatientproject.org/wordpress/wp-content/uploads/2015/10/MBC-list-of-docs-on-probation-as-of-9-29-15-as-of-10-8-15.pdf\" target=\"_blank\">compiled a list of doctors on probation\u003c/a>.\u003c/p>\n\u003cp>Patient advocate Marian Hollingsworth, who works for Consumers Union, \u003ca href=\"http://www.sacbee.com/opinion/op-ed/soapbox/article27279535.html#storylink=cpy\" target=\"_blank\">described in a Sacramento Bee\u003c/a> opinion piece how she felt when she discovered her doctor’s probation.\u003c/p>\n\u003cp>“I was stunned to learn that the doctor I had been referred to for a routine colonoscopy was about to start a 30-day suspension and seven-year probation,” she wrote. “He had a long history of substance abuse and DUIs, but what finally got the board’s attention is that he went after a patient with a hatchet in an alcohol-fueled rage.”\u003c/p>\n\u003cp>The doctors who got into trouble are from all over the state -- in big cities like Los Angeles and rural areas like Humboldt County. In some areas with doctor shortages, if a doctor is on probation it may present an even bigger dilemma for patients. Those patients should be able to decide whether they still want to see the doctor even if it’s their only option for miles, McGiffert said\u003c/p>\n\u003cp>By agreeing to go on probation, doctors are not necessarily admitting they violated ethics rules. Some do it to avoid lengthy and costly legal battles, McGiffert said.\u003c/p>\n\u003cp>Physicians on probation may be barred from performing specific procedures, or prescribing certain medicines for a period of time. They might have to take classes or be supervised. In some cases it means a physician disciplined for sexual misconduct must be chaperoned in the exam room.\u003c/p>\n\u003cp>The issue of physician discipline has been difficult for the board. It has come under fire in recent years for failing to hold problem doctors accountable. Some legislators in 2013\u003ca href=\"http://articles.latimes.com/2013/apr/25/local/la-me-rx-medical-board-20130426\" target=\"_blank\"> called for stripping the board\u003c/a> of its investigative powers. This issue will draw renewed public attention to whether the board is aggressive enough in protecting the public from dangerous doctors.\u003c/p>\n\u003cp>McGiffert said there is concern in the medical field that requiring doctors to tell patients about their probationary status is too awkward.\u003c/p>\n\u003cp>“The objection is that, gee, this would be very uncomfortable for doctors,” McGiffert said. “What does that tell you? Sometimes you need that kind of pressure.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Update:\u003c/strong> In its meeting on Friday, the Medical Board of California voted to deny the petition that would have required doctors on probation to notify their patients. But it did agree to form a committee to review the petition more closely and potentially develop a plan to improve notification to patients of doctors on probation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Billions in Medicaid Funding at Risk as California, Feds Debate",
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"content": "\u003cp>California risks losing billions in health care dollars if the state and federal governments can’t agree this week on a plan to fund reforms of the Medicaid program, hospital officials and experts said.\u003c/p>\n\u003cp>Public hospitals throughout the state are counting on the $7.25 billion in state and federal funds to treat large numbers of low-income and uninsured patients. The plan, known as a Medicaid waiver, also would allow the state to continue improving the efficiency, safety and quality of its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>About a third of all Californians are enrolled in Medi-Cal -- 12.5 million people. The current waiver, which took effect in 2010, expires on Oct. 31, though the federal government can grant an extension while negotiations over the plan continue.\u003c/p>\n\u003cp>[contextly_sidebar id=\"a5pZ22plFG1s4mvtWAOUCrTWG4OLpJXL\"]“It is critically important to us,” said Susan Ehrlich, CEO of San Mateo Medical Center, one of the state’s public hospital and clinic systems. “It is a very large percentage of the overall revenue that we rely on, and we don’t have other ways to make it up.”\u003c/p>\n\u003cp>Ehrlich is one of about a dozen public and University of California hospital leaders who traveled to Washington this week to make their case for the waiver to members of Congress and administration officials.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Erica Murray, CEO of the California Association of Public Hospitals, said one of the sticking points is how long an important provision of the waiver would last, with the state proposing five years and the federal government offering only three. The provision would pay for changes in how public hospitals deliver care, she said.\u003c/p>\n\u003cp>“Three years is not enough,” she said. “We need five years of support and incentive to achieve the goals of where the public systems need to be to stay competitive in their local marketplaces.”\u003c/p>\n\u003cp>Disagreements also exist over how hospitals should be paid to care for uninsured patients. The state wants to have the flexibility to use the money for more primary and preventive care rather than just to pay for emergency room visits and hospitalizations.\u003c/p>\n\u003cp>The state and the federal government have been negotiating since March, when California submitted a plan called “\u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/WaiverRenewal.aspx\" target=\"_blank\">Medi-Cal 2020\u003c/a>.” The plan also includes money to improve dental health programs, to expand the number of providers treating Medi-Cal patients and to start pilot projects addressing social problems of high-need patients.\u003c/p>\n\u003cp>State Department of Health Care Services Director Jennifer Kent said this week that the state needs the waiver to keep public hospitals financially stable so they can continue implementing reforms enacted under the Affordable Care Act. State officials are working toward a resolution and are trying to meet the deadline, Kent said.\u003c/p>\n\u003cp>“Everyone knows this is important,” Kent said. “It just boils down to getting the details worked out. I think we will get there.”\u003c/p>\n\u003cp>A spokesman for the Centers for Medicare & Medicaid Services declined to comment on the ongoing negotiations, but said extensions have been granted in other states.\u003c/p>\n\u003cp>Public hospitals have every right to be concerned about how the discussions are going, but there is always a lot of back and forth in Medicaid waiver negotiations, said Robin Rudowitz, associate director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. “Given the amount of money, I can’t imagine that anyone is going to walk away from the table,” she said.\u003c/p>\n\u003cp>Waivers allow states to make exceptions to the usual Medicaid rules. Under the expiring Medicaid waiver, known as the “Bridge to Reform,” California enrolled about 650,000 uninsured residents in free county-based health coverage until they were able to enroll in Medi-Cal through the Affordable Care Act. The state also transitioned many of its Medi-Cal beneficiaries into managed care.\u003c/p>\n\u003cp>In addition, public hospitals revamped their programs — and created new ones — to improve the health and safety of their patients and to cut costs. For example, they began tracking patients with certain diseases, pairing patients with health coaches and making more weekend appointments for primary care.\u003c/p>\n\u003cp>Now public hospitals say they need money to continue implementing the reforms. The new waiver also would increase the number of hospitals that can access funds.\u003c/p>\n\u003cp>San Mateo Medical Center used the money to cut wait time for primary care appointments, screen diabetic patients for depression and reduce deaths by sepsis. Kern Medical Center reduced pressure ulcers among hospitalized patients and helped obese children lose weight.\u003c/p>\n\u003cp>[contextly_sidebar id=\"iB9CYD3FkXcoqHTBmSs0dLf7lgJv3VwT\"]UCLA Health System developed a program to help train physicians from Latin America so they could begin working in in high-need areas. The university’s health system also improved diabetic patients’ adherence to instructions on taking medication.\u003c/p>\n\u003cp>Santiago Muñoz, UCLA Health System’s chief strategy officer, said that his institution relies on it to help pay for expensive care to children with complex illnesses.\u003c/p>\n\u003cp>“We’re providing a lot of care to Medicaid kids,” said Munoz, who was among those who traveled to Washington this week to push for the waiver. “A lot of this highly specialized care is only available at academic or teaching hospitals.”\u003c/p>\n\u003cp>Without the new waiver, public hospitals will be in a “precarious situation,” said Christina Ghaly, deputy director for strategy and operations for the L.A. County Department of Health Services.\u003c/p>\n\u003cp>Through the waiver, the county’s public hospitals and clinics received about $2 billion in federal funding over the past five years, were able to assign more than 400,000 patients to primary care teams and better integrate physical and mental health services.\u003c/p>\n\u003cp>The goal of the Medicaid waiver, she said, is to shift more care from inpatient to outpatient settings and to get to the bottom of why some patients continue to seek high-cost treatment.\u003c/p>\n\u003cp>“When a person ends up in the emergency department 50 times because they are homeless, you can continue seeing them in the emergency department … or you can address the root cause of their homelessness,” she said.\u003c/p>\n\u003cp>The state’s low Medi-Cal reimbursement rate doesn’t fully cover care for the low-income population, providers said. And even though the Affordable Care Act expanded Medi-Cal, Ghaly said there are still millions of uninsured patients — and public hospitals are disproportionately responsible for their care.\u003c/p>\n\u003cp>“There has to be a deal,” Ghaly said. “If we aren’t able to close that gap … there would be some very difficult decisions.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Anna Gorman 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>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California risks losing billions in health care dollars if the state and federal governments can’t agree this week on a plan to fund reforms of the Medicaid program, hospital officials and experts said.\u003c/p>\n\u003cp>Public hospitals throughout the state are counting on the $7.25 billion in state and federal funds to treat large numbers of low-income and uninsured patients. The plan, known as a Medicaid waiver, also would allow the state to continue improving the efficiency, safety and quality of its Medicaid program, called Medi-Cal.\u003c/p>\n\u003cp>About a third of all Californians are enrolled in Medi-Cal -- 12.5 million people. The current waiver, which took effect in 2010, expires on Oct. 31, though the federal government can grant an extension while negotiations over the plan continue.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“It is critically important to us,” said Susan Ehrlich, CEO of San Mateo Medical Center, one of the state’s public hospital and clinic systems. “It is a very large percentage of the overall revenue that we rely on, and we don’t have other ways to make it up.”\u003c/p>\n\u003cp>Ehrlich is one of about a dozen public and University of California hospital leaders who traveled to Washington this week to make their case for the waiver to members of Congress and administration officials.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Erica Murray, CEO of the California Association of Public Hospitals, said one of the sticking points is how long an important provision of the waiver would last, with the state proposing five years and the federal government offering only three. The provision would pay for changes in how public hospitals deliver care, she said.\u003c/p>\n\u003cp>“Three years is not enough,” she said. “We need five years of support and incentive to achieve the goals of where the public systems need to be to stay competitive in their local marketplaces.”\u003c/p>\n\u003cp>Disagreements also exist over how hospitals should be paid to care for uninsured patients. The state wants to have the flexibility to use the money for more primary and preventive care rather than just to pay for emergency room visits and hospitalizations.\u003c/p>\n\u003cp>The state and the federal government have been negotiating since March, when California submitted a plan called “\u003ca href=\"http://www.dhcs.ca.gov/provgovpart/Pages/WaiverRenewal.aspx\" target=\"_blank\">Medi-Cal 2020\u003c/a>.” The plan also includes money to improve dental health programs, to expand the number of providers treating Medi-Cal patients and to start pilot projects addressing social problems of high-need patients.\u003c/p>\n\u003cp>State Department of Health Care Services Director Jennifer Kent said this week that the state needs the waiver to keep public hospitals financially stable so they can continue implementing reforms enacted under the Affordable Care Act. State officials are working toward a resolution and are trying to meet the deadline, Kent said.\u003c/p>\n\u003cp>“Everyone knows this is important,” Kent said. “It just boils down to getting the details worked out. I think we will get there.”\u003c/p>\n\u003cp>A spokesman for the Centers for Medicare & Medicaid Services declined to comment on the ongoing negotiations, but said extensions have been granted in other states.\u003c/p>\n\u003cp>Public hospitals have every right to be concerned about how the discussions are going, but there is always a lot of back and forth in Medicaid waiver negotiations, said Robin Rudowitz, associate director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. “Given the amount of money, I can’t imagine that anyone is going to walk away from the table,” she said.\u003c/p>\n\u003cp>Waivers allow states to make exceptions to the usual Medicaid rules. Under the expiring Medicaid waiver, known as the “Bridge to Reform,” California enrolled about 650,000 uninsured residents in free county-based health coverage until they were able to enroll in Medi-Cal through the Affordable Care Act. The state also transitioned many of its Medi-Cal beneficiaries into managed care.\u003c/p>\n\u003cp>In addition, public hospitals revamped their programs — and created new ones — to improve the health and safety of their patients and to cut costs. For example, they began tracking patients with certain diseases, pairing patients with health coaches and making more weekend appointments for primary care.\u003c/p>\n\u003cp>Now public hospitals say they need money to continue implementing the reforms. The new waiver also would increase the number of hospitals that can access funds.\u003c/p>\n\u003cp>San Mateo Medical Center used the money to cut wait time for primary care appointments, screen diabetic patients for depression and reduce deaths by sepsis. Kern Medical Center reduced pressure ulcers among hospitalized patients and helped obese children lose weight.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>UCLA Health System developed a program to help train physicians from Latin America so they could begin working in in high-need areas. The university’s health system also improved diabetic patients’ adherence to instructions on taking medication.\u003c/p>\n\u003cp>Santiago Muñoz, UCLA Health System’s chief strategy officer, said that his institution relies on it to help pay for expensive care to children with complex illnesses.\u003c/p>\n\u003cp>“We’re providing a lot of care to Medicaid kids,” said Munoz, who was among those who traveled to Washington this week to push for the waiver. “A lot of this highly specialized care is only available at academic or teaching hospitals.”\u003c/p>\n\u003cp>Without the new waiver, public hospitals will be in a “precarious situation,” said Christina Ghaly, deputy director for strategy and operations for the L.A. County Department of Health Services.\u003c/p>\n\u003cp>Through the waiver, the county’s public hospitals and clinics received about $2 billion in federal funding over the past five years, were able to assign more than 400,000 patients to primary care teams and better integrate physical and mental health services.\u003c/p>\n\u003cp>The goal of the Medicaid waiver, she said, is to shift more care from inpatient to outpatient settings and to get to the bottom of why some patients continue to seek high-cost treatment.\u003c/p>\n\u003cp>“When a person ends up in the emergency department 50 times because they are homeless, you can continue seeing them in the emergency department … or you can address the root cause of their homelessness,” she said.\u003c/p>\n\u003cp>The state’s low Medi-Cal reimbursement rate doesn’t fully cover care for the low-income population, providers said. And even though the Affordable Care Act expanded Medi-Cal, Ghaly said there are still millions of uninsured patients — and public hospitals are disproportionately responsible for their care.\u003c/p>\n\u003cp>“There has to be a deal,” Ghaly said. “If we aren’t able to close that gap … there would be some very difficult decisions.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Anna Gorman 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>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "PriceCheck: How Much for That Flu Shot?",
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"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cp>It's that time of year. And I don't mean pray for rain (although on the health desk, we're doing that, too). Flu season is ramping up.\u003c/p>\n\u003cp>To protect yourself, the \u003ca href=\"http://flu%20shot%20recommendation%20cdc\" target=\"_blank\">Centers for Disease Control recommends\u003c/a> that everyone over 6 months get a flu vaccine. While not 100 percent effective, it can keep you from getting the flu -- or, if you do get sick, it can mean a more mild course of illness and help you avoid serious complications, including hospitalization and even death.\u003c/p>\n\u003caside class=\"pullquote alignright\">\nShare what you paid for a flu shot on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED's PriceCheck\u003c/a>\u003cbr>\n\u003c/aside>\n\u003cp> When it comes to flu shots, we're also concerned about health care costs. On our \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>\" project, we're \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">crowdsourcing prices \u003c/a>for everything from mammograms to colonoscopies.\u003c/p>\n\u003cp>Now we're looking at cost of flu shots. We want to know what you were charged, what your insurer paid and what you paid (if anything) for your flu vaccine.\u003c/p>\n\u003cp>Under the Affordable Care Act, flu shots are supposed to be covered by your insurance, with no copay or other costs out of your pocket. But the \u003ca href=\"http://www.hhs.gov/answers/affordable-care-act/will-the-aca-cover-my-flu-shot/index.html\" target=\"_blank\">Department of Health and Human Services specifies \u003c/a>to check with your insurance company in advance. \"Some insurance plans only cover vaccines given by your doctor or at a limited set of locations,\" HHS says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So, what's your story? We want to know. A \u003ca href=\"http://www.slate.com/articles/health_and_science/medical_examiner/2015/09/pharmacy_flu_vaccine_health_insurance_policies_should_cover_drug_store_shots.single.html\" target=\"_blank\">Slate reporter detailed \u003c/a>the hell he went through in trying to find out why coverage for his flu shot was declined. It wasn't supposed to be.\u003c/p>\n\u003cp>If you go to your own doctor, the shot should be covered, but plenty of people might rather get the flu shot while they're out running errands and pop into any one of a number of big box stores or pharmacies that offer them. Here are a few places, with currently-advertised prices:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.walgreens.com/topic/healthcare-clinic/price-menu.jsp\" target=\"_blank\">Walgreens\u003c/a>: $31.99 per dose for ages 2+; mentions insurance, although does not explicitly say plans are accepted\u003c/li>\n\u003cli>\u003ca href=\"http://www.target.com/c/flu-shots-pharmacy-health/-/N-4yn83\" target=\"_blank\">Target\u003c/a>: $24.99 per shot; \"most insurance accepted\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.costco.com/Pharmacy/adult-immunization-program.html\" target=\"_blank\">Costco\u003c/a>: $14.99; \"many insurance companies cover immunizations given at the pharmacy\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.walmart.com/cp/Immunizations-Flu-Shots/1228302\" target=\"_blank\">Walmart\u003c/a>: $25.00; \"most insurance plans accepted\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.safeway.com/ShopStores/Flu-Shots.page\" target=\"_blank\">Safeway\u003c/a>: While Safeway does not show on its website how much they'll charge, it does offer a \"10% off groceries\" coupon (unless you live in New Jersey, sorry).\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>How Much Did You Pay?\u003c/strong>\u003c/p>\n\u003cp>The prices above are \"charged prices.\" These may differ from what your insurer pays -- and then there's the question of out-of-pocket costs for you. And are these large chains even \"in network\" for you?\u003c/p>\n\u003cp>We want to know -- after you get your flu shot (or if you've already done it), please visit our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck page\u003c/a>. On the left side of the form, type in \"Flu shot\" under \"procedure or supplies\" then continue down the form filling in where you had received the vaccine and, perhaps most importantly, the three cost items: \"total price charged;\" \"insurance paid;\" and \"you paid.\" Please tell us more about your experience in the \"comments\" box -- and do leave an email address so we can contact you if we have questions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Thanks for helping us make health costs transparent. We'll write in a future post about what we learn regarding flu shot costs.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's that time of year. And I don't mean pray for rain (although on the health desk, we're doing that, too). Flu season is ramping up.\u003c/p>\n\u003cp>To protect yourself, the \u003ca href=\"http://flu%20shot%20recommendation%20cdc\" target=\"_blank\">Centers for Disease Control recommends\u003c/a> that everyone over 6 months get a flu vaccine. While not 100 percent effective, it can keep you from getting the flu -- or, if you do get sick, it can mean a more mild course of illness and help you avoid serious complications, including hospitalization and even death.\u003c/p>\n\u003caside class=\"pullquote alignright\">\nShare what you paid for a flu shot on \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">KQED's PriceCheck\u003c/a>\u003cbr>\n\u003c/aside>\n\u003cp> When it comes to flu shots, we're also concerned about health care costs. On our \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>\" project, we're \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/price-check/\" target=\"_blank\">crowdsourcing prices \u003c/a>for everything from mammograms to colonoscopies.\u003c/p>\n\u003cp>Now we're looking at cost of flu shots. We want to know what you were charged, what your insurer paid and what you paid (if anything) for your flu vaccine.\u003c/p>\n\u003cp>Under the Affordable Care Act, flu shots are supposed to be covered by your insurance, with no copay or other costs out of your pocket. But the \u003ca href=\"http://www.hhs.gov/answers/affordable-care-act/will-the-aca-cover-my-flu-shot/index.html\" target=\"_blank\">Department of Health and Human Services specifies \u003c/a>to check with your insurance company in advance. \"Some insurance plans only cover vaccines given by your doctor or at a limited set of locations,\" HHS says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, what's your story? We want to know. A \u003ca href=\"http://www.slate.com/articles/health_and_science/medical_examiner/2015/09/pharmacy_flu_vaccine_health_insurance_policies_should_cover_drug_store_shots.single.html\" target=\"_blank\">Slate reporter detailed \u003c/a>the hell he went through in trying to find out why coverage for his flu shot was declined. It wasn't supposed to be.\u003c/p>\n\u003cp>If you go to your own doctor, the shot should be covered, but plenty of people might rather get the flu shot while they're out running errands and pop into any one of a number of big box stores or pharmacies that offer them. Here are a few places, with currently-advertised prices:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.walgreens.com/topic/healthcare-clinic/price-menu.jsp\" target=\"_blank\">Walgreens\u003c/a>: $31.99 per dose for ages 2+; mentions insurance, although does not explicitly say plans are accepted\u003c/li>\n\u003cli>\u003ca href=\"http://www.target.com/c/flu-shots-pharmacy-health/-/N-4yn83\" target=\"_blank\">Target\u003c/a>: $24.99 per shot; \"most insurance accepted\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.costco.com/Pharmacy/adult-immunization-program.html\" target=\"_blank\">Costco\u003c/a>: $14.99; \"many insurance companies cover immunizations given at the pharmacy\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.walmart.com/cp/Immunizations-Flu-Shots/1228302\" target=\"_blank\">Walmart\u003c/a>: $25.00; \"most insurance plans accepted\"\u003c/li>\n\u003cli>\u003ca href=\"http://www.safeway.com/ShopStores/Flu-Shots.page\" target=\"_blank\">Safeway\u003c/a>: While Safeway does not show on its website how much they'll charge, it does offer a \"10% off groceries\" coupon (unless you live in New Jersey, sorry).\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>How Much Did You Pay?\u003c/strong>\u003c/p>\n\u003cp>The prices above are \"charged prices.\" These may differ from what your insurer pays -- and then there's the question of out-of-pocket costs for you. And are these large chains even \"in network\" for you?\u003c/p>\n\u003cp>We want to know -- after you get your flu shot (or if you've already done it), please visit our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck page\u003c/a>. On the left side of the form, type in \"Flu shot\" under \"procedure or supplies\" then continue down the form filling in where you had received the vaccine and, perhaps most importantly, the three cost items: \"total price charged;\" \"insurance paid;\" and \"you paid.\" Please tell us more about your experience in the \"comments\" box -- and do leave an email address so we can contact you if we have questions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Thanks for helping us make health costs transparent. We'll write in a future post about what we learn regarding flu shot costs.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Anthem Blue Cross Will Repay $8.3 Million to 50,000 California Customers",
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"content": "\u003cp>Anthem Blue Cross has settled a class action lawsuit to refund $8.3 million to tens of thousands of its members and has \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">agreed to forgo mid-year changes \u003c/a>to the deductible and out-of-pocket limits on its members' annual plans.\u003c/p>\n\u003cp>Anthem, California's second largest insurer, had raised annual deductibles, prescription drug deductibles and out-of-pocket limits for about 50,000 customers in mid-year in 2011, prompting two lawsuits alleging breach of contract.\u003c/p>\n\u003cp>One of those who sued was Eric Taub of Westlake Village. In 2011, he and his wife were paying Anthem a combined premium of about $2,400 each month and had individual deductibles of $1,500.\u003c/p>\n\u003cp>With the mid-year change, Taub and his wife saw their deductibles rise to $1,750.\u003c/p>\n\u003cp>\"It's like you're playing a game and you think you're at the goal, and they move the goal post another 10 yards,\" says Taub.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Anthem argued that its contracts allowed for mid-year increases, as long as it provided proper notice of the changes.\u003c/p>\n\u003cp>Taub's suit and another case were combined into one class action. After extensive negotiations, \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">the two sides agreed to settle\u003c/a>. Anthem agreed to no longer make mid-year alterations to individual customers' plans, unless a change in law or regulation supports such modifications. As part of the deal, Anthem does not admit to wrongdoing.\u003c/p>\n\u003cp>\"Anthem should be commended for listening to the heartfelt concerns of its policyholders,\" Jerry Flanagan, lead attorney for plaintiffs' co-counsel Consumer Watchdog, said in a statement. \"This settlement gives consumers the peace-of-mind of knowing that their 'annual' out-of-pocket costs won't change in the middle of the year.\"\u003c/p>\n\u003cp>Anthem issued a statement saying it \"is pleased that all parties were able to come to an agreement.\"\u003c/p>\n\u003cp>The Anthem members who saw their costs rise due to the 2011 plan changes do not need to file a claim to receive their part of the $8.3 million refund. Checks will be mailed to them in December, according to Consumer Watchdog.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The settlement is tentative pending Los Angeles County Superior Court Judge Jane Johnson's final approval.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Anthem Blue Cross has settled a class action lawsuit to refund $8.3 million to tens of thousands of its members and has \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">agreed to forgo mid-year changes \u003c/a>to the deductible and out-of-pocket limits on its members' annual plans.\u003c/p>\n\u003cp>Anthem, California's second largest insurer, had raised annual deductibles, prescription drug deductibles and out-of-pocket limits for about 50,000 customers in mid-year in 2011, prompting two lawsuits alleging breach of contract.\u003c/p>\n\u003cp>One of those who sued was Eric Taub of Westlake Village. In 2011, he and his wife were paying Anthem a combined premium of about $2,400 each month and had individual deductibles of $1,500.\u003c/p>\n\u003cp>With the mid-year change, Taub and his wife saw their deductibles rise to $1,750.\u003c/p>\n\u003cp>\"It's like you're playing a game and you think you're at the goal, and they move the goal post another 10 yards,\" says Taub.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Anthem argued that its contracts allowed for mid-year increases, as long as it provided proper notice of the changes.\u003c/p>\n\u003cp>Taub's suit and another case were combined into one class action. After extensive negotiations, \u003ca href=\"http://www.consumerwatchdog.org/resources/kassouf_taub_-_settlement_agreement.5.29.15_noe.pdf\" target=\"_blank\">the two sides agreed to settle\u003c/a>. Anthem agreed to no longer make mid-year alterations to individual customers' plans, unless a change in law or regulation supports such modifications. As part of the deal, Anthem does not admit to wrongdoing.\u003c/p>\n\u003cp>\"Anthem should be commended for listening to the heartfelt concerns of its policyholders,\" Jerry Flanagan, lead attorney for plaintiffs' co-counsel Consumer Watchdog, said in a statement. \"This settlement gives consumers the peace-of-mind of knowing that their 'annual' out-of-pocket costs won't change in the middle of the year.\"\u003c/p>\n\u003cp>Anthem issued a statement saying it \"is pleased that all parties were able to come to an agreement.\"\u003c/p>\n\u003cp>The Anthem members who saw their costs rise due to the 2011 plan changes do not need to file a claim to receive their part of the $8.3 million refund. Checks will be mailed to them in December, according to Consumer Watchdog.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The settlement is tentative pending Los Angeles County Superior Court Judge Jane Johnson's final approval.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Nearly half of low-income elderly Californians have opted out of a statewide managed care experiment because they feared losing their doctors and were reluctant to make any changes to their health care, according to \u003ca href=\"http://www.thescanfoundation.org/sites/default/files/field_research_medicare_medi-cal_polling_results_102715.pdf\" target=\"_blank\">survey data released Tuesday\u003c/a> by the Field Poll.\u003c/p>\n\u003cp>California is in the middle of a three-year pilot project aimed at nearly 500,000 of the state’s most costly patients -- so-called dual eligibles. The beneficiaries receive both Medicare, the health insurance program for seniors and the disabled, and Medicaid, called Medi-Cal in California, which provides coverage for the poor.\u003c/p>\n\u003caside class=\"pullquote alignright\">But once they are enrolled, less than 10 percent have decided to leave the program.\u003c/aside>\n\u003cp>The state program, known as Cal MediConnect, has had a high rate of people opting out -- about 47 percent, according to the state Department of Health Care Services.\u003c/p>\n\u003cp>“Resistance to change is not surprising,” said Mark DiCamillo, senior vice president of the Field Research Corp. “It is an older population. ... The status quo is the easiest course.”\u003c/p>\n\u003cp>In some cases, DiCamillo said, their fears were valid. Nearly 30 percent of those enrolled in the new managed care program ended up with a different personal doctor, according to the survey. About the same percentage of enrollees in the program said they had been seeing their doctor for one year or less.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But once they are enrolled, less than 10 percent have decided to leave the program, according to the state. About 80 percent of enrollees said they were very or somewhat confident they could get their questions answered and that they know how to manage their health conditions, the poll found.\u003c/p>\n\u003cp>The experiment, which has about 117,000 enrollees, is designed to provide more coordinated care and to improve enrollees’ health, reduce their costs and help keep them in their homes. The participants typically have multiple chronic diseases and, until now, have bounced between two government systems. Medicare pays for most doctor visits and hospitalizations and Medicaid covers nursing homes and long-term care.\u003c/p>\n\u003cp>The fact that people who enroll in the program stay enrolled is encouraging, said Jennifer Kent, director of the Department of Health Care Services. “The reason they are staying in the program is that they are satisfied with, and in some cases, really pleased with the care,” she said.\u003c/p>\n\u003cp>Kent said it continues to be a challenge, however, to get the message out to beneficiaries about the advantages of being in a more coordinated program. “A lot of individuals think they are losing benefits,” she said. “We are working really hard to assure people that is not the case.”\u003c/p>\n\u003cp>Kent also said the state is evaluating the program to ensure that it is doing what it was intended to do -- save money and improve care.\u003c/p>\n\u003cp>William Averill, a cardiologist in Torrance who treats many dual beneficiaries, said he doesn’t believe that the program is accomplishing that goal and that many people have been automatically enrolled without being aware of the change.\u003c/p>\n\u003cp>“The most vulnerable people were the ones who weren’t in a position to understand their choices,” he said. “I think the whole thing is going to collapse under its own weight.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The survey was the first of four planned polls in 2015 and 2016 of 2,502 dual eligibles in California. This first round included 1,394 enrollees in the Cal MediConnect program in five California counties and 678 who opted out. Surveyors also interviewed 430 people in counties where the program is not being implemented. The survey research was funded by the SCAN Foundation and done in conjunction with the California Department of Health Care Services.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly half of low-income elderly Californians have opted out of a statewide managed care experiment because they feared losing their doctors and were reluctant to make any changes to their health care, according to \u003ca href=\"http://www.thescanfoundation.org/sites/default/files/field_research_medicare_medi-cal_polling_results_102715.pdf\" target=\"_blank\">survey data released Tuesday\u003c/a> by the Field Poll.\u003c/p>\n\u003cp>California is in the middle of a three-year pilot project aimed at nearly 500,000 of the state’s most costly patients -- so-called dual eligibles. The beneficiaries receive both Medicare, the health insurance program for seniors and the disabled, and Medicaid, called Medi-Cal in California, which provides coverage for the poor.\u003c/p>\n\u003caside class=\"pullquote alignright\">But once they are enrolled, less than 10 percent have decided to leave the program.\u003c/aside>\n\u003cp>The state program, known as Cal MediConnect, has had a high rate of people opting out -- about 47 percent, according to the state Department of Health Care Services.\u003c/p>\n\u003cp>“Resistance to change is not surprising,” said Mark DiCamillo, senior vice president of the Field Research Corp. “It is an older population. ... The status quo is the easiest course.”\u003c/p>\n\u003cp>In some cases, DiCamillo said, their fears were valid. Nearly 30 percent of those enrolled in the new managed care program ended up with a different personal doctor, according to the survey. About the same percentage of enrollees in the program said they had been seeing their doctor for one year or less.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But once they are enrolled, less than 10 percent have decided to leave the program, according to the state. About 80 percent of enrollees said they were very or somewhat confident they could get their questions answered and that they know how to manage their health conditions, the poll found.\u003c/p>\n\u003cp>The experiment, which has about 117,000 enrollees, is designed to provide more coordinated care and to improve enrollees’ health, reduce their costs and help keep them in their homes. The participants typically have multiple chronic diseases and, until now, have bounced between two government systems. Medicare pays for most doctor visits and hospitalizations and Medicaid covers nursing homes and long-term care.\u003c/p>\n\u003cp>The fact that people who enroll in the program stay enrolled is encouraging, said Jennifer Kent, director of the Department of Health Care Services. “The reason they are staying in the program is that they are satisfied with, and in some cases, really pleased with the care,” she said.\u003c/p>\n\u003cp>Kent said it continues to be a challenge, however, to get the message out to beneficiaries about the advantages of being in a more coordinated program. “A lot of individuals think they are losing benefits,” she said. “We are working really hard to assure people that is not the case.”\u003c/p>\n\u003cp>Kent also said the state is evaluating the program to ensure that it is doing what it was intended to do -- save money and improve care.\u003c/p>\n\u003cp>William Averill, a cardiologist in Torrance who treats many dual beneficiaries, said he doesn’t believe that the program is accomplishing that goal and that many people have been automatically enrolled without being aware of the change.\u003c/p>\n\u003cp>“The most vulnerable people were the ones who weren’t in a position to understand their choices,” he said. “I think the whole thing is going to collapse under its own weight.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The survey was the first of four planned polls in 2015 and 2016 of 2,502 dual eligibles in California. This first round included 1,394 enrollees in the Cal MediConnect program in five California counties and 678 who opted out. Surveyors also interviewed 430 people in counties where the program is not being implemented. The survey research was funded by the SCAN Foundation and done in conjunction with the California Department of Health Care Services.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Please -- Look Beyond Monthly Premium When Picking Health Insurance",
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"content": "\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For L.A.'s Neediest Patients, the Most Important Person May Not Be A Doctor",
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"content": "\u003cp>Month after month, Natalia Pedroza showed up at the doctor’s office with uncontrolled diabetes and high blood pressure. Her medications never seemed to work, and she kept returning to the emergency room in crisis.\u003c/p>\n\u003cp>Walfred Lopez, a Los Angeles County community health worker, was determined to figure out why.\u003c/p>\n\u003caside class=\"pullquote alignright\">“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t.\"\u003cbr>\n\u003ccite>Dr. Clemens Hong, L.A. County Dept. of Health Services\u003c/cite>\u003c/aside>\n\u003cp>Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn’t have immigration papers, she told him, and her children still lived in Mexico.\u003c/p>\n\u003cp>Then she mentioned something she hadn’t told her doctors: She was nearly blind.\u003c/p>\n\u003cp>Pedroza’s doctor, Janina Morrison, was stunned. For years, Morrison said, “people have been changing her medications and changing her insulin doses, not really realizing that she can’t read the bottles.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/231552584\" 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>Health officials across the country face a vexing quandary – how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether community health workers like Lopez may be one part of the answer.\u003c/p>\n\u003cp>Lopez is among 25 workers employed by the county to do everything possible to remove obstacles standing in the way of patients’ health. That may mean coaching them about their diseases, ensuring they take their medications or scheduling medical appointments. Their help can extend beyond the clinic walls, too, to such things as finding housing or getting food stamps.\u003c/p>\n\u003cfigure id=\"attachment_98363\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\">\u003cimg class=\"size-full wp-image-98363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\" alt=\"(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \" width=\"1024\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-400x132.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-800x263.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-960x316.jpg 960w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Breaking Down Barriers\u003c/strong>\u003c/p>\n\u003cp>The workers don’t necessarily have a medical background. They get several months of county-sponsored training, which includes instruction on different diseases and medications, as well as tips on how to help patients change behavior. They are chosen for their ability to relate to both patients and providers. Many have been doing this job for friends and family for years – just without pay.\u003c/p>\n\u003cp>“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t,” said Dr. Clemens Hong, who is heading the program for the county. “That helps break down barriers.”\u003c/p>\n\u003cp>For now, they work with about 150 patients, many of whom have mental health issues, substance abuse problems and multiple chronic diseases. The patients haven’t always had the best experience with the county’s massive health care system.\u003c/p>\n\u003cp>“They tell us, ‘I am just a number on this list,’” Lopez said. “When you call them by name and when you know them one-on-one … they receive that message that I care for you. You are not a number.”\u003c/p>\n\u003cp>By spring, Hong said he hopes to have hundreds more patients in the program.\u003c/p>\n\u003cp>Community health workers have been used for decades in the U.S. and even longer in other countries. But now officials in various counties and states — including Massachusetts, Pennsylvania and Oregon — are relying on them more as pressure grows to improve health outcomes and reduce Medicaid and other public costs, experts said.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The hardest part is the system. Trying to navigate it is sometimes even hard for us.”\u003cbr>\n\u003ccite>Walfred Lopez, community health worker\u003c/cite>\u003c/aside>\n\u003cp>“They are finding a resurgence because of the Affordable Care Act and because health care providers are being held financially accountable for factors that occur outside the clinical walls,” said Dr. Shreya Kangovi, assistant professor of medicine at the University of Pennsylvania and director of the Penn Center for Community Health Workers.\u003c/p>\n\u003cp>Kangovi said community health worker programs, however, are likely to fail if they don’t hire the right people, focus too narrowly on certain diseases or operate outside of the medical system. They also need to be guided by the best scientific evidence on what works.\u003c/p>\n\u003cp>“A lot of people think… they can sort of make it up as they go along, but the reality is that it is really hard,” she said.\u003c/p>\n\u003cp>Hong, who designed the program based on lessons learned from other models, said Los Angeles County is taking a rigorous approach. It is conducting a study comparing the costs and outcomes of patients in the program against similar patients without assigned workers.\u003c/p>\n\u003cp>The patients are chosen based on their illnesses, how often they end up in the hospital and whether doctors believe they would benefit.\u003c/p>\n\u003cp>To Lopez, 43, the work is personal. A former accountant from Guatemala, Lopez has a genetic condition that led to a kidney transplant. Like some of his patients, including Pedroza, he is now on dialysis.\u003c/p>\n\u003cp>He tries to use his experience and education to get what patients need. But even he runs into snags, he said. One time, he had to argue with a clerk who turned away his patient at an appointment because she didn’t have identification.\u003c/p>\n\u003cp>“The hardest part is the system,” Lopez said. “Trying to navigate it is sometimes even hard for us.”\u003c/p>\n\u003cp>Lopez and his fellow community health worker, Jessie Cho, sit in small cubicles in the clinic at Los Angeles County-USC Medical Center, the county’s biggest and busiest public hospital. Throughout the day, they accompany patients to visits and meet with them before and after the doctor does. They also visit patients at home and in the hospital, and give out their cell phone numbers so patients can reach them quickly.\u003c/p>\n\u003cp>Cho said the patients often can’t believe that somebody is willing to listen to them. “Nobody else on the medical team has it as their job to provide empathy and compassion,” she said.\u003c/p>\n\u003cp>Morrison, the clinic physician, said both workers have become an essential part of the health team.\u003c/p>\n\u003cp>“There is just a limited amount I can accomplish in 15 or 20 minutes,” Morrison said. “There are all these mysteries of my patients’ lives that I know are getting in the way of taking care of their chronic medical problems. I either don’t have time to get to the bottom of it or they are never going to really feel that comfortable talking to me about it.”\u003c/p>\n\u003cp>Natalia Pedroza, who wears a colorful scarf around her head and speaks only Spanish, is a perfect example. Morrison said before Lopez came on board, “I wasn’t getting anywhere with her.”\u003c/p>\n\u003cp>Initially, Lopez had a hard time helping her understand her health conditions and overcoming her distrust of the system. When they first met, Pedroza believed the dialysis that kept her kidneys functioning was the cause of her health problems. And she didn’t get why Lopez was always around.\u003c/p>\n\u003cp>But he helped her — by getting her appointments, for instance, and helping arrange for Pedroza to get pre-packaged medications so she wouldn’t have to read the directions. Now Pedroza thinks Lopez is helping her to get better.\u003c/p>\n\u003cp>On a recent afternoon, Lopez sat down with Pedroza before her medical appointment.\u003c/p>\n\u003cp>“How are you feeling?” he asked in Spanish.\u003c/p>\n\u003cp>Pedroza responded that her hair was still falling out and that she still felt sick. She also said she hadn’t been checking her blood sugar because she didn’t know how to use the machine. Lopez calmly demonstrated how the machine worked, and then the two spent several minutes chatting about her job and her neighborhood.\u003c/p>\n\u003cp>Lopez said he believes he has a made a difference for other patients as well. On a recent Sunday, a 43-year-old patient with chronic pain who initially refused his help texted that he planned to go to the emergency room because of a headache. Lopez reached Morrison, who agreed to squeeze him into the schedule a few days later. And the patient didn’t go to the ER.\u003c/p>\n\u003cp>Lopez persuaded another patient, a 56-year-old woman, to take her blood pressure medication before her appointments so that when she arrived, the doctors wouldn’t get worried about her numbers and send her to the hospital.\u003c/p>\n\u003cp>In one case, his ability to bond with a patient almost undermined his goal of getting the man the help he needed. The patient, who was depressed, said he didn’t want to go see a mental health counselor because he was more comfortable talking to Lopez.\u003c/p>\n\u003cp>“It was touching,” Lopez said. “I was about to cry.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Anna Gorman 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>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Month after month, Natalia Pedroza showed up at the doctor’s office with uncontrolled diabetes and high blood pressure. Her medications never seemed to work, and she kept returning to the emergency room in crisis.\u003c/p>\n\u003cp>Walfred Lopez, a Los Angeles County community health worker, was determined to figure out why.\u003c/p>\n\u003caside class=\"pullquote alignright\">“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t.\"\u003cbr>\n\u003ccite>Dr. Clemens Hong, L.A. County Dept. of Health Services\u003c/cite>\u003c/aside>\n\u003cp>Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn’t have immigration papers, she told him, and her children still lived in Mexico.\u003c/p>\n\u003cp>Then she mentioned something she hadn’t told her doctors: She was nearly blind.\u003c/p>\n\u003cp>Pedroza’s doctor, Janina Morrison, was stunned. For years, Morrison said, “people have been changing her medications and changing her insulin doses, not really realizing that she can’t read the bottles.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\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/231552584&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/231552584'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Health officials across the country face a vexing quandary – how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether community health workers like Lopez may be one part of the answer.\u003c/p>\n\u003cp>Lopez is among 25 workers employed by the county to do everything possible to remove obstacles standing in the way of patients’ health. That may mean coaching them about their diseases, ensuring they take their medications or scheduling medical appointments. Their help can extend beyond the clinic walls, too, to such things as finding housing or getting food stamps.\u003c/p>\n\u003cfigure id=\"attachment_98363\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\">\u003cimg class=\"size-full wp-image-98363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\" alt=\"(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \" width=\"1024\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-400x132.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-800x263.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-960x316.jpg 960w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Breaking Down Barriers\u003c/strong>\u003c/p>\n\u003cp>The workers don’t necessarily have a medical background. They get several months of county-sponsored training, which includes instruction on different diseases and medications, as well as tips on how to help patients change behavior. They are chosen for their ability to relate to both patients and providers. Many have been doing this job for friends and family for years – just without pay.\u003c/p>\n\u003cp>“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t,” said Dr. Clemens Hong, who is heading the program for the county. “That helps break down barriers.”\u003c/p>\n\u003cp>For now, they work with about 150 patients, many of whom have mental health issues, substance abuse problems and multiple chronic diseases. The patients haven’t always had the best experience with the county’s massive health care system.\u003c/p>\n\u003cp>“They tell us, ‘I am just a number on this list,’” Lopez said. “When you call them by name and when you know them one-on-one … they receive that message that I care for you. You are not a number.”\u003c/p>\n\u003cp>By spring, Hong said he hopes to have hundreds more patients in the program.\u003c/p>\n\u003cp>Community health workers have been used for decades in the U.S. and even longer in other countries. But now officials in various counties and states — including Massachusetts, Pennsylvania and Oregon — are relying on them more as pressure grows to improve health outcomes and reduce Medicaid and other public costs, experts said.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The hardest part is the system. Trying to navigate it is sometimes even hard for us.”\u003cbr>\n\u003ccite>Walfred Lopez, community health worker\u003c/cite>\u003c/aside>\n\u003cp>“They are finding a resurgence because of the Affordable Care Act and because health care providers are being held financially accountable for factors that occur outside the clinical walls,” said Dr. Shreya Kangovi, assistant professor of medicine at the University of Pennsylvania and director of the Penn Center for Community Health Workers.\u003c/p>\n\u003cp>Kangovi said community health worker programs, however, are likely to fail if they don’t hire the right people, focus too narrowly on certain diseases or operate outside of the medical system. They also need to be guided by the best scientific evidence on what works.\u003c/p>\n\u003cp>“A lot of people think… they can sort of make it up as they go along, but the reality is that it is really hard,” she said.\u003c/p>\n\u003cp>Hong, who designed the program based on lessons learned from other models, said Los Angeles County is taking a rigorous approach. It is conducting a study comparing the costs and outcomes of patients in the program against similar patients without assigned workers.\u003c/p>\n\u003cp>The patients are chosen based on their illnesses, how often they end up in the hospital and whether doctors believe they would benefit.\u003c/p>\n\u003cp>To Lopez, 43, the work is personal. A former accountant from Guatemala, Lopez has a genetic condition that led to a kidney transplant. Like some of his patients, including Pedroza, he is now on dialysis.\u003c/p>\n\u003cp>He tries to use his experience and education to get what patients need. But even he runs into snags, he said. One time, he had to argue with a clerk who turned away his patient at an appointment because she didn’t have identification.\u003c/p>\n\u003cp>“The hardest part is the system,” Lopez said. “Trying to navigate it is sometimes even hard for us.”\u003c/p>\n\u003cp>Lopez and his fellow community health worker, Jessie Cho, sit in small cubicles in the clinic at Los Angeles County-USC Medical Center, the county’s biggest and busiest public hospital. Throughout the day, they accompany patients to visits and meet with them before and after the doctor does. They also visit patients at home and in the hospital, and give out their cell phone numbers so patients can reach them quickly.\u003c/p>\n\u003cp>Cho said the patients often can’t believe that somebody is willing to listen to them. “Nobody else on the medical team has it as their job to provide empathy and compassion,” she said.\u003c/p>\n\u003cp>Morrison, the clinic physician, said both workers have become an essential part of the health team.\u003c/p>\n\u003cp>“There is just a limited amount I can accomplish in 15 or 20 minutes,” Morrison said. “There are all these mysteries of my patients’ lives that I know are getting in the way of taking care of their chronic medical problems. I either don’t have time to get to the bottom of it or they are never going to really feel that comfortable talking to me about it.”\u003c/p>\n\u003cp>Natalia Pedroza, who wears a colorful scarf around her head and speaks only Spanish, is a perfect example. Morrison said before Lopez came on board, “I wasn’t getting anywhere with her.”\u003c/p>\n\u003cp>Initially, Lopez had a hard time helping her understand her health conditions and overcoming her distrust of the system. When they first met, Pedroza believed the dialysis that kept her kidneys functioning was the cause of her health problems. And she didn’t get why Lopez was always around.\u003c/p>\n\u003cp>But he helped her — by getting her appointments, for instance, and helping arrange for Pedroza to get pre-packaged medications so she wouldn’t have to read the directions. Now Pedroza thinks Lopez is helping her to get better.\u003c/p>\n\u003cp>On a recent afternoon, Lopez sat down with Pedroza before her medical appointment.\u003c/p>\n\u003cp>“How are you feeling?” he asked in Spanish.\u003c/p>\n\u003cp>Pedroza responded that her hair was still falling out and that she still felt sick. She also said she hadn’t been checking her blood sugar because she didn’t know how to use the machine. Lopez calmly demonstrated how the machine worked, and then the two spent several minutes chatting about her job and her neighborhood.\u003c/p>\n\u003cp>Lopez said he believes he has a made a difference for other patients as well. On a recent Sunday, a 43-year-old patient with chronic pain who initially refused his help texted that he planned to go to the emergency room because of a headache. Lopez reached Morrison, who agreed to squeeze him into the schedule a few days later. And the patient didn’t go to the ER.\u003c/p>\n\u003cp>Lopez persuaded another patient, a 56-year-old woman, to take her blood pressure medication before her appointments so that when she arrived, the doctors wouldn’t get worried about her numbers and send her to the hospital.\u003c/p>\n\u003cp>In one case, his ability to bond with a patient almost undermined his goal of getting the man the help he needed. The patient, who was depressed, said he didn’t want to go see a mental health counselor because he was more comfortable talking to Lopez.\u003c/p>\n\u003cp>“It was touching,” Lopez said. “I was about to cry.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Starting next week, San Francisco will be the fifth county in the state to implement Laura's Law, the measure that allows judges to force severely mentally ill people to get treatment.\u003c/p>\n\u003cp>The measure is targeted toward people who are resisting care and have a history of hospitalization, incarceration or violence. Family members, mental health providers or police officers can petition the court to compel patients into outpatient treatment, though patients cannot be forced to take medication.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/230340103\" 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>“Living with a mental illness is a constant struggle,” says Cedric Fotso, a peer specialist with San Francisco’s program who has resisted treatment for his own mental health diagnosis. “Stigma is one of the many obstacles to overcome when seeking care.”\u003c/p>\n\u003cp>Other people are in total denial of their illness, or believe they are cured if symptoms lessen after a hospital stay, says David Fariello, a clinical social worker at UCSF and director of Citywide Case Management Programs, which will treat patients referred through Laura’s Law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"Fdpw7sknevwleEnih0SS03R0Fzua6RVc\"]“A lot of these folks also have a very strong distrust of institutions and police, so we get thrown into all that, because we’re an agency,” he says. “Particularly people who’ve lived on the streets, in order to survive, they’ve developed this distrust of others. So it’s very hard to engage folks like that.”\u003c/p>\n\u003cp>Laura’s Law was named for 19-year-old Laura Wilcox, who was killed in 2001 by a psychiatric client at a clinic in Nevada City.\u003c/p>\n\u003cp>The state passed Laura's Law in 2002, but left it up to counties to choose to implement it. For a while, only Nevada County did. In 2013, the state made more money available for the program, by allowing counties to use funds from Proposition 63, a state law that taxes millionaires to expand mental health services. Since then, more counties have been adopting Laura’s Law, most recently, San Diego, Kern and Contra Costa counties.\u003c/p>\n\u003cp>Public health officials estimate only about 100 people in San Francisco will meet the strict eligibility requirements of the program every year, though they hope more people will be guided toward treatment voluntarily. They estimate that treatment costs will be $40,000 per person, per year.\u003c/p>\n\u003cp>Opponents of Laura's Law say it infringes on people's civil rights. They worry that people of color will be disproportionately targeted for court-ordered treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>San Francisco's Laura's Law program, called the Assisted Outpatient Treatment program, will begin serving patients Nov. 2. Referrals can be made at www.cdph.org/aot or by calling 844-255-4097.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting next week, San Francisco will be the fifth county in the state to implement Laura's Law, the measure that allows judges to force severely mentally ill people to get treatment.\u003c/p>\n\u003cp>The measure is targeted toward people who are resisting care and have a history of hospitalization, incarceration or violence. Family members, mental health providers or police officers can petition the court to compel patients into outpatient treatment, though patients cannot be forced to take medication.\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/230340103&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/230340103'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Living with a mental illness is a constant struggle,” says Cedric Fotso, a peer specialist with San Francisco’s program who has resisted treatment for his own mental health diagnosis. “Stigma is one of the many obstacles to overcome when seeking care.”\u003c/p>\n\u003cp>Other people are in total denial of their illness, or believe they are cured if symptoms lessen after a hospital stay, says David Fariello, a clinical social worker at UCSF and director of Citywide Case Management Programs, which will treat patients referred through Laura’s Law.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“A lot of these folks also have a very strong distrust of institutions and police, so we get thrown into all that, because we’re an agency,” he says. “Particularly people who’ve lived on the streets, in order to survive, they’ve developed this distrust of others. So it’s very hard to engage folks like that.”\u003c/p>\n\u003cp>Laura’s Law was named for 19-year-old Laura Wilcox, who was killed in 2001 by a psychiatric client at a clinic in Nevada City.\u003c/p>\n\u003cp>The state passed Laura's Law in 2002, but left it up to counties to choose to implement it. For a while, only Nevada County did. In 2013, the state made more money available for the program, by allowing counties to use funds from Proposition 63, a state law that taxes millionaires to expand mental health services. Since then, more counties have been adopting Laura’s Law, most recently, San Diego, Kern and Contra Costa counties.\u003c/p>\n\u003cp>Public health officials estimate only about 100 people in San Francisco will meet the strict eligibility requirements of the program every year, though they hope more people will be guided toward treatment voluntarily. They estimate that treatment costs will be $40,000 per person, per year.\u003c/p>\n\u003cp>Opponents of Laura's Law say it infringes on people's civil rights. They worry that people of color will be disproportionately targeted for court-ordered treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>San Francisco's Laura's Law program, called the Assisted Outpatient Treatment program, will begin serving patients Nov. 2. Referrals can be made at www.cdph.org/aot or by calling 844-255-4097.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Fresno, Car Washes Common Way to Pay for Funerals",
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"content": "\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/229734373\" 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>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\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/229734373&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/229734373'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bad Day For Bacon: Processed Meats Cause Cancer, WHO Says",
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"content": "\u003cp>The World Health Organization has deemed that processed meats — such as bacon, sausages and hot dogs — cause cancer.\u003c/p>\n\u003cp>In addition, the WHO says red meats including beef, pork, veal and lamb are \"probably carcinogenic\" to people.\u003c/p>\n\u003caside class=\"pullquote alignright\">World Health Organization conclusion puts processed meats in same category as tobacco smoking and asbestos ...\u003c/aside>\n\u003cp>A group of 22 scientists reviewed the evidence linking red meat and processed meat consumption to cancer, and concluded that eating processed meats regularly increases the risk of colorectal cancer. Their evidence review is explained in an \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2815%2900444-1/fulltext\" target=\"_blank\">article\u003c/a> published in \u003cem>The Lancet.\u003c/em>\u003c/p>\n\u003cp>The conclusion puts processed meats in the same \u003ca href=\"http://monographs.iarc.fr/ENG/Classification/ClassificationsAlphaOrder.pdf\" target=\"_blank\">category of cancer risk\u003c/a> as tobacco smoking and asbestos. This does not mean that they are equally dangerous, says the \u003ca href=\"http://www.iarc.fr/\" target=\"_blank\">International Agency for Research on Cancer\u003c/a> — the agency within the WHO that sets the classifications. And it's important to note that even things such as aloe vera are on the list of possible carcinogens.\u003c/p>\n\u003cp>In a Q & A released by the IARC, the agency says that \"eating meat has known health benefits,\" but it also points out that the cancer risk increases with the amount of meat consumed. As we've \u003ca href=\"http://www.npr.org/sections/thesalt/2012/03/12/148457233/death-by-bacon-study-finds-eating-meat-is-risky\" target=\"_blank\">reported\u003c/a>, studies show that the heaviest meat eaters tend to have the highest risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The IARC says high-temperature cooking methods (such as cooking meat in direct contact with a flame) produce more carcinogenic compounds. However, the group says there were not enough data \"to reach a conclusion about whether the way meat is cooked affects the risk of cancer.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.cancer.org/research/acsresearchers/susan-gapstur-phd-mph\">Susan Gapstur\u003c/a> of the American Cancer Society says the society recommends \"consuming a healthy diet with an emphasis on plant foods and limiting consumption of processed meat and red meat,\" she told us in a written statement.\u003c/p>\n\u003caside class=\"pullquote alignright\">... WHO also says red meats including beef, pork, veal and lamb are “probably carcinogenic” to people.\u003c/aside>\n\u003cp>The recommendation, Gapstur tells The Salt, is based on research. For instance, a systematic literature review on colorectal cancer published in 2011 by the World Cancer Research Fund found a statistically significant, 16 percent increased risk of colorectal cancer associated with each 3.5 ounces of red and processed meat consumed per day. As the ACS points out, this is an amount of meat roughly equivalent in size to a deck of cards. And according to the experts convened by IARC to make its new evaluation, eating just half that amount of processed meats daily – about 1.8 ounces per day — will increase the risk of colorectal cancer — by about 18 percent.\u003c/p>\n\u003cp>\u003cem>The Lancet\u003c/em> paper points out that red meat also contains \"high biological-value proteins and important micronutrients such as B vitamins, iron and zinc.\" And the North American Meat Institute says lots of research points to the benefits of red meat consumption.\u003c/p>\n\u003cp>\"Scientific evidence shows cancer is a complex disease not caused by single foods and that a balanced diet and healthy lifestyle choices are essential to good health,\" writes Barry Carpenter, president of the North American Meat Institute, in a \u003ca href=\"https://www.meatinstitute.org/index.php?ht=display/ReleaseDetails/i/116609\" target=\"_blank\">statement\u003c/a> on the new WHO classification.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Carpenter says it's important to put this new classification in context. \"IARC's panel was given the basic task of looking at hazards that meat could pose at some level, under circumstance, but was not asked to consider any off-setting benefits, like the nutrition that meat delivers or the implications of drastically reducing or removing meat from the diet altogether,\" the statement concludes.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Bad+Day+For+Bacon%3A+Processed+Meats+Cause+Cancer%2C+WHO+Says+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"excerpt": "The World Health Organization's decision puts bacon, hot dogs and sausages in the same category of cancer risk as tobacco smoking. And beef, pork, veal and lamb are \"probably carcinogenic,\" WHO says.",
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},
"closealltabs": {
"id": "closealltabs",
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"order": 1
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"title": "Code Switch / Life Kit",
"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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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"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",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"order": 9
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"id": "freakonomics-radio",
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"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
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"id": "fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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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",
"meta": {
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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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"link": "/radio/program/how-i-built-this",
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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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"order": 15
},
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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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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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"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
"id": "masters-of-scale",
"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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"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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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
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"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
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"officialWebsiteLink": "/perspectives/",
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
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