When Health Care Is Far From Home

Richard Sandor, 65, of Hayfork, took the hour long bus ride to Mad River Clinic to pick up his medication for chronic pain. (Heidi de Marco/KHN).

Richard Sandor, 65, of Hayfork, took the hour-long bus ride to Mad River Clinic to pick up his medication for chronic pain. (Heidi de Marco/KHN).

The biggest barrier to treatment for residents of a tiny town in the mountains of Northern California isn’t insurance coverage — it’s distance.

By Daniela Hernandez, Kaiser Health News

HAYFORK, Calif. — It’s Tuesday morning, half past eight and already hot, when the small bus pulls up to the community clinic. Most of the passengers are waiting in front — an old man with a cane, two mothers with four kids between them, packed lunches in hand.

Two more arrive. A gray-bearded man with a pirate bandana steps from the shelter of his Subaru. A sunken-cheeked woman rushes up on her bike.

“Woohoo! We have a full car!” the driver says brightly after they’ve all climbed aboard. The riders smile back, some with a hint of resignation. It’s time for the weekly trip to the clinic in Mad River, about 30 miles down a winding mountain road. The tight twists and turns are hard on the stomach, but even harder on the joints — especially if you have chronic Lyme disease, as more than a few of these riders do.

Jeff Clarke is one of them. He acquired Lyme long ago from deer ticks that dwell in the region’s sprawling forests. But today he’s going to ask about a lump that’s been growing in his left breast. It’s starting to hurt, and he’s worried. His fellow riders list their own ailments matter-of-factly: asthma, dental decay, diabetes, drug addiction, heart disease and much more. Continue reading

Many Who Got Obamacare Subsidies Now Face Big Tax Bill

(Getty Images)

(Getty Images)

By Anna Gorman, Kaiser Health News

Roberta and Curtis Campbell typically look forward to tax time. Most years, they receive a refund – a little extra cash to pay off credit card bills.

‘This is supposed to be a safety net health care, and I am getting burned left and right by having used it.’  

But this year the couple got a shock:  According to their tax preparer, they owe the IRS more than $6,000.

That’s the money the Campbells received from the federal government last year to make their Obamacare health coverage more affordable. Roberta, unemployed when she signed up for the plan, got a job halfway through the year and Curtis found full-time work. The couple’s total yearly income became too high to qualify for federal subsidies. Now they have to pay all the money back. Continue reading

4-Year Contract Dispute Between Kaiser, NUHW Thaws; Union ‘Hopeful’

(Ted Eytan/Flickr)

(Ted Eytan/Flickr)

For more than four years, the National Union of Healthcare Workers, representing 2,600 Kaiser mental health clinicians in California, has been in a small war with the health care giant.

NUHW members have gone on strikes of varying lengths three times over what it says are lengthy delays in providing care to mental health patients.

In 2011, the union filed a 34-page complaint with the California Department of Managed Health Care alleging Kaiser’s mental health services were “sorely understaffed and frequently fail to provide timely and appropriate care.” Continue reading

California Lawmakers Scrutinize Psychotropic Drug Prescriptions to Foster Kids

In California, 63,000 children and teenagers are in foster care in private homes or group homes run by the state.

A quarter of them were prescribed potent psychotropic drugs.

That sobering statistic was unearthed in a Bay Area News Group investigation last year, which analyzed a decade of state statistics. The drugs include Lithium and Depakote as well as anti-psychotics such as Haldol, Risperdal and Abilify. Continue reading

Calif. Calls Kaiser Mental Health Services ‘Inadequate’ as Treatment Delays Persist

Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)

A teenager with major depression and thoughts of suicide is forced to wait 24 days for an initial appointment.

A sexual assault victim, diagnosed with PTSD and major depression, sends numerous emails requesting individual psychotherapy, only to have her psychiatrist suggest she should get outside help at her own expense because no weekly appointments are available. Total time between appointments: Five months.

Following up on a survey that resulted in a $4 million fine against the HMO in 2013.  

A patient deemed high-risk for domestic abuse doesn’t show up for appointments, but mental health staff do not attempt contact. The couples therapy called for in his treatment plan does not occur. Domestic violence resulting in severe injury ensues. The man then tries to make an appointment but can’t get one.

Continue reading

Beyond Abolishing the ‘Personal Belief Exemption’ To Raise Vaccination Rates

Students leaving a vaccine clinic after being vaccinated against whooping cough at a middle school in Los Angeles. (Kevork Djansezian/Getty Images)

Students leaving a vaccine clinic after being vaccinated against whooping cough at a middle school in Los Angeles. (Kevork Djansezian/Getty Images)

On Wednesday in Sacramento, a MoveOn.org member is expected to deliver a petition with 21,000 signatures calling on the state’s government to abolish the personal belief exemption.

“Focusing on the parental-choice issue risks provoking a counter-productive backlash.”

She will be holding a press conference with Sen. Richard Pan (D-Sacramento), who announced a bill earlier this month to do just that. When he made the announcement, Pan repeatedly spoke of wanting to increase vaccination rates.

It sounds so good: Just wipe out the option to refuse vaccines, and vaccination rates will improve.

But is abolishing the personal belief exemption — a choice that permits parents to lawfully send their children to school unvaccinated — the best way to accomplish that goal? Continue reading

Is Your Dishwasher Increasing Your Child’s Allergy Risk?

(Getty Images)

(Getty Images)

By Rob Stein, NPR

Could using a dishwashing machine increase the chances your child will develop allergies? That’s what some provocative new research suggests — but don’t rip out your machine just yet.

The study involved 1,029 Swedish children (ages 7 or 8) and found that those whose parents said they mostly wash the family’s dishes by hand were significantly less likely to develop eczema, and somewhat less likely to develop allergic asthma and hay fever.

“I think it is very interesting that with a very common lifestyle factor like dishwashing, we could see effects on allergy development,” says Dr. Bill Hesselmar of Sweden’s University of Gothenburg, who led the study. Continue reading

Covered California Grants Special Enrollment Through April

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

Covered California will offer a special extension to buy health insurance through the marketplace for people who say they weren’t aware they would face a tax penalty for being uninsured.

Covered California Executive Director Peter Lee announced the extension Friday. He said the special enrollment will start on Monday and run through April 30. People must attest to the fact that they were not aware of the penalty, which they can do when they apply on the Covered California website.

Lee said as many as 600,000 people may face a penalty under the Affordable Care Act. While the extension does not exempt people from paying the 2014 tax penalty, it would help them avoid bigger penalties in 2015. Continue reading

More Pressure on Providers in Face of Medi-Cal Expansion

Dr. Davi Pakter, of Berkeley LifeLong Clinic, prepares to see patients. (Julie Small/KQED)

Dr. Davi Pakter, of Berkeley LifeLong Clinic, (right) prepares to see patients. (Julie Small/KQED)

Medi-Cal — the public health insurance program for low-income Californians — is growing faster under federal health care reform than the state expected. Twelve million residents — nearly a third of the state’s population — now rely on Medi-Cal, and that’s increased pressure to find more doctors willing and able to treat patients for what has historically been low reimbursement rates.

At the LifeLong Clinic in West Berkeley most of the patients waiting to see a doctor are on Medi-Cal. Among them, 26-year-old Amanda Hopkins, says she enrolled half a year ago when the state expanded the benefits program.

“It’s been relieving to have Medi-Cal and know that if something happened — I needed an ambulance or there was an emergency — I wouldn’t have to worry about being in debt thousands of dollars,” she said. Continue reading

When A Court Ordered Kids Vaccinated — Against Parents’ Will

(Getty Images)

(Getty Images)

By Anders Kelto, NPR

A highly contagious disease was sweeping across the United States. Thousands of children were sick and some were dying. In the midst of this outbreak, health officials did something that experts say had never been done before and hasn’t been done since. They forced parents to vaccinate their children.

The church ran a school with about a thousand kids. None had been vaccinated.  

It sounds like something that would have happened a hundred years ago. But this was 1991 — and the disease was measles.

Dr. Robert Ross was deputy health commissioner of the hardest-hit city, Philadelphia, where the outbreak was centered around the Faith Tabernacle Congregation in the northern part of town.

“This church community did not believe in either immunizations or medical care,” says Ross. Today, he heads The California Endowment, a private health foundation, based in Los Angeles. Continue reading