Judge Orders Overhaul in Segregation for California’s Mentally Ill Inmates

All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)

All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)

By Julie Small

Segregating prison inmates who repeatedly break the rules or turn violent against other inmates or guards is not new in California. For years the state has placed these inmates in special housing sections with multiple barriers between them and others.

Evidence that segregation ‘can and does cause serious psychological harm’ in inmates with serious mental illness.

But the practice of isolating inmates whose bad behavior may be part of a mental illness is under fire amid a rash of suicides and attempted suicides. The focus on this type of treatment comes against a backdrop of lawsuits brought by inmates against the state over the last two decades. Those lawsuits have exposed a correctional system poorly equipped to handle their extraordinary needs.

Now a federal judge says that kind of punishment poses too great a risk for inmates with serious mental illness who, he says, can and do worsen in segregation.  Continue reading

Fresno Considers Ending Health Services for the Undocumented

Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)

Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)

Brandon Hauk’s job is about to get a lot harder. The health of about 7,000 patients he helps at Clinica Sierra Vista in Fresno is in the hands of the county board of supervisors – they are set to vote Tuesday whether or not to shut down a program that covers specialty care for the undocumented.

Hauk doesn’t want to think about how he’s going to explain that to people when their primary care doctor says they need to see a cardiologist, pulmonologist, or endocrinologist.

“What do you say to somebody that has chronic illness and we can’t refer them out? Sorry?” says Hauk. “I mean, how can you tell someone that has abdominal bleeds, I’m sorry, but we can’t help you.”

Fresno’s Medically Indigent Services Program was set up decades ago to provide health coverage for the poor, and later, the undocumented. But now that the Affordable Care Act has gone into effect, the county says it doesn’t need the program anymore. Now tens of thousands of uninsured Fresnans have health coverage through Obamacare. More than that, the county says it can’t afford to keep the program going. Continue reading

The Assisted Living Reform Bills That Died

By Polly Stryker

Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)

Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)

Last Thursday, August 14, was the day that bills still in the state Senate Appropriations Committee sank or swam. The Senate Appropriations Committee is where bills costing $150,000 or more go for consideration. If bills make it out of this committee, then bills are still in play and could make it to the governor’s desk, albeit with potential amendments along the way. If not, they die.

Going into the home stretch of this legislative session, 16 bills were on the table that, altogether, constituted the first major overhaul of the assisted living industry in nearly 30 years.

Two have already made it to the governor’s desk. AB1523 mandates liability insurance for all assisted living facilities. Advocates say liability insurance is one of the best ways to improve conditions in the industry. Operators whose violations make buying insurance too expensive will be simply forced out of business. The industry group California Assisted Living Association supported AB1523. AB1572 mandates facility operators allow and support resident and family councils at assisted living facilities. CALA supported that one as well.

Most of the rest of the bills are still swimming. But what about the bills that died?

Continue reading

California Prisons Begin ‘Use-of-Force’ Reforms for Mentally Ill Inmates

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

By Julie Small

The number of inmates with mild to severe mental illness has grown to 37,000 in California, about a quarter of the prison population.

A series of lawsuits brought by inmates against the state over the last two decades has exposed a correctional system poorly equipped to handle their extraordinary needs.

Now California is trying to comply with a federal court order to change when and how correctional officers use pepper spray to force uncooperative inmates to leave their cells or follow orders.

Pepper spray may have contributed to three inmate deaths and an unknown number of injuries — unknown because the California Department of Corrections and Rehabilitations doesn’t consider the effects of pepper spray an injury. Continue reading

Old Muni Buses Are Reborn as Mobile Showers for the Homeless

Doniece Sandoval is the founder of Lava Mae, a mobile shower service for homeless people.

Doniece Sandoval is the founder of Lava Mae, a mobile shower service for homeless people. (Lynne Shallcross/KQED)

By Lynne Shallcross

Showering is a daily routine that most of us probably take for granted. But for people living on the streets or in shelters in San Francisco, finding a shower can be one of the biggest daily challenges.

‘Then no one has to know you’re homeless unless you tell them.’

For the more than 3,000 unsheltered homeless people in San Francisco, there are only roughly 20 showers available — fewer if any are out of service. Then there are the logistics of sign-up lists, limited hours, waiting lines and figuring out how to get there.

Doniece Sandoval, a marketing and communications professional and South Texas native, had seen plenty of shower-less homeless in her two decades in San Francisco. But when she passed a young homeless woman on the street who was crying that she’d never be clean, Sandoval decided to do something about it.

So she hatched the idea for Lava Mae, a new service that provides showers in a retrofitted, retired Muni bus. Lava Mae, a play on the Spanish word for “wash me,” is in the pilot phase of its service. Continue reading

Covered California to Request Evidence of Lawful Presence in U.S.

CCHP enrollment counselor Kristen Chow explains Covered California and federal subsidies to a Chinese-language caller. Currently, more than 90 percent of the HMO's members are ethnically Chinese. (Marcus Teply/KQED)

CCHP enrollment counselor explains Covered California and federal subsidies to a caller. (Marcus Teply/KQED)

Some enrollees who get their health insurance through Covered California, the state’s Obamacare exchange, will be getting notices in the next few weeks requesting evidence that they are lawfully in the country.

Yesterday, many news outlets reported on the Obama administration’s announcement that it was sending letters to about 310,000 people who have signed up for insurance through the Affordable Care Act, but whose documentation of citizenship or legal immigration status was at odds with government records. From the Wall Street Journal:

The Obama administration moved Tuesday to cut off health insurance for up to 310,000 people who signed up through the HealthCare.gov system unless they can provide documents in the next few weeks showing they are U.S. citizens or legal residents.

Those individuals have until Sept. 5 to send in additional information that could confirm they are in the U.S. legally, a condition of using the online insurance exchanges to obtain coverage.

Continue reading

Obamacare: With One-Third of Californians Now on Medi-Cal, Can State Manage?

By Anna Gorman, Kaiser Health News

California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.

The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state’s population.

That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state’s health care system, and it has raised concerns about California’s ability to meet the increased demand for health care.

Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past.  Continue reading

Lawsuit Claims Service Reductions at San Pablo Hospital Violate Civil Rights Act

Photo: Doctor's Medical Center

Photo: Doctors Medical Center

by Alexandra Garreton, Jon Brooks, and Bay City News

Contra Costa County officials say they’re doing their best to keep the largest hospital in west Contra Costa County from going under. And that means cutting patient services.

This month Doctors Medical Center in San Pablo stopped accepting ambulances and reduced the number of in-patient beds to 50. County Health Services officials said last week that the 22 to 24 emergency ambulance patients normally seen at DMC each day — including three to four considered to be in critical condition — are now being diverted to other area hospitals.

Last fall, Doctor’s Medical Center announced a fiscal emergency and planned closure of the hospital. In recent months, at least 88 doctors, nurses and other hospital staffers have left, according to DMC spokesman Chuck Finney.

The hospital plans to cut more beds and close their cardiac unit in September.

Continue reading

As Aging White Man, Robin Williams Was Particularly at Risk for Suicide

An Instagram photo that comedian and actor Robin Williams posted on his last birthday, July 21. The caption: ‘Happy Birthday to me! A visit from one of my favorite leading ladies, Crystal.’

An Instagram photo that comedian and actor Robin Williams posted on his last birthday, July 21. The caption: ‘Happy Birthday to me! A visit from one of my favorite leading ladies, Crystal.’

You don’t really expect a professional baseball player to be the one person to articulate the effect Robin Williams had on much of the general public, but that was my feeling when I read this quote in today’s San Francisco Chronicle from Giants pitcher Tim Lincecum, who had once been thrilled to receive a congatulatory handshake from Williams. Said Lincecum:

He made things feel like they weren’t so bad.”

Remembering some of Williams’ early manic groundbreaking appearances on television and movies, the statement rang true, as did the chilling irony in its description of a man who seemingly had everything but clearly thought that things were that bad, after all.

The suicide rate for white men increased almost 40 percent between 1999 and 2011.

Considering his suicide, it’s not surprising that Williams’ publicist said Monday that the comedian suffered from severe depression. Williams also struggled with substance abuse issues for decades. Since his death, a national conversation has ensued on the insidious effects of depression, and how it can prove fatal even in those who, to the outside world, seemingly have everything to live for.

Around the country, media organizations have been interviewing mental health experts on the subject. The Chronicle talked to some who worried about the impact of Williams’ suicide on those struggling with depression. “I get concerned about people wondering if people as promising as him with all these resources available can’t make it, what are the chances for them?” Patricia Arean, a UCSF clinical psychologist and psychiatry professor, told the paper.

She said many people who are depressed often can’t find their way to the appropriate treatment if what they’re currently doing to address their condition isn’t working. Continue reading