Kaiser, Nurses Union Brace for Upcoming Contract Battle

(April Dembosky/KQED)

Members of the California Nurses Association rallied in Sacramento in May to raise awareness around what they say are patient care concerns in California hospitals. (April Dembosky/KQED)

Going to a nurses’ union meeting is a little bit like going to an evangelical church service.

Contract talks begin next week on new four-year contract.
“We all have to stand up, and it’s a struggle,” says nurse Veronica Cambra, reporting a grievance at Kaiser Hospital in Fremont as though she’s giving testimony. “And we will overcome this, okay?”

The rest of the nurses respond with the passion of a devout congregation, humming “Mmm hmmm,” and “That’s right,” through the series of speeches.

The union heads at the front of the room interject now and then to rally the group around a unifying message. Continue reading

PriceCheck: What Insurance Companies Are Paying for Mammograms

(Illustration: Andy Warner)

(Illustration: Andy Warner)

It’s been almost three weeks since we launched our PriceCheck project, and women statewide are continuing to share what they — or their insurance companies — have paid for a mammogram.

Is your insurer paying $134 or $1,200?    

I talked about PriceCheck and our most recent data with Rachael Myrow on The California Report Thursday morning.

It’s been fun to see people’s mouths fall open when I tell them the range we’re seeing that insurers pay for mammograms across California:  $134 on the low end to $1,200 on the high end. Continue reading

Feds Want California to Clear Medi-Cal Backlog

State officials have until Monday to submit plan. (Justin Sullivan/Getty Images)

State officials must submit plan by Monday. (Justin Sullivan/Getty Images)

By Phil Galewitz, Kaiser Health News

Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given California and five other states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage.

600,000 people signed up, but not yet enrolled, in Medi-Cal.

“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor.

In addition to California, the other states are Alaska, Kansas, Michigan, Missouri and Tennessee. Continue reading

Like Other Animals, We Need Stress — in Moderation

A stress system gone awry can quite literally make people sick. (Getty Images)

A stress system gone awry can quite literally make people sick. (Getty Images)

By Richard Harris, NPR

Ask somebody about stress, and you’re likely to hear an outpouring about all the bad things that cause it — and the bad things that result. But if you ask a biologist, you’ll hear that stress can be good.

In fact, it’s essential.

But people who responded to NPR’s poll talked mostly about the downside of stress.

For example, the adrenal glands of all animals have evolved to pump out stress hormones in unexpected situations — the hormones spur action and increase fuel to the brain, helping the animal react to danger appropriately. Those hormones also flow to memory centers in the brain, to help the critter remember those notable moments and places.

“If it turns out to be dangerous and if the animal actually turns out to survive danger, then it will be aware of this as a potentially dangerous place,” explains Bruce McEwen, head of the neuroendocrinology laboratory at The Rockefeller University. “In that sense, stress is good.” Continue reading

Anthem Blue Cross Sued Over Covered California Doctor Networks

The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)

The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)

By Julie Appleby, Kaiser Health News

Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a class action lawsuit filed Tuesday.

As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.

As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.

Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.

However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said. Continue reading

School Nursing in Small-Town California: Much More Than You Think

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Bernice Arnett, school nurse for the Newman-Crows Landing Unified School District, is in charge of student health at the district’s seven public schools. (Ryder Diaz/KQED)

Editor’s Note: School nursing is more than Band-Aids and ice packs. Nurses help students with complex medical conditions and tough home lives. Bernice Arnett is a nurse for seven schools in Newman-Crows Landing Unified School District — two Central Valley towns just south of Modesto. This month, our ongoing health series called Vital Signs focuses on prevention. Arnett talks about how she’s working to keep students and families in her community healthy.

By Bernice Arnett

There have been days where I have visited all seven sites in one day. But I was doing reactive nursing rather than proactive nursing. There were times that I’d have to actually triage in my head what I should go do first.

You treat the whole student. Sometimes you treat the whole family. And a lot of times, families are desperate. They don’t know where to turn. Continue reading

San Francisco Supes Approve Laura’s Law, Can Compel Mentally Ill Into Treatment

(jivedanson/Flickr)

(jivedanson/Flickr)

Update 10pm by Isabel Angell

San Francisco Supervisors passed a version of Laura’s Law today that compels treatment for certain mental health patients. Supervisor Mark Farrell, who sponsored the legislation, said Laura’s Law will be an “important tool” for the city.

“I do believe we need to do more as a city and we need to do more to help those who are clearly suffering and cannot help themselves. In order to make a difference here at the local level, we have to continue to challenge ourselves and the status quo,” Farrell said before the vote.

A last-minute amendment from Supervisor Jane Kim that added an external evaluation after three years helped the ordinance pass 9-2. Supervisor Eric Mar, who cast one of the “no” votes, called mental health treatment a civil rights issue.

Continue reading

Feds Say Autism Therapy Now Covered As Children’s Medicaid Benefit

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

CMS officials released federal guidance for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.

“ABA therapy must be covered (by Medi-Cal). It’s very, very clear.”

“It’s a good day. It’s such a good day,” said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. “Whenever you get a decision that we’ve been seeking for years, that is a good day.”

Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid — and therefore it also must be covered under Medi-Cal, California’s version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. Continue reading

Stanford Study: Inactivity, More Than Diet, Linked to Obesity Increase

(Getty Images)

(Getty Images)

New research from Stanford shows that physical activity — or lack thereof — may be a bigger driver of the obesity epidemic than diet is.

The rate of Americans reporting inactivity has skyrocketed.

The researchers looked at national survey results of people’s health habits — including diet and exercise — from 1988 to 2010. The stunner was the increase in people who reported no leisure-time physical activity.

In 1988, 19 percent of women were inactive. By 2010, that number had jumped to 52 percent. Continue reading

Is It Time to Reform California’s Sex Offender Registry?

(Scott Pacaldo/Flickr)

California is one of just four states that requires sex offenders to register for the rest of their lives. (Scott Pacaldo/Flickr)

By Tara Siler

Back in 1947 California became the first state to require sex offenders to register with law enforcement after being released from prison. Now there are just under 100,000 sex offenders on the state’s lifetime registry — most of whom can be found on the state’s public website. But here’s what a lot of people don’t know: California is one of just four states requiring all sex offenders to register for the rest of their lives.

‘The reality is that for most of them the offense happened years ago.’
The state board that oversees the registry believes it’s time to overhaul the registry to make it smaller and easier to spot those at high risk of reoffending.

“K” — as he wants to be identified — is a case in point. He was added to the registry last year when he was released from prison. In 2009, he was convicted of multiple felony charges, including lewd and lascivious conduct.

While K claims the touching was consensual, the woman said it wasn’t. In any case, the woman was developmentally disabled and K was her caregiver. Continue reading