Author Archives: April Dembosky

Opposing Sides Testify Before State Committee over Insurance Proposition

Peter Lee, seen here in a 2012 photo, is the executive director of Covered California and testified Thursday before the joint legislative committee on health.

Peter Lee, seen here in a 2012 photo, is the executive director of Covered California and testified Thursday before the joint legislative committee on health.

State insurance commissioner Dave Jones is flatly rejecting accusations that a proposition on November’s ballot would undermine the implementation of the Affordable Care Act in California.

If passed by voters, Proposition 45 would give the commissioner the power to reject excessive rate hikes for health insurance –- and, he argues, keep health premiums affordable for consumers. Last month, Covered California, the state’s health insurance exchange, said the measure could compromise its operations, possibly causing delays in approving health plans before they are federally mandated to go on sale to consumers, or curtailing its own authority to negotiate the details of plans with insurers.

“These conclusions are fundamentally flawed,” Jones said on Wednesday, speaking before the state’s joint legislative committee on health. Continue reading

Hobby Lobby Decision Has Limited Impact in California

 Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores was announced Monday. (Chip Somodevilla/Getty Images)

Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores was announced Monday. (Chip Somodevilla/Getty Images)

Most women in California won’t be affected by Monday’s U.S. Supreme Court landmark decision in Sebelius v. Hobby Lobby. The Christian owners of the craft store chain challenged the Affordable Care Act’s requirement that companies provide contraception coverage to their employees. The Court ruled that closely-held, for-profit companies can opt out if they object on religious grounds.

But it’s not so easy in California. That’s because the ruling doesn’t apply to state laws. California has had the Women’s Contraceptive Equity Act on the books since 1999. It requires health insurance companies that cover prescription drugs to also cover birth control.

“For most workers in California, nothing will change,” says Maggie Crosby, attorney with the ACLU of Northern California. “Women should feel secure that if they have birth control coverage today, they will have it tomorrow.”

She says the state law is still in full effect after Monday’s Supreme Court ruling. Continue reading

Hobby Lobby decision has limited impact on California

Most women in California won’t be affected by Monday’s U.S. Supreme Court landmark decision in Sebelius v. Hobby Lobby. The Christian owners of the craft store chain challenged the Affordable Care Act’s requirement that companies provide contraception coverage to their employees. The Court ruled that closely-held, for-profit companies can opt out if they object on religious grounds.

But it’s not so easy in California. That’s because the ruling doesn’t apply to state laws. And California has had the Women’s Contraceptive Equity Act on the books since 1999. It requires health insurance companies that cover prescription drugs to also cover birth control.

“For most workers in California, nothing will change,” says Maggie Crosby, attorney with the ACLU of Northern California. “Women should feel secure that if they have birth control coverage today, they will have it tomorrow.” Continue reading

Coordinated Care for Those Nearing Life’s End — But Does It Save Money?

Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)

Sutter nurse Aileen Capuyan listens to Bob Martinez’s lungs. (April Dembosky/KQED)

Bob Martinez has been in the hospital so many times, the surgical staff treats him like a regular at a coffee shop.

“They all know me!” he says. “If I go in there today, they’d say, ‘How’re ya doing Mr. Martinez?’ ”

‘I’m so sick and tired of being in hospitals. I don’t want to go back no more. I said, God, no more.’

Martinez is 81, a long-retired life insurance salesman. In the last few years, he’s had more than a dozen surgeries on his right leg, including a foot amputation, a casualty of severe diabetes. His heart disease has warranted almost half a dozen heart procedures. After one of his recent operations, he said he’d had enough.

“I’m so sick and tired of being in hospitals,” he says shaking his head. “I don’t want to go back no more. I said, God, no more. No more.”

That’s when hospital staff told him about a program through Sutter Health that would send people to take care of him at home. It’s called the Advanced Illness Management program, or AIM. It’s designed for people like Martinez who have multiple chronic illnesses. Continue reading

Study Finds Pesticide Exposure in Pregnancy Linked to Autism

(tpmartins/Flickr)

(tpmartins/Flickr)

Pregnant women living within a mile of fields where pesticides were applied faced almost double the risk of having a baby who developed autism — compared to women who lived more than a mile away, a new study finds.

U.C. Davis researchers tracked pesticide applications on farms in the Central Valley, near Sacramento, and the Bay Area and matched that data to the addresses of women who lived nearby when they were pregnant.

The fetus tends to be vulnerable to certain kinds of insults,” said Irva Hertz-Picciotto, an environmental epidemiologist at the MIND Institute at U.C. Davis and lead author of the study. “Pesticides may be one of those sets of chemicals that we need to be particularly careful about.

The study was published Monday in Environmental Health Perspectives. Continue reading

California Caregivers Sue Their Employer for Wage Violations

Plaintiff Ginger Rogers with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)

Plaintiff Ginger Rogers (right) with one of her attorneys, Hina Shaw, reviewing the complaint that was filed today against Kindred Healthcare and affiliates. (Photo: Sara Feldman)

Professional caregivers filed a class action lawsuit in California Wednesday on behalf of hundreds of workers throughout the state. They say their employer, Kindred Healthcare and its affiliates, shorted them on wages, overtime, and breaks.

Ginger Rogers, a caregiver with 25 years experience, says Kindred Healthcare hired her in 2012 to look after a patient at a skilled nursing facility in Castro Valley, outside San Francisco. She says she asked her supervisor if she could leave her patient’s bedside to take a lunch break. The supervisor told her no, adding that coffee breaks weren’t allowed either, according to the complaint filed in Alameda Superior Court today.

“That’s illegal,” says Hina Shah, co-director of the Women’s Employment Rights Clinic at Golden Gate University, who is representing Rogers and the other plaintiffs. “The law mandates two 10-minute breaks and a 30-minute meal break for every five hours of work. But more importantly, the type of work that these caregivers are doing is physically and mentally demanding, and to require someone to work 12-hour shifts without any kind of break is very detrimental to their health and is onerous.” Continue reading

Resident Physicians at Children’s Oakland Rally Over Contract Stalemate

Medical workers stage a protest in front of UCSF Benioff Children's Hospital Oakland. (Mark Andrew Boyer/KQED)

Medical residents stage a protest in front of UCSF Benioff Children’s Hospital Oakland. (Mark Andrew Boyer/KQED)

Resident physicians at UCSF Benioff Children’s Hospital Oakland say their salaries aren’t keeping up with the cost of living in the Bay Area. Theirs is one of the latest health care union battles to heat up in California between workers and hospital administration, and is drawing a new generation of members to union organizing.

“A lot of people think being a doctor is super glamorous and you make tons of money and everyone loves you,” said Alana Arnold, a second-year resident. “But in fact, residency is difficult. We’re here to learn and train. And we have to protect ourselves just like any other workforce.”

She and other pediatric medicine residents in Oakland have joined with SEIU’s Committee of Interns and Residents to fight for higher compensation, and a special fund for patients to cover bus tokens and other costs to help them get to appointments and maintain care.  Continue reading

State Leaders in Budget Fight over In-Home Health Services

(Getty Images)

The State Capitol Building in Sacramento. (Getty Images)

The primary is over, and now it’s crunch time to come up with a state budget. A key fiscal battle is pitting legislative Democrats against the governor in overtime pay for in-home care workers.

Last fall, the federal government changed the overtime rules for caregivers who cook, bathe and provide other help for elderly or disabled people who live in their own homes. Starting next January, caregivers are entitled to overtime pay for any hours they work exceeding 40 in each week.

Gov. Jerry Brown says California can’t afford the overtime pay. He wants to cap workers’ hours to avoid triggering the overtime rules. The budget proposals he released in January and May reflect this cap, as well as rate cuts for in-home health care providers. Continue reading

Lawmakers Push for More Mental Health Spending

(seliaymiwell/flickr)

(seliaymiwell/flickr)

California lawmakers announced a series of budget proposals Wednesday calling for more training of law enforcement officers on how to handle people with mental illness. While lawmakers have been working on the proposals for weeks, there is renewed emphasis on them in the aftermath of a gun rampage that left seven people dead near UC Santa Barbara last weekend.

“How do we stop this before it happens?” said Sen. Hannah-Beth Jackson (D-Santa Barbara).

Jackson said police officers who visited the shooter before the violence erupted failed to investigate him thoroughly and failed to recognize warning signs of mental health problems. “This is a young man whose mental illness was right out there on YouTube, right out there on Facebook, and in screeds that he posted on blogs,” Jackson said. “And yet no one did or was able to recognize the potential for violence that resulted in this mass set of murders.”

Sen. Loni Hancock (D-Berkeley) says the problem continues inside the state’s jails and prisons, where nearly half the inmates suffer from mental illness. She cited incidents where mentally ill inmates were improperly pepper sprayed. Continue reading

Adequacy of Doctor Networks Key Issue for Covered California

Screenshot from CoveredCA.com, the website of Covered California.

Screenshot from CoveredCA.com, the website of Covered California.

Contract negotiations are about to begin for health insurance companies that want to sell plans next year through the state marketplace, Covered California. One area of scrutiny by the agency is sure to be adequacy of provider networks offered by insurers. 

“Insurers have gotten the message that there’s some consumer dissatisfaction out there.”
Last year, in order to keep premium costs down, insurance companies sold plans with a narrowed list of doctors for customers to choose from. The goal was to offer doctors and other providers more patients in exchange for a lower cost of providing services.

But many more people signed up for Covered California plans than had been anticipated, leaving perhaps too few doctors to see the patients. Many people scrambled to find a doctor. Complaints to the state show that some people were forced to leave a trusted specialist; some women in their third trimester of pregnancy found they’d have to switch to an unknown obstetrician for their birth. 

“It’s unfair and unrealistic,” said Betsy Imholz, an advocate with Consumers’ Union.
Continue reading