Author Archives: April Dembosky

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



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



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, the website of Covered California.

Screenshot from, 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

Obamacare in Jail: How San Francisco Policy Helps Inmates

A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)

A new law permits San Francisco Sheriff Department staff to enroll people into health plans. (Thomas Hawk/Flickr)

The San Francisco Sheriff’s Department is implementing a new city law allowing its staff to enroll inmates into health insurance under the Affordable Care Act. Sheriff Ross Mirkarimi believes that making sure people have health coverage when they’re released will help prevent them from committing another crime and coming back.

“I believe that will go a long way to helping us improve public safety by using a public health strategy,” he said.

Health insurance sign-ups available to all inmates at the San Francisco county jail.

He estimates this will help save taxpayers millions of dollars.

One inmate – Sophia – recently requested help signing up for health insurance. Sophia, who asked that her last name not be used, was caught driving a stolen car in January and sentenced to three months in the county jail. She says that was because she stopped getting treatment for her substance abuse and mental health problems when her health insurance expired. Continue reading

Two Different Reactions to Obamacare

The 2014 enrollment period for the Affordable Care Act closes tonight. For some people the new health law is a godsend. Others barely noticed its existence.

Donna Zeuli and her husband lost their insurance when he retired two years ago. Private insurers denied them both because of pre-existing conditions and the COBRA plan offered through his union was too expensive. So they decided to take their chances and wait for Obamacare to take effect.

Then, last fall, Zeuli had a mini stroke at her home in Magalia, Calif., in the foothills of Chico, and was rushed to the ER.

“You can’t believe the angst I had about not having insurance,” says Zeuli, 55. “The only thing I could think about was how much is this going to cost me. Do the minimum. But make sure I’m not gonna die.” Continue reading

Deadline Tuesday: Final Days to Enroll for 2014 Health Insurance

(Getty Images)

(Getty Images)

Time’s up.

After various extensions, the deadline to finish signing up for a health plan under the Affordable Care Act is here. People have until 11:59 p.m. Tuesday to complete their applications.

If you don’t have insurance you may have to pay a penalty on your taxes next year — as much as 1 percent of income.

Dana Howard from the state marketplace Covered California says the deadline is real. There will be no more grace periods for people who encounter long lines or technical difficulties on the website. There will be no special dispensation this time for people who wait until the last minute.

“We’re not making up a new policy for people who have not taken this seriously,” Howard said. “This is your health. This is a new law.” Continue reading