Author Archives: April Dembosky

April Dembosky covers health care news and trends across California for KQED's local news and its statewide program The California Report. She has reported extensively on the economics of health care, the roll-out of the Affordable Care Act in California, and aging and end-of-life issues. Her work is regularly rebroadcast on NPR and has been recognized with awards from the Third Coast International Audio Festival, the Society for Professional Journalists, and the Association of Health Care Journalists.

Gov. Brown Meets with Nurses Over Ebola Preparedness

Gov. Jerry Brown and other state officials meet with California nurses to discuss Ebola preparedness. (Brad Alexander/Office of the Governor)

Gov. Jerry Brown and other state officials meet with California nurses to discuss Ebola preparedness. (Brad Alexander/Office of the Governor)

Gov. Jerry Brown met with top public health officials and nursing union leaders Tuesday to discuss efforts to prepare for Ebola. The meetings came on the heels of new guidance issued by the Centers for Disease Control and Prevention Monday night.

There are no known cases of Ebola in California. But after two nurses in Texas became infected after treating an Ebola patient there, the CDC is now recommending that hospitals provide better protective equipment for health workers, and hands-on training for how to put it on and take it off.

But the California Nurses Association (CNA) says the guidelines don’t go far enough. Continue reading

Ebola Now an Issue in Nurses’ Contract Bargaining

(Centers for Disease Control via Getty Images)

(Centers for Disease Control via Getty Images)

Nurses’ calls for better hospital preparation around Ebola have landed on the bargaining table. California’s powerful nurses’ union has been bargaining with Kaiser Permanente for months over a new contract, and is now adding to its list of demands better training, protection, and insurance coverage for nurses who may treat patients infected with Ebola.

Diane McClure, a nurse at Kaiser’s South Sacramento facility, says nurses still had no meaningful training more than a month after a patient was admitted to the hospital for a potential Ebola infection, though he later tested negative for the virus.

“Kaiser felt all they had to do was pull up some CDC flyers and put them on the lunchroom tables or up in the bathrooms,” she says. Continue reading

Prop. 45 Fight Worthy of Television Drama

Kevin Spacey stars as Frank Underwood in the Netflix series "House of Cards." (Kevin Winter/Getty Images)

Kevin Spacey stars as Frank Underwood in the Netflix series “House of Cards.” (Kevin Winter/Getty Images)

The power play behind Proposition 45 could be fodder for an episode of House of Cards:

Dave Jones might not like this comparison, but he’s the Frank Underwood in this fight.

“Power is a lot like real estate. It’s all about location, location, location. The closer you are to the source, the higher your property value,” so goes protagonist Frank Underwood, who plays the menacing House majority whip scheming to get closer to the president.

You’d never think there’d be such positioning over who gets to regulate health insurance.

But this is California. And no less than three state agencies want to have a say in this one. Continue reading

More Than Half of California’s Hospitals Dinged for Readmissions

Chinese Hospital in San Francisco received the second-highest fine of any hospital statewide. (m./Flickr)

Chinese Hospital in San Francisco received the second-highest fine of any hospital statewide. (m./Flickr)

The federal government is fining 64 percent of California hospitals for having too many Medicare patients return to the hospital within a month of being discharged, according to an analysis of Medicare data by Kaiser Health News.

Sutter Surgical Hospital North Valley in Yuba City was the only facility in the state that received the maximum 3 percent fine. Chinese Hospital in San Francisco received the second highest fine: 2.16 percent of all Medicare billings in the coming year.

“Any little bit hurts. We will definitely feel it,” says Peggy Cmiel, chief nursing officer at Chinese Hospital.

The fines are meant to encourage hospitals to do a better job of caring for patients after they’re released. In the past, many hospitals benefited if a patient returned after surgery – more treatment meant more money. Now, the Medicare program that pays for those treatments wants to reverse the trend by fining hospitals that don’t do a good enough job transitioning patients out of the hospital. Continue reading

Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesy: Bob Pack)

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November’s ballot. (Photo Courtesyof Bob Pack)

Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville. Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch. In the afternoon, they changed out of their costumes and set out for a walk with their mother down Camino Tassajara. Destination: Baskin Robbins 31 Flavors.

“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, ’cause he liked counting the bubble gums that he would get.”

Bob Pack stayed home to rest. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there,” he says.

An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived. Continue reading

Drought May Be Driving Increase in West Nile

A security guard walks the perimeter of the Almaden Reservoir on January 28, 2014 in San Jose, California. Now in its third straight year of drought conditions, California is experiencing its driest year on record, dating back 119 years, and reservoirs throughout the state have low water levels. Santa Clara County reservoirs are at 3 percent of capacity or lower. California Gov. Jerry Brown officially declared a drought emergency to speed up assistance to local governments, streamline water transfers and potentially ease environmental protection requirements for dam releases. (Photo by Justin Sullivan/Getty Images)

A security guard walks the perimeter of the Almaden Reservoir in San Jose. (Justin Sullivan/Getty Images)

Public health experts say the state’s historic drought is partly to blame for the recent rise in West Nile virus infections. Cases this year have more than doubled to 311, compared to the same time last year.

West Nile virus is spread by mosquitoes. They contract the virus when they feed on infected birds, then spread it to other birds they bite next. A shortage of water can accelerate this cycle.

“When we have less water, birds and mosquitoes are seeking out the same water sources, and therefore are more likely to come in to closer proximity to one another, thus amplifying the virus,” said Vicki Kramer, chief of vector-borne diseases at the state department of public health.

Also, the water sources that do exist are more likely to stagnate. Stagnant water creates an excellent habitat for mosquitoes to breed. Continue reading

Students Struggle to Access Mental Health Services on UC Campuses

Students at Sproul Plaza, UC Berkeley. (Henry Zbyszynski/Flickr)

Students at Sproul Plaza, UC Berkeley. In the last six years, the number of students seeking health at counseling centers has increased 37 percent across the UC system. (Henry Zbyszynski/Flickr)

Students throughout the University of California system are having trouble accessing mental health care, and health services directors are raising alarms that increased staffing and funding could be warranted to meet demand.

“The increased need for mental health services on our campuses is outstripping our ability to provide those services,” said Dr. John Stobo, senior vice president for health sciences and services for the University of California. “It is a major problem. It’s not only a problem for UC, this is a national issue.”

In the last six years, the number of students seeking help at university counseling centers has increased 37 percent, according to data presented at UC Regents board meeting on Thursday.

“This is real. Students are having difficulty accessing mental health services on campus,” said Dr. Gina Fleming, medical director for the UC Self-Insured Health Plans. “They’re waiting longer to get an appointment. They’re having fewer appointments within the course of therapy, and more are needing to be referred off campus.” Continue reading

Kaiser Agrees to Pay $4 Million Fine Over Mental Health Care

Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)

Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)

Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.

The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.

Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case. 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)

Update: Fresno County’s Board of Supervisors voted 4-1 to end the contract providing care to the poor and to undocumented immigrants. 

Original Post:

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

Unions Fight Sale of Safety-Net Hospitals

Six safety-net hospitals owned by the Daughters of Charity Health System — four in the Bay Area and two in Los Angeles — are for sale. The company says it’s out of money and needs another organization to take over.

The mission of Daughters of Charity hospitals is to take care of the poor and needy. CEO Robert Issai says that three-quarters of the patients are covered by government health programs, which pay significantly less than private insurers.

“We’ve always had that 25 percent of commercial business to make ends meet,” he said.

But a lot of that dried up when the recession hit in 2008. People lost their jobs and their insurance. Then the government cut back too, slashing reimbursement rates. Continue reading