Author Archives: Jon Brooks

State Revokes Blue Shield of California’s Tax-Exempt Status

(Steve Rhodes via Flickr)

(Steve Rhodes via Flickr)

On the Blue Shield of California Web page called “What Does Being a Not-for-Profit Mean to Us?” the health insurer provides an answer:

Operationally, it means we don’t answer to Wall Street – we don’t need to generate returns to shareholders. Philosophically, being a not-for-profit means we’re guided by our mission to ensure all Californians have access to high-quality health care at an affordable price.

Well, the state’s Franchise Tax Board may have found that something in that description does not conform with reality. In a story first reported by the L.A. Times and confirmed by Blue Shield of California to KQED, the board has stripped the company of its tax-exempt status.

Yes the loss of tax exemption is true and we have filed a formal protest of the decision with the FTB,” Blue Shield said in an email. The tax board said the revocation occurred on Aug. 28, 2014, and the Times said the company must now file returns from 2013 on. When asked the reason for the revocation, the board responded that is not considered public information and could not be disclosed.

Whatever the reason, the Times said the move could transfer tens of millions of dollars each year from the company to the state. Calling the action highly unusual, the newspaper said it came on the heels of a state audit investigating the justification for the company’s tax exemption. Continue reading

49ers Wunderkind Retires After 1 Year, Brings Concussion Issue Again to Fore

SANTA CLARA, CA - NOVEMBER 23:  Logan Paulsen #82 of the Washington Redskins is tackled by Chris Borland #50 of the San Francisco 49ers at Levi's Stadium on November 23, 2014 in Santa Clara, California.  (Photo by Ezra Shaw/Getty Images)

Chris Borland, #50, of the San Francisco 49ers tackles a Washington Redskins player at a game last fall. Borland announced he will retire from the 49ers after just one year. (Ezra Shaw/Getty Images)

“From what I’ve researched and what I’ve experienced, I don’t think it’s worth the risk.”

“I feel largely the same, as sharp as I’ve ever been. For me, it’s wanting to be proactive. … I’m concerned that if you wait till you have symptoms, it’s too late.”

“(T)o be the type of player I want to be in football, I think I’d have to take on some risks that, as a person, I don’t want to take on.”

“I just want to live a long, healthy life, and I don’t want to have any neurological diseases or die younger than I would otherwise.”

These are not comments that can fill the stakeholders in the National Football League with confidence in terms of being on top of the concussion issue. They were all made by 24-year-old 49ers linebacker Chris Borland after announcing his retirement yesterday, after just one year in the league. Borland, a player who was thought to have a bright if bone-rattlng future in the NFL, did the research on player concussions and decided the risk was just too great. (You can watch his interview with ESPN’s “Outside the Lines,” where he first announced his decision, here.) Continue reading

County Health Programs Need to Serve More Undocumented Californians, Advocates Say

Touro University medical student Shamis Fallah (L) administers a Tdap vaccination in the arm of Phillip Briskell during a 2010 Solano County health fair in  Vallejo.   (Photo by Justin Sullivan/Getty Images)

Touro University medical student Shamis Fallah (L) administers a Tdap vaccination in the arm of Phillip Briskell during a 2010 Solano County health fair in Vallejo. (Photo by Justin Sullivan/Getty Images)

by Jenny Gold, Kaiser Health News

With millions of Californians gaining coverage under the health care law, counties need to strengthen their health programs to serve the remaining 3 million uninsured people, nearly half of whom are living in the state illegally, according to a report by a statewide advocacy coalition.

Under state law, each county is responsible for providing care to low-income Californians who are uninsured. But eligibility restrictions in county programs vary dramatically, leaving the uninsured with uneven access to care across the state, according to the report by Health Access California.

The coalition, which surveyed all 58 counties last fall, found that 48 of them preclude residents who are in the country illegally from enrolling in county programs, and 43 exclude any resident earning more than twice the federal poverty level. (The poverty level is $11,770 per year for an individual and $24,250 per year for a family of four.) Continue reading

At UCSF, Patients, Doctors Share Decisions on Treatment

Dr. Jasmine Wong, a surgeon at UC San Francisco, explains treatment options to Gutierrez. A small red USB audio recorder sits between them and captures the conversation (Photo by Heidi de Marco/KHN).

Dr. Jasmine Wong, a surgeon at UC San Francisco, explains treatment options to Gutierrez. A small red USB audio recorder sits between them and captures the conversation (Photo by Heidi de Marco/KHN).

By Anna Gorman, Kaiser Health News

SAN FRANCISCO — Rose Gutierrez has a big decision to make.

Gutierrez, who was diagnosed with breast cancer last spring, had surgery and 10 weeks of chemotherapy. But the cancer is still there. Now Dr. Jasmine Wong, a surgeon at UC San Francisco, is explaining the choices – Gutierrez can either have another lumpectomy followed by radiation, or she can get a total mastectomy.

“I think both options are reasonable,” Wong said. “It’s just a matter of how you feel personally about preserving your breast, how you feel about having radiation therapy.”

Many patients aren’t accustomed to speaking up, so hospital provides tools for decisionimaking on treatments.

“I’m kind of scared about that,” said Gutierrez, 52, sitting on an exam table with her daughter on a chair beside her.

“Well if you made it through chemo, radiation is going to be a lot easier,” Wong told Gutierrez, who is from Merced, Calif.

In many hospitals and clinics around the country, oncologists and surgeons simply tell cancer patients what treatments they should have, or at least give them strong recommendations. But here, under a formal process called “shared decision making,” doctors and patients are working together to make choices about care. Continue reading

1.4 Million Californians Sign Up For Obamacare, But State Falls Short of Goal

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 Kristen Chow explains Covered California and federal subsidies to a Chinese-language caller in 2013. (Marcus Teply/KQED)

Covered California, the state’s Obamacare exchange, has released its latest numbers for 2015 enrollment to date. Among the highlights:

  • Through Feb. 22, the end of open enrollment, 495,073 newly enrolled in a Covered California plan. Total enrollments numbered 1.4 million. AP is reporting that falls 300,000 short of the state’s goal for signups.
  • More than 780,000 new enrollees in Medi-Cal
  • As of Dec. 14, 2014, 92 percent of Covered California participants renewed for 2015.
  • Ninety percent of both old and new enrollees are eligible for a subsidy to help pay premiums.

Covered California said the number of new enrollees was consistent with its forecast.

A spokesperson for the exchange said it did not yet have a total number for all Californians who have enrolled under the Affordable Care Act, including those who who now receive Medi-Cal,  Continue reading

California Bill Would Outlaw Unvaccinated Workers at Child-Care Facilities

Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine.  (Lisa Aliferis/KQED)

Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine. (Lisa Aliferis/KQED)

Child-care facilities and preschools would be prevented from employing anyone who has not been vaccinated against influenza, pertussis and measles under a bill introduced in the California state Senate last week

SB792, sponsored by state Sen. Tony Mendoza (D-Artesia) would amend the state Health and Safety Code to add the requirement that workers be vaccinated.

“Children under the age of five are one of the most vulnerable age groups for contracting infection and developing complications from these very serious diseases, so it is critical that we use all available methods to protect them,” Mendoza said in a press release announcing the legislation.

From the L.A .Times:

Currently, there are no vaccine requirements for day-care workers. Across schools, restaurants and the workplace, adults generally are not tracked for vaccinations as closely as young children entering school.

Since a December outbreak that started in Disneyland, 131 cases of measles in California have been confirmed, the Department of Public Health said Monday. Among those individuals for whom the department has vaccination documentation, 55 were unvaccinated and 18 had one or more doses of the Measles, Mumps and Rubella (MMR) vaccine. In the Bay Area, Alameda County has seen six cases, and Marin, San Mateo, Santa Clara and Solano counties have each experienced a handful.

A previously introduced bill, SB277, would eliminate parents’ right to leave their children unvaccinated due to a personal belief exemption if enrolled in school or a child-care facility.

Read Transcript of Today’s Oral Arguments in Supreme Court Obamacare Case

Today’s oral arguments in the latest Obamacare case to come before the Supreme Court are now over. Proponents of the law are worried that if the plaintiffs prevail, canceling subsidies to insurance buyers in the federal exchange, the Affordable Care Act could be heading for a death spiral. The Supreme Court website has put up a full transcript of the proceedings, which you can read here. A report on today’s events from Associated Press follows.

Here is AP’s write-up of today’s events:

WASHINGTON (AP) — The Supreme Court was sharply divided Wednesday in the latest challenge to President Barack Obama’s health overhaul, this time over the tax subsidies that make insurance affordable for millions of Americans.

The justices aggressively questioned lawyers on both sides of what Justice Elena Kagan called “this never-ending saga,” the latest politically charged fight over the Affordable Care Act.

Chief Justice John Roberts said almost nothing in nearly 90 minutes of back-and-forth, and Justice Anthony Kennedy’s questions did not make clear how he will come out. Roberts was the decisive vote to uphold the law in 2012.

Otherwise, the same liberal-conservative divide that characterized the earlier case was evident. Continue reading

Silicon Valley is Thinner Than San Francisco-Oakland, Report Says

Woman's feet on scale.

(Justin Sullivan/Getty Images)

The South Bay and San Francisco compete on a multitude of fronts: Which will snag the hottest tech firms, which can retain or attract the most sports teams, which will win the prize for least affordable housing…

But no matter how many prestige points San Francisco racks up, the South Bay can claim bragging rights based on at least one important metric: weight.

That’s according to WalletHub, a personal finance website that spends a lot of time compiling data on all sorts of things. (Last month they told us the Bay Area is one of the more diverse regions in the U.S.) From the site:

In light of National Nutrition Month, WalletHub analyzed 100 of the most populated U.S. metro areas to identify those where weight-related problems call for heightened attention. We did so by examining 12 key metrics, among which are the percentage of adults and high school students who are obese and the percentage of people who are physically inactive.

Continue reading

4-Year Contract Dispute Between Kaiser, NUHW Thaws; Union ‘Hopeful’

(Ted Eytan/Flickr)

(Ted Eytan/Flickr)

For more than four years, the National Union of Healthcare Workers, representing 2,600 Kaiser mental health clinicians in California, has been in a small war with the health care giant.

NUHW members have gone on strikes of varying lengths three times over what it says are lengthy delays in providing care to mental health patients.

In 2011, the union filed a 34-page complaint with the California Department of Managed Health Care alleging Kaiser’s mental health services were “sorely understaffed and frequently fail to provide timely and appropriate care.” Continue reading

Calif. Calls Kaiser Mental Health Services ‘Inadequate’ as Treatment Delays Persist

Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)

A teenager with major depression and thoughts of suicide is forced to wait 24 days for an initial appointment.

A sexual assault victim, diagnosed with PTSD and major depression, sends numerous emails requesting individual psychotherapy, only to have her psychiatrist suggest she should get outside help at her own expense because no weekly appointments are available. Total time between appointments: Five months.

Following up on a survey that resulted in a $4 million fine against the HMO in 2013.  

A patient deemed high-risk for domestic abuse doesn’t show up for appointments, but mental health staff do not attempt contact. The couples therapy called for in his treatment plan does not occur. Domestic violence resulting in severe injury ensues. The man then tries to make an appointment but can’t get one.

Continue reading