Author Archives: Rachel Dornhelm

Rachel Dornhelm got her start in radio at WHYY. After anthropology graduate school, Rachel lived in Uzbekistan working with youth near the drying Aral Sea. Rachel returned to radio full-time in 2001. Her work has appeared on WNYC, WBUR, Marketplace, NPR news magazines and KQED.

New Report Finds Dramatic Racial Disparities for California Kids

(Getty Images)

(Getty Images)

Many children of color in the state face different health and education opportunities from the earliest years.

That’s according to a new study from the Annie E. Casey Foundation.

The report looked at factors like birthweight, access to preschool and, later, reading and math proficiency. The researchers then created an index that weighted these and other social markers to measure a child’s opportunity to thrive later on.

The findings were stark. On a scale of 0 to 1000 (with 1000 being the highest), Asian and Pacific Islander children in California scored 768, Whites 748, American Indians 529, Latinos 405, and African American children 395.

“A multicultural state needs multicultural solutions,” Nadereh Pourat, UCLA Center for Health Policy Research

The report gives this analogy for thinking about the results. Think about a power grid that brings power to an area. A “prosperity grid” offers critical links to help kids succeed – in this case whether someone in their household has a high school diploma, their parents income, and achievement levels at their school.

“The inability of children of color to connect to this network through their neighborhoods clearly has significant consequences for their healthy development and well-being,” the authors wrote. Continue reading

California Measles Cases Jump Dramatically; 49 So Far in 2014

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

The state is reporting 49 confirmed cases of measles so far in 2014.

Last year at this time there were just four.

This is the first year since 2000, when officials declared measles eliminated in the U.S., that the number of cases in California climbed above 40. And it’s just April.

The California Department of Public Health says the highest number of cases – 21 – have been reported in Orange County. Other affected counties in Southern California include Los Angeles County with 10, Riverside with 5 and San Diego County with 4.

In Northern California the cases were spread out between Alameda, Contra Costa, Santa Clara and San Mateo. Continue reading

Oakland Schools Help Parents Sign Up for Covered California

Gabino Pablo gets help with Covered Calfiornia enrollment as the deadline approaches. (Rachel Dornhelm/KQED)

Antonia Briones (left), an Alameda County Social Services Agency eligibility technician, helps Gabino Pablo (right) with Covered California enrollment as the deadline approaches. (Rachel Dornhelm/KQED)

The robocall went out this week to every parent of an Oakland public school student:

“Hello! This is the Oakland Unified School District calling to remind you that March 31st is the deadline for enrolling in health insurance … The OUSD Central Family Resource Center is here to help.”

The day after that call went out the Central Family Resource Center, housed in a small portable building. was swamped. Over a 100 calls came in and 30 families dropped by.

“We’re just getting flooded with calls and people dropping in asking for appointments so we’re all hands on deck trying to respond to the demand,” said Eliza Schiffrin, the center’s program coordinator.

Oakland parent Gabino Pablo came in to sign up for coverage for himself, and Medi-Cal for his 5 week old daughter. He said he knew the deadline was looming, but has no internet access at home.

“I don’t speak much English. I am Mayan, my second language is Spanish and it’s hard,” said Pablo. “A lot of people need help [signing up]. When I go home from here, I am going to tell people I know and send them over here.”

Pablo estimates that only 1 in 10 of the adults in his immediate community are signed up for health insurance.

Schiffrin says the center has taken their staff on the road, too, visiting individual schools to help people sign up.

Continue reading

Higher Autism Numbers Announced as Feds Introduce Early Screening Program

(Getty Images)

(Getty Images)

Every two years, the federal government announces the rate of autism. This is what NPR’s shots blog had to say about today’s numbers, which show 1 in 68 children in the U.S. have an autism spectrum disorder.

That’s a remarkable jump from just two years ago, when the figure was 1 in 88 and an even bigger jump from 2007, when it was just 1 in 150.

But officials at the Centers for Disease Control and Prevention officials say the agency’s skyrocketing estimates don’t necessarily mean that kids are more likely to have autism now than they were 10 years ago.

“It may be that we’re getting better at identifying autism,” says Coleen Boyle, director of the CDC’s National Center on Birth Defects and Developmental disabilities.

For one thing, the prevalence seems to vary in different communities and among children of different races. The CDC found white children are far more likely to be identified with autism, even though scientists don’t believe the rates are truly different between whites, Hispanics or blacks.

“What we need to focus on is getting more people identified so they can get the supports they need,” Shannon Rosa, Bay Area parent advocate.

That means that the discrepancy lies in the diagnosis and services available in different communities. The shots blog points out the work of George Washington University anthropologist Roy Richard Grinker.

Along with other researchers, he studied autism prevalence in South Korea. They found that 1 in 38 children there met the criteria for autism spectrum disorder. Grinker thinks that the US number is likely closer to the one they saw in South Korea. Which means that in two years the CDC estimate will likely tick higher still.

Continue reading

Covered California Gives Until April 15 to Finish Applications in Progress

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

The deadline for Covered California applications is fast approaching: midnight on March 31.

The state is still strongly encouraging people to finish by that time. However, on Wednesday, Covered California announced that if you have an application in the works by March 31, you will have until April 15 to complete it.

Peter Lee, executive director of Covered California, said health exchange enrollment has been surging ahead of the deadline. Continue reading

Advocates Want State to Delay Health Transition for Elderly and Disabled

(Getty Images)

(Getty Images)

Next month, a federal pilot program aimed at improving care for the most vulnerable is set to start rolling out in some California counties.

Cal MediConnect is supposed to help seniors and disabled people in seven California counties get better coordinated health services — from in-home caregivers to physicians. Those who are affected will automatically be rolled into the program. They have the opportunity, though, to make choices about where and how they will get their care.

But some advocates say information about making those choices has been unclear and is coming too late.

With four counties set to roll out the program in April and May, they are calling on the state to put the program on hold.

“We sent (the state) a letter with five other organizations saying there should be a delay,” said Amber Cutler, a staff attorney with the National Senior Citizens Law Center. “They are always putting out fires (with this) and have no time to prepare to prevent problems. That is particularly troublesome when thinking about adding Los Angeles and Alameda in July. We’re talking about hundreds of thousands of people who will be affected.” Continue reading

How Important Is Cost Transparency To Lowering Health Costs?

AetnaRate_Images Money_Apr62012

(flickr: Images Money)

The largest public employees retirement system in the country – CalPERS – has plenty to gain from a drop in health care costs. After all, they cover 1.6 million employees, retirees and their families in California.

Now they’re saying, they found a way to decrease the amount they’ve spent on knee and hip replacements by 19 percent in a year, which could have implications for other employer health plans.

Lisa Alferis blogged about the CalPERS experiment in controlling costs right here on State of Health about a year ago. Aliferis wrote that they decided to tackle costs around these two surgeries, which cost them $55 million dollars a year in 2008.

Now, you might not think there would be much difference in the price for getting a knee or hip replacement across the state. But think again. CalPERS asked Anthem Blue Cross — which manages its PPO plans — to examine the range of prices for these operations in California.

Anthem came back with the startling information that CalPERS was paying $15,000 on the low end to $110,000 on the high end, a more than seven-fold difference from lowest to highest.

“So we started asking ourselves,” Kathy Donneson, Chief of the CalPERS Heatlhy Plan Administration Division told me, “what are we getting from the $110,000 surgery that we couldn’t get from the $15,000 surgery?”

That’s when CalPERS turned to what’s called a “value based purchasing” approach for elective hip and knee replacements, starting with its non-Medicare population. CalPERS set a threshold price of $30,000 for the hospitalization and device charges for these operations. That $30,000 is slightly higher than the average price CalPERS had been paying for a hip or knee replacement. Anthem identified 46 hospitals across the state which would do these operations at the threshold price.

Continue reading

Low-income California Children Among Least Likely to Get Dental Care

Almost 60% of California children on Medi-Cal did not receive any dental care in 2011 (nmoira/flickr)

Almost 60 percent of California children on Medi-Cal did not receive any dental care in 2011. (nmoira/flickr)

Young people who don’t get the routine dental care they need find themselves at a disadvantage, studies have shown: not just in overall health but also in school performance.

Now a study from the Pew Charitable Trusts finds that California is among the 10 states where low-income children are least likely to receive dental care.

Almost 60 percent of children with Medi-Cal did not receive any dental care in 2011, said co-author Jane Koppelman.

“What it means is that kids can have insurance, they can have (Medi-Cal), but it’s more like a hunting license than an entitlement,” says Koppelman, research director for the Pew Children’s Dental Campaign. “It’s a license to try to find a dentist who can give you care. And in a lot of areas that is quite a trial.”

Continue reading

What Will California’s Health Benefit Exchange Application Look Like?

DraftImmediately following the Supreme Court’s decision on the Affordable Care Act, the head of California’s Health Benefit Exchange laid out his vision for revolutionizing the health insurance market.

“We know buying insurance is really complicated. We want to make it as easy as buying a book on Amazon,” said Peter Lee, executive director of the California Health Benefit Exchange.

But as the state has worked to create the actual application for health insurance, the idea of a one-click purchase is far from the reality.

“This is a brand new law and it’s complicated,” says Sam Karp, vice president of programs at the California HealthCare Foundation (CHCF). “It’s reasonable to expect the implementation will take not just a year. It will take a few years.” Continue reading

Quick Read: House Bill Would Create 15,000 New Residency Positions

Facing a huge shortage in doctors in coming decades, two US representatives introduced a bill that would significantly increase the number of Medicare-sponsored residencies. The number of those residencies has not increased in 15 years. The Association of American Medical Colleges (AAMC) is estimating that the U.S. healthcare system could be short hundreds of thousands of doctors in coming decades.

A bipartisan House bill reintroduced Thursday would create 15,000 more medical residency positions under Medicare in a move to alleviate the looming U.S. doctor shortage. The measure from Reps. Allyson Schwartz (D-Pa.) and Aaron Schock (R-Ill.) would mandate that 50 percent of the positions train residents in primary care.

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