By April Laissle
California is well behind almost every other state when it comes to caring for its kids, to an annual report from the Annie E. Casey Foundation and its Oakland-based partner, Children Now.
The report looks at four indicators of children’s well-being: family stability, economic stability, health, and education. This year, California inched up one spot to 40th overall, but ranked 26th in the health category.
Some of that progress is due to the expansion of health insurance under the Affordable Care Act, though advocates say there is still work to be done.
“We have increased the number of children now that are on Medi-Cal,” said Jessica Mindnich, research director at Children Now. “But do these kids actually have access to doctors and to dentists? Are they able to get in in a timely manner?” Continue reading
Aerial view of the California Health Care Facility in Stockton. (Photo: California Department of Correction and Rehabilitation)
By Julie Small
The federal receiver who manages medical care in California prisons reopened admissions Monday at a Stockton facility for the state’s sickest inmates. The receiver’s decision ends a temporary court-ordered suspension at Stockton’s California Health Care Facility.
“We are going to slowly begin admitting medical patients.”
In early 2014 the federal overseer of medical care in California prisons suspended all transfers to the $800 million prison medical complex because of unsanitary conditions. Receiver Clark Kelso found doctors and nurses at the facility lacked essential supplies, such as bandages and catheters for incontinent inmates. He also found that staff was too small to provide around-the-clock care to the hundreds of inmates at the prison with complex medical conditions.
Spokeswoman Joyce Hayhoe said Monday that after a series of improvements, the Stockton prison may accept inmates again. Continue reading
By Lynne Shallcross
We are wrapping up the first phase of our PriceCheck project. The goal is to shine a light on costs of common health care procedures in California. We’re starting with screening mammograms, and already we’ve found that the cash price (for people who are uninsured or have gone out of network) varies from a low of $60 at the H. Claude Hudson Comprehensive Health Center in Los Angeles, a county-run clinic, to $801 at U.C. San Francisco on the high end.
Together with KPCC in Los Angeles and ClearHealthCosts.com, we’re also asking you, the members of our community, to share what you’ve been charged — and what your provider has been paid — for common health procedures.
In order to do that, you need to get familiar with your insurance company’s “explanation of benefits” or EOB. That’s the form your insurer sends to explain what was paid, to whom, at what level and why.
Here’s a typical EOB, that we’ve marked with some explanations below:
An explanation of benefits from Anthem Blue Cross.
Under the Affordable Care Act Sandra Lopez, 41, owner of Las Fajitas in Newport Beach, obtained health insurance for the first time since arriving in the U.S. in 1990. (Heidi de Marco/Kaiser Health News).
By Heidi de Marco, Kaiser Health News
Alongside one of Newport Beach’s canals, blocks from the beach, Sandra Lopez is finally living her idea of the American dream.
For years Lopez took home remedies or asked friends to bring her medicine from Mexico.
In 1996, six years after crossing the border from Mexico without papers, she began working at Las Fajitas, a popular Mexican restaurant as a cashier and cook. With the help of her boss, she received a work visa in 2001.
Eleven years after that, she bought the business – a bustling establishment where Lopez knows most customers by name. Mexican lanterns hang from the ceiling, and cheers from a soccer match on TV fill the room.
Lopez, now a legal resident, said the income from her small business fluctuates monthly. “People think that because you own a business, you have lots of money…that life is easy,” she said. “But it’s hard work and I have so many bills to pay.” Continue reading
State officials must submit plan by Monday. (Justin Sullivan/Getty Images)
By Phil Galewitz, Kaiser Health News
Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given California and five other states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage.
600,000 people signed up, but not yet enrolled, in Medi-Cal.
“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor.
In addition to California, the other states are Alaska, Kansas, Michigan, Missouri and Tennessee. Continue reading
A stress system gone awry can quite literally make people sick. (Getty Images)
By Richard Harris, NPR
Ask somebody about stress, and you’re likely to hear an outpouring about all the bad things that cause it — and the bad things that result. But if you ask a biologist, you’ll hear that stress can be good.
In fact, it’s essential.
But people who responded to NPR’s poll talked mostly about the downside of stress.
For example, the adrenal glands of all animals have evolved to pump out stress hormones in unexpected situations — the hormones spur action and increase fuel to the brain, helping the animal react to danger appropriately. Those hormones also flow to memory centers in the brain, to help the critter remember those notable moments and places.
“If it turns out to be dangerous and if the animal actually turns out to survive danger, then it will be aware of this as a potentially dangerous place,” explains Bruce McEwen, head of the neuroendocrinology laboratory at The Rockefeller University. “In that sense, stress is good.” Continue reading
The Anthem Blue Cross headquarters in Woodland Hills, California. (David McNew/Getty Images)
By Julie Appleby, Kaiser Health News
Statewide insurance giant Anthem Blue Cross misled “millions of enrollees” about whether their doctors and hospitals were participating in its new plans, and failed to disclose that many policies wouldn’t cover care outside its approved network, according to a class action lawsuit filed Tuesday.
As a result, many consumers are on the hook for thousands in medical bills, advocacy group says.
As a result, many consumers have been left on the hook for thousands of dollars in medical bills, and have been unable to see their longtime doctors, alleges the suit by Consumer Watchdog based in Santa Monica.
Anthem spokesman Darrel Ng declined to comment directly on the lawsuit. He said Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year.
However, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed, he said. Continue reading
Update 10pm by Isabel Angell
San Francisco Supervisors passed a version of Laura’s Law today that compels treatment for certain mental health patients. Supervisor Mark Farrell, who sponsored the legislation, said Laura’s Law will be an “important tool” for the city.
“I do believe we need to do more as a city and we need to do more to help those who are clearly suffering and cannot help themselves. In order to make a difference here at the local level, we have to continue to challenge ourselves and the status quo,” Farrell said before the vote.
A last-minute amendment from Supervisor Jane Kim that added an external evaluation after three years helped the ordinance pass 9-2. Supervisor Eric Mar, who cast one of the “no” votes, called mental health treatment a civil rights issue.
By David Gorn, California Healthline
CMS officials released federal guidance for states on Medicaid coverage of autism therapy on Monday, and that guidance indicates it is covered for beneficiaries under age 21.
“ABA therapy must be covered (by Medi-Cal). It’s very, very clear.”
“It’s a good day. It’s such a good day,” said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, an advocacy group based in Tarzana. “Whenever you get a decision that we’ve been seeking for years, that is a good day.”
Applied behavior analysis treatment, known as ABA therapy, now is a benefit for those under age 21 under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provision of Medicaid — and therefore it also must be covered under Medi-Cal, California’s version of Medicaid, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. Continue reading
It’s not clear when the backlog will be cleared. (Getty Images)
By Helen Shen, Kaiser Health News
A massive backlog of Medi-Cal applications is well into its third month, and California officials have provided little information about how and when the largest such bottleneck in the nation might be cleared.
The California Department of Health Care Services in Sacramento first reported 800,000 pending applications in April. By May, that number had grown by 100,000 and has not budged much since. As the state works through older applications, new ones continue each day to enter the system, which has been plagued by computer glitches and inefficient procedures for verifying applicants’ personal information.
There are no estimates of processing times or how long delays will persist, though a state official said last month that new applications in May appeared to have slowed. Continue reading