Protestors carry signs against proposed Medi-Cal cuts outside San Francisco City Hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)
By David Gorn, California Healthline
The irony of the situation was not lost on Linda Trowbridge, CEO of the Center for Elders’ Independence in Oakland.
At an Assembly hearing in Sacramento last week, Trowbridge said funding for California’s Program of All-Inclusive Care for the Elderly — or PACE — has been systematically cut over the past six years and yet it is often cited as the model of care the state would like to pursue.
“Adult day health care is essentially skilled nursing care in a community setting, and this Medi-Cal rate reduction threatens our whole industry.”
The federally subsidized program is aimed at providing and coordinating care to allow seniors and people with disabilities to remain living at home.
“Everybody who is in this program would otherwise be in a skilled nursing facility,” Trowbridge said. The program saves the state money, she said, pointing to estimates that PACE centers cost 11 percent of what it would cost to have people go to nursing facilities. Ironically, the PACE program is one of the state’s models for its Coordinated Care Initiative for dual eligibles, Trowbridge said. Continue reading
The single-story housing units at the California Health Care Facility in Stockton provide wheelchair access, around-the-clock care for inmates. (Julie Small/KQED)
By Julie Small
California prison officials are hoping to resume transfers of sick inmates to a new, state-of-the-art medical facility in Stockton later this month. While not licensed as a hospital, the prison medical facility provides high-level, round-the-clock care to inmates with the most complex medical conditions.
The federal overseer of inmate health care halted admissions at the prison in late January, citing unsanitary conditions and shortages of staff and supplies that have persisted for months.
The state spent $839 million to build the California Health Care Facility located at the southern edge of Stockton. The single-story housing was designed with rooms and doorways large enough to fit gurneys, wheelchairs, and medical equipment to care for 1,700 inmates with complex medical conditions. But shortly after the facility opened in July 2013, staff and inmates reported problems getting essential medical and personal hygiene supplies. Continue reading
By Anna Gorman, Kaiser Health News
In an effort to reduce California’s backlog of health and safety complaints at nursing homes, Los Angeles County public health officials told its inspectors to close cases without fully investigating them, according to internal documents and interviews.
The effort known as the “Complaint Workload Clean Up Project” has been going on since at least the summer of 2012, according to internal memoranda sent by email to managers and inspectors by county Department of Public Health supervisors.
Nearly one-third of the 1,286 nursing homes in the state are in L.A. County.
State and federal officials, who contract with Los Angeles County to inspect nursing homes on their behalf, said they are now investigating the matter. Contacted by a reporter, the California Department of Public Health issued a statement Sunday saying it did not approve the practice and has ordered Los Angeles County officials to “immediately discontinue” it. The county’s approach conflicts with the policies and protocols of the California Department of Public Health, spokesman Anita Gore said in the statement. Continue reading
Many over-the-counter products contain acetaminophen. One dose is usually not a problem, but it’s easy to lose track of how much your child is taking. An overdose can cause liver failure or death. (Scott Olson/Getty Images)
By Scott Hensley, NPR
Concerns about drug risks have led 28 state attorneys general to ask the Food and Drug Administration to reverse its approval of Zohydro, a long-acting narcotic painkiller, before the medicine is even put on the market.
People often underestimate the risks of individual drugs and combinations of drugs for young children.
The risks for addiction and overdose from the potent opioid outweigh the benefits of pain relief, critics say. Some point to the risk for children, in particular. A single capsule of Zohydro could kill a kid, the medicine’s instructions warn.
Other opioid painkillers, such as Vicodin and Percocet, are already fixtures in America’s medicine cabinets. And as the prescriptions for drugs like these have surged, so have the reports of overdoses and deaths — for children and adults.
But opioids are just one kind of risky medicine. Doctors have a disturbingly long list of drugs that can lead to the death of a child after just one or two doses. Continue reading
By David Gorn, California Healthline
A recurring theme at the annual California Association for Behavior Analysis conference starting today in Burlingame likely will be the new definition of autism in the medical community.
Does the new designation make it harder to get a key treatment covered?
The national guidelines for doctors and other clinicians was updated last year. DSM-5 is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, put out by the American Psychiatric Association.
In DSM-5, there is a new category in the autism spectrum — social communication disorder, or SCD. Since there are no clinical guidelines for treating SCD, autism advocates worry the new designation could be used by insurance companies to stop covering applied behavior analysis (ABA therapy) in treating autism disorder.
“It’s likely a small percentage [of SCD children among those with autism spectrum disorder], but it definitely will affect some people,” said Karen Fessel, director of the Autism Health Insurance Project. “There are no guidelines put out by insurance companies yet, so likely there will be no adjustments till October this year.” Continue reading
By Jordan Rau, Kaiser Health News
People buying health insurance through the health law’s new online marketplaces are more willing than the public at large to accept a limited roster of doctors and hospitals in return for lower premiums, a poll released Wednesday finds. But that enthusiasm nosedives if they are told their regular doctor isn’t included in the plan.
But there’s a split between those with employer-sponsored insurance and those who buy it on their own.
As a way to keep costs down and be competitive, insurers across the country have pieced together limited networks of doctors, hospitals and other medical providers. Consumers wanting broader choices of providers are often given the option of buying plans with higher premiums.
The narrow networks have encountered resistance from doctors, patient groups and some insurance regulators, who fear consumers will not grasp their limited options until they seek medical care. Roughly 6 million people this year are expected to buy their own insurance through the health care exchanges that started operation in January.
Most people with private insurance still get their coverage through their employer. Among members of that group, limited networks are unpopular, according to the poll from The Kaiser Family Foundation. Fifty-five percent would rather buy a plan that costs more but allows them to see a wider range of doctors and hospitals, while only 34 percent prefer a less expensive plan with limited providers. Continue reading
A recent Death Cafe, held at San Francisco’s Zen Hospice Project. (Jeremy Raff/KQED)
By Jeremy Raff
In a dimly lit room decorated with several Buddhas and a large red-and-white Zen illustration, twenty-nine people sat in a circle. Some were eating chocolate bundt cake. It was an unusual setting to be discussing the topic at hand: death and dying. These death cafes have sprung up around the world to address the taboo subject head-on. Organizers hope that increased awareness of death will help people make the most of their lives.
Roy Remer, the group’s facilitator, hushed the room and passed around pieces of cardstock covered in Post-its. Each person wrote intimate words on them — family members’ names, roles they play (mother, mentor), significant relationships and important objects. The Post-its became a boiled-down map of what each person holds dearest. Then, Remer walked the circle, visiting each person with inevitable gravity. He then ripped away Post-its from each one.
Some reflexively clutched their children’s names. But most averted their eyes, looking stunned. It wasn’t easy for Remer either. “It felt violent,” he said. The exercise simulated loss and started the conversation about death and dying. Continue reading
By Brittany Patterson
Toss those vitamin bottles and instead opt for a well-balanced diet if you’re looking to prevent heart disease or cancer.
The U.S. Preventive Services Task Force released new recommendations Monday regarding both multivitamins and certain supplements — and their potential to help prevent heart disease and cancer. The task force “concludes that the current evidence is insufficient to assess the balance of benefits and harms” of the use of multivitamins, vitamins, minerals and other dietary supplements to prevent heart disease or cancer.
The task force is, however, recommending against use of beta-carotene and vitamin E supplements. Continue reading
Anna Gorman, Kaiser Health News
In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.
The bill, SB 1005, would extend state-funded Medi-Cal to low-income immigrants who, because they are in the country without permission, are now eligible only for emergency and pregnancy coverage. It would also create a marketplace similar to Covered California to offer insurance policies to higher income immigrants who lack legal status.
It’s not clear how much the new coverage would cost or how the state would fund it.
Sen. Ricardo Lara, a Democrat who represents Long Beach and southeast Los Angeles, announced the proposed legislation at a press conference Friday. He said immigrants contribute to the California economy and deserve to have access to health insurance. Continue reading
Clinical pharmacist Diana Arouchanova worked with patient Diana Freedman’s physician to switch one of the medications that helped lower her blood pressure (Heidi de Marco/KHN)
Anna Gorman, Kaiser Health News
Jill Freedman felt like her heart was jumping out of her chest. She knew her blood pressure was too high and feared having a heart attack or a stroke.
“I was freaking out,” said Freedman, 55. “You get very emotional when you think you could drop dead at any moment.”
Her doctor doubled one of her medications, she said, but that only made her feel worse. So Freedman turned to the one person she knew she could count on — her pharmacist.
“We are the most overeducated and underutilized healthcare professional in the U.S.”
“It was Diana who figured out what the problem was,” said Freedman, referring to her longtime pharmacist Diana Arouchanova. “Had she not been on top of what I’m going through, God knows how many more weeks this could have potentially gone on.”
Arouchanova, who owns Clinicare Pharmacy in Northridge, reviewed Freedman’s medications and realized that her problem stemmed from the dangerous combination of two prescriptions. She got the physician to change the medications and started checking Freedman’s blood pressure daily. Soon, it began to drop. Continue reading