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May 14, 2013 | 5:06 PM | By

California’s Health Insurance Exchange Builds Critical Outreach Network

Covered California, the state’s health insurance exchange, announced the recipients of $37 million in education and outreach grants on Tuesday. It’s a critical step in the drive toward the full implementation of the federal health law on Jan. 1. “This program now belongs to California … and to Californians, and we have to make it work,” said Dr. Robert Ross, a Covered California board member.

The grants were awarded to 48 lead organizations, which will be supported by 226 community partner groups. They will focus on education and outreach to the 5.3 million Californians the exchange seeks to enroll, with an estimated 2.6 million of those people eligible for subsidies to help them afford insurance. Five of the recipients will target their outreach to small businesses.

Californians will be able to shop for insurance on the new marketplace starting Oct. 1, with coverage going into effect on Jan. 1. Most people must have insurance or pay a penalty. In 2014 the penalty is $95 per person or 1 percent of income (whichever is greater), and the penalty rises to $695 or 2.5 percent of income (again, whichever is greater) by 2016.  Continue reading →

FILED UNDER: KQED blogs, Reform, Affordable Care Act, Covered California, Obamacare
May 3, 2013 | 10:18 AM | By

How Nurses and Other ‘Mid-Level Providers’ Fill Growing Gap in Primary Care

By Jose Martinez, KPCC

(Keith Brofsky/Getty Images)

(Keith Brofsky/Getty Images)

Simmi Gandhi — a family nurse practitioner at South LA’s UMMA Community Clinic — is at work early. When she calls a patient, she apologizes for waking the woman up. But she knew the woman was waiting for test results.

In Urdu, she tells the patient her mammogram shows the mass in the woman’s breast isn’t cancer. After Gandhi hangs up, she doesn’t miss a beat: She starts debriefing for her next patient, who’s been missing appointment for months.

“Looks like he has diabetes,” she says. “I had asked for him to be able to get an appointment six weeks thereafter, so that was back in September. That was cancelled, and then he didn’t come for two appointments that were rescheduled. And now he’s finally back.”

Simmi Gandhi is what’s called a midlevel provider — which includes registered nurses, physician assistants and nurse practitioners. These are medical professionals who are in-between physicians and lower skilled medical technicians and nurses. At the UMMA clinic, she provides a wide range of primary care people in need.

“A community like this has less resources,” she says. “A lot of the folks that live here have less education as I’m sure everybody’s aware, our educational system is stressed so the basic education people get around their bodies … is low.” Continue reading →

FILED UNDER: KQED blogs, Place Matters, Midlevel Providers, Primary Care
April 16, 2013 | 10:30 AM | By

Supreme Court Seems Skeptical of Patenting Human Genes

SCOTUS_SupremeCourtIn arguments at the Supreme Court Monday, justices appeared skeptical about patenting human genes.

The U.S. Patent and Trademark Office has been granting parents on human genes for nearly 30 years. This is the first case questioning that premise to reach the Supreme Court. At the heart of the case are two genes associated with breast cancer, BRCA1 and BRCA 2. People with certain mutations in these genes have a significantly higher risk for breast, ovarian and other cancers.

Opponents of patenting human genes say genes are products of nature and therefore cannot be patented. Myriad Genetics, which holds the patent on the genes, say that once genes are isolated from the body and processed they are no longer a product of nature.

The Associated Press captured the back and forth:

Justices attempted to break the argument down to an everyday level by discussing things like chocolate chip cookies, baseball bats and jungle plants.

[Gregory A.] Castanias, the Myriad lawyer, argued that the justices could think about the gene question like a baseball bat. “A baseball bat doesn’t exist until it’s isolated from a tree. But that’s still the product of human invention to decide where to begin the bat and where to end the bat,” he said.

That didn’t work for Chief Justice John Roberts. Continue reading →

FILED UNDER: KQED blogs, Policy, Breast Cancer Genes, Patents
April 4, 2013 | 11:06 AM | By

New Flu Strain in China: How Far Will It Spread?

It was four years ago this month that a new strain of flu virus was reported in Mexico and captured global attention. Ultimately, the World Health Organization declared it a pandemic. More than 18,000 people died in 2009 from the virus.

Now, in China, global influenza experts are watching another novel virus, H7N9. So far, nine people are sick, and three are dead. As Helen Branswell at The Canadian Press (and self-described “flu freak“) reports “those first three sick people and the genetic sequences of the flu viruses that infected them were enough to make the hairs on the backs of knowledgeable necks stand on end.”

Branswell also tweeted that case “numbers are a moving target” right now.

She lays out why flu experts are racing to determine if we’re on the brink of the second pandemic in five years in this report:

Influenza scientists always pay attention when animal flu viruses start making people sick. There is a rich soup of flu viruses in nature, most of which human immune systems have never seen. Many of those viruses, at least in theory, have the potential to trigger pandemics.

So when China notified the World Health Organization over the weekend that it had found three cases of infection with H7N9 viruses, there was immediate concern. Continue reading →

FILED UNDER: KQED blogs, Policy, H7N9, Influenza, Science
April 3, 2013 | 3:29 PM | By

State Hires Consumer Group To Help Review Health Insurance Rates

California Insurance Commissioner Dave Jones has irritated the insurance industry and surprised public-policy analysts by hiring Consumer Watchdog, a vocal insurance industry critic, to assist in reviewing health insurance rate increases, the Los Angeles Times reports.

In a one-year contract worth up to $88,000, Consumer Watchdog will supplement the rate review process already done by the insurance department.

From the Los Angeles Times:

The insurance industry expressed dismay that the state enlisted its longtime nemesis to help review rate increases, and some experts questioned whether it’s necessary to further antagonize insurers at a time when state officials are trying to work closely with the industry to implement a massive healthcare expansion.

Public-policy experts also scoffed at the arrangement. Continue reading →

FILED UNDER: KQED blogs, Policy, Reform, Health Insurance Rates, Premiums
March 29, 2013 | 4:33 PM | By

Valley Fever Cases Skyrocketing, Says CDC

BY RACHEL COOK, Reporting on Health Collaborative

Farming in California's Central Valley is a source of smog, a major contributor to the region's high asthma rates. (Getty Images)

Valley Fever is a disease caused by a fungus found in the soil in certain parts of the southwestern U.S., including California. (Getty Images)

The Centers for Disease Control and Prevention confirms in a new research article this week what doctors, epidemiologists and people who suffer from valley fever have experienced first-hand — cases of the fungal disease rose at stunning rates over the last decade, especially in California and Arizona.

The CDC’s analysis addresses the findings reported in Just One Breath, a series of news stories on valley fever by the Reporting on Health Collaborative published in The [Bakersfield] Californian and other outlets. The series chronicled the rise in valley fever cases and deaths and the lack of attention by state and federal policymakers.

“I do think that the reporting series helped to put (valley fever) at the forefront, especially in California,” said Dr. Benjamin Park, medical officer in the CDC’s Mycotic Diseases Branch and the study’s senior author.

The total number of valley fever cases rose by more than 850 percent between 1998 and 2011 in the area where valley fever is most common.
People catch coccidioidomycosis, also known as valley fever, after inhaling fungal spores that are common in the dry parts of the Southwest as well as Mexico and Latin America. Experts say the lack of funding and serious attention to valley fever has stalled efforts to combat the disease.

But valley fever seems to be gaining policy attention. House Majority Whip Kevin McCarthy, R-Bakersfield, and CDC Director Dr. Tom Frieden recently met to talk about valley fever’s impact in the Southwest. Continue reading →

FILED UNDER: KQED blogs, Place Matters, Valley Fever
March 20, 2013 | 12:31 PM | By

Settlement Called ‘Less Harmful’ for In-Home Support Recipients

By David Gorn, California Healthline

California officials and disability rights advocates yesterday announced a settlement of a lawsuit challenging a 20 percent budget trigger cut in In-Home Supportive Services care.

The settlement allows an 8 percent reduction this year and a 7 percent reduction in 2014. It also changes the cuts from permanent to temporary.

The size and timing of the cuts are based, in part, on a current 3.6 percent IHSS cut established in 2009. That reduction will remain in effect, and an additional 4.4 percent cut will be added onto that this year followed by a 3.4 percent additional cut next year, bringing the totals to 8 percent this year and 7 percent next year. Continue reading →

FILED UNDER: KQED blogs, Policy, Adult Day Health Care, In Home Supportive Services
March 18, 2013 | 11:44 AM | By

San Diego Emergency Departments Consider New Guidelines to Crack Down on Painkiller Abuse

By Kenny Goldberg, KPBS

More than 260 San Diegans died from drug overdoses in 2011. The vast majority of these deaths were linked to prescription painkillers like Oxycontin and Percocet.

Hospital emergency departments in San Diego are now reevaluating their role in dispensing these medications.

Bobby Stevens, not his real name, first started popping Oxycontin when he was in high school in northern San Diego county. His classmates used to hand it out at parties.

Stevens soon became hooked. At the height of his addiction, he was taking up to 20 Oxycontin pills a day, plus the anti-anxiety drug Xanax and the amphetamine Adderall. He was spending $1500 a week on his habit. Continue reading →

FILED UNDER: KQED blogs, Policy, Oxycontin, Prescription Drug Abuse, Science
March 14, 2013 | 5:00 AM | By

Preventing Subsequent Suicide Attempts One Phone Call at a Time

By Lauren M. Whaley, CHCF Center for Health Reporting

Every day in California, nine people die by suicide. Both in California and nationwide, suicide is the 10th leading cause of death. According to a recent study, in 2009, more than a half-million adults in California seriously thought about killing themselves. Last fall, the California Mental Health Services Authority launched a statewide campaign called Know the Signs as part of a larger suicide prevention initiative.

One of the highest risk groups for suicide is people who have previously attempted suicide. In Sacramento, an innovative program seeks to reach that group directly and easily: through the simple phone call.

One of the program’s clients is John, a 29-year-old student at Sacramento’s American River College. Today, he describes himself as happy-go-lucky. But a year ago, he had lost two jobs, was facing bankruptcy and had to move in with friends.

Already feeling “emotionally and mentally stripped,” he was then was diagnosed with HIV. “That took away pretty much the last thing that I had, which I thought was my health,” he recalls.

One day last August, he reached an end. Feeling he was “tired of doing this,” he decided to take his own life.

“In my room, I wrote out my note,” he remembered. “I got all my medication out on my bed and I just started taking it. And … All of a sudden, what I just realized is here I am laying here on my floor. … I think, ‘Oh My God, what am I doing? What am I doing?’”

He called out for help, and his roommates called 9-1-1.

He woke up in downtown Sacramento at Sutter General Hospital’s emergency department with nurses pumping his stomach. He recovered. But before he was discharged, he was visited by a social worker, who told him about a unique program that would match him with a suicide prevention specialist. John signed up. That person would give him a call every few days for a month just to check in.

“Ultimately, I knew that I had a cushion for support,” John said about receiving those calls. “I knew that if I was having a hard time, I absolutely had somebody available there.” Continue reading →

FILED UNDER: KQED blogs, Policy, Mental Health, Suicide Prevention
March 11, 2013 | 5:04 PM | By

Emotional Hearing about Future of Medical Board of California

By Scott Detrow, KQED

A bureaucratic hearing in Sacramento took an emotional Monday morning, as parent after parent told state legislators how their children died from overdosing on prescription drugs.

The parents who testified during the Medical Board of California’s “sunset review” hearing all said the agency should do more to crack down on doctors who abuse their prescription-writing powers.

Tammy Smick, of Downey, says she’s outraged the doctors who gave prescriptions to her drug-addicted son Alex are still practicing medicine. “What has the California Medical Board done about the death of our son? As far as I can tell, absolutely nothing, and that is just shameful,” she told the panel of senators and assembly members. Continue reading →

FILED UNDER: KQED blogs, Policy, Medical Board of California, Prescription Drug Abuse