By Elaine Korry
Don Fox prepared for his late-night rounds. He collected a few warm blankets and protein bars, then hit the streets, seeking out people in crisis who needed food and warmth. “Our principle is, we hang out where people are,” said Fox. “We walk the streets in those areas, make eye contact, and ask if they need help.”
Fox is an Episcopal priest with San Francisco Night Ministry, a program founded by volunteer clergy in 1964 to serve a then-emerging population of mentally ill homeless people. A half-century later, the problem hasn’t gone away.
On a recent night Fox walked San Francisco’s Civic Center, where he met a 53-year-old Navy veteran slumped on the sidewalk. The man, a slight figure in a torn sweatshirt and Oakland A’s cap, said he had been homeless and in and out of jail for about six years.
He said that a few months ago, he had run out of his anti-psychotic medication, Risperdal. Late one night he started to feel suicidal and went to San Francisco General Hospital for help. “I wasn’t well, put it that way,” he told me. He spent the early morning hours in the emergency department, but then said he was told to leave. “I was telling them that I needed to stay a little longer. They wouldn’t let me stay longer, so they made me leave.” Continue reading
CORRECTION: Due to a reporting error, the original version of this story incorrectly identified John Muir Medical Center, Concord as the facility where Maria Ramirez’s granddaughter was taken. We regret that error. The post has been edited so that it no longer contains the incorrect information.
By Elaine Korry
Maria Ramirez began caring for her granddaughter when the girl was just a toddler. Her granddaughter began hurting herself — cutting her arms and swallowing things — before she was 10. Soon, says Ramirez, she couldn’t let the girl out of her sight. “She was running in front of cars, just really impulsive,” says Ramirez. “It was out of control, and I was really scared.”
Ramirez has a job and health insurance, so she did what any parent or guardian would do: she took her granddaughter to her local hospital for treatment. But instead of finding help, she always got the same reply, “No beds, no beds.”
Ramirez, a Bay Area artist who loves gardening, says she knew early on that her granddaughter was going to need help. “She was a hard child to make smile. She was very serious,” says Ramirez. Continue reading
Carole Ford of Lakeport, seen here in front of the community health center she runs, was often taken to hospitals far from her Lakeport home to treat her mental illness. (Elaine Korry/KQED)
By Elaine Korry
In the small town of Clearlake, about a hundred miles north of San Francisco, Carole Ford, a great-grandmother with a mane of silver-gray hair, runs a community mental health center called The Bridge. She leads support groups and prepares meals for her mostly homeless clients. It’s hardly glamorous work, but Ford says this is her dream job. “I know that I’m where I’m supposed to be — and doing what I’m supposed to be doing,” she says.
Employees had to scour the state, looking for a vacant psychiatric bed. “Then it’s another 2 to 3 hour drive.”
But Ford, 71, hasn’t always been so content. She had a traumatic childhood and many bouts of depression. As a younger adult adult she often felt suicidal. She recalls being dragged away to the hospital in Lake County, where she says she felt like she was dumped. There was no psychiatrist or therapist; no peer support or services of any kind. Continue reading
A smoggy sunset in San Diego. (Sandy Huffaker/Getty Images)
When people think of climate change, they tend to think of it as a science and environmental issue. But climbing levels of greenhouse gases, particulate matter, and rising seas hurts more than the environment. It harms people’s health, too.
“Climate change is one of greatest public health threats of our time,” said Anne Kelsey Lamb of Oakland’s Public Health Institute.
Lamb was talking to a roomful of her own in a gathering this week when some 100 public health professionals from around the state and beyond were in Oakland to learn more about the intersection between climate change and public health — and what they can do about it. Continue reading
(Justin Sullivan/Getty Images)
Over at the New York Times, Elisabeth Rosenthal continues her terrific series on the high cost of health care in America. Tuesday’s installment is a deeply-reported look into the murky world of hospital prices, where a “stitch tops $500,” says the headline.
The lowest-cost silver-tier plan costs 26 percent more in Alameda County vs. Orange County.
But it’s where Rosenthal sets most of her reporting that makes the story a must-read for anyone in the Bay Area. She profiles patients receiving care at California Pacific Medical Center, a Sutter Health hospital — and her piece indirectly brings up the question of higher health insurance premiums here.
These higher premiums were made evident when Covered California released its plans for all the 19 “rating regions” of the state. In Alameda County, for example, the “silver tier” premiums for a 40-year-old range from $317 to $365. In Orange County, the range is $252 to $290 and Kaiser coming in at a high of $332. In other words, the lowest-cost silver-tier plan is 26 percent more expensive in Alameda County vs. Orange County.
Glenn Melnick, a health economist at USC, is quoted throughout the Times piece, and I called him Tuesday morning to talk about this NorCal vs. SoCal difference. “I would say that hospital prices represent a disproportionate share of that differential,” he said, and added that premiums are higher in the Bay Area even after accounting for the higher cost of living here. Continue reading
Sharon Wilson, 53, picks up her weekly allotment of produce from the AIDS Project of the East Bay. Wilson, who has HIV, says without help, she couldn’t afford to buy fresh vegetables. (Angela Hart/KQED)
By Angela Hart
Several times each week, Sharon Wilson, a 53-year-old HIV-positive retired caregiver, takes an hour-long bus ride from her Berkeley home to her clinic in downtown Oakland. Wilson doesn’t mind making the trip, because she says the care she has received there since her diagnosis has saved her life.
Wilson says multiple chronic diseases, including HIV, have made it impossible for her to work. Ensuing financial struggles make managing her disease increasingly difficult.
“I can’t afford healthy food and all the medications I need to take,” Wilson said as she described her strict antiretroviral drug regimen. “It’s not easy to learn a new way of living. I take a handful of pills when I wake up in the morning, a handful of pills with lunch, and another handful before I go to bed.”
For people like Wilson, the AIDS Project of the East Bay — one of Alameda County’s six HIV specialty clinics — is a place of refuge. There, Wilson has received primary care for her HIV and specialty care since 2006. She’s been referred to Oakland’s Highland Hospital multiple times to treat other chronic conditions, including congestive heart failure and arthritis. Continue reading
California Air Resources Board field representative Barry Pratt (right) questions Canadian trucker Henry Gustof, left, as a CARB team inspects trucks for compliance with clean air rules at a weighing station north of Los Angeles. Gustof’s engine met CARB standards. (Chris Richard/KQED)
By Chris Richard
Every time Bloomington dump truck operator Ruben Garcia pulls up at a job site, he finds himself caught in the same conversation: “What are you going to do next year?”
Not everyone has a good answer.
“If we can clean up these fleets, then we will definitely have a positive impact on public health.”
Truckers in the Port of Oakland grabbed headlines recently
when they held a demonstration at Oakland City Hall, demanding an extension to the January 1st
deadline to upgrade their engines to meet California pollution standards
. They also want additional state subsidies to help them meet the cost. Meanwhile, general freight and construction truck drivers face a separate January deadline to start replacing their vehicles or install filters that can cost as much as a second-hand truck. That rule applies to most of the big rigs on the state’s roads. It’s an especially heavy burden for small operators.
“It’s like telling the person who works in an office that they’ve got to tear down the office because the outside of the office building doesn’t work well with the environment.” he said. “Those trucks are our offices. That’s how we make our living.” Continue reading
By Anna Gorman, Kaiser Health News
California has mistakenly sent letters to 246,000 low-income residents, warning they may need to find new doctors next year under the state’s newly expanded Medicaid program.
The error frustrated counties and community health centers which have repeatedly assured patients they can keep their providers when the Affordable Care Act takes effect in 2014. The patients are part of the state’s “bridge to reform” program, which was designed to cover uninsured, poor Californians until they became eligible for Medi-Cal, the state’s version of Medicaid.
Bridge to reform launched in 2011 and more than 600,000 people across the state enrolled in county-based health coverage. Many people formed relationships with doctors and started seeking regular care. But county and clinic administrators said the incorrect information in the mailing this month has put the counties’ efforts in jeopardy.
The mix-up occurred as people are scrambling to figure out how the health law impacts them, and as private policy holders have been receiving letters canceling their insurance plans. Continue reading
By Nancy Shute, NPR
California has a new law that’s supposed to get more of the state’s children vaccinated against measles, whooping cough and other infectious diseases.
But the law has taken a strange turn on its way to being put into action, one that may instead make it easier for parents to exempt their children from required vaccinations.
In recent years the number of parents who request so-called personal belief exemptions from vaccines has been rising. It’s gotten to the point that public health officials fear that there could be disease outbreaks in parts of California. Same goes for other states where exemption rates are high.
On Sept. 20, 2012, California Gov. Edmund G. Brown Jr. signed a bill aimed at boosting childhood immunization rates. His signing letter included these instructions: Continue reading
By David Gorn, California Healthline
Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state’s Medicaid program, could further complicate matters.
Rural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.
“The rollout has gone relatively smoothly, but the access to providers — that’s a real question still.”
On Nov. 1, the state launched an ambitious plan to transition Medi-Cal beneficiaries in rural areas from fee-for-service care arrangements to managed care plans. The move shifts 28 rural counties to the financial model the state is using throughout the rest of the state.
Also on Nov. 1, the state launched the last phase of its Healthy Families transition — moving children in rural counties to Medi-Cal managed care. Healthy Families is California’s Children’s Health Insurance Program. Continue reading