Policy

Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed

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High-Priced Drug Sovaldi Coming to California Prisoners with Hepatitis C

Chino State Prison. (Kevork Djansezian/Getty Images)

Chino State Prison. (Kevork Djansezian/Getty Images)

By George Lauer, California Healthline

It’s the drug that can cure most people with hepatitis C in 12 weeks — but comes at a high cost: $1,000 a pill. Now, California Correctional Health Care Services, which oversees clinical care and drug prescriptions for 125,000 inmates at 34 prisons across the state, began using Sovaldi last month.

Made by Gilead Sciences of Foster City, Sovaldi has become part of the “community standard” for medical professionals treating patients with hepatitis C, according to prison officials. A full course of treatment runs about $84,000.

Hepatitis C, a viral infection that can lead to liver failure, cancer or other health problems, is often associated with intravenous drug use. Many of the estimated 3.2 million Americans living with hepatitis C in the U.S. are poor, imprisoned, elderly or all of the above, giving public systems a disproportionate share of hepatitis C patients. Continue reading

For Some, Medi-Cal Might Mean Ultimately Losing Their Homes

Anne-Louise Vernon in front of her home in Campbell. (Photo: Pauline Bartolone)

Anne-Louise Vernon in front of her home in Campbell. She recently enrolled in Medi-Cal then found out the state could use proceeds from her home to recover costs of her health care. (Photo: Pauline Bartolone)

By Pauline Bartolone, Capital Public Radio

Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She was hoping to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan.

“It never even occurred to me I might be on Medi-Cal,” she said, in reference to the state’s version of Medicaid, “and I didn’t know anything about it.”

She says she asked whether there were any strings attached.

“And the woman said very cheerfully, “Oh no, no, it’s all free. There’s nothing you have to worry about, this is your lucky day.’” she recounts.

Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55. Continue reading

State Reverses Abortion Coverage Rule for 2 Catholic Universities

Santa Clara University's employee health insurance will stop covering 'elective' abortions next year unless state officials change their minds. (Michael Zimmer/Flickr)

The two universities affected by the move are Loyola Marymount and Santa Clara University, above. (Michael Zimmer/Flickr)

By Ted Goldberg and Lisa Aliferis

In a reversal, Gov. Jerry Brown’s administration is barring two Catholic universities in California from offering health plans to their employees that limit abortion coverage.

Previously, state health officials had approved plans used by Santa Clara University and Loyola Marymount in Los Angeles that did not cover any abortion procedures, unless they were “medically necessary” to protect the health of the mother.

But earlier this month, the Department of Managed Health Care (DMHC) said they were reviewing that approval.

The DMHC is now sending letters to insurance companies for both universities, requiring them to cover all abortions.  Continue reading

Strong Support for Proposition 45 — Tougher Rules on Health Insurance Rates

(Getty Images)

(Getty Images)

By Helen Shen, Kaiser Health News

California voters are showing strong early support for a ballot initiative that would expand the state’s authority to regulate health insurance rates.

Nearly 7 of every 10 respondents indicated that they would vote in favor of Proposition 45, while 16 percent would vote against it, according to a Field poll released Wednesday.

Proposition 45 would give California’s insurance commissioner the power to veto excessive health insurance rate increases.

Health insurance rates in the state are currently overseen by the Department of Managed Health Care and the California Department of Insurance. Insurance companies are required to submit proposed rate increases for review each year by state regulators, who may declare rates unreasonable but cannot block them from going into effect. Continue reading

Diverting Mentally Ill to Treatment, Not Jail

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio's mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

Officers Ned Bandoske (left) and Ernest Stevens are part of San Antonio’s mental health squad — a six-person unit that answers the frequent emergency calls where mental illness may play a role. (Jenny Gold/KHN)

This week, Julie Small has reported on this blog about court-ordered overhauls in caring for mentally ill inmates in California prisons. About one-fourth of California’s inmates — 37,000 people — have mild to severe mental illness.

As Small reported, U.S. District Judge Lawrence Karlton ordered the California Department of Corrections and Rehabilitation (CDCR) in April to draft new policies for use of force and has signed off on CDCR’s plans. Now the department is working on plans to comply with Karlton’s orders to change how it handles segregation for inmates with mental illness.

So, I was riveted by a report this morning from NPR and Kaiser Health News about a different approach — a coordinated, comprehensive approach — to a county-run mental health system. The story was set in Texas’ Bexar County, (pronouced “bear”) home to San Antonio and the Alamo, and the program is now a model for the nation. Continue reading

Judge Orders Overhaul in Segregation for California’s Mentally Ill Inmates

All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)

All Inmates are shackled whenever they leave their cells. (Julie Small/KQED)

By Julie Small

Segregating prison inmates who repeatedly break the rules or turn violent against other inmates or guards is not new in California. For years the state has placed these inmates in special housing sections with multiple barriers between them and others.

Evidence that segregation ‘can and does cause serious psychological harm’ in inmates with serious mental illness.

But the practice of isolating inmates whose bad behavior may be part of a mental illness is under fire amid a rash of suicides and attempted suicides. The focus on this type of treatment comes against a backdrop of lawsuits brought by inmates against the state over the last two decades. Those lawsuits have exposed a correctional system poorly equipped to handle their extraordinary needs.

Now a federal judge says that kind of punishment poses too great a risk for inmates with serious mental illness who, he says, can and do worsen in segregation.  Continue reading

Fresno Considers Ending Health Services for the Undocumented

Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)

Fresno residents demonstrate their support for a county health program that covers care for undocumented immigrants (Courtesy: Fresno Building Healthy Communities)

Update: Fresno County’s Board of Supervisors voted 4-1 to end the contract providing care to the poor and to undocumented immigrants. 

Original Post:

Brandon Hauk’s job is about to get a lot harder. The health of about 7,000 patients he helps at Clinica Sierra Vista in Fresno is in the hands of the county board of supervisors – they are set to vote Tuesday whether or not to shut down a program that covers specialty care for the undocumented.

Hauk doesn’t want to think about how he’s going to explain that to people when their primary care doctor says they need to see a cardiologist, pulmonologist, or endocrinologist.

“What do you say to somebody that has chronic illness and we can’t refer them out? Sorry?” says Hauk. “I mean, how can you tell someone that has abdominal bleeds, I’m sorry, but we can’t help you.”

Fresno’s Medically Indigent Services Program was set up decades ago to provide health coverage for the poor, and later, the undocumented. But now that the Affordable Care Act has gone into effect, the county says it doesn’t need the program anymore. Now tens of thousands of uninsured Fresnans have health coverage through Obamacare. More than that, the county says it can’t afford to keep the program going. Continue reading

The Assisted Living Reform Bills That Died

By Polly Stryker

Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)

Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)

Last Thursday, August 14, was the day that bills still in the state Senate Appropriations Committee sank or swam. The Senate Appropriations Committee is where bills costing $150,000 or more go for consideration. If bills make it out of this committee, then bills are still in play and could make it to the governor’s desk, albeit with potential amendments along the way. If not, they die.

Going into the home stretch of this legislative session, 16 bills were on the table that, altogether, constituted the first major overhaul of the assisted living industry in nearly 30 years.

Two have already made it to the governor’s desk. AB1523 mandates liability insurance for all assisted living facilities. Advocates say liability insurance is one of the best ways to improve conditions in the industry. Operators whose violations make buying insurance too expensive will be simply forced out of business. The industry group California Assisted Living Association supported AB1523. AB1572 mandates facility operators allow and support resident and family councils at assisted living facilities. CALA supported that one as well.

Most of the rest of the bills are still swimming. But what about the bills that died?

Continue reading

California Prisons Begin ‘Use-of-Force’ Reforms for Mentally Ill Inmates

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

By Julie Small

The number of inmates with mild to severe mental illness has grown to 37,000 in California, about a quarter of the prison population.

A series of lawsuits brought by inmates against the state over the last two decades has exposed a correctional system poorly equipped to handle their extraordinary needs.

Now California is trying to comply with a federal court order to change when and how correctional officers use pepper spray to force uncooperative inmates to leave their cells or follow orders.

Pepper spray may have contributed to three inmate deaths and an unknown number of injuries — unknown because the California Department of Corrections and Rehabilitations doesn’t consider the effects of pepper spray an injury. Continue reading