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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Early Elective Deliveries Down in California, Still More Work to be Done

(Getty Images)

Doctors, advocates also working to reduce rates of babies born by caesarian-section. (Getty Images)

By Brittany Patterson

In California, about 500,000 babies are born every year. Statewide efforts to reduce early deliveries and maternal death have netted improvements, but more work is still to be done, said advocates who gathered this week to share notes on how to improve maternal and child health across the state.

One specific bright spot was reduction of early elective deliveries — where a woman chooses to deliver her baby early, defined as between 36 and 39 weeks. These are scheduled deliveries that are not medically necessary. But babies born before 39 weeks are more likely to have feeding and breathing problems, trouble keeping themselves warm, and infections.

In 2010, 14.7 percent of births in California were scheduled before 39 weeks. Today, in-part because of intense campaigning, that rate has dropped to less than three percent of total births at about half of the state’s hospitals. The effort to decrease the practice was spearheaded by the March of Dimes, but strengthened by data collected and synthesized by the California Maternity Data Center. Continue reading

California Catholic Leadership Challenges State Abortion Order

 Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores was announced Monday. (Chip Somodevilla/Getty Images)

Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores in July. (Chip Somodevilla/Getty Images)

Associated Press — California’s Catholic leadership has filed a federal civil rights complaint over a state requirement that health insurance cover abortions.

The California Catholic Conference, which represents the state’s bishops and archbishops, sent a letter Tuesday to the U.S. Department of Health and Human Services. It contends that California’s Department of Managed Health Care discriminated against those morally opposed to abortion and requests an investigation.

The complaint is under review, said Rachel Seeger, spokeswoman for the federal agency’s Office for Civil Rights.

The state agency didn’t immediately comment. Continue reading

Why Advocates Say Brown’s Veto of Livestock Antibiotics Bill is a Good Thing

(iStock/Getty Images)

(iStock/Getty Images)

By Joe Rubin

Senate Bill 835 was crafted as a measure aimed at limiting antibiotic use in livestock. To those concerned about the growing problem of antibiotic resistance, it might seem surprising that Gov. Jerry Brown vetoed the bill earlier this week. Yet advocates believe that in striking down the bill, California is poised to take a leading role on the issue.

‘The governor sent a message that he isn’t going to accept fig-leaf solutions to tackle this problem.’ — Natural Resources Defense Council spokesman    

Here’s why: Critics had assailed the bill as too industry-friendly and unlikely to make much impact on antibiotic resistance.

SB835 would have codified a recent Food and Drug Administration voluntary ban on the use of antibiotics for growth-promoting purposes. The measure had sailed through the Legislature. But a coalition, including the Natural Resources Defense Council (NRDC), Consumers Union and several leading medical experts on antibiotic resistance, quietly created a campaign urging the governor to veto the bill. Continue reading

Brown Vetoes Adult Day Health Bill; Future of Program Unknown

There is a 45% increased risk of death in people who are lonely compared to not lonely, according to a UCSF study.

The state has tried to eliminate adult day health care in the past.  (Photo: Getty Images)

By David Gorn, California Healthline

On Monday, Gov. Jerry Brown vetoed a bill to codify Community Based Adult Services as a Medi-Cal benefit and continue offering it as a benefit into the future.

“It puts everything up for grabs. It’s a real step backward.”
The state has attempted to eliminate adult day health care in the past. The CBAS program, serving some of the oldest, most frail Californians on Medi-Cal, is the result of a 2011 settlement of a lawsuit challenging the state the last time the state tried to cut the program.

The veto Monday of AB1552 by Assemblywoman Bonnie Lowenthal (D-Long Beach) leaves an uncertain future for CBAS. The agreement in the 2011 settlement expired at the end of August, but CBAS is included as a Medi-Cal benefit in a proposed amendment of the state’s Medicaid waiver and is included in the Coordinated Care Intitiative. CMS is expected to approve the amendment by the end of this month. Continue reading

Brown Signs Package of Assisted-Living Reform Bills

(Neon Tommy)

(Neon Tommy)

By Deborah Schoch, Center for Health Reporting

Gov. Jerry Brown signed into law Monday a bill imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.

The top fine will now be $15,000, for violations causing death or serious injury, up from $150.

The relatively low fines were highlighted in a series of stories produced last year by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.

The bill to increase fines, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes. Continue reading

Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November's ballot. (Photo Courtesy: Bob Pack)

After Troy and Alana Pack were killed by an impaired driver, their father became an advocate for change, ultimately writing Prop. 46 on November’s ballot. (Photo Courtesyof Bob Pack)

Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville. Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch. In the afternoon, they changed out of their costumes and set out for a walk with their mother down Camino Tassajara. Destination: Baskin Robbins 31 Flavors.

“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, ’cause he liked counting the bubble gums that he would get.”

Bob Pack stayed home to rest. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there,” he says.

An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived. Continue reading

Marijuana Legalization Move Begins (Again) in California

(Getty Images)

(Getty Images)

The Marijuana Policy Project, a national advocacy group, took the first formal steps Wednesday toward a 2016 ballot initiative to legalize marijuana in California.

The group officially filed papers with the secretary of state to register a new committee, the Marijuana Policy Project of California. The registration allows the committee to start soliciting and spending funds.

Ballot language will not be drafted until early 2015, but the goal is to regulate pot in a similar way to alcohol, the group says. Continue reading

Medi-Cal Backlog Will Be ‘Down Significantly’ in Six Weeks

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

At an Assembly Committee on Health hearing yesterday, Department of Health Care Services Director Toby Douglas said the backlog of Medi-Cal applications — at one point in March topping 900,000 unprocessed eligibility claims — now is down to about 250,000 applications and will be “down significantly” from that by the start of November.

Douglas answered a number of concerns at the hearing, including announcing a shift in DHCS policy regarding asthma and allergy testing, as well as Denti-Cal and special-needs dental care issues.

The counties and DHCS, Douglas said, reduced the Medi-Cal application backlog by 650,000 over six months — more than 100,000 a month. A similar pace in the next month-and-a-half would get it down to about 100,000 applications. Continue reading

Advocacy Groups File Lawsuit Over Medi-Cal Backlog

(s_falkow: Flickr)

(s_falkow: Flickr)

By Anna Gorman, Kaiser Health News

California’s lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the health care they are entitled to receive, according to a lawsuit filed Wednesday by a coalition of health advocates and legal services groups.

A Tulare County man had applied for Medi-Cal but died of a pulmonary embolism while waiting for the state to confirm his eligibility.

The lawsuit, filed in Alameda County Superior Court, says the state is failing to process applications within 45 days as required by law. Some applicants have been waiting to receive their Medi-Cal cards since the end of last year, according to the suit. The applicants include children, pregnant women and adults with life-threatening health conditions, who advocates say are either postponing treatment or paying cash to see doctors.

Medi-Cal is the state’s version of Medicaid, the publicly funded health insurance program for low-income Americans. About 11 million people receive Medi-Cal benefits in California, including 2.2 million who applied since January. Roughly 350,000 applications are still pending. Continue reading

S.F. Supervisor Wiener Announces He’s Taking HIV Preventive Drug

San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)

San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)

San Francisco Supervisor Scott Wiener publicly announced Wednesday afternoon that he is taking Truvada, an FDA-approved drug that dramatically reduces the risk of HIV infection. He appears to the be the first public official to make such an announcement.

“My hope is that by disclosing my PrEP use… I can get more people thinking about PrEP as a possibility.”  

Wiener said he began taking the medication earlier this year. This preventive approach is also referred to as pre-exposure prophylaxis or PrEP.

“I am using PrEP as a personal health choice that I made in consultation with my physician,” he said in an interview at his office at City Hall. “My hope is that by disclosing my PrEP use publicly that I can help move the conversation forward and get more people thinking about PrEP as a possibility, and encouraging people to consult with their medical provider.”

Truvada combines two different drugs into a single pill that, when taken daily, can reduce the risk of HIV infection by more than 90 percent. It was approved by the FDA in 2012, and was developed by the Foster City company Gilead. Both the Centers for Disease Control and the World Health Organization recommend its use by people who are at high risk of HIV infection. Still, it is the subject of debate, especially within the gay community. Continue reading