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

Sacramento Patient Being Tested for Possible Exposure to Ebola

Ebola virus magnified 108,000 times. (Getty Images)

Ebola virus magnified 108,000 times. (Getty Images)

By Lisa Aliferis and April Dembosky

Don’t panic, folks. Really.

A patient who may have been exposed to the Ebola virus is being tested at Kaiser’s South Sacramento Hospital.

The other key information here is that California Department of Public Health officials call the unidentified patient “low risk,” according to criteria established by the CDC that considers travel history, exposure to infection, and clinical features.

In a call with reporters Wednesday afternoon, CDPH deputy Dr. Gil Chavez said the state has received no reports of any high risk patients. CDPH said the patient is being tested out of an “abundance of caution.”

In a statement, Dr. Stephen Parodi, director of hospital operations for Kaiser Northern California, said the unidentified patient is being kept in a specially equipped negative pressure room, and staff working with the patient are using “personal protective equipment.” 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

Old Muni Buses Are Reborn as Mobile Showers for the Homeless

Doniece Sandoval is the founder of Lava Mae, a mobile shower service for homeless people.

Doniece Sandoval is the founder of Lava Mae, a mobile shower service for homeless people. (Lynne Shallcross/KQED)

By Lynne Shallcross

Showering is a daily routine that most of us probably take for granted. But for people living on the streets or in shelters in San Francisco, finding a shower can be one of the biggest daily challenges.

‘Then no one has to know you’re homeless unless you tell them.’

For the more than 3,000 unsheltered homeless people in San Francisco, there are only roughly 20 showers available — fewer if any are out of service. Then there are the logistics of sign-up lists, limited hours, waiting lines and figuring out how to get there.

Doniece Sandoval, a marketing and communications professional and South Texas native, had seen plenty of shower-less homeless in her two decades in San Francisco. But when she passed a young homeless woman on the street who was crying that she’d never be clean, Sandoval decided to do something about it.

So she hatched the idea for Lava Mae, a new service that provides showers in a retrofitted, retired Muni bus. Lava Mae, a play on the Spanish word for “wash me,” is in the pilot phase of its service. Continue reading

Covered California to Request Evidence of Lawful Presence in U.S.

CCHP enrollment counselor Kristen Chow explains Covered California and federal subsidies to a Chinese-language caller. Currently, more than 90 percent of the HMO's members are ethnically Chinese. (Marcus Teply/KQED)

CCHP enrollment counselor explains Covered California and federal subsidies to a caller. (Marcus Teply/KQED)

Some enrollees who get their health insurance through Covered California, the state’s Obamacare exchange, will be getting notices in the next few weeks requesting evidence that they are lawfully in the country.

Yesterday, many news outlets reported on the Obama administration’s announcement that it was sending letters to about 310,000 people who have signed up for insurance through the Affordable Care Act, but whose documentation of citizenship or legal immigration status was at odds with government records. From the Wall Street Journal:

The Obama administration moved Tuesday to cut off health insurance for up to 310,000 people who signed up through the HealthCare.gov system unless they can provide documents in the next few weeks showing they are U.S. citizens or legal residents.

Those individuals have until Sept. 5 to send in additional information that could confirm they are in the U.S. legally, a condition of using the online insurance exchanges to obtain coverage.

Continue reading