Tag Archives: california

Physician-assisted death becomes legal in California

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Gov. Jerry Brown on Oct. 5 signed California’s controversial End of Life Option Act, which permits physician-aided death for terminally ill patients. California becomes the fifth state in the nation to allow doctors to prescribe lethal doses of medication to certain patients seeking to end their lives.

The law, modeled after Oregon’s law, requires two doctors to agree that the person has six months or less to live and is mentally competent.

Until Brown, a former Jesuit seminarian, announced he had signed the bill it was unclear where the governor stood on the issue. He released a brief statement outlining his moral dilemma, saying, “I do not know what I would do if I were dying and in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.” Continue reading

California announces SHOP exchange insurers and rates

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

The health benefit exchange for California’s 500,000 small employers named six health insurers last week and announced the rates those insurers will charge. Small businesses (meaning 50 or fewer workers) employ 4.5 million workers in California.

This news from California may be useful to health care journalists covering the exchanges in other states, particularly those 16 states (and Washington, D.C.) that are running their own exchanges.

With this announcement on Aug. 1, California becomes the second state to publish the names of the insurers and their rates for its Small Business Health Options Program (SHOP) exchange, following Oregon and Washington, D.C. Enrollment on the exchanges begins Oct. 1 for insurance coverage effective Jan. 1. The Golden State’s health benefit exchange is called Covered California.

In the Los Angeles Times, Marc Lifsher writes that more than 7 million Californians under age 65 are uninsured, including 25 percent of all workers and 40 percent of workers at companies with fewer than 10 employees. Continue reading

Las Vegas hospital sends 1,500 patients with mental health issues to other cities

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Nevada has been shipping mental health patients out of state as it has cut funding for mental health services, according to a Sacramento Bee investigation.

In recent years, as Nevada has slashed funding for mental health services, the number of mentally ill patients being bused out of southern Nevada has steadily risen, growing 66 percent from 2009 to 2012. During that same period, the hospital has dispersed those patients to an ever-increasing number of states.

Cynthia Hubert, Phillip Reese and Jim Sanders report that Rawson-Neal Psychiatric Hospital in Las Vegas, the primary state psychiatric hospital, put more than 1,500 patients on Greyhound buses bound for other cities.

The reporters reviewed bus receipts kept by Nevada’s mental health division. Southern Nevada Adult Mental Health Services has had a contract with Greyhound since July 2009, a bus company spokesman said. He also revealed that “Greyhound has contracts with ‘a number’ of hospitals around the country, but declined to identify them.”

Mental health professionals in other places are quoted as saying putting someone with a mental illness on a bus is risky and several said their counties don’t do it.

The Center for Medicare and Medicaid Services is investigating Rawson-Neal and the situation has prompted statements from California’s Senate president and a member of the U.S. Commission on Civil Rights.

Investigation exposes police inaction in face of abuse allegations at Calif. facilities

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In recent weeks, California Watch’s long-running focus on abuse of the developmentally disabled at state-run institutions has coalesced into a broad indictment of the flawed oversight and enforcement programs at those facilities.

Ryan Gabrielson’s centerpiece is a classic deep investigation which relies on a mix of data and anecdotes to show that, even though the centers are equipped with a state-run police force, in 36 incidences of alleged abuse over the past four years, “documents obtained by California Watch reveal that patients suffered molestation, forced oral sex and vaginal lacerations. But for years, the state-run police force has moved so slowly and ineffectively that predators have stayed a step ahead of law enforcement or abused new victims, records show.”

Beyond that, California Watch has gone above and beyond to make their investigation as accessible and shareable as possible with a share-friendly chart, an 11.75-minute YouTube video, or even an “explainer” companion piece.

Community relies on foreign-educated doctors

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Armed with reams of data, The Bakersfield Californian‘s Kellie Schmitt charged headlong into the potential minefield of issues surrounding foreign educated-physicians with “Importing Doctors.” The series delivers a thorough take on the ramifications of the fact that the majority of her county’s doctors attended medical school overseas. (The national average, for the record, is around 25 percent).

In addition to her opening piece, which considers the benefits and drawbacks of relying on international medical graduates, Schmitt filed follow-up installments keying in on specific questions raised by her overall investigation. Of particular interest is the clear line she draws between foreign-born physicians who attended medical school in their home country before they came to the United States and American-born physicians who attended schools, often located in Mexico and the Caribbean, that cater to students who were unable to gain admittance to American medical schools. It’s a distinction that a less-nuanced data analysis could easily overlook.

Finally, while the investigation’s results are illuminating, health care journalists will probably be even more interested in Schmitt’s “How we crunched the numbers” sidebar, which can be found on the left sidebar of this story. The paper used data from the state medical board and the American Board of Medical Specialties.

Meth and other drugs overwhelm reservations

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

New America Media’s Jacob Simas and Two Rivers Tribune‘s Allie Hostler joined forces to examine how the nation’s rural methamphetamine epidemic has devastated the Hoopa Valley Indian Reservation in Northern California, as well as the nation’s American Indian population in general. The Indian Health Service does not track drug abuse, and hard tribe-by-tribe numbers are hard to come by, but the scope of the problem is clear.

Meth abuse rates have reached 30 percent on some rural Indian reservations, and in some Indian communities as many as 65 percent of all documented cases involving child neglect and placement of children in foster care can be traced back to parental involvement with methamphetamine. California Indian Legal Services estimates that in nearly every case they oversee that involves a child being removed from their home, one or both of the parents is using meth. Often in those cases, the baby itself was born with prenatal exposure to the drug.

The broken economy in Hoopa and resulting poverty – the annual household income on the reservation hovers around $13,000 and most families receive tribal government assistance – would seem adequate to explain away the high rates of substance abuse. But those in the community with a sense of history say it’s much more complicated.
Melodie George-Moore teaches English and Native American literature at Hoopa High School. She’s also a leader of traditional Hoopa ceremonies. She believes Hoopa’s drug problem has its roots in historical trauma.

The reservation’s rampant substance abuse has its roots in what the duo calls Hoopa’s “broken economy,” as well as the “historical trauma” unique to conquered native populations. But whatever the cause, the meth epidemic’s public health impact is far-reaching and long-running.

“People who were using during a different time of their life – some might even be in leadership roles in the community – that exposure is now manifesting itself as a very serious disease, because of speed use 30 to 40 years earlier,” she said. “There are young people lining up on dialysis, fetal exposure issues, developmental and behavioral issues… There are days when it’s absolutely overwhelming, some of the realities we see here, the physiological and social realities.”

The second installment in the series focuses on efforts to solve the problem, which include grassroots movements and sweat lodges, as well as a thoroughly overwhelmed infrastructure.

The Tribe’s court estimates that alcohol or substance abuse is a factor in approximately 65 to 70 percent of eviction cases heard by the court, and 75 to 80 percent of child custody and divorce cases. In 2010 the court reported that alcohol or substance abuse was a significant factor in 80 percent of the child abuse and neglect cases heard on the reservation.

The articles were produced as a project for The California Endowment Health Journalism Fellowships, a program of USC’s Annenberg School for Communication & Journalism.