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She has won several regional Emmy awards, a regional and a national Edward R. Murrow award. The Association for Health Journalists awarded Lesley best beat coverage. The Society of Professional Journalists has recognized her reporting several times. The Society of Environmental Journalists spotlighted her ongoing coverage of California's historic drought. \u003c/span>\u003cspan style=\"font-weight: 400;\">Before joining KQED in 2016, she covered food and sustainability for Capital Public Radio, the environment for Colorado Public Radio, and reported for both KUOW and KCTS9 in Seattle. \u003c/span>\u003cspan style=\"font-weight: 400;\">When not hunched over her laptop Lesley enjoys skiing with her toddler, surfing with her husband or scheming their next globetrotting adventure. Before motherhood she relished dancing tango till sunrise. 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FM","link":"/"}},"science_1992363":{"type":"posts","id":"science_1992363","meta":{"index":"posts_1591205157","site":"science","id":"1992363","score":null,"sort":[1712955643000]},"guestAuthors":[],"slug":"as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons","title":"As California Seeks to Legalize Psychedelics for Therapy, Oregon Provides Key Lessons","publishDate":1712955643,"format":"standard","headTitle":"As California Seeks to Legalize Psychedelics for Therapy, Oregon Provides Key Lessons | KQED","labelTerm":{"site":"science"},"content":"\u003cp>California has an opportunity to massively expand places where people can use psychedelic drugs under supervision, according to a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012\">new bill proposing to legalize substances\u003c/a> in approved service centers, including psilocybin, MDMA and mescaline for therapeutic use.\u003c/p>\n\u003cp>It’s a model similar to Oregon’s Psilocybin Services Act — the first law in the United States to establish a regulatory framework for receiving psilocybin, or psychedelic mushrooms — which went into effect in 2023.\u003c/p>\n\u003cp>Now, as California lawmakers look to legalize the therapeutic use of psychedelics, uneven outcomes of that legal experiment in Oregon are surfacing.\u003c/p>\n\u003cp>“It was billed by a lot of people as a solution to Oregon’s mental health problems, as a new option for mental health treatment,” said Mason Marks, a visiting professor of law at Harvard Law School who served on the advisory board for Oregon’s new psychedelics law. “Now, some years later, you have evidence to suggest the system is largely serving a psychedelic tourism of people flying in from out of state to pay very high prices.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If passed in California, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012\">SB 1012\u003c/a> would create a professional licensing board to train facilitators, develop guidelines and regulate the therapeutic use of psychedelics. People could then use regulated psychedelic substances like magic mushrooms under the supervision of a facilitator.\u003c/p>\n\u003cp>The bill passed a critical and tense state committee hearing Monday afternoon. But only after lawmakers added an amendment that said facilitators must also hold at least one medical license, such as psychologists, psychiatrists, therapists, social workers and nurse practitioners.\u003c/p>\n\u003cp>In California, the program would be overseen by a new department called the Division of Regulated Psychedelic Substances Control that would adopt rules over the coming years for the approved substances.\u003c/p>\n\u003cp>“We know psychedelic therapy saves lives, and safe and controlled access to these innovative treatments will be transformative for so many Californians seeking relief from mental health and addiction challenges,” San Francisco state Sen. Scott Wiener said upon announcing the bill. “When paired with therapeutic support, psychedelics show amazing promise for treating conditions that resist other forms of treatment.”\u003c/p>\n\u003cp>Last year, Wiener pursued a different bill that would have broadly decriminalized personal use and possession of psychedelic substances. But Gov. Gavin Newsom vetoed it and asked for a bill that focused on psychedelic therapy instead.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"news_11974814,science_1982857,arts_13898354\"]“Both peer-reviewed science and powerful personal anecdotes lead me to support new opportunities to address mental health through psychedelic medicines like those addressed in this bill,” Newsom said in his veto message last year. “I urge the legislature to send me legislation next year that includes therapeutic guidelines.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">Studies\u003c/a> have shown that MDMA-assisted therapy can help mitigate symptoms of post-traumatic stress disorder and depression. Other \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901083/\">studies\u003c/a> have also linked psilocybin as a tool for treating depression and LSD as an option for generalized anxiety disorder. However, a small portion of people have negative experiences using psychedelics, including anxiety, aggression and suicidal thoughts, particularly with recreational use outside of controlled studies where dosage is tightly controlled.\u003c/p>\n\u003cp>The research literature points out the importance of a person’s mindset heading into a psychedelic experience, as well as their immediate environment, to preventing these negative outcomes, what Timothy Leary and his colleagues in the 1960s coined the “set and setting.”\u003c/p>\n\u003cp>Today, clinical trials are underway at the Food and Drug Administration to approve several treatment courses with psychedelics, and an MDMA treatment course could be approved as early as August.\u003c/p>\n\u003ch2>\u003cstrong>A trip to the mushroom doctor\u003c/strong>\u003c/h2>\n\u003cp>For ages, psychedelic substances have been used across cultures and societies for healing and medicinal purposes, as well as for recreational use. And unlike daily medications or weekly counseling, treatment with psychedelics usually takes a day or two, typically followed by counseling, according to Jennifer Mitchell, the chief of staff for research at the San Francisco Veterans Affairs and professor of psychiatry at UCSF.\u003c/p>\n\u003cp>That different approach to treatment attracted Tobias Shea, a veteran who participated in one of Oregon’s programs in 2023 who was struggling with post-traumatic stress symptoms after two tours in Afghanistan.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"State Sen. Scott Wiener (D-San Francisco)\"]‘We know psychedelic therapy saves lives, and safe and controlled access to these innovative treatments will be transformative for so many Californians seeking relief from mental health and addiction challenges.’[/pullquote]“I went through a big bout of depression in 2012 that I just couldn’t navigate,” he said. “I just suffered through it.”\u003c/p>\n\u003cp>Before he went through with the therapy session in Oregon last fall, he had phone calls with a facilitator who asked him about his background and mental health to see if he would be a good candidate for the program.\u003c/p>\n\u003cp>On the day of his appointment, he arrived at the service center, which he described as a relaxed environment, similar to a massage parlor or spa. In a small, enclosed room, someone was assigned to give him the appropriate dosage. A different facilitator then entered the room, and the two went over his intentions for the session, which lasted seven hours.\u003c/p>\n\u003cp>For his first session, Shea said he sought to reflect on some of his experiences in the military and the grief he had struggled with following his father’s death.\u003c/p>\n\u003cp>“I don’t want to sound cliche here when I say this, but it opened my mind again to the bigger picture of, like, not just being a soldier anymore and not being involved with the military,” he said. “It brought me back into what it means to be a human.”\u003c/p>\n\u003ch2>Setbacks in Oregon, teachings for California\u003c/h2>\n\u003cp>Shea’s success story comes alongside mixed perceptions about issues with Oregon’s program. It’s still in its infancy, so advocates say there’s still time for things to sort out. But already, the state had to bail out the program using tax dollars because it hadn’t made enough money from service fees and revenues.\u003c/p>\n\u003cp>Educating and training new facilitators — who work directly with individuals with mental challenges and who could need emergency help — has also been a hurdle. Organizations like the Synthesis Institute, which trained people to deliver psilocybin therapy, promised to revolutionize psychedelic-assisted therapy in Oregon. However, the school abruptly closed down in 2023 after going bankrupt.\u003c/p>\n\u003cp>“An issue there with Oregon that I think has come up is how well-trained the guides are and what they’re being used for,” said Mitchell of UCSF.\u003c/p>\n\u003cp>Marks, who served on the Oregon Psilocybin Advisory Board for a year, is also critical of how centers brand their services as “therapy” when, in fact, they are not yet FDA-approved. Instead of psychedelic-assisted therapy as it’s often branded, he said Oregon legalized “supported adult use of psilocybin” and points out that providers can’t diagnose medication conditions or make medical claims.\u003c/p>\n\u003cp>It’s also proven to be unaffordable for many people who can’t pay out of pocket, reserving the new treatment approach for people who can pay for and travel to it. Several service centers have reported that the majority of their clients are \u003ca href=\"https://www.opb.org/article/2023/11/29/psilocybin-mushrooms-oregon-service-centers-price/\">visitors from out of state\u003c/a>.\u003c/p>\n\u003cp>“My estimation of the average cost of a psilocybin treatment course in Oregon is from about $1,500 to $3,500, and that’s for a single dose,” Marks said. “That obviously could get pretty expensive pretty quickly and is not affordable for a lot of people.”\u003c/p>\n\u003cp>Sen. Wiener’s bill incorporates some of the critiques from Oregon’s model. It also creates a new public-private fund that will promote education and safety around psychedelic substances, as well as guardrails against conflicts of interest among officials crafting psychedelic laws.\u003c/p>\n\u003cp>According to the legislation, board members cannot have any immediate family with ownership or economic interest in any institution that’s engaged in psychedelic-assisted therapy education.\u003c/p>\n\u003cp>As states roll out psilocybin decriminalization policies unevenly around the country, there’s increasingly room for inequitable opportunities and treatment outcomes, as well as drug enforcement challenges. But, believers say the inevitable kinks of the new policy will be worked out.\u003c/p>\n\u003cp>“Hindsight’s 2020, so we can use Oregon as the beta tester and say, ‘Oh, that didn’t work. Oh, that works really well,’” Mitchell said. “I want to laud them for trying it first.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Following Gov. Gavin Newsom’s veto last year, lawmakers hope SB 1012 can finally regulate supervised use of psychedelics in California. ","status":"publish","parent":0,"modified":1713225945,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":1457},"headData":{"title":"As California Seeks to Legalize Psychedelics for Therapy, Oregon Provides Key Lessons | KQED","description":"Following Gov. Gavin Newsom’s veto last year, lawmakers hope SB 1012 can finally regulate supervised use of psychedelics in California. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California has an opportunity to massively expand places where people can use psychedelic drugs under supervision, according to a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012\">new bill proposing to legalize substances\u003c/a> in approved service centers, including psilocybin, MDMA and mescaline for therapeutic use.\u003c/p>\n\u003cp>It’s a model similar to Oregon’s Psilocybin Services Act — the first law in the United States to establish a regulatory framework for receiving psilocybin, or psychedelic mushrooms — which went into effect in 2023.\u003c/p>\n\u003cp>Now, as California lawmakers look to legalize the therapeutic use of psychedelics, uneven outcomes of that legal experiment in Oregon are surfacing.\u003c/p>\n\u003cp>“It was billed by a lot of people as a solution to Oregon’s mental health problems, as a new option for mental health treatment,” said Mason Marks, a visiting professor of law at Harvard Law School who served on the advisory board for Oregon’s new psychedelics law. “Now, some years later, you have evidence to suggest the system is largely serving a psychedelic tourism of people flying in from out of state to pay very high prices.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If passed in California, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB1012\">SB 1012\u003c/a> would create a professional licensing board to train facilitators, develop guidelines and regulate the therapeutic use of psychedelics. People could then use regulated psychedelic substances like magic mushrooms under the supervision of a facilitator.\u003c/p>\n\u003cp>The bill passed a critical and tense state committee hearing Monday afternoon. But only after lawmakers added an amendment that said facilitators must also hold at least one medical license, such as psychologists, psychiatrists, therapists, social workers and nurse practitioners.\u003c/p>\n\u003cp>In California, the program would be overseen by a new department called the Division of Regulated Psychedelic Substances Control that would adopt rules over the coming years for the approved substances.\u003c/p>\n\u003cp>“We know psychedelic therapy saves lives, and safe and controlled access to these innovative treatments will be transformative for so many Californians seeking relief from mental health and addiction challenges,” San Francisco state Sen. Scott Wiener said upon announcing the bill. “When paired with therapeutic support, psychedelics show amazing promise for treating conditions that resist other forms of treatment.”\u003c/p>\n\u003cp>Last year, Wiener pursued a different bill that would have broadly decriminalized personal use and possession of psychedelic substances. But Gov. Gavin Newsom vetoed it and asked for a bill that focused on psychedelic therapy instead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"Related Stories ","postid":"news_11974814,science_1982857,arts_13898354"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“Both peer-reviewed science and powerful personal anecdotes lead me to support new opportunities to address mental health through psychedelic medicines like those addressed in this bill,” Newsom said in his veto message last year. “I urge the legislature to send me legislation next year that includes therapeutic guidelines.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.nature.com/articles/s41591-021-01336-3\">Studies\u003c/a> have shown that MDMA-assisted therapy can help mitigate symptoms of post-traumatic stress disorder and depression. Other \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901083/\">studies\u003c/a> have also linked psilocybin as a tool for treating depression and LSD as an option for generalized anxiety disorder. However, a small portion of people have negative experiences using psychedelics, including anxiety, aggression and suicidal thoughts, particularly with recreational use outside of controlled studies where dosage is tightly controlled.\u003c/p>\n\u003cp>The research literature points out the importance of a person’s mindset heading into a psychedelic experience, as well as their immediate environment, to preventing these negative outcomes, what Timothy Leary and his colleagues in the 1960s coined the “set and setting.”\u003c/p>\n\u003cp>Today, clinical trials are underway at the Food and Drug Administration to approve several treatment courses with psychedelics, and an MDMA treatment course could be approved as early as August.\u003c/p>\n\u003ch2>\u003cstrong>A trip to the mushroom doctor\u003c/strong>\u003c/h2>\n\u003cp>For ages, psychedelic substances have been used across cultures and societies for healing and medicinal purposes, as well as for recreational use. And unlike daily medications or weekly counseling, treatment with psychedelics usually takes a day or two, typically followed by counseling, according to Jennifer Mitchell, the chief of staff for research at the San Francisco Veterans Affairs and professor of psychiatry at UCSF.\u003c/p>\n\u003cp>That different approach to treatment attracted Tobias Shea, a veteran who participated in one of Oregon’s programs in 2023 who was struggling with post-traumatic stress symptoms after two tours in Afghanistan.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We know psychedelic therapy saves lives, and safe and controlled access to these innovative treatments will be transformative for so many Californians seeking relief from mental health and addiction challenges.’","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"State Sen. Scott Wiener (D-San Francisco)","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“I went through a big bout of depression in 2012 that I just couldn’t navigate,” he said. “I just suffered through it.”\u003c/p>\n\u003cp>Before he went through with the therapy session in Oregon last fall, he had phone calls with a facilitator who asked him about his background and mental health to see if he would be a good candidate for the program.\u003c/p>\n\u003cp>On the day of his appointment, he arrived at the service center, which he described as a relaxed environment, similar to a massage parlor or spa. In a small, enclosed room, someone was assigned to give him the appropriate dosage. A different facilitator then entered the room, and the two went over his intentions for the session, which lasted seven hours.\u003c/p>\n\u003cp>For his first session, Shea said he sought to reflect on some of his experiences in the military and the grief he had struggled with following his father’s death.\u003c/p>\n\u003cp>“I don’t want to sound cliche here when I say this, but it opened my mind again to the bigger picture of, like, not just being a soldier anymore and not being involved with the military,” he said. “It brought me back into what it means to be a human.”\u003c/p>\n\u003ch2>Setbacks in Oregon, teachings for California\u003c/h2>\n\u003cp>Shea’s success story comes alongside mixed perceptions about issues with Oregon’s program. It’s still in its infancy, so advocates say there’s still time for things to sort out. But already, the state had to bail out the program using tax dollars because it hadn’t made enough money from service fees and revenues.\u003c/p>\n\u003cp>Educating and training new facilitators — who work directly with individuals with mental challenges and who could need emergency help — has also been a hurdle. Organizations like the Synthesis Institute, which trained people to deliver psilocybin therapy, promised to revolutionize psychedelic-assisted therapy in Oregon. However, the school abruptly closed down in 2023 after going bankrupt.\u003c/p>\n\u003cp>“An issue there with Oregon that I think has come up is how well-trained the guides are and what they’re being used for,” said Mitchell of UCSF.\u003c/p>\n\u003cp>Marks, who served on the Oregon Psilocybin Advisory Board for a year, is also critical of how centers brand their services as “therapy” when, in fact, they are not yet FDA-approved. Instead of psychedelic-assisted therapy as it’s often branded, he said Oregon legalized “supported adult use of psilocybin” and points out that providers can’t diagnose medication conditions or make medical claims.\u003c/p>\n\u003cp>It’s also proven to be unaffordable for many people who can’t pay out of pocket, reserving the new treatment approach for people who can pay for and travel to it. Several service centers have reported that the majority of their clients are \u003ca href=\"https://www.opb.org/article/2023/11/29/psilocybin-mushrooms-oregon-service-centers-price/\">visitors from out of state\u003c/a>.\u003c/p>\n\u003cp>“My estimation of the average cost of a psilocybin treatment course in Oregon is from about $1,500 to $3,500, and that’s for a single dose,” Marks said. “That obviously could get pretty expensive pretty quickly and is not affordable for a lot of people.”\u003c/p>\n\u003cp>Sen. Wiener’s bill incorporates some of the critiques from Oregon’s model. It also creates a new public-private fund that will promote education and safety around psychedelic substances, as well as guardrails against conflicts of interest among officials crafting psychedelic laws.\u003c/p>\n\u003cp>According to the legislation, board members cannot have any immediate family with ownership or economic interest in any institution that’s engaged in psychedelic-assisted therapy education.\u003c/p>\n\u003cp>As states roll out psilocybin decriminalization policies unevenly around the country, there’s increasingly room for inequitable opportunities and treatment outcomes, as well as drug enforcement challenges. But, believers say the inevitable kinks of the new policy will be worked out.\u003c/p>\n\u003cp>“Hindsight’s 2020, so we can use Oregon as the beta tester and say, ‘Oh, that didn’t work. Oh, that works really well,’” Mitchell said. “I want to laud them for trying it first.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1992363/as-california-seeks-to-legalize-psychedelics-for-therapeutic-use-oregon-provides-key-lessons","authors":["11840"],"categories":["science_39","science_3890","science_40","science_4450"],"tags":["science_4417","science_4414","science_4008","science_5269"],"featImg":"science_1992374","label":"science"},"science_1992298":{"type":"posts","id":"science_1992298","meta":{"index":"posts_1591205157","site":"science","id":"1992298","score":null,"sort":[1712782817000]},"guestAuthors":[],"slug":"a-bay-area-lawmaker-pushes-to-expand-access-to-methadone","title":"A Bay Area Lawmaker Pushes to Expand Access to Methadone","publishDate":1712782817,"format":"audio","headTitle":"A Bay Area Lawmaker Pushes to Expand Access to Methadone | KQED","labelTerm":{"site":"science"},"content":"\u003cp>Jen Jeffries was arrested on drug charges back in 2007. She was 21 years old, living on the streets in San Francisco at that time, and injecting heroin several times a day. She no longer wanted to get high but needed the drug to avoid going into withdrawal.\u003c/p>\n\u003cp>“You have a runny nose, watery eyes, yawning, sneezing, diarrhea, and horrible stomach cramps,” Jeffries said.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Assemblymember Matt Haney\"]‘It is infuriating and mind-boggling that during the worst drug crisis in history, as thousands of Californians die every year, that we would keep one of the most effective treatments for addiction locked away where people can’t access it.’[/pullquote]Jeffries landed in jail, where a doctor offered her \u003ca href=\"https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone\">methadone\u003c/a>. The medication reduces opioid craving and withdrawal and blunts the effects of opioids. But, after she was released, Jeffries had a hard time staying on the daily medication. California state law mandates that new patients can only get a single dose at a time and only from a licensed clinic. That remains true today.\u003c/p>\n\u003cp>State law has allowed these clinics, formally known as opioid treatment programs, to maintain exclusive rights to distribute methadone since the drug’s approval in the early 1970s during the Vietnam War. Today, primary care physicians are still prohibited from prescribing the medication.\u003c/p>\n\u003cp>Patients often find themselves having to conform to the clinics’ dosing schedules, and they are required to engage in regular counseling and drug screenings.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[aside postID=\"news_11979144,news_11975973,news_11972898\" label=\"Related Stories\"]On good days, Jeffries slept on the sidewalk near the clinic’s front door so she could take methadone in the morning, but she said most of the time her life was too chaotic to plan ahead.\u003c/p>\n\u003cp>“When you’re on the streets, and you don’t know when you’re going to sleep,” Jeffries said. “You don’t know when you’re waking up. It’s not feasible to be at a specific place at a specific time.”\u003c/p>\n\u003cp>Jeffries yo-yoed between heroin and methadone for years while she struggled to stabilize her life.\u003c/p>\n\u003ch2>Addressing methadone access in California\u003c/h2>\n\u003cp>With more and more Americans dying from opioid overdoses, the federal government updated its methadone regulations this year for the first time in two decades and is now allowing people to \u003ca href=\"https://www.npr.org/sections/health-shots/2024/02/02/1228349518/opioid-overdose-addiction-methadone#:~:text=Under%20the%20revised%20rules%2C%20methadone,treatment%20programs%20(OTPs)%20nationwide.\">receive more take-home doses of the medication\u003c/a>.\u003c/p>\n\u003cp>However, California has not followed the federal example. A new bill introduced by Assemblymember Matt Haney would align the state with the new federal guidance.\u003c/p>\n\u003cp>“It is infuriating and mind-boggling that during the worst drug crisis in history, as thousands of Californians die every year, that we would keep one of the most effective treatments for addiction locked away where people can’t access it,” Haney said.\u003c/p>\n\u003cp>The state has one of the most restrictive methadone policies in the world, according to Dr. Leslie Suen, an addiction medicine physician at UCSF. She is not allowed to prescribe take-home doses of methadone to patients discharged from the emergency department. The same rules restrict family doctors in California.\u003c/p>\n\u003cp>“In other countries like Canada, the United Kingdom, Australia, methadone is widely available in primary care settings,” she said. “So anybody walking into their primary care doctor’s office is able to enroll into methadone treatment.”\u003c/p>\n\u003cp>Suen said more flexible policies would save lives. “When someone is on methadone, they are able to stabilize their lives, they are able to get jobs, they are able to reconnect their families, and that chaotic addiction cycle goes away.”\u003c/p>\n\u003cfigure id=\"attachment_1992181\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1992181 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED.jpg\" alt=\"A woman in a black shirt and stands in front of a green wall. \" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jen Jeffries in San Francisco on March 27, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A healthy baby\u003c/h2>\n\u003cp>In 2015, Jeffries was still living on the streets and panhandling to support her drug habit when she discovered she was pregnant at 29 years old.\u003c/p>\n\u003cp>“Thankfully, when I found out I was pregnant, I was able to stop injecting heroin and just stayed on the methadone,” she said. “Because if you’re in withdrawal when you’re pregnant, the baby’s in withdrawal before you are, and it’s a very good way to lose your child.”\u003c/p>\n\u003cp>California’s restrictions are lighter for patients carrying a baby. For the time, Jeffries could take several doses of methadone home from the clinic, and she said it was much easier to kick her habit.\u003c/p>\n\u003cp>“It was the hardest thing I’ve ever done,” Jeffries said. “I was on the streets until I was six months pregnant.”\u003c/p>\n\u003cp>But she managed, and eventually, she gave birth to a healthy newborn.\u003c/p>\n\u003cp>“Today he is nine years old,” Jeffries said. “He is amazing. He is just the best little boy in the world.”\u003c/p>\n\u003cp>Jeffries still takes methadone each day, and she said it keeps her family’s life stable. She attends regular drug counseling and passes her drug tests — both enable her to pick up her medication every 27 days rather than attend the clinic daily.\u003c/p>\n\u003cp>“It helps me get to work,” she said. “It helps me take care of my son. It helps me get through the day. I don’t have to worry about being sick.”\u003c/p>\n\u003cp>But she said there needs to be fewer barriers to recovery. “A lot of our folks on the streets change their minds really quickly. You have to catch them and then keep them, not make it hard for them. Most can’t go every day.”\u003c/p>\n\u003ch2>Challenges and opposition: safeguards vs. accessibility\u003c/h2>\n\u003cp>Assemblymember Haney’s new proposal would expand methadone access in California in the following ways:\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">It allows doctors in a hospital to prescribe patients up to 72 hours’ worth of take-home doses of methadone.\u003c/li>\n\u003cli style=\"font-weight: 400\">It increases the amount of methadone a patient can take home from a specialized clinic.\u003c/li>\n\u003cli style=\"font-weight: 400\">Expedites entry into a treatment program.\u003c/li>\n\u003cli style=\"font-weight: 400\">Patients no longer need to show at least one year of recorded opioid usage before receiving treatment or participating in frequent counseling services.\u003c/li>\n\u003cli style=\"font-weight: 400\">Allows physicians greater discretion to determine the appropriate dosage of methadone to administer for a patient.\u003c/li>\n\u003c/ul>\n\u003cp>However, opponents to the proposal have suggested numerous amendments to these new recommendations, pointing out that a person can overdose on methadone if improperly used.\u003c/p>\n\u003cp>“We’re concerned that this bill doesn’t have reasonable safeguards that will prevent people from misusing the medication or prevent them from selling the medication to people and resulting in more overdose and death,” said Jason Kletter, president of California Opioid Maintenance Providers — a group of 120 treatment centers in the state.\u003c/p>\n\u003cp>He said specialized clinics prioritize comprehensive care to patients, including counseling, drug testing, and monitoring for potential drug interactions. He said that expanded access could compromise quality care by reducing the frequency of patient interactions and oversight.\u003c/p>\n\u003cfigure id=\"attachment_1992182\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1992182 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED.jpg\" alt=\"A woman with tattoos holds a box of narcan. \" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jen Jeffries holds a box of Narcan in San Francisco on March 27, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A rare success story\u003c/h2>\n\u003cp>Today, Jeffries works full-time for the San Francisco Department of Public Health as a peer counselor for the city’s post-overdose engagement team.\u003c/p>\n\u003cp>On a blustery Wednesday morning this year, she wandered through the Tenderloin neighborhood in San Francisco, approaching folks on the street holding fentanyl pipes. She kneeled down to stroke a man’s large black and white shepherd dog. She offered the group fentanyl test strips, clean needles and other harm-reduction supplies.\u003c/p>\n\u003cp>A man with stringy blond hair, a thin blue flannel shirt, and bloodshot eyes took a box of \u003ca href=\"https://www.cdc.gov/stopoverdose/naloxone/index.html#:~:text=What%20is%20naloxone%3F,use%20and%20small%20to%20carry.\">naloxone\u003c/a> or Narcan out of her hand, thanking her. She explained how to use the medication to reverse an overdose.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“My name’s Jen. I work over there,” she said. “If you ever need anything, you can come ask for me. Have a nice day. Love your doggy.”\u003c/p>\n\n","blocks":[],"excerpt":"A new proposal would increase flexibility and accessibility to methadone. Assemblymember Matt Haney thinks this will address the state's opioid crisis.","status":"publish","parent":0,"modified":1712882985,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1346},"headData":{"title":"A Bay Area Lawmaker Pushes to Expand Access to Methadone | KQED","description":"A new proposal would increase flexibility and accessibility to methadone. Assemblymember Matt Haney thinks this will address the state's opioid crisis.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]f-aaef00f5a073/079febb6-f8f3-4d41-b522-b14800ffeecd/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jen Jeffries was arrested on drug charges back in 2007. She was 21 years old, living on the streets in San Francisco at that time, and injecting heroin several times a day. She no longer wanted to get high but needed the drug to avoid going into withdrawal.\u003c/p>\n\u003cp>“You have a runny nose, watery eyes, yawning, sneezing, diarrhea, and horrible stomach cramps,” Jeffries said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘It is infuriating and mind-boggling that during the worst drug crisis in history, as thousands of Californians die every year, that we would keep one of the most effective treatments for addiction locked away where people can’t access it.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Assemblymember Matt Haney","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Jeffries landed in jail, where a doctor offered her \u003ca href=\"https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone\">methadone\u003c/a>. The medication reduces opioid craving and withdrawal and blunts the effects of opioids. But, after she was released, Jeffries had a hard time staying on the daily medication. California state law mandates that new patients can only get a single dose at a time and only from a licensed clinic. That remains true today.\u003c/p>\n\u003cp>State law has allowed these clinics, formally known as opioid treatment programs, to maintain exclusive rights to distribute methadone since the drug’s approval in the early 1970s during the Vietnam War. Today, primary care physicians are still prohibited from prescribing the medication.\u003c/p>\n\u003cp>Patients often find themselves having to conform to the clinics’ dosing schedules, and they are required to engage in regular counseling and drug screenings.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11979144,news_11975973,news_11972898","label":"Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>On good days, Jeffries slept on the sidewalk near the clinic’s front door so she could take methadone in the morning, but she said most of the time her life was too chaotic to plan ahead.\u003c/p>\n\u003cp>“When you’re on the streets, and you don’t know when you’re going to sleep,” Jeffries said. “You don’t know when you’re waking up. It’s not feasible to be at a specific place at a specific time.”\u003c/p>\n\u003cp>Jeffries yo-yoed between heroin and methadone for years while she struggled to stabilize her life.\u003c/p>\n\u003ch2>Addressing methadone access in California\u003c/h2>\n\u003cp>With more and more Americans dying from opioid overdoses, the federal government updated its methadone regulations this year for the first time in two decades and is now allowing people to \u003ca href=\"https://www.npr.org/sections/health-shots/2024/02/02/1228349518/opioid-overdose-addiction-methadone#:~:text=Under%20the%20revised%20rules%2C%20methadone,treatment%20programs%20(OTPs)%20nationwide.\">receive more take-home doses of the medication\u003c/a>.\u003c/p>\n\u003cp>However, California has not followed the federal example. A new bill introduced by Assemblymember Matt Haney would align the state with the new federal guidance.\u003c/p>\n\u003cp>“It is infuriating and mind-boggling that during the worst drug crisis in history, as thousands of Californians die every year, that we would keep one of the most effective treatments for addiction locked away where people can’t access it,” Haney said.\u003c/p>\n\u003cp>The state has one of the most restrictive methadone policies in the world, according to Dr. Leslie Suen, an addiction medicine physician at UCSF. She is not allowed to prescribe take-home doses of methadone to patients discharged from the emergency department. The same rules restrict family doctors in California.\u003c/p>\n\u003cp>“In other countries like Canada, the United Kingdom, Australia, methadone is widely available in primary care settings,” she said. “So anybody walking into their primary care doctor’s office is able to enroll into methadone treatment.”\u003c/p>\n\u003cp>Suen said more flexible policies would save lives. “When someone is on methadone, they are able to stabilize their lives, they are able to get jobs, they are able to reconnect their families, and that chaotic addiction cycle goes away.”\u003c/p>\n\u003cfigure id=\"attachment_1992181\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1992181 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED.jpg\" alt=\"A woman in a black shirt and stands in front of a green wall. \" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-02-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jen Jeffries in San Francisco on March 27, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A healthy baby\u003c/h2>\n\u003cp>In 2015, Jeffries was still living on the streets and panhandling to support her drug habit when she discovered she was pregnant at 29 years old.\u003c/p>\n\u003cp>“Thankfully, when I found out I was pregnant, I was able to stop injecting heroin and just stayed on the methadone,” she said. “Because if you’re in withdrawal when you’re pregnant, the baby’s in withdrawal before you are, and it’s a very good way to lose your child.”\u003c/p>\n\u003cp>California’s restrictions are lighter for patients carrying a baby. For the time, Jeffries could take several doses of methadone home from the clinic, and she said it was much easier to kick her habit.\u003c/p>\n\u003cp>“It was the hardest thing I’ve ever done,” Jeffries said. “I was on the streets until I was six months pregnant.”\u003c/p>\n\u003cp>But she managed, and eventually, she gave birth to a healthy newborn.\u003c/p>\n\u003cp>“Today he is nine years old,” Jeffries said. “He is amazing. He is just the best little boy in the world.”\u003c/p>\n\u003cp>Jeffries still takes methadone each day, and she said it keeps her family’s life stable. She attends regular drug counseling and passes her drug tests — both enable her to pick up her medication every 27 days rather than attend the clinic daily.\u003c/p>\n\u003cp>“It helps me get to work,” she said. “It helps me take care of my son. It helps me get through the day. I don’t have to worry about being sick.”\u003c/p>\n\u003cp>But she said there needs to be fewer barriers to recovery. “A lot of our folks on the streets change their minds really quickly. You have to catch them and then keep them, not make it hard for them. Most can’t go every day.”\u003c/p>\n\u003ch2>Challenges and opposition: safeguards vs. accessibility\u003c/h2>\n\u003cp>Assemblymember Haney’s new proposal would expand methadone access in California in the following ways:\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">It allows doctors in a hospital to prescribe patients up to 72 hours’ worth of take-home doses of methadone.\u003c/li>\n\u003cli style=\"font-weight: 400\">It increases the amount of methadone a patient can take home from a specialized clinic.\u003c/li>\n\u003cli style=\"font-weight: 400\">Expedites entry into a treatment program.\u003c/li>\n\u003cli style=\"font-weight: 400\">Patients no longer need to show at least one year of recorded opioid usage before receiving treatment or participating in frequent counseling services.\u003c/li>\n\u003cli style=\"font-weight: 400\">Allows physicians greater discretion to determine the appropriate dosage of methadone to administer for a patient.\u003c/li>\n\u003c/ul>\n\u003cp>However, opponents to the proposal have suggested numerous amendments to these new recommendations, pointing out that a person can overdose on methadone if improperly used.\u003c/p>\n\u003cp>“We’re concerned that this bill doesn’t have reasonable safeguards that will prevent people from misusing the medication or prevent them from selling the medication to people and resulting in more overdose and death,” said Jason Kletter, president of California Opioid Maintenance Providers — a group of 120 treatment centers in the state.\u003c/p>\n\u003cp>He said specialized clinics prioritize comprehensive care to patients, including counseling, drug testing, and monitoring for potential drug interactions. He said that expanded access could compromise quality care by reducing the frequency of patient interactions and oversight.\u003c/p>\n\u003cfigure id=\"attachment_1992182\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1992182 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED.jpg\" alt=\"A woman with tattoos holds a box of narcan. \" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/04/240328-METHADONE-BILL-MD-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Jen Jeffries holds a box of Narcan in San Francisco on March 27, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>A rare success story\u003c/h2>\n\u003cp>Today, Jeffries works full-time for the San Francisco Department of Public Health as a peer counselor for the city’s post-overdose engagement team.\u003c/p>\n\u003cp>On a blustery Wednesday morning this year, she wandered through the Tenderloin neighborhood in San Francisco, approaching folks on the street holding fentanyl pipes. She kneeled down to stroke a man’s large black and white shepherd dog. She offered the group fentanyl test strips, clean needles and other harm-reduction supplies.\u003c/p>\n\u003cp>A man with stringy blond hair, a thin blue flannel shirt, and bloodshot eyes took a box of \u003ca href=\"https://www.cdc.gov/stopoverdose/naloxone/index.html#:~:text=What%20is%20naloxone%3F,use%20and%20small%20to%20carry.\">naloxone\u003c/a> or Narcan out of her hand, thanking her. She explained how to use the medication to reverse an overdose.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“My name’s Jen. I work over there,” she said. “If you ever need anything, you can come ask for me. Have a nice day. Love your doggy.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1992298/a-bay-area-lawmaker-pushes-to-expand-access-to-methadone","authors":["11229"],"categories":["science_39","science_4450"],"tags":["science_3541","science_4414","science_5264","science_3072"],"featImg":"science_1992299","label":"science"},"science_1991871":{"type":"posts","id":"science_1991871","meta":{"index":"posts_1591205157","site":"science","id":"1991871","score":null,"sort":[1710945038000]},"guestAuthors":[],"slug":"systemic-neglect-how-staffing-shortages-in-nursing-homes-leave-patients-trapped-in-hospitals","title":"Systemic Neglect: How Staffing Shortages In Nursing Homes Leave Patients Trapped in Hospitals","publishDate":1710945038,"format":"standard","headTitle":"Systemic Neglect: How Staffing Shortages In Nursing Homes Leave Patients Trapped in Hospitals | KQED","labelTerm":{"site":"science"},"content":"\u003cp>On a warm September morning in 2020, David Alter was cleaning up his kitchen in Berkeley. He saw his wife, Lisa, move towards him out of the corner of his eye. He turned to dry his hands on a towel, and then he heard a loud noise.\u003c/p>\n\u003cp>“I’ll never forget that sound,” he said. “It was like the sound of a baseball getting hit. She did nothing to brace her fall. Her head smacked directly on the linoleum floor.”\u003c/p>\n\u003cp>His wife lay still as blood pooled around her body, and Alter sprinted to the bathroom to scavenge for bandages. He wrapped Lisa’s head in gauze and then carried her to the car before speeding to the emergency department at Kaiser Permanente’s Richmond Medical Center, where he said a doctor diagnosed Lisa with a brain bleed.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Kristof Stremikis, director of market analysis and insight, California Health Care Foundation\"]‘We definitely know that across California more patients are spending longer times in the hospital.’[/pullquote]Lisa has Huntington’s disease, a genetic disorder that causes nerve cells to break down over time, ravaging the brain and body. The condition is marked by involuntary jerking and writhing movements. It impairs one’s gait, posture and balance. Eventually, Lisa could not walk, talk or think.\u003c/p>\n\u003cp>Alter had failed for an entire year to find a nursing home for his wife, as she was no longer safe at home.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It got to the point that we were going to the ER weekly,” Alter said. “If the fall was late at night, we wouldn’t go right away because we were too exhausted. I would patch her up. I would use suture strips or even sometimes Krazy Glue to close cuts.”\u003c/p>\n\u003cfigure id=\"attachment_1991935\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1991935 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg\" alt=\"A man wearing glasses and a dark shirt sits next to a woman lying down in a bed.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">David Alter sits next to his wife, Lisa Alter, in Walnut Creek on Feb. 9, 2024. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He had called hundreds of skilled nursing facilities across California. He penned personal letters to facility directors illustrated with color photos of their family, describing his wife as “a vibrant woman, wife, elementary school teacher and mother.”\u003c/p>\n\u003cp>He received denial after denial. There was not a single facility that would accept a complex patient who would likely need many years of specialized, very expensive care. Lisa received her Huntington’s disease diagnosis when she was 45 years old. From the onset of symptoms, people with the condition have a life expectancy of 10 to 25 years. Lisa’s needs will likely increase over time.\u003c/p>\n\u003cp>Alter turned to social workers with the Huntington’s Disease Society for help. They advised him to leave his wife in the hospital the next time she landed in the emergency department. “That’s the last resort if the caregiver isn’t safe to take their loved one home,” said Jessica Marsolek, the society’s associate director of community services.\u003c/p>\n\u003cfigure id=\"attachment_1991923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg\" alt=\"A hallway of a medical center with people walking through.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Richmond Medical Center on March 19, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hospitals are much more equipped to connect and successfully transfer patients to nursing homes. “I don’t know anybody that’s gotten into a nursing home any other way,” said Maura Gibney, executive director for California Advocates for Nursing Home Reform. She regularly advises families to leave their loved ones in the hospital. “That’s the only way.”\u003c/p>\n\u003cp>Four days after Lisa’s fall, she was ready for discharge from Kaiser’s emergency department in Richmond, but Alter made the decision not to pick her up. She wouldn’t leave the hospital for several months.\u003c/p>\n\u003ch2>Part of a growing trend\u003c/h2>\n\u003cp>Patients spend more and more time in the hospital, even people who — like Lisa Alter — are medically stable and ready for a lower level of care at a facility like a nursing home or a psychiatric treatment center. Increasingly, they languish for weeks, months and even years, which delays their recovery, and that, in turn, delays care for patients who need urgent care.\u003c/p>\n\u003cp>“We can’t accept some patients trying to transfer in from smaller hospitals,” said Dr. Valerie Norton, emergency medicine physician at Scripps Mercy Hospital in San Diego. “Because we don’t have room for them. Or there might be somebody down in the emergency department that’s waiting to be admitted into the hospital. And we have to wait until somebody else gets discharged before we can move them upstairs. If you’re lying in a bed in the emergency department, that’s just a hard gurney with a broken hip, and you’re waiting 16 hours for a bed to open up somewhere, that’s pretty tough.”\u003c/p>\n\u003cfigure id=\"attachment_1991924\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991924\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg\" alt='The side of a building that says \"Kaiser Permanente.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Richmond Medical Center on March 19, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2022, the average length of stay inside hospitals across the country \u003ca href=\"https://www.aha.org/issue-brief/2022-12-05-patients-and-providers-faced-increasing-delays-timely-discharges\">increased by 19.2%\u003c/a> compared to the year before, according to an issue brief prepared by the American Hospital Association. In California, 4,500 patients are stranded inside hospitals every day, according to a \u003ca href=\"https://calhospital.org/wp-content/uploads/2024/01/Impact-of-Inadequate-Networks-CHA-Analysis-FINAL.pdf\">report from the California Hospital Association, \u003c/a>which attributes the problem of discharge delays to insurance companies openly disregarding “the clinical guidance of doctors and nurses” and “delaying or denying the care” that patients need.\u003c/p>\n\u003cp>“We definitely know that across California, more patients are spending longer times in the hospital,” said Kristof Stremikis, who directs the California Health Care Foundation’s market analysis and insight team.\u003c/p>\n\u003cp>“It’s both very complicated and incredibly simple,” Stremikis said. “It’s rising demand with problems in the supply. There’s more patients that need to be discharged. They tend to be sicker. They tend to have more complex conditions. And then on the supply side, there’s just fewer and fewer places to send them.”\u003c/p>\n\u003cp>[aside postID=\"science_1991739,news_11976372,news_11968579\" label=\"Related Stories\"]As the country’s demographics trend older, more and more patients require care at nursing homes, but those facilities are plagued by dire staffing shortages, according to the \u003ca href=\"https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Historic-Staffing-Shortages-Continue-To-Force-Nursing-Homes-To-Limit-New-Admissions,-Creating-Bottlenecks-at-Hospitals-and-.aspx\">American Health Care Association\u003c/a>. A lack of workers downstream means patients like Lisa Alter get stuck upstream inside the hospital’s emergency department.\u003c/p>\n\u003cp>“We don’t have anywhere safe to send them,” Norton said. “They would qualify to be at a lower level of care like a skilled nursing facility or an assisted living facility. But because of their multiple medical problems or their psychiatric condition, there’s not a place that’s willing to take them.”\u003c/p>\n\u003cp>The number of days patients are stuck at Scripps has tripled in recent years, she said, and costs the health care system $56 million a year.\u003c/p>\n\u003cp>“It’s just insane how long these patients stay in the hospital,” Norton said. “And we’re not getting paid for that. We’re just eating that cost. And they should be in a nursing home somewhere.”\u003c/p>\n\u003cp>The problem was exacerbated by the pandemic, which accelerated feelings of anguish and other persistent mental health issues in health care workers.\u003c/p>\n\u003cp>Nearly half of health care workers across the U.S. reported often feeling burned out in 2022, according to a \u003ca href=\"https://www.cdc.gov/vitalsigns/health-worker-mental-health/index.html\">federal survey from the Centers for Disease Control\u003c/a>. About the same amount said they intended to look for a new job.\u003c/p>\n\u003cp>“We’ve had a long, long, long-term problem,” said Craig Cornett, CEO of the California Association of Health Facilities. “Every other part of the health care sector has recovered its staff to its pre-COVID days. We are the only part of the health care continuum that is still below where we were before COVID.”\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"David Alter, software engineer\"]‘You shouldn’t have to leave someone in the hospital and force them to take care of it.’[/pullquote]California is spending $26 million to \u003ca href=\"https://yourcnastory.org/\">recruit\u003c/a> more health care workers to help fill this gap, with the hope of attracting 5,500 certified nursing assistants by 2027. State lawmakers are considering \u003ca href=\"https://legiscan.com/CA/text/SB895/id/2868455\">SB 895\u003c/a>, a new bill that would allow select community college districts to offer nursing degrees, lowering the bar for entry and making it easier for workers to enter the health care industry.\u003c/p>\n\u003cp>But, Cornett said, the workforce challenge is huge, and it is not going away.\u003c/p>\n\u003ch2>The breaking point\u003c/h2>\n\u003cp>Alter always thought he’d grow old alongside his wife. But he could no longer parent his two children, hold a full-time job as a software engineer, and care for Lisa around the clock.\u003c/p>\n\u003cfigure id=\"attachment_1991920\" class=\"wp-caption aligncenter\" style=\"max-width: 1330px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg\" alt=\"A man, woman, and two children wearing tie die t shirts stands outside a home.\" width=\"1330\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg 1330w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-800x1203.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-1020x1534.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-160x241.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-768x1155.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-1021x1536.jpg 1021w\" sizes=\"(max-width: 1330px) 100vw, 1330px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A family photo of Lisa (left) and David Alter and their children Zachary and Maya in front of their home in Berkeley in 2010, the year before Lisa was diagnosed with Huntington’s disease. \u003ccite>(Courtesy of David Alter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When he learned that his wife was ready to be discharged from the emergency department at Kaiser Richmond, he steadied himself.\u003c/p>\n\u003cp>“I remember talking to them, and I said: ‘I’m not gonna pick her up. I’m not going to take her home.’”\u003c/p>\n\u003cp>Alter said the hospital’s discharge team struggled to find a nursing home for Lisa, too. His wife Lisa would spend over four months at Kaiser, a time period that Alter described as “excruciating” for him. He was so worried that the hospital would force him to take his wife home that he held off from visiting her in the hospital initially.\u003c/p>\n\u003cp>“It’s incredibly emotional to walk away,” Alter said. “And Kaiser’s calling you. And they’re like, ‘Why aren’t you picking her up?’ It’s really, really stressful. And it gets worse every day she’s there.”\u003c/p>\n\u003cp>Kaiser Permanente declined an interview for this story. In an emailed statement, the organization said it strives to find the right care for patients as quickly as possible. “While the vast majority of placements occur in a timely fashion, there are some circumstances, including the need for highly specialized care and patient or family preferences, that can present challenges,” the statement said.\u003c/p>\n\u003cp>\u003cb>Patient discrimination\u003c/b>\u003c/p>\n\u003cp>On top of staffing issues, facilities have a financial incentive to choose patients who can pay the highest price. “It’s unfortunate, but it is true,” Stremikis said. “Medi-Cal rates are way lower than private payers. It’s just another example of the inequalities within our system.”\u003c/p>\n\u003cp>Medi-Cal is the state’s insurance program, which covers Alter’s wife. It’s supposed to pay for her to receive specialized care at a round-the-clock facility, but that has not been his experience. “There’s nowhere I can place her,” Alter said.\u003c/p>\n\u003cfigure id=\"attachment_1991922\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991922\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg\" alt=\"A person holds an image of a man, woman and young child.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">David Alter holds a photo of himself, his wife Lisa, and their son Zachary at his home in Berkeley on March 18, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eventually, after more than four months, Kaiser Permanente did find housing for Lisa in Walnut Creek. The home provides food and supervision but not specialized nurses or regular doctor visits. Alter said she’s not at the right facility, but he doesn’t know what to do. He hired consultants and lawyers and wrote his legislators, all to no avail.\u003c/p>\n\u003cp>Three years after Alter left his wife in the hospital as a hail mary play to get her the care she needs, that’s still not happening. “You’re just defeated,” he said.\u003c/p>\n\u003cp>Meanwhile, his wife declines. “She’s 70 or 80 pounds,” Alter said. “She’s so tiny. She’s skin and bones.”\u003c/p>\n\u003cp>He also worries she could injure herself again, land back in the hospital, and then get stuck in the cycle all over again.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“You shouldn’t have to leave someone in the hospital and force them to take care of it,” Alter said. “That’s not the right solution. As a society, we’re not set up in a way to care for people properly.”\u003c/p>\n\n","blocks":[],"excerpt":"One woman with Huntington's disease was left in limbo at Kaiser’s emergency department in Richmond for more than 4 months as she waited for space in a nursing home. ","status":"publish","parent":0,"modified":1710956564,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":41,"wordCount":2084},"headData":{"title":"Systemic Neglect: How Staffing Shortages In Nursing Homes Leave Patients Trapped in Hospitals | KQED","description":"One woman with Huntington's disease was left in limbo at Kaiser’s emergency department in Richmond for more than 4 months as she waited for space in a nursing home. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]f-aaef00f5a073/2b50ce24-d6da-4ae1-8623-b131010710cc/audio.mp3","sticky":false,"WpOldSlug":"california-patients-stranded-in-hospitals-due-to-lack-of-specialized-care-facilities","excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1991871/systemic-neglect-how-staffing-shortages-in-nursing-homes-leave-patients-trapped-in-hospitals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>On a warm September morning in 2020, David Alter was cleaning up his kitchen in Berkeley. He saw his wife, Lisa, move towards him out of the corner of his eye. He turned to dry his hands on a towel, and then he heard a loud noise.\u003c/p>\n\u003cp>“I’ll never forget that sound,” he said. “It was like the sound of a baseball getting hit. She did nothing to brace her fall. Her head smacked directly on the linoleum floor.”\u003c/p>\n\u003cp>His wife lay still as blood pooled around her body, and Alter sprinted to the bathroom to scavenge for bandages. He wrapped Lisa’s head in gauze and then carried her to the car before speeding to the emergency department at Kaiser Permanente’s Richmond Medical Center, where he said a doctor diagnosed Lisa with a brain bleed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We definitely know that across California more patients are spending longer times in the hospital.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Kristof Stremikis, director of market analysis and insight, California Health Care Foundation","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Lisa has Huntington’s disease, a genetic disorder that causes nerve cells to break down over time, ravaging the brain and body. The condition is marked by involuntary jerking and writhing movements. It impairs one’s gait, posture and balance. Eventually, Lisa could not walk, talk or think.\u003c/p>\n\u003cp>Alter had failed for an entire year to find a nursing home for his wife, as she was no longer safe at home.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It got to the point that we were going to the ER weekly,” Alter said. “If the fall was late at night, we wouldn’t go right away because we were too exhausted. I would patch her up. I would use suture strips or even sometimes Krazy Glue to close cuts.”\u003c/p>\n\u003cfigure id=\"attachment_1991935\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1991935 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg\" alt=\"A man wearing glasses and a dark shirt sits next to a woman lying down in a bed.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240209-AVOIDABLEBEDDAYS-KSM-1-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">David Alter sits next to his wife, Lisa Alter, in Walnut Creek on Feb. 9, 2024. \u003ccite>(Kathryn Styer Martínez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He had called hundreds of skilled nursing facilities across California. He penned personal letters to facility directors illustrated with color photos of their family, describing his wife as “a vibrant woman, wife, elementary school teacher and mother.”\u003c/p>\n\u003cp>He received denial after denial. There was not a single facility that would accept a complex patient who would likely need many years of specialized, very expensive care. Lisa received her Huntington’s disease diagnosis when she was 45 years old. From the onset of symptoms, people with the condition have a life expectancy of 10 to 25 years. Lisa’s needs will likely increase over time.\u003c/p>\n\u003cp>Alter turned to social workers with the Huntington’s Disease Society for help. They advised him to leave his wife in the hospital the next time she landed in the emergency department. “That’s the last resort if the caregiver isn’t safe to take their loved one home,” said Jessica Marsolek, the society’s associate director of community services.\u003c/p>\n\u003cfigure id=\"attachment_1991923\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991923\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg\" alt=\"A hallway of a medical center with people walking through.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-09-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Richmond Medical Center on March 19, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hospitals are much more equipped to connect and successfully transfer patients to nursing homes. “I don’t know anybody that’s gotten into a nursing home any other way,” said Maura Gibney, executive director for California Advocates for Nursing Home Reform. She regularly advises families to leave their loved ones in the hospital. “That’s the only way.”\u003c/p>\n\u003cp>Four days after Lisa’s fall, she was ready for discharge from Kaiser’s emergency department in Richmond, but Alter made the decision not to pick her up. She wouldn’t leave the hospital for several months.\u003c/p>\n\u003ch2>Part of a growing trend\u003c/h2>\n\u003cp>Patients spend more and more time in the hospital, even people who — like Lisa Alter — are medically stable and ready for a lower level of care at a facility like a nursing home or a psychiatric treatment center. Increasingly, they languish for weeks, months and even years, which delays their recovery, and that, in turn, delays care for patients who need urgent care.\u003c/p>\n\u003cp>“We can’t accept some patients trying to transfer in from smaller hospitals,” said Dr. Valerie Norton, emergency medicine physician at Scripps Mercy Hospital in San Diego. “Because we don’t have room for them. Or there might be somebody down in the emergency department that’s waiting to be admitted into the hospital. And we have to wait until somebody else gets discharged before we can move them upstairs. If you’re lying in a bed in the emergency department, that’s just a hard gurney with a broken hip, and you’re waiting 16 hours for a bed to open up somewhere, that’s pretty tough.”\u003c/p>\n\u003cfigure id=\"attachment_1991924\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991924\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg\" alt='The side of a building that says \"Kaiser Permanente.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Richmond Medical Center on March 19, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2022, the average length of stay inside hospitals across the country \u003ca href=\"https://www.aha.org/issue-brief/2022-12-05-patients-and-providers-faced-increasing-delays-timely-discharges\">increased by 19.2%\u003c/a> compared to the year before, according to an issue brief prepared by the American Hospital Association. In California, 4,500 patients are stranded inside hospitals every day, according to a \u003ca href=\"https://calhospital.org/wp-content/uploads/2024/01/Impact-of-Inadequate-Networks-CHA-Analysis-FINAL.pdf\">report from the California Hospital Association, \u003c/a>which attributes the problem of discharge delays to insurance companies openly disregarding “the clinical guidance of doctors and nurses” and “delaying or denying the care” that patients need.\u003c/p>\n\u003cp>“We definitely know that across California, more patients are spending longer times in the hospital,” said Kristof Stremikis, who directs the California Health Care Foundation’s market analysis and insight team.\u003c/p>\n\u003cp>“It’s both very complicated and incredibly simple,” Stremikis said. “It’s rising demand with problems in the supply. There’s more patients that need to be discharged. They tend to be sicker. They tend to have more complex conditions. And then on the supply side, there’s just fewer and fewer places to send them.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"science_1991739,news_11976372,news_11968579","label":"Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>As the country’s demographics trend older, more and more patients require care at nursing homes, but those facilities are plagued by dire staffing shortages, according to the \u003ca href=\"https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Historic-Staffing-Shortages-Continue-To-Force-Nursing-Homes-To-Limit-New-Admissions,-Creating-Bottlenecks-at-Hospitals-and-.aspx\">American Health Care Association\u003c/a>. A lack of workers downstream means patients like Lisa Alter get stuck upstream inside the hospital’s emergency department.\u003c/p>\n\u003cp>“We don’t have anywhere safe to send them,” Norton said. “They would qualify to be at a lower level of care like a skilled nursing facility or an assisted living facility. But because of their multiple medical problems or their psychiatric condition, there’s not a place that’s willing to take them.”\u003c/p>\n\u003cp>The number of days patients are stuck at Scripps has tripled in recent years, she said, and costs the health care system $56 million a year.\u003c/p>\n\u003cp>“It’s just insane how long these patients stay in the hospital,” Norton said. “And we’re not getting paid for that. We’re just eating that cost. And they should be in a nursing home somewhere.”\u003c/p>\n\u003cp>The problem was exacerbated by the pandemic, which accelerated feelings of anguish and other persistent mental health issues in health care workers.\u003c/p>\n\u003cp>Nearly half of health care workers across the U.S. reported often feeling burned out in 2022, according to a \u003ca href=\"https://www.cdc.gov/vitalsigns/health-worker-mental-health/index.html\">federal survey from the Centers for Disease Control\u003c/a>. About the same amount said they intended to look for a new job.\u003c/p>\n\u003cp>“We’ve had a long, long, long-term problem,” said Craig Cornett, CEO of the California Association of Health Facilities. “Every other part of the health care sector has recovered its staff to its pre-COVID days. We are the only part of the health care continuum that is still below where we were before COVID.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘You shouldn’t have to leave someone in the hospital and force them to take care of it.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"David Alter, software engineer","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>California is spending $26 million to \u003ca href=\"https://yourcnastory.org/\">recruit\u003c/a> more health care workers to help fill this gap, with the hope of attracting 5,500 certified nursing assistants by 2027. State lawmakers are considering \u003ca href=\"https://legiscan.com/CA/text/SB895/id/2868455\">SB 895\u003c/a>, a new bill that would allow select community college districts to offer nursing degrees, lowering the bar for entry and making it easier for workers to enter the health care industry.\u003c/p>\n\u003cp>But, Cornett said, the workforce challenge is huge, and it is not going away.\u003c/p>\n\u003ch2>The breaking point\u003c/h2>\n\u003cp>Alter always thought he’d grow old alongside his wife. But he could no longer parent his two children, hold a full-time job as a software engineer, and care for Lisa around the clock.\u003c/p>\n\u003cfigure id=\"attachment_1991920\" class=\"wp-caption aligncenter\" style=\"max-width: 1330px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991920\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg\" alt=\"A man, woman, and two children wearing tie die t shirts stands outside a home.\" width=\"1330\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED.jpg 1330w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-800x1203.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-1020x1534.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-160x241.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-768x1155.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-12-KQED-1021x1536.jpg 1021w\" sizes=\"(max-width: 1330px) 100vw, 1330px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A family photo of Lisa (left) and David Alter and their children Zachary and Maya in front of their home in Berkeley in 2010, the year before Lisa was diagnosed with Huntington’s disease. \u003ccite>(Courtesy of David Alter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When he learned that his wife was ready to be discharged from the emergency department at Kaiser Richmond, he steadied himself.\u003c/p>\n\u003cp>“I remember talking to them, and I said: ‘I’m not gonna pick her up. I’m not going to take her home.’”\u003c/p>\n\u003cp>Alter said the hospital’s discharge team struggled to find a nursing home for Lisa, too. His wife Lisa would spend over four months at Kaiser, a time period that Alter described as “excruciating” for him. He was so worried that the hospital would force him to take his wife home that he held off from visiting her in the hospital initially.\u003c/p>\n\u003cp>“It’s incredibly emotional to walk away,” Alter said. “And Kaiser’s calling you. And they’re like, ‘Why aren’t you picking her up?’ It’s really, really stressful. And it gets worse every day she’s there.”\u003c/p>\n\u003cp>Kaiser Permanente declined an interview for this story. In an emailed statement, the organization said it strives to find the right care for patients as quickly as possible. “While the vast majority of placements occur in a timely fashion, there are some circumstances, including the need for highly specialized care and patient or family preferences, that can present challenges,” the statement said.\u003c/p>\n\u003cp>\u003cb>Patient discrimination\u003c/b>\u003c/p>\n\u003cp>On top of staffing issues, facilities have a financial incentive to choose patients who can pay the highest price. “It’s unfortunate, but it is true,” Stremikis said. “Medi-Cal rates are way lower than private payers. It’s just another example of the inequalities within our system.”\u003c/p>\n\u003cp>Medi-Cal is the state’s insurance program, which covers Alter’s wife. It’s supposed to pay for her to receive specialized care at a round-the-clock facility, but that has not been his experience. “There’s nowhere I can place her,” Alter said.\u003c/p>\n\u003cfigure id=\"attachment_1991922\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991922\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg\" alt=\"A person holds an image of a man, woman and young child.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/03/240318-AVOIDABLE-BED-DAYS-MD-06-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">David Alter holds a photo of himself, his wife Lisa, and their son Zachary at his home in Berkeley on March 18, 2024. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eventually, after more than four months, Kaiser Permanente did find housing for Lisa in Walnut Creek. The home provides food and supervision but not specialized nurses or regular doctor visits. Alter said she’s not at the right facility, but he doesn’t know what to do. He hired consultants and lawyers and wrote his legislators, all to no avail.\u003c/p>\n\u003cp>Three years after Alter left his wife in the hospital as a hail mary play to get her the care she needs, that’s still not happening. “You’re just defeated,” he said.\u003c/p>\n\u003cp>Meanwhile, his wife declines. “She’s 70 or 80 pounds,” Alter said. “She’s so tiny. She’s skin and bones.”\u003c/p>\n\u003cp>He also worries she could injure herself again, land back in the hospital, and then get stuck in the cycle all over again.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“You shouldn’t have to leave someone in the hospital and force them to take care of it,” Alter said. “That’s not the right solution. As a society, we’re not set up in a way to care for people properly.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1991871/systemic-neglect-how-staffing-shortages-in-nursing-homes-leave-patients-trapped-in-hospitals","authors":["11229"],"categories":["science_39","science_40","science_4450"],"tags":["science_4414","science_1648","science_5259","science_2918"],"featImg":"science_1991934","label":"science"},"science_1991739":{"type":"posts","id":"science_1991739","meta":{"index":"posts_1591205157","site":"science","id":"1991739","score":null,"sort":[1709812832000]},"guestAuthors":[],"slug":"bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack","title":"Bay Area Psychiatry Resident Pushes for Hospital Safety After Violent Attack","publishDate":1709812832,"format":"standard","headTitle":"Bay Area Psychiatry Resident Pushes for Hospital Safety After Violent Attack | KQED","labelTerm":{"site":"science"},"content":"\u003cp>When Dani Golomb started her shift on Sept. 5, 2020, she had no idea that she’d be beaten, dragged and knocked unconscious.\u003c/p>\n\u003cp>Like usual, the psychiatry resident reported to an inpatient unit at California Pacific Medical Center at 8 a.m. The hospital was extending one patient’s legal hold, and it fell on Golomb to deliver the news.\u003c/p>\n\u003cp>“Most of the patients we’re seeing are San Francisco’s sickest,” Golomb said, referring to what health care workers call “5150s,” a California legal code that allows people experiencing a mental health crisis to be involuntarily committed for 72 hours if they are a danger to others or themselves.\u003c/p>\n\u003cp>The patient had been violent before and had a temper.\u003c/p>\n\u003cp>“‘I know this isn’t what you wanted to hear, and I know you want to go home. I want to inform you that we are keeping you longer,’” Golomb, who was 33 at the time, recalled saying to the patient. “‘You will have the opportunity to meet with a judge on Monday.’”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The patient called her a thief and a liar, Golomb told KQED in a recent interview.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Chris Van Gorder, CEO, Scripps Health\"]‘Violence in emergency rooms is not exactly new. But it is worse than it’s ever been, by far.’[/pullquote]Golomb said she placed paperwork and the phone number for a patient advocacy line on the foot of the bed before slowly walking out of the room, closing the door behind her. She was seeing other patients when she heard someone yell “thief” and “liar.”\u003c/p>\n\u003cp>Suddenly, from behind, came a forceful shove and Golomb was on the ground being “punched in the head, neck and shoulders,” she said. The patient grabbed her metal clipboard, “smashing it repeatedly on my head, dragging me by my hair.”\u003c/p>\n\u003cp>Golomb suffered a concussion and a traumatic brain injury, but she wouldn’t find out about that until later.\u003c/p>\n\u003cp>“I came to, and there was one of our wonderful nurses kneeling before me,” she said. “I don’t know if he broke up what was happening or if another patient pulled [them off]. But I immediately ran off to go upstairs to collect myself and just cry.”\u003c/p>\n\u003cp>Health care workers suffer the highest rates of injury caused by violence on the job. They are five times as likely than workers overall to experience a violent injury, according to \u003ca href=\"https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm\">federal statistics\u003c/a>. California hospitals tallied roughly \u003ca href=\"https://www.dir.ca.gov/dosh/WPVIH_Annual_Reports.html\">10,000 incidents annually in recent years\u003c/a>.\u003c/p>\n\u003cp>In February, San Mateo County prosecutors charged an unhoused man with attempted murder after he \u003ca href=\"https://www.beckershospitalreview.com/legal-regulatory-issues/sutter-hospital-employee-stabbed-man-charged.html\">allegedly stabbed a health worker nine times with a pocket knife\u003c/a> at Sutter Health’s Mills-Peninsula Medical Center in Burlingame.\u003c/p>\n\u003cp>[aside postID=\"news_11955211,news_11944448\" label=\"Related Stories\"]Nurses in the Santa Clara County health system have authorized a strike over what they describe as violent work conditions. James Mount, who works in the intensive care unit at the St. Louise Regional Hospital in Gilroy, said the vast majority of his colleagues don’t feel safe.\u003c/p>\n\u003cp>“They have witnessed the escalation of violence within hospitals since COVID,” he said. “It’s disheartening. Our challenge is to try and feel secure in our job and take care of our patients. That’s why we are there. What we are asking for is for someone to protect those frontline workers who are treating the patients.”\u003c/p>\n\u003cfigure id=\"attachment_1991425\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991425\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg\" alt='The outside of a building and sign that reads \"Sutter Health.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Staff inside the Sutter Health inpatient psych unit in San Francisco where Golomb was attacked said they are regularly threatened and assaulted, including being pushed, punched and pulled to the ground, according to interviews with Golomb and more than a half dozen of her resident colleagues and nurses and a KQED review of internal documents.\u003c/p>\n\u003cp>In a survey conducted by the psych residents, three-quarters of those who responded and work on that unit said they are in “an unsafe situation on a daily or weekly basis.” They all report they have experienced violence or harassment from a patient.\u003c/p>\n\u003cp>“Violence in emergency rooms is not exactly new. But it is worse than it’s ever been, by far,” said Chris Van Gorder, the CEO of Scripps Health in San Diego. He attributes the uptick in violence to a surge in homelessness, a drug crisis and a lack of available care for behavioral health patients.\u003c/p>\n\u003cp>“The hospital is the end of the food chain,” he said. “Nobody else knows what to do with you. They bring you to the hospital emergency room and assume that we’re going to somehow be able to take care of you.”\u003c/p>\n\u003cp>Golomb and her colleagues said the hospital is not doing enough to ensure their safety, as 91% of the residents responded to the survey saying the security presence was “not at all adequate.”\u003c/p>\n\u003cfigure id=\"attachment_1991428\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991428\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg\" alt=\"A person's hand holds up a cellphone with an image of people holding signs.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, holds a photo of herself and fellow psych unit staff holding signs asking for more safety measures at their hospital at her home in San Francisco on Feb. 9, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s one of the reasons that Golomb and about 15 of her resident colleagues \u003ca href=\"https://sfstandard.com/2023/01/17/san-francisco-hospital-cpmc-residents-unionize/\">announced in January their plans to unionize\u003c/a> and join the Committee of Interns and Residents, which represents 30,000 resident and fellow physicians and is a local of the powerful Service Employees International Union.\u003c/p>\n\u003cp>As part of their bargaining with Sutter Health, residents demand round-the-clock security presence in the inpatient psych unit. At the time of Golomb’s attack, the unit was located in the Pacific Heights neighborhood across the street from the larger medical campus. Staff would call security, and they “would come running from a full city block away,” Golomb said.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dani Golomb, psychiatry resident, California Pacific Medical Center\"]‘They see their doctor get pummeled, dragged and beat up. What must that feel like as a patient?’[/pullquote]In 2022, Sutter moved the inpatient psych unit to its California Pacific Medical Center Davies campus near the Duboce Triangle in San Francisco and, in a statement to KQED, Sutter said it had spent nearly $40 million to “enhance safety at the facility,” on things like cameras, panic buttons, duress alarms and secured doors. Staff can reach security by phone and a voice-operated device.\u003c/p>\n\u003cp>“Inpatient psychiatric units, in particular, are among the more challenging work environments to fully secure while providing therapeutic and compassionate care to the patients being served by them,” Sutter’s statement said.\u003c/p>\n\u003cp>But Golomb and other hospital staff said security officers at the new facility are often stationed on the lower floors of the hospital, on the other side of the building, which means they would have to run across the building and then ride an elevator up to the third-floor psych unit before badging through two sets of doors.\u003c/p>\n\u003cfigure id=\"attachment_1991429\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991429\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg\" alt=\"A man wearing glasses and a jacket over scrubs sits outside on a bench.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Kalis, a residency doctor at CPMC Sutter Davies Campus, poses for a portrait at the hospital in San Francisco on Feb. 13, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The security issue is particularly salient for us residents because we’re actively asking for [Sutter] to help us, and we’ve not been receiving that help,” said Eric Kalis, a second-year psychiatry resident with California Pacific Medical Center.\u003c/p>\n\u003cp>Sutter’s statement said the hospital had planned to staff the inpatient psych unit with a “dedicated in-unit security officer” from 11 a.m. to 7 p.m. when it moved into the Davies facility in 2022. However, that “proved challenging” and didn’t initially happen.\u003c/p>\n\u003cp>“Since late last year, this position has been consistently staffed,” the statement said.\u003c/p>\n\u003cp>The hospital said it recently extended the hours, beginning at 9 a.m.\u003c/p>\n\u003ch2>Fallout from the assault\u003c/h2>\n\u003cp>For days following her assault, Golomb “felt very surreal and odd and strange.” She had trouble with her vision, hearing, balance and sense of spatial relations. She had trouble multitasking and making decisions, and her mood was volatile.\u003c/p>\n\u003cp>A series of brain scans revealed that an abnormal cluster of blood vessels in her brain had bled either during or after the attack.\u003c/p>\n\u003cp>“And while all that was going on, I was desperately trying to find out what to do,” Golomb said. “What does a resident do when they are assaulted? And I couldn’t get any answers.”\u003c/p>\n\u003cp>After a week, Golomb returned to work and “white-knuckled it” for a while, powering through what she described as “excruciating headaches.” She felt embarrassed, having been “torn apart in front of my colleagues,” and worried about the attack’s impact on her patients.\u003c/p>\n\u003cp>“They see their doctor get pummeled, dragged and beat up,” she said. “What must that feel like as a patient?”\u003c/p>\n\u003ch2>California passes controversial plans to expand involuntary holds\u003c/h2>\n\u003cp>State lawmakers have passed a flurry of laws in recent years targeted at workplace violence in health care, including requiring \u003ca href=\"https://www.nationalnursesunited.org/press/california-senate-approves-rn-sponsored-bill-reduce-workplace-violence-hospitals\">hospitals to have a violence prevention plan\u003c/a> and \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_1251-1300/sb_1299_cfa_20140609_152624_asm_comm.html\">report violent incidents to the state\u003c/a>. This year, an association of hospitals — including Sutter and Scripps — are pushing \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB977\">AB 977\u003c/a>, which would increase penalties on people who are violent toward patients or hospital staff.\u003c/p>\n\u003cp>Lawmakers have also thrown billions of dollars at trying to address the mental health issues at the root cause of some of that violence.\u003c/p>\n\u003cfigure id=\"attachment_1991430\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991430\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg\" alt='A purple button that says \"Doctors Uniting for Patient Care.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Kalis, a residency doctor at CPMC Sutter Davies Campus, wears a pin that says, ‘Doctors Uniting for Patient Care’ at the hospital in San Francisco on Feb. 13, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This includes a new California civil CARE Court, which launched last fall in \u003ca href=\"https://www.kqed.org/news/11955211/californias-new-care-courts-prompt-orange-county-to-weigh-best-practices\">eight counties, including San Francisco\u003c/a>. It allows family members and first responders to ask judges to order people with psychotic illness into treatment.\u003c/p>\n\u003cp>Last year, California passed \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">SB 43\u003c/a>, a controversial update to its conservatorship law, which for decades has allowed involuntary holds and treatment for people who are a danger to themselves or others or if they are unable to seek food, clothing or shelter as a result of mental illness. With Gov. Gavin Newsom’s approval, it now covers people who cannot care for themselves because of a substance use disorder.\u003c/p>\n\u003cp>“We know, and as we see every single day, we have gaping holes in our safety net and it allows people to fall onto our sidewalks with a horrible splat,” said state Sen. Susan Talamantes Eggman, who authored the update.\u003c/p>\n\u003cp>\u003ca href=\"https://www.disabilityrightsca.org/\">Disability rights groups\u003c/a> pushed back, saying it deprived people of their liberty, privacy and civil rights.\u003c/p>\n\u003cp>Meanwhile, hospital officials said the efforts could create more problems for the facilities and health care workers who treat these individuals.\u003c/p>\n\u003cp>“Where are you going to take those patients? We’re not equipped to be a jail,” Van Gorder said. “They’re all going to go to the hospital, and I think we’ve got this looming crisis on our hands.”\u003c/p>\n\u003cp>Van Gorder pushed the San Diego County Board of Supervisors to delay the implementation of SB 43, which it did for a year. He also helped create a \u003ca href=\"https://www.scripps.org/news_items/7725-hospital-violence-task-force-makes-progress-on-protecting-health-care-workers\">hospital violence task force\u003c/a>, in partnership with San Diego County’s District Attorney, which allows police to make rounds through hospitals and improves training and tracking of violent cases.\u003c/p>\n\u003cp>San Francisco County, the first county in California to implement SB 43, began to submit people for conservatorship at the beginning of the year.\u003c/p>\n\u003ch2>‘I was not myself and spiraling’\u003c/h2>\n\u003cp>To hear Golomb tell it, the attack strained her relationship with her supervisors. She felt blamed for not de-escalating the situation before the attack and described her conversations with hospital officials about it as “volatile.”\u003c/p>\n\u003cfigure id=\"attachment_1991426\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991426\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg\" alt=\"A woman wearing a red shirt plays with an animal in a home.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, repairs a quilt she made at her home, with her bunny Hanky nearby, in San Francisco on Feb. 9, 2024. Golomb makes art as a coping mechanism after experiencing workplace violence incidents where patients have attacked staff. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Golomb took a few more weeks off and then returned to work part time, leaving more work for her resident colleagues. “I felt very stressed, guilty, overwhelmed by that,” she said. “I was not myself and spiraling.”\u003c/p>\n\u003cp>Exhausted and suffering from head, neck and back pain, Golomb talked with her doctor and decided to take a second leave, this time for a full year. While she was out, Golomb said the hospital told her it couldn’t guarantee her position when she returned. She thought: “‘Oh my God, is my career jeopardized because of this?’”\u003c/p>\n\u003cp>Golomb tried all kinds of therapy: physical, occupational, speech, vestibular and neuromuscular. She unsuccessfully attempted to match with another residency program. Returning to work at Sutter “became my only option.”\u003c/p>\n\u003cp>“You have to fight tooth and nail to get here,” said Golomb, who is on course to graduate from her residency in June 2025 and plans to pursue a private psychiatry practice. “And that’s what I did, and that’s what I chose to do.”\u003c/p>\n\u003cp>When she returned to work at Sutter, two things helped her turn things around: art and labor organizing. She joined a support group for artists with head injuries and stitched quilts and hand-built ceramics.\u003c/p>\n\u003cp>“I’ve always been an artist way before I was interested in medicine,” she said. “It was just very tethering, making a blanket that’s going to keep you warm or a bowl that can hold your soup.”\u003c/p>\n\u003cp>Back at work, Golomb felt like she had something to prove and had to shake a reputation that she had dramatized the assault to get out of work. She dove into the effort to unionize residents at California Pacific Medical Center.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“It was a way to demonstrate my care for others,” she said. “Having shared goals and putting the work in was really what allowed me to survive. Because going back was absolutely terrifying.”\u003c/p>\n\n","blocks":[],"excerpt":"Residents of the California Pacific Medical Center are pushing the Sutter Health network for increased security in an inpatient psych unit after a horrific assault.","status":"publish","parent":0,"modified":1710790309,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":54,"wordCount":2441},"headData":{"title":"Bay Area Psychiatry Resident Pushes for Hospital Safety After Violent Attack | KQED","description":"Residents of the California Pacific Medical Center are pushing the Sutter Health network for increased security in an inpatient psych unit after a horrific assault.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]f-aaef00f5a073/64caf7a4-0ff3-44e0-b72f-b1370105a410/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1991739/bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Dani Golomb started her shift on Sept. 5, 2020, she had no idea that she’d be beaten, dragged and knocked unconscious.\u003c/p>\n\u003cp>Like usual, the psychiatry resident reported to an inpatient unit at California Pacific Medical Center at 8 a.m. The hospital was extending one patient’s legal hold, and it fell on Golomb to deliver the news.\u003c/p>\n\u003cp>“Most of the patients we’re seeing are San Francisco’s sickest,” Golomb said, referring to what health care workers call “5150s,” a California legal code that allows people experiencing a mental health crisis to be involuntarily committed for 72 hours if they are a danger to others or themselves.\u003c/p>\n\u003cp>The patient had been violent before and had a temper.\u003c/p>\n\u003cp>“‘I know this isn’t what you wanted to hear, and I know you want to go home. I want to inform you that we are keeping you longer,’” Golomb, who was 33 at the time, recalled saying to the patient. “‘You will have the opportunity to meet with a judge on Monday.’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The patient called her a thief and a liar, Golomb told KQED in a recent interview.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Violence in emergency rooms is not exactly new. But it is worse than it’s ever been, by far.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Chris Van Gorder, CEO, Scripps Health","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Golomb said she placed paperwork and the phone number for a patient advocacy line on the foot of the bed before slowly walking out of the room, closing the door behind her. She was seeing other patients when she heard someone yell “thief” and “liar.”\u003c/p>\n\u003cp>Suddenly, from behind, came a forceful shove and Golomb was on the ground being “punched in the head, neck and shoulders,” she said. The patient grabbed her metal clipboard, “smashing it repeatedly on my head, dragging me by my hair.”\u003c/p>\n\u003cp>Golomb suffered a concussion and a traumatic brain injury, but she wouldn’t find out about that until later.\u003c/p>\n\u003cp>“I came to, and there was one of our wonderful nurses kneeling before me,” she said. “I don’t know if he broke up what was happening or if another patient pulled [them off]. But I immediately ran off to go upstairs to collect myself and just cry.”\u003c/p>\n\u003cp>Health care workers suffer the highest rates of injury caused by violence on the job. They are five times as likely than workers overall to experience a violent injury, according to \u003ca href=\"https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm\">federal statistics\u003c/a>. California hospitals tallied roughly \u003ca href=\"https://www.dir.ca.gov/dosh/WPVIH_Annual_Reports.html\">10,000 incidents annually in recent years\u003c/a>.\u003c/p>\n\u003cp>In February, San Mateo County prosecutors charged an unhoused man with attempted murder after he \u003ca href=\"https://www.beckershospitalreview.com/legal-regulatory-issues/sutter-hospital-employee-stabbed-man-charged.html\">allegedly stabbed a health worker nine times with a pocket knife\u003c/a> at Sutter Health’s Mills-Peninsula Medical Center in Burlingame.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11955211,news_11944448","label":"Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Nurses in the Santa Clara County health system have authorized a strike over what they describe as violent work conditions. James Mount, who works in the intensive care unit at the St. Louise Regional Hospital in Gilroy, said the vast majority of his colleagues don’t feel safe.\u003c/p>\n\u003cp>“They have witnessed the escalation of violence within hospitals since COVID,” he said. “It’s disheartening. Our challenge is to try and feel secure in our job and take care of our patients. That’s why we are there. What we are asking for is for someone to protect those frontline workers who are treating the patients.”\u003c/p>\n\u003cfigure id=\"attachment_1991425\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991425\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg\" alt='The outside of a building and sign that reads \"Sutter Health.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240208-HOSPITALVIOLENCE-05-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Sutter Health CPMC Davies Campus in San Francisco on Feb. 8, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Staff inside the Sutter Health inpatient psych unit in San Francisco where Golomb was attacked said they are regularly threatened and assaulted, including being pushed, punched and pulled to the ground, according to interviews with Golomb and more than a half dozen of her resident colleagues and nurses and a KQED review of internal documents.\u003c/p>\n\u003cp>In a survey conducted by the psych residents, three-quarters of those who responded and work on that unit said they are in “an unsafe situation on a daily or weekly basis.” They all report they have experienced violence or harassment from a patient.\u003c/p>\n\u003cp>“Violence in emergency rooms is not exactly new. But it is worse than it’s ever been, by far,” said Chris Van Gorder, the CEO of Scripps Health in San Diego. He attributes the uptick in violence to a surge in homelessness, a drug crisis and a lack of available care for behavioral health patients.\u003c/p>\n\u003cp>“The hospital is the end of the food chain,” he said. “Nobody else knows what to do with you. They bring you to the hospital emergency room and assume that we’re going to somehow be able to take care of you.”\u003c/p>\n\u003cp>Golomb and her colleagues said the hospital is not doing enough to ensure their safety, as 91% of the residents responded to the survey saying the security presence was “not at all adequate.”\u003c/p>\n\u003cfigure id=\"attachment_1991428\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991428\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg\" alt=\"A person's hand holds up a cellphone with an image of people holding signs.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-28-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, holds a photo of herself and fellow psych unit staff holding signs asking for more safety measures at their hospital at her home in San Francisco on Feb. 9, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s one of the reasons that Golomb and about 15 of her resident colleagues \u003ca href=\"https://sfstandard.com/2023/01/17/san-francisco-hospital-cpmc-residents-unionize/\">announced in January their plans to unionize\u003c/a> and join the Committee of Interns and Residents, which represents 30,000 resident and fellow physicians and is a local of the powerful Service Employees International Union.\u003c/p>\n\u003cp>As part of their bargaining with Sutter Health, residents demand round-the-clock security presence in the inpatient psych unit. At the time of Golomb’s attack, the unit was located in the Pacific Heights neighborhood across the street from the larger medical campus. Staff would call security, and they “would come running from a full city block away,” Golomb said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘They see their doctor get pummeled, dragged and beat up. What must that feel like as a patient?’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dani Golomb, psychiatry resident, California Pacific Medical Center","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>In 2022, Sutter moved the inpatient psych unit to its California Pacific Medical Center Davies campus near the Duboce Triangle in San Francisco and, in a statement to KQED, Sutter said it had spent nearly $40 million to “enhance safety at the facility,” on things like cameras, panic buttons, duress alarms and secured doors. Staff can reach security by phone and a voice-operated device.\u003c/p>\n\u003cp>“Inpatient psychiatric units, in particular, are among the more challenging work environments to fully secure while providing therapeutic and compassionate care to the patients being served by them,” Sutter’s statement said.\u003c/p>\n\u003cp>But Golomb and other hospital staff said security officers at the new facility are often stationed on the lower floors of the hospital, on the other side of the building, which means they would have to run across the building and then ride an elevator up to the third-floor psych unit before badging through two sets of doors.\u003c/p>\n\u003cfigure id=\"attachment_1991429\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991429\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg\" alt=\"A man wearing glasses and a jacket over scrubs sits outside on a bench.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-05-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Kalis, a residency doctor at CPMC Sutter Davies Campus, poses for a portrait at the hospital in San Francisco on Feb. 13, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The security issue is particularly salient for us residents because we’re actively asking for [Sutter] to help us, and we’ve not been receiving that help,” said Eric Kalis, a second-year psychiatry resident with California Pacific Medical Center.\u003c/p>\n\u003cp>Sutter’s statement said the hospital had planned to staff the inpatient psych unit with a “dedicated in-unit security officer” from 11 a.m. to 7 p.m. when it moved into the Davies facility in 2022. However, that “proved challenging” and didn’t initially happen.\u003c/p>\n\u003cp>“Since late last year, this position has been consistently staffed,” the statement said.\u003c/p>\n\u003cp>The hospital said it recently extended the hours, beginning at 9 a.m.\u003c/p>\n\u003ch2>Fallout from the assault\u003c/h2>\n\u003cp>For days following her assault, Golomb “felt very surreal and odd and strange.” She had trouble with her vision, hearing, balance and sense of spatial relations. She had trouble multitasking and making decisions, and her mood was volatile.\u003c/p>\n\u003cp>A series of brain scans revealed that an abnormal cluster of blood vessels in her brain had bled either during or after the attack.\u003c/p>\n\u003cp>“And while all that was going on, I was desperately trying to find out what to do,” Golomb said. “What does a resident do when they are assaulted? And I couldn’t get any answers.”\u003c/p>\n\u003cp>After a week, Golomb returned to work and “white-knuckled it” for a while, powering through what she described as “excruciating headaches.” She felt embarrassed, having been “torn apart in front of my colleagues,” and worried about the attack’s impact on her patients.\u003c/p>\n\u003cp>“They see their doctor get pummeled, dragged and beat up,” she said. “What must that feel like as a patient?”\u003c/p>\n\u003ch2>California passes controversial plans to expand involuntary holds\u003c/h2>\n\u003cp>State lawmakers have passed a flurry of laws in recent years targeted at workplace violence in health care, including requiring \u003ca href=\"https://www.nationalnursesunited.org/press/california-senate-approves-rn-sponsored-bill-reduce-workplace-violence-hospitals\">hospitals to have a violence prevention plan\u003c/a> and \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_1251-1300/sb_1299_cfa_20140609_152624_asm_comm.html\">report violent incidents to the state\u003c/a>. This year, an association of hospitals — including Sutter and Scripps — are pushing \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB977\">AB 977\u003c/a>, which would increase penalties on people who are violent toward patients or hospital staff.\u003c/p>\n\u003cp>Lawmakers have also thrown billions of dollars at trying to address the mental health issues at the root cause of some of that violence.\u003c/p>\n\u003cfigure id=\"attachment_1991430\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991430\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg\" alt='A purple button that says \"Doctors Uniting for Patient Care.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240213-HOSPITALVIOLENCE-06-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Eric Kalis, a residency doctor at CPMC Sutter Davies Campus, wears a pin that says, ‘Doctors Uniting for Patient Care’ at the hospital in San Francisco on Feb. 13, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This includes a new California civil CARE Court, which launched last fall in \u003ca href=\"https://www.kqed.org/news/11955211/californias-new-care-courts-prompt-orange-county-to-weigh-best-practices\">eight counties, including San Francisco\u003c/a>. It allows family members and first responders to ask judges to order people with psychotic illness into treatment.\u003c/p>\n\u003cp>Last year, California passed \u003ca href=\"https://www.kqed.org/news/11944448/a-war-of-compassion-debate-over-forced-treatment-of-mental-illness-splits-california-liberals\">SB 43\u003c/a>, a controversial update to its conservatorship law, which for decades has allowed involuntary holds and treatment for people who are a danger to themselves or others or if they are unable to seek food, clothing or shelter as a result of mental illness. With Gov. Gavin Newsom’s approval, it now covers people who cannot care for themselves because of a substance use disorder.\u003c/p>\n\u003cp>“We know, and as we see every single day, we have gaping holes in our safety net and it allows people to fall onto our sidewalks with a horrible splat,” said state Sen. Susan Talamantes Eggman, who authored the update.\u003c/p>\n\u003cp>\u003ca href=\"https://www.disabilityrightsca.org/\">Disability rights groups\u003c/a> pushed back, saying it deprived people of their liberty, privacy and civil rights.\u003c/p>\n\u003cp>Meanwhile, hospital officials said the efforts could create more problems for the facilities and health care workers who treat these individuals.\u003c/p>\n\u003cp>“Where are you going to take those patients? We’re not equipped to be a jail,” Van Gorder said. “They’re all going to go to the hospital, and I think we’ve got this looming crisis on our hands.”\u003c/p>\n\u003cp>Van Gorder pushed the San Diego County Board of Supervisors to delay the implementation of SB 43, which it did for a year. He also helped create a \u003ca href=\"https://www.scripps.org/news_items/7725-hospital-violence-task-force-makes-progress-on-protecting-health-care-workers\">hospital violence task force\u003c/a>, in partnership with San Diego County’s District Attorney, which allows police to make rounds through hospitals and improves training and tracking of violent cases.\u003c/p>\n\u003cp>San Francisco County, the first county in California to implement SB 43, began to submit people for conservatorship at the beginning of the year.\u003c/p>\n\u003ch2>‘I was not myself and spiraling’\u003c/h2>\n\u003cp>To hear Golomb tell it, the attack strained her relationship with her supervisors. She felt blamed for not de-escalating the situation before the attack and described her conversations with hospital officials about it as “volatile.”\u003c/p>\n\u003cfigure id=\"attachment_1991426\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991426\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg\" alt=\"A woman wearing a red shirt plays with an animal in a home.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/02/240209-HOSPITALVIOLENCE-15-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dani Golomb, psychiatry resident at CPMC Sutter Davies Campus, repairs a quilt she made at her home, with her bunny Hanky nearby, in San Francisco on Feb. 9, 2024. Golomb makes art as a coping mechanism after experiencing workplace violence incidents where patients have attacked staff. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Golomb took a few more weeks off and then returned to work part time, leaving more work for her resident colleagues. “I felt very stressed, guilty, overwhelmed by that,” she said. “I was not myself and spiraling.”\u003c/p>\n\u003cp>Exhausted and suffering from head, neck and back pain, Golomb talked with her doctor and decided to take a second leave, this time for a full year. While she was out, Golomb said the hospital told her it couldn’t guarantee her position when she returned. She thought: “‘Oh my God, is my career jeopardized because of this?’”\u003c/p>\n\u003cp>Golomb tried all kinds of therapy: physical, occupational, speech, vestibular and neuromuscular. She unsuccessfully attempted to match with another residency program. Returning to work at Sutter “became my only option.”\u003c/p>\n\u003cp>“You have to fight tooth and nail to get here,” said Golomb, who is on course to graduate from her residency in June 2025 and plans to pursue a private psychiatry practice. “And that’s what I did, and that’s what I chose to do.”\u003c/p>\n\u003cp>When she returned to work at Sutter, two things helped her turn things around: art and labor organizing. She joined a support group for artists with head injuries and stitched quilts and hand-built ceramics.\u003c/p>\n\u003cp>“I’ve always been an artist way before I was interested in medicine,” she said. “It was just very tethering, making a blanket that’s going to keep you warm or a bowl that can hold your soup.”\u003c/p>\n\u003cp>Back at work, Golomb felt like she had something to prove and had to shake a reputation that she had dramatized the assault to get out of work. She dove into the effort to unionize residents at California Pacific Medical Center.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It was a way to demonstrate my care for others,” she said. “Having shared goals and putting the work in was really what allowed me to survive. Because going back was absolutely terrifying.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1991739/bay-area-medical-psychiatry-pushes-for-hospital-safety-after-violent-attack","authors":["11608"],"categories":["science_39","science_40","science_4450"],"tags":["science_4417","science_4414","science_1648","science_249","science_5254"],"featImg":"science_1991427","label":"science"},"science_1991160":{"type":"posts","id":"science_1991160","meta":{"index":"posts_1591205157","site":"science","id":"1991160","score":null,"sort":[1705615482000]},"guestAuthors":[],"slug":"how-kern-countys-carbon-removal-industry-can-save-californias-oil-country","title":"How Kern County's Carbon Removal Industry Can Save California's Oil Country","publishDate":1705615482,"format":"standard","headTitle":"How Kern County’s Carbon Removal Industry Can Save California’s Oil Country | KQED","labelTerm":{},"content":"\u003cp>Omar Hayat sees the future in a patch of dirt near Bakersfield, California, where oil was discovered more than a century ago. That discovery paved the way for Kern County’s lucrative petroleum industry. Now, Hayat hopes to use the same dirt patch to launch a new business — one that may help California reach its ambitious climate goals.\u003c/p>\n\u003cp>“We want to be accepted as a solution,” said Hayat, the executive vice president of operations at California Resources Corporation, one of the state’s leading oil producers.\u003c/p>\n\u003cp>Hayat is leading the company’s push to store climate-warming carbon more than a mile underground in the cracks and crevices of ancient rock formations. The firm is one of several companies developing plans to capture carbon from oil and gas plants and the air and store it deep beneath California’s oil country at the foot of the San Joaquin Valley.\u003c/p>\n\u003cp>Kern County is betting those projects will make it the center of California’s nascent carbon removal and storage industry. The county is already the state’s largest oil producer and a top producer of agricultural products, but climate change — and the state’s effort to mitigate it — threatens those economic mainstays. The county hopes the new carbon management industry will help make up for the hundreds of millions in tax revenue it anticipates losing by 2045 when California plans to phase out all oil drilling and eliminate most carbon emissions.\u003c/p>\n\u003cp>“Our economy is built on oil and agriculture. This is how we keep our libraries open. This is how we provide Meals on Wheels. This is how we provide our services to the million people here,” said Lorelei Oviatt, the county’s director of planning and natural resources.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In late December, Kern and the federal government took steps that could allow CRC to begin capturing and storing carbon next year. The county published its draft environmental review of the company’s project, and the U.S. \u003ca href=\"https://www.epa.gov/publicnotices/intent-issue-class-vi-underground-injection-control-permits-carbon-terravault-jv\">Environmental Protection Agency said it plans to approve\u003c/a> permits to allow CRC to inject carbon under an oil field.\u003c/p>\n\u003cp>Kern has found opportunity in renewable energy, becoming the state’s biggest producer of solar and wind energy. But the county’s push for carbon management amounts to a huge experiment — with its economy and community, as well as California’s climate commitments, hanging in the balance.\u003c/p>\n\u003cp>In the \u003ca href=\"https://psbweb.kerncounty.com/planning/pdfs/eirs/ctv1/CTV1_DEIR_Vol_1_Ch_1-12_upd.pdf\">900-page environmental assessment (PDF)\u003c/a>, Kern officials determined that CRC’s project is likely to have “significant and unavoidable” impacts on local air quality, even with measures taken to curb emissions. The report also notes the proximity of proposed pipelines to schools and neighborhoods. Those are among several issues likely to be contested when the public begins weighing in on the project this week.\u003c/p>\n\u003cp>Still, the county sees carbon management as critical to its future.\u003c/p>\n\u003cp>“It’s existential,” Oviatt said. “What is this place going to look like in 30 years? What’s it going to look like in five?”\u003c/p>\n\u003ch2>‘Enormous Numbers’\u003c/h2>\n\u003cp>In addition to moving quickly towards clean sources of energy, countries \u003ca href=\"https://www.ipcc.ch/report/ar6/syr/downloads/report/IPCC_AR6_SYR_LongerReport.pdf\">will need to remove carbon from the air (PDF)\u003c/a> in order to avoid the worst effects of climate change, according to the IPCC, the United Nations panel that assesses the science of climate change.\u003c/p>\n\u003cp>Today, \u003ca href=\"https://res.cloudinary.com/dbtfcnfij/images/v1700717007/Global-Status-of-CCS-Report-Update-23-Nov/Global-Status-of-CCS-Report-Update-23-Nov.pdf?_i=AA\">41 commercial carbon capture facilities (PDF)\u003c/a> are \u003ca href=\"https://www.iea.org/energy-system/carbon-capture-utilisation-and-storage/direct-air-capture\">operating worldwide\u003c/a>. Together, they have the capacity to capture much less than 1% of the emissions that countries produce every year — negating annual emissions equivalent to 49 million metric tons of carbon per year.\u003c/p>\n\u003cp>California, which has positioned itself as a global leader in climate action, wants to pull an unprecedented amount of carbon from the air — 100 million metric tons — by 2045. That represents nearly a quarter of the emissions the state produces today.\u003c/p>\n\u003cp>“Those are enormous numbers, relative to where not just California is today, but where the world is today,” said Michael Wara, director of the climate and energy policy program at Stanford University.\u003c/p>\n\u003cp>Still, the Biden administration is pouring billions into the carbon capture and storage industry, and Kern is racing to get a piece of it. Much of that money goes to regions led by Republican lawmakers who support boosting domestic energy production. Until he resigned from Congress last month, Bakersfield Republican and former House Speaker Kevin McCarthy represented much of Kern County.\u003c/p>\n\u003cp>Last year, the U.S. Department of Energy announced it would offer $3.5 billion for companies to demonstrate direct air capture, a process that sucks carbon from the air so that it can be stowed underground. The department recently said it would give $1.2 billion in grants for “Direct Air Capture hubs” in Louisiana and Texas.\u003c/p>\n\u003cp>Carbon removal projects proposed in California, all located in the conservative-leaning Central Valley, earned more than $20 million from the pool of federal funding for feasibility and planning studies, including roughly $12 million to a group led in part by CRC, Hayat’s company, and the city of Bakersfield. The amount is small compared to the billions to be disbursed elsewhere but significant enough to continue fueling ambitions in Kern.\u003c/p>\n\u003cfigure id=\"attachment_1991162\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991162\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1.jpg\" alt=\"\" width=\"1536\" height=\"1024\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-768x512.jpg 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">Omar Hayat, executive vice president of operations at California Resources Corporation. \u003ccite>(Harika Maddala)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Several other major oil and gas companies are also racing to launch their own carbon capture facilities in Kern, including Chevron and \u003ca href=\"https://www.aeraenergy.com/responsibility/carbon-frontier/\">Aera Energy\u003c/a>. Though certain details of CRC’s carbon removal proposal have not been made public, its ambitions center on a project called “Carbon TerraVault 1.” The project would be located in the Elk Hills Oil Field, one of the most productive in the nation, near the site where oil was discovered in 1911. The company wants to inject millions of tons of liquefied carbon a mile underground, beginning with carbon dioxide from the oilfield.\u003c/p>\n\u003ch2>‘Looking for Hope’\u003c/h2>\n\u003cp>If all of the projects proposed for the county come online, planning director Oviatt said Kern could be home to most of the storage required to achieve the state’s carbon removal goals. Oviatt frames the growth of this industry as inevitable. Even if the projects currently proposed don’t win regulatory approval, she’s confident that more proposals will follow them, she said at a recent public forum.\u003c/p>\n\u003cp>The county estimates that the carbon removal industry could generate as much as $64 million per year in tax revenues and create thousands of jobs. Kern envisions much of that money coming from a proposed \u003ca href=\"https://cmbp.kernplanning.com/\">Carbon Management Business Park\u003c/a>, which it sees as a way to bring in emerging climate-friendly industries — including future direct air capture projects.\u003c/p>\n\u003cp>If the oil industry leaves Kern, more than 16,000 jobs could disappear, and the area’s already-high poverty and unemployment rates could climb. A county-commissioned study estimates the business park could support up to 22,000 permanent jobs, both in carbon removal and adjacent industries.\u003c/p>\n\u003cp>“That’s encouraging,” Oviatt said. “We are looking for hope.”\u003c/p>\n\u003cp>But realizing that vision is dependent on buy-in from the private sector. Oviatt said a handful of companies have expressed interest in the idea, but so far, none have submitted formal applications.\u003c/p>\n\u003cp>And community support for the county’s vision is hardly unanimous. At an October county Board of Supervisors meeting, residents and environmental activists expressed concerns about the need for pipelines to carry carbon across the state, which could rupture or leak.\u003c/p>\n\u003cp>They also questioned whether the proposed TerraVault and business park would worsen air quality. The American Lung Association consistently ranks Kern County’s air as among the most polluted in the country.\u003c/p>\n\u003cp>“It does not make sense to proceed with this park given the current health and air quality conditions in Kern County,” said Emma De La Rosa, an advocate with the Leadership Counsel for Justice and Accountability.\u003c/p>\n\u003cp>Other community organizers like Ileana Navarro with the Central California Environmental Justice Network called for greater transparency and questioned the technology’s track record.\u003c/p>\n\u003cp>“Projects worldwide have failed to live up to their promise on climate benefits, so why take the risk here in our backyards and in the backyards of already overburdened communities?” the Bakersfield resident asked.\u003c/p>\n\u003cfigure id=\"attachment_1991163\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991163\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1.jpg\" alt=\"\" width=\"1536\" height=\"1024\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-768x512.jpg 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">Pumping jacks spread throughout an oilfield in Kern County, California.\u003c/figcaption>\u003c/figure>\n\u003cp>The county’s environmental review shows that pipelines carrying carbon dioxide and injection sites are slated to sit within a few miles of a handful of elementary schools and a couple of towns.\u003c/p>\n\u003cp>Oviatt said that any future project would be located far away from neighborhoods to reduce the health risks to residents. But she was frank about the county’s prospects if a thriving carbon removal industry fails to take off in the region.\u003c/p>\n\u003cp>“I think we’re all concerned about our health, but we’re also concerned: Will Kern County survive these policies of the state of California?” Oviatt told the meeting. “I wanted to make sure the community understands that we are at a very, very difficult crossroads.”\u003c/p>\n\u003ch2>Kern County’s ‘Gift From God’\u003c/h2>\n\u003cp>Carbon can’t be injected and permanently stowed underground just anywhere, but the storage potential in the Central Valley is “a gift from God,” George Peridas, the energy program director at Lawrence Livermore National Laboratory, said at an April symposium on carbon management. The San Joaquin Valley is one of about three dozen areas nationwide with the potential to store the climate pollutant, according to assessments by the U.S. Geological Survey. That’s because, in theory, depleted oil and gas fields can make ideal reservoirs for captured carbon.\u003c/p>\n\u003cp>For decades, petroleum companies operating in the region have made billions pumping fossil fuels out of the ground. Now, these same corporations hope to also make money by pumping liquefied carbon back underground.\u003c/p>\n\u003cp>“It’s just like reconfiguring a Lego set,” Hayat, the oil executive, said. “Instead of using that CO2, for example, for increasing oil and gas production, we’re just putting it away for storage.”\u003c/p>\n\u003cp>But critics say it’s not so simple.\u003c/p>\n\u003cp>Storing carbon permanently and safely remains a complex technological challenge full of potential pitfalls. Extracting oil is different than ensuring carbon stays buried for thousands of years without leaking, according to Daniel Ress, a staff attorney at the Center on Race, Poverty and the Environment. California already has \u003ca href=\"https://www.kvpr.org/local-news/2023-07-21/state-releases-draft-plan-to-plug-leaky-oil-wells-many-of-them-in-kern-county\">thousands of uncapped oil wells\u003c/a>, many of which are leaking greenhouse gasses and other pollutants into the air. Ress is concerned that carbon stored underground could escape.\u003c/p>\n\u003cp>“I’m skeptical that this can be done well in this area where there’s so much oil and gas exploration,” Ress said.\u003c/p>\n\u003cp>Until now, oil companies have almost exclusively injected carbon to extract more oil from the earth. The CEO of Occidental Petroleum — CRC’s former parent company — \u003ca href=\"https://www.politico.com/newsletters/power-switch/2023/12/18/carbon-removal-climate-savior-or-distraction-00132266\">said last year\u003c/a> that carbon removal could give the petroleum industry “a license to continue to operate for the next 60, 70, 80 years.” California law prohibits companies from using captured carbon to enhance drilling in the state. Still, some environmentalists like Ress worry that injecting carbon could be used to extend the life of fossil fuels.\u003c/p>\n\u003cp>Several major obstacles remain on the path to building and operating carbon capture and storage plants. California has just \u003ca href=\"https://www.reuters.com/sustainability/climate-energy/climate-tech-company-heirloom-opens-us-commercial-carbon-capture-plant-2023-11-09/\">one commercial carbon removal project\u003c/a> in operation. The state has also banned new carbon pipelines until federal regulations are put in place, which could challenge CRC’s ambitious plans. Without pipelines to move the carbon from industrial centers to the vault, the company’s potential customer base is limited.\u003c/p>\n\u003cp>But last month, the county and the EPA’s actions boosted CRC’s hope for its TerraVault project. Company president and CEO Francisco Leon called the moves a “significant milestone” in attaining California’s “ambitious climate goals.”\u003c/p>\n\u003cp>Kern is the first county in the state to assess the environmental risks of a carbon storage project, working on the draft for about a year. Still, CRC’s project is facing a potentially lengthy approval process. The planning commission is expected to vote on the project in March, with a vote from county supervisors likely this summer.\u003c/p>\n\u003cp>\u003cem>This story is a collaboration between \u003ca href=\"https://www.kvpr.org/\">KVPR\u003c/a>, Inside Climate News, the Investigative Editing Corps and Report for America.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://insideclimatenews.org/\">Inside Climate News\u003c/a> is a nonprofit, independent news organization that covers climate, energy and the environment. Sign up for the ICN newsletter \u003ca href=\"https://insideclimatenews.org/newsletter/\">here\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The county is already the state’s largest oil producer and a top producer of agricultural products, but climate change — and the state’s effort to mitigate it — threatens those economic mainstays.","status":"publish","parent":0,"modified":1705621077,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":45,"wordCount":2136},"headData":{"title":"How Kern County's Carbon Removal Industry Can Save California's Oil Country | KQED","description":"The county is already the state’s largest oil producer and a top producer of agricultural products, but climate change — and the state’s effort to mitigate it — threatens those economic mainstays.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"source":"Inside Climate News","sticky":false,"nprByline":"\u003ca href=\"https://insideclimatenews.org/profile/emma-foehringer-merchant/\"> Emma Foehringer Merchant, Inside Climate News\u003c/a>\u003cbr>\u003ca href=\"https://www.kvpr.org/people/joshua-yeager/\">Joshua Yeager, KVPR\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/science/1991160/how-kern-countys-carbon-removal-industry-can-save-californias-oil-country","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Omar Hayat sees the future in a patch of dirt near Bakersfield, California, where oil was discovered more than a century ago. That discovery paved the way for Kern County’s lucrative petroleum industry. Now, Hayat hopes to use the same dirt patch to launch a new business — one that may help California reach its ambitious climate goals.\u003c/p>\n\u003cp>“We want to be accepted as a solution,” said Hayat, the executive vice president of operations at California Resources Corporation, one of the state’s leading oil producers.\u003c/p>\n\u003cp>Hayat is leading the company’s push to store climate-warming carbon more than a mile underground in the cracks and crevices of ancient rock formations. The firm is one of several companies developing plans to capture carbon from oil and gas plants and the air and store it deep beneath California’s oil country at the foot of the San Joaquin Valley.\u003c/p>\n\u003cp>Kern County is betting those projects will make it the center of California’s nascent carbon removal and storage industry. The county is already the state’s largest oil producer and a top producer of agricultural products, but climate change — and the state’s effort to mitigate it — threatens those economic mainstays. The county hopes the new carbon management industry will help make up for the hundreds of millions in tax revenue it anticipates losing by 2045 when California plans to phase out all oil drilling and eliminate most carbon emissions.\u003c/p>\n\u003cp>“Our economy is built on oil and agriculture. This is how we keep our libraries open. This is how we provide Meals on Wheels. This is how we provide our services to the million people here,” said Lorelei Oviatt, the county’s director of planning and natural resources.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In late December, Kern and the federal government took steps that could allow CRC to begin capturing and storing carbon next year. The county published its draft environmental review of the company’s project, and the U.S. \u003ca href=\"https://www.epa.gov/publicnotices/intent-issue-class-vi-underground-injection-control-permits-carbon-terravault-jv\">Environmental Protection Agency said it plans to approve\u003c/a> permits to allow CRC to inject carbon under an oil field.\u003c/p>\n\u003cp>Kern has found opportunity in renewable energy, becoming the state’s biggest producer of solar and wind energy. But the county’s push for carbon management amounts to a huge experiment — with its economy and community, as well as California’s climate commitments, hanging in the balance.\u003c/p>\n\u003cp>In the \u003ca href=\"https://psbweb.kerncounty.com/planning/pdfs/eirs/ctv1/CTV1_DEIR_Vol_1_Ch_1-12_upd.pdf\">900-page environmental assessment (PDF)\u003c/a>, Kern officials determined that CRC’s project is likely to have “significant and unavoidable” impacts on local air quality, even with measures taken to curb emissions. The report also notes the proximity of proposed pipelines to schools and neighborhoods. Those are among several issues likely to be contested when the public begins weighing in on the project this week.\u003c/p>\n\u003cp>Still, the county sees carbon management as critical to its future.\u003c/p>\n\u003cp>“It’s existential,” Oviatt said. “What is this place going to look like in 30 years? What’s it going to look like in five?”\u003c/p>\n\u003ch2>‘Enormous Numbers’\u003c/h2>\n\u003cp>In addition to moving quickly towards clean sources of energy, countries \u003ca href=\"https://www.ipcc.ch/report/ar6/syr/downloads/report/IPCC_AR6_SYR_LongerReport.pdf\">will need to remove carbon from the air (PDF)\u003c/a> in order to avoid the worst effects of climate change, according to the IPCC, the United Nations panel that assesses the science of climate change.\u003c/p>\n\u003cp>Today, \u003ca href=\"https://res.cloudinary.com/dbtfcnfij/images/v1700717007/Global-Status-of-CCS-Report-Update-23-Nov/Global-Status-of-CCS-Report-Update-23-Nov.pdf?_i=AA\">41 commercial carbon capture facilities (PDF)\u003c/a> are \u003ca href=\"https://www.iea.org/energy-system/carbon-capture-utilisation-and-storage/direct-air-capture\">operating worldwide\u003c/a>. Together, they have the capacity to capture much less than 1% of the emissions that countries produce every year — negating annual emissions equivalent to 49 million metric tons of carbon per year.\u003c/p>\n\u003cp>California, which has positioned itself as a global leader in climate action, wants to pull an unprecedented amount of carbon from the air — 100 million metric tons — by 2045. That represents nearly a quarter of the emissions the state produces today.\u003c/p>\n\u003cp>“Those are enormous numbers, relative to where not just California is today, but where the world is today,” said Michael Wara, director of the climate and energy policy program at Stanford University.\u003c/p>\n\u003cp>Still, the Biden administration is pouring billions into the carbon capture and storage industry, and Kern is racing to get a piece of it. Much of that money goes to regions led by Republican lawmakers who support boosting domestic energy production. Until he resigned from Congress last month, Bakersfield Republican and former House Speaker Kevin McCarthy represented much of Kern County.\u003c/p>\n\u003cp>Last year, the U.S. Department of Energy announced it would offer $3.5 billion for companies to demonstrate direct air capture, a process that sucks carbon from the air so that it can be stowed underground. The department recently said it would give $1.2 billion in grants for “Direct Air Capture hubs” in Louisiana and Texas.\u003c/p>\n\u003cp>Carbon removal projects proposed in California, all located in the conservative-leaning Central Valley, earned more than $20 million from the pool of federal funding for feasibility and planning studies, including roughly $12 million to a group led in part by CRC, Hayat’s company, and the city of Bakersfield. The amount is small compared to the billions to be disbursed elsewhere but significant enough to continue fueling ambitions in Kern.\u003c/p>\n\u003cfigure id=\"attachment_1991162\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991162\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1.jpg\" alt=\"\" width=\"1536\" height=\"1024\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Omar-Hayat-1536x1024-1-768x512.jpg 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">Omar Hayat, executive vice president of operations at California Resources Corporation. \u003ccite>(Harika Maddala)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Several other major oil and gas companies are also racing to launch their own carbon capture facilities in Kern, including Chevron and \u003ca href=\"https://www.aeraenergy.com/responsibility/carbon-frontier/\">Aera Energy\u003c/a>. Though certain details of CRC’s carbon removal proposal have not been made public, its ambitions center on a project called “Carbon TerraVault 1.” The project would be located in the Elk Hills Oil Field, one of the most productive in the nation, near the site where oil was discovered in 1911. The company wants to inject millions of tons of liquefied carbon a mile underground, beginning with carbon dioxide from the oilfield.\u003c/p>\n\u003ch2>‘Looking for Hope’\u003c/h2>\n\u003cp>If all of the projects proposed for the county come online, planning director Oviatt said Kern could be home to most of the storage required to achieve the state’s carbon removal goals. Oviatt frames the growth of this industry as inevitable. Even if the projects currently proposed don’t win regulatory approval, she’s confident that more proposals will follow them, she said at a recent public forum.\u003c/p>\n\u003cp>The county estimates that the carbon removal industry could generate as much as $64 million per year in tax revenues and create thousands of jobs. Kern envisions much of that money coming from a proposed \u003ca href=\"https://cmbp.kernplanning.com/\">Carbon Management Business Park\u003c/a>, which it sees as a way to bring in emerging climate-friendly industries — including future direct air capture projects.\u003c/p>\n\u003cp>If the oil industry leaves Kern, more than 16,000 jobs could disappear, and the area’s already-high poverty and unemployment rates could climb. A county-commissioned study estimates the business park could support up to 22,000 permanent jobs, both in carbon removal and adjacent industries.\u003c/p>\n\u003cp>“That’s encouraging,” Oviatt said. “We are looking for hope.”\u003c/p>\n\u003cp>But realizing that vision is dependent on buy-in from the private sector. Oviatt said a handful of companies have expressed interest in the idea, but so far, none have submitted formal applications.\u003c/p>\n\u003cp>And community support for the county’s vision is hardly unanimous. At an October county Board of Supervisors meeting, residents and environmental activists expressed concerns about the need for pipelines to carry carbon across the state, which could rupture or leak.\u003c/p>\n\u003cp>They also questioned whether the proposed TerraVault and business park would worsen air quality. The American Lung Association consistently ranks Kern County’s air as among the most polluted in the country.\u003c/p>\n\u003cp>“It does not make sense to proceed with this park given the current health and air quality conditions in Kern County,” said Emma De La Rosa, an advocate with the Leadership Counsel for Justice and Accountability.\u003c/p>\n\u003cp>Other community organizers like Ileana Navarro with the Central California Environmental Justice Network called for greater transparency and questioned the technology’s track record.\u003c/p>\n\u003cp>“Projects worldwide have failed to live up to their promise on climate benefits, so why take the risk here in our backyards and in the backyards of already overburdened communities?” the Bakersfield resident asked.\u003c/p>\n\u003cfigure id=\"attachment_1991163\" class=\"wp-caption alignnone\" style=\"max-width: 1536px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991163\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1.jpg\" alt=\"\" width=\"1536\" height=\"1024\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/Oil-Pumps-1536x1024-1-768x512.jpg 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\">\u003cfigcaption class=\"wp-caption-text\">Pumping jacks spread throughout an oilfield in Kern County, California.\u003c/figcaption>\u003c/figure>\n\u003cp>The county’s environmental review shows that pipelines carrying carbon dioxide and injection sites are slated to sit within a few miles of a handful of elementary schools and a couple of towns.\u003c/p>\n\u003cp>Oviatt said that any future project would be located far away from neighborhoods to reduce the health risks to residents. But she was frank about the county’s prospects if a thriving carbon removal industry fails to take off in the region.\u003c/p>\n\u003cp>“I think we’re all concerned about our health, but we’re also concerned: Will Kern County survive these policies of the state of California?” Oviatt told the meeting. “I wanted to make sure the community understands that we are at a very, very difficult crossroads.”\u003c/p>\n\u003ch2>Kern County’s ‘Gift From God’\u003c/h2>\n\u003cp>Carbon can’t be injected and permanently stowed underground just anywhere, but the storage potential in the Central Valley is “a gift from God,” George Peridas, the energy program director at Lawrence Livermore National Laboratory, said at an April symposium on carbon management. The San Joaquin Valley is one of about three dozen areas nationwide with the potential to store the climate pollutant, according to assessments by the U.S. Geological Survey. That’s because, in theory, depleted oil and gas fields can make ideal reservoirs for captured carbon.\u003c/p>\n\u003cp>For decades, petroleum companies operating in the region have made billions pumping fossil fuels out of the ground. Now, these same corporations hope to also make money by pumping liquefied carbon back underground.\u003c/p>\n\u003cp>“It’s just like reconfiguring a Lego set,” Hayat, the oil executive, said. “Instead of using that CO2, for example, for increasing oil and gas production, we’re just putting it away for storage.”\u003c/p>\n\u003cp>But critics say it’s not so simple.\u003c/p>\n\u003cp>Storing carbon permanently and safely remains a complex technological challenge full of potential pitfalls. Extracting oil is different than ensuring carbon stays buried for thousands of years without leaking, according to Daniel Ress, a staff attorney at the Center on Race, Poverty and the Environment. California already has \u003ca href=\"https://www.kvpr.org/local-news/2023-07-21/state-releases-draft-plan-to-plug-leaky-oil-wells-many-of-them-in-kern-county\">thousands of uncapped oil wells\u003c/a>, many of which are leaking greenhouse gasses and other pollutants into the air. Ress is concerned that carbon stored underground could escape.\u003c/p>\n\u003cp>“I’m skeptical that this can be done well in this area where there’s so much oil and gas exploration,” Ress said.\u003c/p>\n\u003cp>Until now, oil companies have almost exclusively injected carbon to extract more oil from the earth. The CEO of Occidental Petroleum — CRC’s former parent company — \u003ca href=\"https://www.politico.com/newsletters/power-switch/2023/12/18/carbon-removal-climate-savior-or-distraction-00132266\">said last year\u003c/a> that carbon removal could give the petroleum industry “a license to continue to operate for the next 60, 70, 80 years.” California law prohibits companies from using captured carbon to enhance drilling in the state. Still, some environmentalists like Ress worry that injecting carbon could be used to extend the life of fossil fuels.\u003c/p>\n\u003cp>Several major obstacles remain on the path to building and operating carbon capture and storage plants. California has just \u003ca href=\"https://www.reuters.com/sustainability/climate-energy/climate-tech-company-heirloom-opens-us-commercial-carbon-capture-plant-2023-11-09/\">one commercial carbon removal project\u003c/a> in operation. The state has also banned new carbon pipelines until federal regulations are put in place, which could challenge CRC’s ambitious plans. Without pipelines to move the carbon from industrial centers to the vault, the company’s potential customer base is limited.\u003c/p>\n\u003cp>But last month, the county and the EPA’s actions boosted CRC’s hope for its TerraVault project. Company president and CEO Francisco Leon called the moves a “significant milestone” in attaining California’s “ambitious climate goals.”\u003c/p>\n\u003cp>Kern is the first county in the state to assess the environmental risks of a carbon storage project, working on the draft for about a year. Still, CRC’s project is facing a potentially lengthy approval process. The planning commission is expected to vote on the project in March, with a vote from county supervisors likely this summer.\u003c/p>\n\u003cp>\u003cem>This story is a collaboration between \u003ca href=\"https://www.kvpr.org/\">KVPR\u003c/a>, Inside Climate News, the Investigative Editing Corps and Report for America.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://insideclimatenews.org/\">Inside Climate News\u003c/a> is a nonprofit, independent news organization that covers climate, energy and the environment. Sign up for the ICN newsletter \u003ca href=\"https://insideclimatenews.org/newsletter/\">here\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1991160/how-kern-countys-carbon-removal-industry-can-save-californias-oil-country","authors":["byline_science_1991160"],"categories":["science_31","science_35","science_39","science_40","science_4450"],"tags":["science_182","science_194","science_192","science_952"],"featImg":"science_1991161","label":"source_science_1991160"},"science_1991112":{"type":"posts","id":"science_1991112","meta":{"index":"posts_1591205157","site":"science","id":"1991112","score":null,"sort":[1705591842000]},"guestAuthors":[],"slug":"californians-are-being-shipped-to-washington-after-they-die-to-be-composted","title":"Californians Eager for Human Composting After They Die","publishDate":1705591842,"format":"standard","headTitle":"Californians Eager for Human Composting After They Die | KQED","labelTerm":{"site":"science"},"content":"\u003cp>When Dennis Cunningham was diagnosed with terminal cancer, he wanted his death to reflect the values he lived by.\u003c/p>\n\u003cp>A committed civil rights lawyer, he defended the Black Panthers, AIDS protestors, and later, environmental activists from Earth First. In his spare time, he built sculptures out of driftwood, bottle caps, and rusted car parts in his backyard studio in Bernal Heights.[pullquote size=\"medium\" align=\"right\" citation=\"Miranda Mellis, Dennis Cunningham’s daughter\"]‘It was totally in keeping with who he was to not make waste, but to use waste.’[/pullquote]He wanted his body to be part of that same cycle of decay and regeneration. He instructed his kids to have him composted after he died.\u003c/p>\n\u003cp>“It was totally in keeping with who he was to not make waste, but to use waste,” said Cunningham’s daughter, Miranda Mellis.\u003c/p>\n\u003cp>To Cunningham, being turned into soil and spread on the forest floor to fertilize new trees was much more appealing than being burned to ash or entombed in a concrete vault underground.\u003c/p>\n\u003cp>Likewise, a growing number of Americans are eager to see more environmentally friendly alternatives to conventional burial and cremation. Human composting is the latest option, though the number of facilities and states that offer it are scarce.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s literally illegal to compost a body in the state of California,” said Joe Mellis, Cunningham’s son. “We had to transport his body from California to Washington to do this.”\u003c/p>\n\u003cp>Seven states have legalized human composting to date, including Washington, Colorado, Nevada and New York. It took California lawmakers three tries to pass a law to do the same, but it won’t take effect until 2027.\u003c/p>\n\u003cfigure id=\"attachment_1991119\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991119\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED.jpg\" alt=\"A person smiles and holds a pot in their hands in front of a brightly painted building.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Katrina Spade, founder and CEO of Recompose, in front of the company’s Seattle facility holding a box of soil that was once a human at Recompose Seattle on Oct. 06, 2022, in Seattle, Washington. \u003ccite>(Mat Hayward/Getty Images for Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cunningham ended up at Recompose, a human composting facility in Seattle. Founder and CEO Katrina Spade said about 15% of their clients are shipped from California and another 14% from other states.[aside label='More Stories on Health' tag='health']“We pick them up at Sea-Tac,” she said about the Seattle-Tacoma airport.\u003c/p>\n\u003cp>Walking into the lobby of Recompose is like walking into a spa. Meditation music whispers from hidden speakers. Living art tapestries decorate the walls; earthy green and yellow shades cover the windows.\u003c/p>\n\u003cp>“When the light comes through, we hope it reminds you of the forest light,” Spade said as she toured the gathering space where families can hold ceremonies.\u003c/p>\n\u003ch2>The science of human composting\u003c/h2>\n\u003cp>The composting itself happens in a cavernous warehouse in the back that Spade calls the greenhouse. She describes the smell alternately as that of a grassy meadow after a rain and a barnyard. Inside are 34 white hexagonal cylinders, or individual vessels, stacked on top of each other in the shape of a beehive.\u003c/p>\n\u003cp>When a new body comes in, the staff lay it in one of the vessels on a bed of wood chips, alfalfa, and straw, Spade said, then they cover it with more of the same.\u003c/p>\n\u003cfigure id=\"attachment_1991118\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991118\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED.jpg\" alt=\"A pile of hay sits on a bed inside an opening in a wall.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A mannequin covered in wood chips and straw rests inside the Threshold Vessel at Recompose Seattle on Oct. 06, 2022, in Seattle, Washington. \u003ccite>(Mat Hayward/Getty Images for Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The idea to me of being cocooned in that plant material, it’s very safe feeling,” Spade said. “If you were alive, it would probably be a little itchy.”\u003c/p>\n\u003cp>Wrapped in that cocoon, the microbes and bacteria go to work on the body, naturally raising the temperature inside the vessel to 150 degrees Fahrenheit. Under\u003ca href=\"https://app.leg.wa.gov/WAC/default.aspx?cite=308-47-065\"> Washington state regulations\u003c/a>, natural heat has to be sustained for three straight days to kill off any pathogens.[pullquote size=\"medium\" align=\"right\" citation=\"Katrina Spade, founder and CEO, Recompose\"]‘The idea to me of being cocooned in that plant material, it’s very safe feeling.’[/pullquote]“Seven or eight years I’ve been doing this, and still, when I see that temperature spike, I think, ‘Holy mackerel!’” Spade said, channeling her inner 8th-grade science fair nerd. “It just feels like some sort of miracle, even though it is nature.”\u003cem> \u003c/em>\u003c/p>\n\u003cp>The body stays in the vessel for about 30 to 40 days. Every week or so, the staff rotate it to let air through, and the body transforms and consolidates into a cubic yard of dark brown dirt, enough to fill the bed of a pickup truck. The staff removes any titanium hips or knees left over in the process, then grinds the bones down to sand and mixes them back in with the soil.\u003c/p>\n\u003cp>The process takes about two months altogether and costs about \u003ca href=\"https://recompose.life/death-care/#pricing\">$7,000\u003c/a> — about twice the cost of cremation but half that of conventional burial. Environmentally, Spade said composting is way better than both, citing internal company research that shows it saves more than a metric ton of carbon compared to the alternatives.\u003c/p>\n\u003ch2>Inspiration and opposition to human composting\u003c/h2>\n\u003cp>During the deadliest period of the COVID-19 pandemic, so many people were being cremated in California, and the emissions violated local air district rules.\u003c/p>\n\u003cp>This is one of the factors that inspired Assemblymember Cristina Garcia, a Democrat from Bell Gardens, to carry a bill to legalize human composting in California,\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB351\"> AB 351\u003c/a>. It passed the state legislature in 2022 but won’t take effect until 2027 to give regulatory agencies time to prepare.\u003c/p>\n\u003cfigure id=\"attachment_1991116\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991116\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED.jpg\" alt=\"A room with a large stretcher-like device in it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Recompose Gathering Space is where the laying-in (funeral) ceremony takes place. The body, shrouded in natural cloth, lies on a dark green bed called the cradle. \u003ccite>(Courtesy of Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The pandemic exacerbated the situation and reminded us of the importance of the choices we make throughout our life cycle,” Garcia told KQED after the bill was signed into law. “It added a sense of urgency of why this needed to be a reality sooner than later here in California.”\u003c/p>\n\u003cp>Garcia’s effort was the third time lawmakers tried to pass the bill. It was held up mainly due to administrative logjams, as the opposition to human composting was minimal and tepid.[pullquote size=\"medium\" align=\"right\" citation=\"Assemblymember Cristina Garcia\"]‘The pandemic exacerbated the situation and reminded us of the importance of the choices we make throughout our life cycle. It added a sense of urgency of why this needed to be a reality sooner than later here in California.’[/pullquote]“I find this bill disgusting and I completely oppose it,” said Serea Abdosh, a 19-year-old student and one of a handful of residents who lodged objections at state legislative hearings in the spring of 2022.\u003c/p>\n\u003cp>The California Catholic Conference also raised concerns about the safety of composted human remains, pointing out that supporters of the bill relied on just one small, non-peer-reviewed study from Recompose to contend that all toxic elements of the body, like dental implants or chemotherapy treatments, were properly eliminated.\u003c/p>\n\u003cp>The bishops also argued that composting a human body and scattering the remains was undignified. It “risks people treading over human remains without their knowledge,” the Catholic Conference wrote in a statement, “while repeated dispersions in the same area are tantamount to a mass grave.”\u003c/p>\n\u003cp>Recompose’s Spade countered by saying her company has composted many Catholics.\u003c/p>\n\u003cp>“We’ve had priests bless the body before,” she said. “We’ve had priests bless the soil after.”\u003c/p>\n\u003cp>Rabbis have also considered how human composting can comply with Jewish death care rituals, and “some are even creating liturgy, or creating words to say around these kinds of processes,” according to Courtney Applewhite, who studied death and grief during her doctoral research at UC Santa Barbara.\u003c/p>\n\u003ch2>Rituals after composting\u003c/h2>\n\u003cp>Composting certainly affected the grieving process for Joe and Miranda Mellis after their dad died. Most of his soil was spread on the floor of a forest in Southwest Washington. Another portion went under a beloved hemlock tree on his family’s land in Michigan.\u003c/p>\n\u003cp>Some of the kids kept some compost for themselves. Joe has a box in his home office in Los Angeles. Miranda buried some in the woods behind her house in Olympia. In \u003ca href=\"https://app.leg.wa.gov/wac/default.aspx?cite=308-47A-020\">Washington\u003c/a>, human compost can be spread anywhere as long as \u003ca href=\"https://app.leg.wa.gov/wac/default.aspx?cite=308-47A-020\">the landowner says it’s OK\u003c/a>. California plans to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB351\">follow suit\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_1991115\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991115\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED.jpg\" alt=\"A vibrant forest scene.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Bells Mountain Forest is a permanently protected natural wilderness. The stewards of Bells Mountain use the soil donated by the Recompose community to revitalize wetlands, riparian habitats, local plants and vulnerable wildlife species. \u003ccite>(Courtesy of Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This tree is a vine maple,” Miranda said as she dodged a spider web and ducked under the low, thin, mossy branches arching out in all directions, a spot she chose because it feels “parental.”[pullquote size=\"medium\" align=\"right\" citation=\"Miranda Mellis, Dennis Cunningham’s daughter\"]‘I meditate here, and sometimes I talk to him here. I think of this as like a telephone booth to the afterworld. I can just hear him as if he’s sitting right next to me.’[/pullquote]She kneeled next to a little altar she built over the roots, tending a small bowl of rocks and shells her father collected and a jagged crystal surrounded by a ring of pinecones.\u003c/p>\n\u003cp>“I meditate here, and sometimes I talk to him here. I think of this as like a telephone booth to the afterworld,” she said. “I can just hear him as if he’s sitting right next to me.”\u003c/p>\n\u003cp>Having her father here, the sense of his body giving back to the earth, it all somehow mitigated the pain of the loss, she said. It made her less afraid of her own mortality.\u003c/p>\n\u003cp>“After all of this, I thought, ‘I think I want to do it, too,’” she said.\u003c/p>\n\u003cp>Both Miranda and Joe say they also want to be composted when they die.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"California legalized human composting in 2022, but the law won’t take effect until 2027. This San Francisco man didn’t want to wait.","status":"publish","parent":0,"modified":1705690487,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1717},"headData":{"title":"Californians Eager for Human Composting After They Die | KQED","description":"California legalized human composting in 2022, but the law won’t take effect until 2027. This San Francisco man didn’t want to wait.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/c2ae2619-2d30-47f5-8759-b0fa011af056/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1991112/californians-are-being-shipped-to-washington-after-they-die-to-be-composted","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Dennis Cunningham was diagnosed with terminal cancer, he wanted his death to reflect the values he lived by.\u003c/p>\n\u003cp>A committed civil rights lawyer, he defended the Black Panthers, AIDS protestors, and later, environmental activists from Earth First. In his spare time, he built sculptures out of driftwood, bottle caps, and rusted car parts in his backyard studio in Bernal Heights.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘It was totally in keeping with who he was to not make waste, but to use waste.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Miranda Mellis, Dennis Cunningham’s daughter","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>He wanted his body to be part of that same cycle of decay and regeneration. He instructed his kids to have him composted after he died.\u003c/p>\n\u003cp>“It was totally in keeping with who he was to not make waste, but to use waste,” said Cunningham’s daughter, Miranda Mellis.\u003c/p>\n\u003cp>To Cunningham, being turned into soil and spread on the forest floor to fertilize new trees was much more appealing than being burned to ash or entombed in a concrete vault underground.\u003c/p>\n\u003cp>Likewise, a growing number of Americans are eager to see more environmentally friendly alternatives to conventional burial and cremation. Human composting is the latest option, though the number of facilities and states that offer it are scarce.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s literally illegal to compost a body in the state of California,” said Joe Mellis, Cunningham’s son. “We had to transport his body from California to Washington to do this.”\u003c/p>\n\u003cp>Seven states have legalized human composting to date, including Washington, Colorado, Nevada and New York. It took California lawmakers three tries to pass a law to do the same, but it won’t take effect until 2027.\u003c/p>\n\u003cfigure id=\"attachment_1991119\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991119\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED.jpg\" alt=\"A person smiles and holds a pot in their hands in front of a brightly painted building.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-03-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Katrina Spade, founder and CEO of Recompose, in front of the company’s Seattle facility holding a box of soil that was once a human at Recompose Seattle on Oct. 06, 2022, in Seattle, Washington. \u003ccite>(Mat Hayward/Getty Images for Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Cunningham ended up at Recompose, a human composting facility in Seattle. Founder and CEO Katrina Spade said about 15% of their clients are shipped from California and another 14% from other states.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on Health ","tag":"health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“We pick them up at Sea-Tac,” she said about the Seattle-Tacoma airport.\u003c/p>\n\u003cp>Walking into the lobby of Recompose is like walking into a spa. Meditation music whispers from hidden speakers. Living art tapestries decorate the walls; earthy green and yellow shades cover the windows.\u003c/p>\n\u003cp>“When the light comes through, we hope it reminds you of the forest light,” Spade said as she toured the gathering space where families can hold ceremonies.\u003c/p>\n\u003ch2>The science of human composting\u003c/h2>\n\u003cp>The composting itself happens in a cavernous warehouse in the back that Spade calls the greenhouse. She describes the smell alternately as that of a grassy meadow after a rain and a barnyard. Inside are 34 white hexagonal cylinders, or individual vessels, stacked on top of each other in the shape of a beehive.\u003c/p>\n\u003cp>When a new body comes in, the staff lay it in one of the vessels on a bed of wood chips, alfalfa, and straw, Spade said, then they cover it with more of the same.\u003c/p>\n\u003cfigure id=\"attachment_1991118\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991118\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED.jpg\" alt=\"A pile of hay sits on a bed inside an opening in a wall.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-MH-02-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A mannequin covered in wood chips and straw rests inside the Threshold Vessel at Recompose Seattle on Oct. 06, 2022, in Seattle, Washington. \u003ccite>(Mat Hayward/Getty Images for Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The idea to me of being cocooned in that plant material, it’s very safe feeling,” Spade said. “If you were alive, it would probably be a little itchy.”\u003c/p>\n\u003cp>Wrapped in that cocoon, the microbes and bacteria go to work on the body, naturally raising the temperature inside the vessel to 150 degrees Fahrenheit. Under\u003ca href=\"https://app.leg.wa.gov/WAC/default.aspx?cite=308-47-065\"> Washington state regulations\u003c/a>, natural heat has to be sustained for three straight days to kill off any pathogens.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘The idea to me of being cocooned in that plant material, it’s very safe feeling.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Katrina Spade, founder and CEO, Recompose","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“Seven or eight years I’ve been doing this, and still, when I see that temperature spike, I think, ‘Holy mackerel!’” Spade said, channeling her inner 8th-grade science fair nerd. “It just feels like some sort of miracle, even though it is nature.”\u003cem> \u003c/em>\u003c/p>\n\u003cp>The body stays in the vessel for about 30 to 40 days. Every week or so, the staff rotate it to let air through, and the body transforms and consolidates into a cubic yard of dark brown dirt, enough to fill the bed of a pickup truck. The staff removes any titanium hips or knees left over in the process, then grinds the bones down to sand and mixes them back in with the soil.\u003c/p>\n\u003cp>The process takes about two months altogether and costs about \u003ca href=\"https://recompose.life/death-care/#pricing\">$7,000\u003c/a> — about twice the cost of cremation but half that of conventional burial. Environmentally, Spade said composting is way better than both, citing internal company research that shows it saves more than a metric ton of carbon compared to the alternatives.\u003c/p>\n\u003ch2>Inspiration and opposition to human composting\u003c/h2>\n\u003cp>During the deadliest period of the COVID-19 pandemic, so many people were being cremated in California, and the emissions violated local air district rules.\u003c/p>\n\u003cp>This is one of the factors that inspired Assemblymember Cristina Garcia, a Democrat from Bell Gardens, to carry a bill to legalize human composting in California,\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB351\"> AB 351\u003c/a>. It passed the state legislature in 2022 but won’t take effect until 2027 to give regulatory agencies time to prepare.\u003c/p>\n\u003cfigure id=\"attachment_1991116\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991116\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED.jpg\" alt=\"A room with a large stretcher-like device in it.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-05-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Recompose Gathering Space is where the laying-in (funeral) ceremony takes place. The body, shrouded in natural cloth, lies on a dark green bed called the cradle. \u003ccite>(Courtesy of Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The pandemic exacerbated the situation and reminded us of the importance of the choices we make throughout our life cycle,” Garcia told KQED after the bill was signed into law. “It added a sense of urgency of why this needed to be a reality sooner than later here in California.”\u003c/p>\n\u003cp>Garcia’s effort was the third time lawmakers tried to pass the bill. It was held up mainly due to administrative logjams, as the opposition to human composting was minimal and tepid.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘The pandemic exacerbated the situation and reminded us of the importance of the choices we make throughout our life cycle. It added a sense of urgency of why this needed to be a reality sooner than later here in California.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Assemblymember Cristina Garcia","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“I find this bill disgusting and I completely oppose it,” said Serea Abdosh, a 19-year-old student and one of a handful of residents who lodged objections at state legislative hearings in the spring of 2022.\u003c/p>\n\u003cp>The California Catholic Conference also raised concerns about the safety of composted human remains, pointing out that supporters of the bill relied on just one small, non-peer-reviewed study from Recompose to contend that all toxic elements of the body, like dental implants or chemotherapy treatments, were properly eliminated.\u003c/p>\n\u003cp>The bishops also argued that composting a human body and scattering the remains was undignified. It “risks people treading over human remains without their knowledge,” the Catholic Conference wrote in a statement, “while repeated dispersions in the same area are tantamount to a mass grave.”\u003c/p>\n\u003cp>Recompose’s Spade countered by saying her company has composted many Catholics.\u003c/p>\n\u003cp>“We’ve had priests bless the body before,” she said. “We’ve had priests bless the soil after.”\u003c/p>\n\u003cp>Rabbis have also considered how human composting can comply with Jewish death care rituals, and “some are even creating liturgy, or creating words to say around these kinds of processes,” according to Courtney Applewhite, who studied death and grief during her doctoral research at UC Santa Barbara.\u003c/p>\n\u003ch2>Rituals after composting\u003c/h2>\n\u003cp>Composting certainly affected the grieving process for Joe and Miranda Mellis after their dad died. Most of his soil was spread on the floor of a forest in Southwest Washington. Another portion went under a beloved hemlock tree on his family’s land in Michigan.\u003c/p>\n\u003cp>Some of the kids kept some compost for themselves. Joe has a box in his home office in Los Angeles. Miranda buried some in the woods behind her house in Olympia. In \u003ca href=\"https://app.leg.wa.gov/wac/default.aspx?cite=308-47A-020\">Washington\u003c/a>, human compost can be spread anywhere as long as \u003ca href=\"https://app.leg.wa.gov/wac/default.aspx?cite=308-47A-020\">the landowner says it’s OK\u003c/a>. California plans to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB351\">follow suit\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_1991115\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1991115\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED.jpg\" alt=\"A vibrant forest scene.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/231211-RECOMPOSE-GETTY-04-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Bells Mountain Forest is a permanently protected natural wilderness. The stewards of Bells Mountain use the soil donated by the Recompose community to revitalize wetlands, riparian habitats, local plants and vulnerable wildlife species. \u003ccite>(Courtesy of Recompose)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This tree is a vine maple,” Miranda said as she dodged a spider web and ducked under the low, thin, mossy branches arching out in all directions, a spot she chose because it feels “parental.”\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘I meditate here, and sometimes I talk to him here. I think of this as like a telephone booth to the afterworld. I can just hear him as if he’s sitting right next to me.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Miranda Mellis, Dennis Cunningham’s daughter","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>She kneeled next to a little altar she built over the roots, tending a small bowl of rocks and shells her father collected and a jagged crystal surrounded by a ring of pinecones.\u003c/p>\n\u003cp>“I meditate here, and sometimes I talk to him here. I think of this as like a telephone booth to the afterworld,” she said. “I can just hear him as if he’s sitting right next to me.”\u003c/p>\n\u003cp>Having her father here, the sense of his body giving back to the earth, it all somehow mitigated the pain of the loss, she said. It made her less afraid of her own mortality.\u003c/p>\n\u003cp>“After all of this, I thought, ‘I think I want to do it, too,’” she said.\u003c/p>\n\u003cp>Both Miranda and Joe say they also want to be composted when they die.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1991112/californians-are-being-shipped-to-washington-after-they-die-to-be-composted","authors":["3205"],"categories":["science_39","science_40","science_4450"],"tags":["science_5178","science_192","science_4417","science_5181"],"featImg":"science_1991120","label":"science"},"science_1991079":{"type":"posts","id":"science_1991079","meta":{"index":"posts_1591205157","site":"science","id":"1991079","score":null,"sort":[1705073455000]},"guestAuthors":[],"slug":"one-mothers-struggle-to-prevent-suicides-on-the-golden-gate-bridge","title":"One Mother's Struggle to Prevent Suicides on the Golden Gate Bridge","publishDate":1705073455,"format":"audio","headTitle":"One Mother’s Struggle to Prevent Suicides on the Golden Gate Bridge | KQED","labelTerm":{"site":"science"},"content":"\u003cp>Golden Gate Bridge officials \u003ca class=\"c-link\" href=\"https://www.kqed.org/news/11971560/san-francisco-finally-installs-suicide-prevention-nets-on-golden-gate-bridge\" target=\"_blank\" rel=\"noopener noreferrer\" data-stringify-link=\"https://www.kqed.org/news/11971560/san-francisco-finally-installs-suicide-prevention-nets-on-golden-gate-bridge\" data-sk=\"tooltip_parent\">have finally installed a stainless steel suicide deterrent net\u003c/a> that extends 1.7 miles along the west and east sides of the bridge. It looks like a chain link fence suspended 20 feet below the pedestrian walkway, connected to the iconic reddish-orange beams of the bridge. The project cost $224 million, and city officials approved it more than a decade ago after years of pushing from suicide prevention advocates. After years of meetings and delays, the advocate’s dreams are a reality. What follows is the story of one family’s struggle and contains the description of suicide.\u003c/p>\n\u003cp>Michael James Bishop pulled out of his garage on Pine Street in San Francisco around 8:45 a.m. on March 28, 2011. He drove his gray Honda to the parking lot at the Golden Gate Bridge. He scrawled a detailed suicide note and laid it on the passenger seat of his car.\u003c/p>\n\u003cp>The sun was shining for the first time in weeks. It was 51 degrees outside. The 28-year-old with brown curly hair, green eyes and silver-rimmed glasses stepped out of his car and walked to the middle of the bridge. Then Bishop turned toward San Francisco and leaped.\u003c/p>\n\u003cp>“A motorist who was driving by happened to see my son go over the rail,” said Kay James, Bishop’s mother.\u003c/p>\n\u003cfigure id=\"attachment_11972462\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972462\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240105-BridgeSafetyNet-41-BL-KQED.jpg\" alt=\"Swirling ocean waters with nets in foreground seen from above, on a bridge.\" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Waves crash below the Golden Gate Bridge’s new safety net on Jan. 5, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>A half-hour later, U.S. Coast Guard workers recovered his body in the swirling waters below the bridge.\u003c/p>\n\u003cp>When James received a call from the sheriff, she was shocked. “That he would kill himself — never entered my mind. He was so sweet. He was a very gentle young man.”\u003c/p>\n\u003cp>Her son had a lot going for him. He was in a relationship with a woman he adored. He played the violin in an orchestra. He was on tap to start a new job at an environmental fund. In fact, that fatal day was supposed to be his first day at work.\u003c/p>\n\u003cp>But he’d struggled with depression in the past, and he was overwhelmed. The suicide note said, “I’m so sorry. I just can’t handle things.”\u003c/p>\n\u003cp>“I just felt so devastated,” James said. “You feel like your world is coming to an end.”\u003c/p>\n\u003cfigure id=\"attachment_1986047\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1986047\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pedestrians and the recently installed safety net on the Golden Gate Bridge on Jan. 5, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Her son’s computer history revealed he had researched the Golden Gate Bridge. It’s an iconic landmark, but it’s also a lethal one. Since 1937, about 2000 people have leaped over the guardrail — an average of two to three people a month. Bishop was one of 37 people who jumped to their deaths in 2011.\u003c/p>\n\u003cp>In the years that followed, James tirelessly advocated for a deterrent net. When she first started attending meetings before the transit district board of directors, she said they were not convinced a barrier was necessary.\u003c/p>\n\u003cp>“But, when they heard from the families of loved ones, they were very moved, and they changed their minds,” James said.\u003c/p>\n\u003ch2>Why people choose the Golden Gate Bridge\u003c/h2>\n\u003cp>The stunning location is commonly thought to be one reason why people jump from the magnificent structure into the crashing waves below. But mental health experts say the view is not the draw — instead, accessibility is usually the primary driver.\u003c/p>\n\u003cfigure id=\"attachment_11972469\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972469\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240109-BridgeSafetyNet-09-BL-KQED.jpg\" alt=\"Old photos of a mother and son on a wall. \" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Photos of Kay James and her son Michael Bishop hang on the wall of her home in Moraga on Jan. 9, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>“People who have attempted suicide will say that they felt more comfortable with a given method,” said Matthew Nock, professor and chair of the Department of Psychology at Harvard University, “They were comfortable jumping off a bridge, whereas they were afraid to hang themselves or take an overdose, or they didn’t have access to a firearm.”\u003c/p>\n\u003cp>“The Golden Gate Bridge is the perfect target,” said Mel Blaustein, a psychiatrist at St. Mary’s Medical Center in San Francisco who has \u003ca href=\"https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2009.09020296\">researched\u003c/a> bridge suicides for many years. “There’s a parking lot, and there’s a bus that takes you there. It’s easy and fast. And when I say fast, it takes four seconds to hit the water.”\u003c/p>\n\u003cp>[aside postID=news_11971560 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/AP23355641681751-1020x680.jpg']One jumper \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2009.09020296\">reportedly\u003c/a> left a note on the bridge reading, “Why do you make it so easy?”\u003c/p>\n\u003cp>The net is intended to make people rethink their decision.\u003c/p>\n\u003cp>“There’s pretty universal agreement that if we know that people are going to try and kill themselves by jumping off a specific bridge, then it’s ethical, reasonable, and clinically wise to put up a netting and prevent those suicides because some percentage of folks who are deterred are never going to try and kill themselves again,” Nock said.\u003c/p>\n\u003cp>A UC Berkeley researcher in the 1970s followed people after they had been stopped on the bridge during a suicide attempt, publishing the findings in a landmark \u003ca href=\"https://urldefense.com/v3/__https:/www.goldengate.org/assets/1/6/suicide-deterrent-seiden-study.pdf__;!!Iwwt!WQL2fS495XM_tK3zg56PranBFZsA2LlOqkQexKhe-RTXTTHKT0brzzUEv6qYoRpvUt7i4DAo4Rpn2w%24\">study (PDF)\u003c/a>. The vast majority of people did not go on to die by suicide somewhere else, even years later.\u003c/p>\n\u003cp>“For some people, suicide is impulsive,” Nock said. “If they’re stopped from making a suicide, they may never make a suicide attempt again.”\u003c/p>\n\u003cfigure id=\"attachment_11972468\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972468\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240108-BridgeSafetyNet-61-BL-KQED.jpg\" alt=\"A memorial to suicides with the Golden Gate Bridge in the background. \" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">A memorial for those who have died on the Golden Gate Bridge covers a fence at Fort Point in San Francisco on Jan. 8, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>Kay James wished a net would have deterred her son Michael. She has talked to people who survived suicide attempts at the Golden Gate. They told her they regretted their decision the minute they let go of the guardrail.\u003c/p>\n\u003cp>“That’s really hard for me because I think, ‘If only he would have had a second chance.’ And, of course, with a net, you definitely have a second chance.”\u003c/p>\n\u003cp>\u003cem>If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the \u003ca href=\"https://988lifeline.org/\">Suicide & Crisis Lifeline\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"After years of delays, the newly installed stainless steel suicide-deterrent safety net on Golden Gate Bridge may offer a literal lifeline to families and individuals struggling with depression.","status":"publish","parent":0,"modified":1705085018,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1060},"headData":{"title":"One Mother's Struggle to Prevent Suicides on the Golden Gate Bridge | KQED","description":"After years of delays, the newly installed stainless steel suicide-deterrent safety net on Golden Gate Bridge may offer a literal lifeline to families and individuals struggling with depression.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]f-aaef00f5a073/96c99e7b-c225-4037-b8fc-b0f50115905c/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1991079/one-mothers-struggle-to-prevent-suicides-on-the-golden-gate-bridge","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Golden Gate Bridge officials \u003ca class=\"c-link\" href=\"https://www.kqed.org/news/11971560/san-francisco-finally-installs-suicide-prevention-nets-on-golden-gate-bridge\" target=\"_blank\" rel=\"noopener noreferrer\" data-stringify-link=\"https://www.kqed.org/news/11971560/san-francisco-finally-installs-suicide-prevention-nets-on-golden-gate-bridge\" data-sk=\"tooltip_parent\">have finally installed a stainless steel suicide deterrent net\u003c/a> that extends 1.7 miles along the west and east sides of the bridge. It looks like a chain link fence suspended 20 feet below the pedestrian walkway, connected to the iconic reddish-orange beams of the bridge. The project cost $224 million, and city officials approved it more than a decade ago after years of pushing from suicide prevention advocates. After years of meetings and delays, the advocate’s dreams are a reality. What follows is the story of one family’s struggle and contains the description of suicide.\u003c/p>\n\u003cp>Michael James Bishop pulled out of his garage on Pine Street in San Francisco around 8:45 a.m. on March 28, 2011. He drove his gray Honda to the parking lot at the Golden Gate Bridge. He scrawled a detailed suicide note and laid it on the passenger seat of his car.\u003c/p>\n\u003cp>The sun was shining for the first time in weeks. It was 51 degrees outside. The 28-year-old with brown curly hair, green eyes and silver-rimmed glasses stepped out of his car and walked to the middle of the bridge. Then Bishop turned toward San Francisco and leaped.\u003c/p>\n\u003cp>“A motorist who was driving by happened to see my son go over the rail,” said Kay James, Bishop’s mother.\u003c/p>\n\u003cfigure id=\"attachment_11972462\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972462\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240105-BridgeSafetyNet-41-BL-KQED.jpg\" alt=\"Swirling ocean waters with nets in foreground seen from above, on a bridge.\" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Waves crash below the Golden Gate Bridge’s new safety net on Jan. 5, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>A half-hour later, U.S. Coast Guard workers recovered his body in the swirling waters below the bridge.\u003c/p>\n\u003cp>When James received a call from the sheriff, she was shocked. “That he would kill himself — never entered my mind. He was so sweet. He was a very gentle young man.”\u003c/p>\n\u003cp>Her son had a lot going for him. He was in a relationship with a woman he adored. He played the violin in an orchestra. He was on tap to start a new job at an environmental fund. In fact, that fatal day was supposed to be his first day at work.\u003c/p>\n\u003cp>But he’d struggled with depression in the past, and he was overwhelmed. The suicide note said, “I’m so sorry. I just can’t handle things.”\u003c/p>\n\u003cp>“I just felt so devastated,” James said. “You feel like your world is coming to an end.”\u003c/p>\n\u003cfigure id=\"attachment_1986047\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1986047\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2024/01/240105-BridgeSafetyNet-43-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pedestrians and the recently installed safety net on the Golden Gate Bridge on Jan. 5, 2024. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Her son’s computer history revealed he had researched the Golden Gate Bridge. It’s an iconic landmark, but it’s also a lethal one. Since 1937, about 2000 people have leaped over the guardrail — an average of two to three people a month. Bishop was one of 37 people who jumped to their deaths in 2011.\u003c/p>\n\u003cp>In the years that followed, James tirelessly advocated for a deterrent net. When she first started attending meetings before the transit district board of directors, she said they were not convinced a barrier was necessary.\u003c/p>\n\u003cp>“But, when they heard from the families of loved ones, they were very moved, and they changed their minds,” James said.\u003c/p>\n\u003ch2>Why people choose the Golden Gate Bridge\u003c/h2>\n\u003cp>The stunning location is commonly thought to be one reason why people jump from the magnificent structure into the crashing waves below. But mental health experts say the view is not the draw — instead, accessibility is usually the primary driver.\u003c/p>\n\u003cfigure id=\"attachment_11972469\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972469\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240109-BridgeSafetyNet-09-BL-KQED.jpg\" alt=\"Old photos of a mother and son on a wall. \" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Photos of Kay James and her son Michael Bishop hang on the wall of her home in Moraga on Jan. 9, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>“People who have attempted suicide will say that they felt more comfortable with a given method,” said Matthew Nock, professor and chair of the Department of Psychology at Harvard University, “They were comfortable jumping off a bridge, whereas they were afraid to hang themselves or take an overdose, or they didn’t have access to a firearm.”\u003c/p>\n\u003cp>“The Golden Gate Bridge is the perfect target,” said Mel Blaustein, a psychiatrist at St. Mary’s Medical Center in San Francisco who has \u003ca href=\"https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2009.09020296\">researched\u003c/a> bridge suicides for many years. “There’s a parking lot, and there’s a bus that takes you there. It’s easy and fast. And when I say fast, it takes four seconds to hit the water.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11971560","hero":"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/AP23355641681751-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>One jumper \u003ca href=\"https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2009.09020296\">reportedly\u003c/a> left a note on the bridge reading, “Why do you make it so easy?”\u003c/p>\n\u003cp>The net is intended to make people rethink their decision.\u003c/p>\n\u003cp>“There’s pretty universal agreement that if we know that people are going to try and kill themselves by jumping off a specific bridge, then it’s ethical, reasonable, and clinically wise to put up a netting and prevent those suicides because some percentage of folks who are deterred are never going to try and kill themselves again,” Nock said.\u003c/p>\n\u003cp>A UC Berkeley researcher in the 1970s followed people after they had been stopped on the bridge during a suicide attempt, publishing the findings in a landmark \u003ca href=\"https://urldefense.com/v3/__https:/www.goldengate.org/assets/1/6/suicide-deterrent-seiden-study.pdf__;!!Iwwt!WQL2fS495XM_tK3zg56PranBFZsA2LlOqkQexKhe-RTXTTHKT0brzzUEv6qYoRpvUt7i4DAo4Rpn2w%24\">study (PDF)\u003c/a>. The vast majority of people did not go on to die by suicide somewhere else, even years later.\u003c/p>\n\u003cp>“For some people, suicide is impulsive,” Nock said. “If they’re stopped from making a suicide, they may never make a suicide attempt again.”\u003c/p>\n\u003cfigure id=\"attachment_11972468\" class=\"wp-caption alignnone\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11972468\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/240108-BridgeSafetyNet-61-BL-KQED.jpg\" alt=\"A memorial to suicides with the Golden Gate Bridge in the background. \" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">A memorial for those who have died on the Golden Gate Bridge covers a fence at Fort Point in San Francisco on Jan. 8, 2024.\u003c/figcaption>\u003c/figure>\n\u003cp>Kay James wished a net would have deterred her son Michael. She has talked to people who survived suicide attempts at the Golden Gate. They told her they regretted their decision the minute they let go of the guardrail.\u003c/p>\n\u003cp>“That’s really hard for me because I think, ‘If only he would have had a second chance.’ And, of course, with a net, you definitely have a second chance.”\u003c/p>\n\u003cp>\u003cem>If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the \u003ca href=\"https://988lifeline.org/\">Suicide & Crisis Lifeline\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1991079/one-mothers-struggle-to-prevent-suicides-on-the-golden-gate-bridge","authors":["11229"],"categories":["science_39","science_40","science_4450"],"tags":["science_4417","science_4414","science_5201","science_5181","science_309","science_5202"],"featImg":"science_1986051","label":"science"},"science_1985952":{"type":"posts","id":"science_1985952","meta":{"index":"posts_1591205157","site":"science","id":"1985952","score":null,"sort":[1704456004000]},"guestAuthors":[],"slug":"how-to-support-your-mental-health-amidst-vicarious-trauma-and-war","title":"How to Protect Your Mental Health When Viewing War on Social Media","publishDate":1704456004,"format":"audio","headTitle":"How to Protect Your Mental Health When Viewing War on Social Media | KQED","labelTerm":{"site":"science"},"content":"\u003cp>The moment Haleema Bharoocha wakes up in the morning, she scrolls through social media to find out what’s happening in Gaza. The 25-year-old Muslim UC Berkeley graduate student said the footage makes her want to vomit, scream and cry.\u003c/p>\n\u003cp>Bharoocha couldn’t eat after watching footage \u003ca href=\"https://www.cnn.com/2023/12/08/middleeast/babies-al-nasr-gaza-hospital-what-we-know-intl/index.html#:~:text=Infants%20found%20dead%20and%20decomposing%20in%20evacuated%20hospital%20ICU%20in,Here's%20what%20we%20know&text=The%20bodies%20of%20decomposing%20babies,Baalousha%2C%20reportedly%20on%20November%2027.\">of newborns found dead at a hospital in Gaza\u003c/a>. Nurses had fled during intense fighting.[pullquote size=\"medium\" align=\"right\" citation=\"Sara Ghalaini, a licensed psychotherapist in Berkeley\"]‘If you’re surrounded by it, or witnessing it, you yourself are also part of that even if you don’t realize you are.’[/pullquote]\u003c/p>\n\u003cp>“How could you have an appetite after you saw decomposing babies in a hospital?” she asked. “It really does feel like I’m kind of hanging on by the last thread that I have in myself.”\u003c/p>\n\u003cp>Recently, while studying at the library, she said she started to hallucinate.\u003c/p>\n\u003cp>“There was a plastic wrapper that fell. But in my mind, for like two seconds, I thought it was a rat crawling towards me, and I just jumped,” she said. “Or I thought the person sitting next to me was moving. But they weren’t.”\u003c/p>\n\u003cp>As the Israel-Hamas war stretches into its 12th week, videos from overseas continue to shock viewers and listeners in the Bay Area. Footage from war has never been palatable. But today, social media provides instantaneous images from the battleground; horrific and violent videos — both real and fake. Every day, social media platforms are rivers of atrocities, which can leave people emotionally triggered, overwhelmed and unstable.\u003c/p>\n\u003cp>Shoshanna Howard learned about the initial attacks by Hamas on Israel when she was scrolling through social media. In the days following the Oct. 7 offensive, she happened upon a video that went viral showing what appeared to be \u003ca href=\"https://www.cnn.com/videos/world/2023/10/07/gaza-hostages-jeep-woman-amanpour-israel-vpx.cnn\">Hamas fighters pulling a woman with blood seeping through her sweatpants out of a truck\u003c/a>. She was limping, handcuffed and blindfolded.\u003c/p>\n\u003cp>“That broke me,” Howard said. “I could not fathom what was happening. And then seeing friends calling it liberation.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Howard, who is Jewish and has cousins living in Israel, was mortified that people she cared about were responding to the horrific acts by making statements that, to her, felt anti-Jewish. As the days passed, it became harder and harder to focus on running her communications business in Oakland.\u003c/p>\n\u003cp>“That’s when I started to have night terrors,” Howard said. “I was ending my days going into my closet. I would just cry and turn off the lights. Close the door. It just felt like what I had to do.”\u003c/p>\n\u003cp>These symptoms reflect \u003ca href=\"https://compassionbehavioralhealth.com/blog/signs-and-symptoms-of-secondary-trauma/\">secondary trauma\u003c/a>, according to \u003ca href=\"https://www.yusracoachinganddevelopment.com/meet-sara\">Sara Ghalaini\u003c/a>, a licensed psychotherapist in Berkeley. She said an individual may experience symptoms of post-traumatic stress disorder if they are exposed to people who have been traumatized or hear descriptions of traumatic events.\u003c/p>\n\u003cp>“If you’re surrounded by it or witnessing it, you yourself are also part of that, even if you don’t realize you are,” Ghalaini said.\u003c/p>\n\u003cp>She recommended people who are suffering surround themselves with community. Some people may find relief praying at a mosque, temple or church. Others may feel better after hitting the gym. Ghalaini said we are experiencing a “collective grief” and advised people to be gentle on themselves as there is no quick fix.\u003c/p>\n\u003cp>Bharoocha said she feels less helpless when she is protesting. She volunteers for groups that have organized numerous rallies, including a \u003ca href=\"https://www.berkeleyside.org/2023/10/25/students-walk-out-class-demanding-uc-berkeley-support-palestine\">mass student walkout on Oct. 25\u003c/a>. “For me, those are spaces to grieve and process,” she said.\u003c/p>\n\u003cp>[aside tag=\"mental-health, war\" label=\"More Related Stories\"]Howard found relief in listening to sermons or Hebrew songs online. She said she has \u003ca href=\"https://www.songtell.com/karolina-israel/af-echad-lo-ba-li\">Karolina’s “Af Echad Lo Ba li”\u003c/a> on repeat. But Howard’s major lifeline is talking to her psychotherapist, who recommended taking a break from social media.\u003c/p>\n\u003cp>Howard said that has been “really, really significant” for her mental health. She also suggests people find somewhere safe to talk.\u003c/p>\n\u003cp>“A place that you can go, that you can let down your guard, that you can speak your truth, and even do the work of accessing deeper truths,” said Robyn Bloom, the director of adult services for Jewish Family and Children’s Services in San Francisco.\u003c/p>\n\u003cp>Many organizations in the Bay Area, like the \u003ca href=\"https://khalilcenter.com/\">Khalil Center\u003c/a> or \u003ca href=\"https://www.jfcs.org/about/resources-during-israel-hamas-war/\">Jewish Family and Children Services\u003c/a> offer mental health support. You can also join a sewing circle or take a walk in nature.\u003c/p>\n\u003cp>“What’s happening is not normal,” Ghalaini said. “What’s happening is awful, and it’s happening to a lot of people whether you’re there or not.”\u003c/p>\n\u003cp>Ghalaini’s best advice is to slow down. Give yourself and the people around you a lot of grace.\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"As the Israel-Hamas war stretches on, videos from overseas continue to shock viewers and listeners in the Bay Area. Social media platforms are rivers of atrocities, which can leave people emotionally triggered and overwhelmed. Here's advice from mental health professionals on how to cope.","status":"publish","parent":0,"modified":1706641598,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":841},"headData":{"title":"How to Protect Your Mental Health When Viewing War on Social Media | KQED","description":"As the Israel-Hamas war stretches on, videos from overseas continue to shock viewers and listeners in the Bay Area. Social media platforms are rivers of atrocities, which can leave people emotionally triggered and overwhelmed. Here's advice from mental health professionals on how to cope.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]f-aaef00f5a073/b03c84bf-5738-4724-b23e-b0d901296f02/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1985952/how-to-support-your-mental-health-amidst-vicarious-trauma-and-war","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The moment Haleema Bharoocha wakes up in the morning, she scrolls through social media to find out what’s happening in Gaza. The 25-year-old Muslim UC Berkeley graduate student said the footage makes her want to vomit, scream and cry.\u003c/p>\n\u003cp>Bharoocha couldn’t eat after watching footage \u003ca href=\"https://www.cnn.com/2023/12/08/middleeast/babies-al-nasr-gaza-hospital-what-we-know-intl/index.html#:~:text=Infants%20found%20dead%20and%20decomposing%20in%20evacuated%20hospital%20ICU%20in,Here's%20what%20we%20know&text=The%20bodies%20of%20decomposing%20babies,Baalousha%2C%20reportedly%20on%20November%2027.\">of newborns found dead at a hospital in Gaza\u003c/a>. Nurses had fled during intense fighting.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘If you’re surrounded by it, or witnessing it, you yourself are also part of that even if you don’t realize you are.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Sara Ghalaini, a licensed psychotherapist in Berkeley","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“How could you have an appetite after you saw decomposing babies in a hospital?” she asked. “It really does feel like I’m kind of hanging on by the last thread that I have in myself.”\u003c/p>\n\u003cp>Recently, while studying at the library, she said she started to hallucinate.\u003c/p>\n\u003cp>“There was a plastic wrapper that fell. But in my mind, for like two seconds, I thought it was a rat crawling towards me, and I just jumped,” she said. “Or I thought the person sitting next to me was moving. But they weren’t.”\u003c/p>\n\u003cp>As the Israel-Hamas war stretches into its 12th week, videos from overseas continue to shock viewers and listeners in the Bay Area. Footage from war has never been palatable. But today, social media provides instantaneous images from the battleground; horrific and violent videos — both real and fake. Every day, social media platforms are rivers of atrocities, which can leave people emotionally triggered, overwhelmed and unstable.\u003c/p>\n\u003cp>Shoshanna Howard learned about the initial attacks by Hamas on Israel when she was scrolling through social media. In the days following the Oct. 7 offensive, she happened upon a video that went viral showing what appeared to be \u003ca href=\"https://www.cnn.com/videos/world/2023/10/07/gaza-hostages-jeep-woman-amanpour-israel-vpx.cnn\">Hamas fighters pulling a woman with blood seeping through her sweatpants out of a truck\u003c/a>. She was limping, handcuffed and blindfolded.\u003c/p>\n\u003cp>“That broke me,” Howard said. “I could not fathom what was happening. And then seeing friends calling it liberation.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Howard, who is Jewish and has cousins living in Israel, was mortified that people she cared about were responding to the horrific acts by making statements that, to her, felt anti-Jewish. As the days passed, it became harder and harder to focus on running her communications business in Oakland.\u003c/p>\n\u003cp>“That’s when I started to have night terrors,” Howard said. “I was ending my days going into my closet. I would just cry and turn off the lights. Close the door. It just felt like what I had to do.”\u003c/p>\n\u003cp>These symptoms reflect \u003ca href=\"https://compassionbehavioralhealth.com/blog/signs-and-symptoms-of-secondary-trauma/\">secondary trauma\u003c/a>, according to \u003ca href=\"https://www.yusracoachinganddevelopment.com/meet-sara\">Sara Ghalaini\u003c/a>, a licensed psychotherapist in Berkeley. She said an individual may experience symptoms of post-traumatic stress disorder if they are exposed to people who have been traumatized or hear descriptions of traumatic events.\u003c/p>\n\u003cp>“If you’re surrounded by it or witnessing it, you yourself are also part of that, even if you don’t realize you are,” Ghalaini said.\u003c/p>\n\u003cp>She recommended people who are suffering surround themselves with community. Some people may find relief praying at a mosque, temple or church. Others may feel better after hitting the gym. Ghalaini said we are experiencing a “collective grief” and advised people to be gentle on themselves as there is no quick fix.\u003c/p>\n\u003cp>Bharoocha said she feels less helpless when she is protesting. She volunteers for groups that have organized numerous rallies, including a \u003ca href=\"https://www.berkeleyside.org/2023/10/25/students-walk-out-class-demanding-uc-berkeley-support-palestine\">mass student walkout on Oct. 25\u003c/a>. “For me, those are spaces to grieve and process,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"tag":"mental-health, war","label":"More Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Howard found relief in listening to sermons or Hebrew songs online. She said she has \u003ca href=\"https://www.songtell.com/karolina-israel/af-echad-lo-ba-li\">Karolina’s “Af Echad Lo Ba li”\u003c/a> on repeat. But Howard’s major lifeline is talking to her psychotherapist, who recommended taking a break from social media.\u003c/p>\n\u003cp>Howard said that has been “really, really significant” for her mental health. She also suggests people find somewhere safe to talk.\u003c/p>\n\u003cp>“A place that you can go, that you can let down your guard, that you can speak your truth, and even do the work of accessing deeper truths,” said Robyn Bloom, the director of adult services for Jewish Family and Children’s Services in San Francisco.\u003c/p>\n\u003cp>Many organizations in the Bay Area, like the \u003ca href=\"https://khalilcenter.com/\">Khalil Center\u003c/a> or \u003ca href=\"https://www.jfcs.org/about/resources-during-israel-hamas-war/\">Jewish Family and Children Services\u003c/a> offer mental health support. You can also join a sewing circle or take a walk in nature.\u003c/p>\n\u003cp>“What’s happening is not normal,” Ghalaini said. “What’s happening is awful, and it’s happening to a lot of people whether you’re there or not.”\u003c/p>\n\u003cp>Ghalaini’s best advice is to slow down. Give yourself and the people around you a lot of grace.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1985952/how-to-support-your-mental-health-amidst-vicarious-trauma-and-war","authors":["11229"],"categories":["science_39","science_40","science_4450"],"tags":["science_4414","science_249","science_697"],"featImg":"science_1985978","label":"science"},"science_1985979":{"type":"posts","id":"science_1985979","meta":{"index":"posts_1591205157","site":"science","id":"1985979","score":null,"sort":[1704398406000]},"guestAuthors":[],"slug":"kaiser-eases-restrictions-on-postpartum-depression-care-after-investigations","title":"Kaiser Eases Restrictions on Postpartum Depression Care After Investigations","publishDate":1704398406,"format":"standard","headTitle":"Kaiser Eases Restrictions on Postpartum Depression Care After Investigations | KQED","labelTerm":{"term":4951,"site":"science"},"content":"\u003cp>A year after her son, Nico, was born and she still felt like an empty shell of herself despite multiple attempts to find treatment, Miriam McDonald “came out” as suffering from debilitating postpartum depression, a decision she now says was totally worth it.\u003c/p>\n\u003cp>For months, McDonald battled her health provider and insurer, Kaiser Permanente, which denied her the one and only FDA-approved medication for postpartum depression, brexanolone. [pullquote size=\"medium\" align=\"right\" citation=\"Miriam McDonald, mother\"]‘No woman should suffer like I did after having a child. The policy was completely unfair. I was in purgatory.’[/pullquote]But since she shared the details of her struggle in a\u003ca href=\"https://www.kqed.org/news/11879309/theres-only-1-drug-for-postpartum-depression-why-does-kaiser-permanente-make-it-so-hard-to-get\"> 2021 KQED investigation\u003c/a>, Kaiser has revamped its coverage guidelines twice, according to internal documents recently obtained by KQED, and federal regulators — citing KQED’s reporting — have launched an investigation into the insurer that is still ongoing.\u003c/p>\n\u003cp>“This will prevent other women from having to go through a year of depression to find something that works,” McDonald said after learning of Kaiser’s policy changes. “No woman should suffer like I did after having a child. The policy was completely unfair. I was in purgatory.”\u003c/p>\n\u003cp>When McDonald experienced her first symptoms of postpartum depression in 2019, including suicidal thoughts, Kaiser’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. But, because the drug was only approved for use up to six months postpartum, experts said this amounted to a blanket denial for all Kaiser patients, a potential violation of state and federal law.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One month after KQED published its investigation, Kaiser overhauled its guidelines, instead recommending women try just one medication before becoming eligible for brexanolone, and if that trial could not be completed before the six-month window expired, women could bypass it and go straight to brexanolone.\u003c/p>\n\u003cp>“Kaiser basically went from having the most restrictive policy to the most robust,” said Joy Burkhard, executive director of the nonprofit\u003ca href=\"https://www.2020mom.org/\"> Policy Center for Maternal Mental Health\u003c/a>. “It’s now a gold standard for the rest of the industry.”\u003c/p>\n\u003ch2>Next, a federal investigation\u003c/h2>\n\u003cp>But the scrutiny over Kaiser didn’t stop there. By late 2022, the federal Department of Labor had launched an investigation into the insurer, according to emails reviewed by KQED. Investigators called McDonald and contacted other patients to discuss the difficulty they had accessing postpartum mental health care, including brexanolone.\u003c/p>\n\u003cp>A few months later, in March 2023, Kaiser revised its brexanolone guidelines again, removing all fail-first recommendations. Patients need only decline a trial of another medication. [pullquote size=\"medium\" align=\"right\" citation=\"Kaiser Permanente statement\"]‘Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.’[/pullquote]“Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” Kaiser said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”\u003c/p>\n\u003cp>The Department of Labor said in an email to KQED that it “will not confirm or deny the existence of an ongoing investigation” as a matter of policy but added the agency could sue a private insurer and force it to change its policies if they violate federal law. It can also force insurers to provide treatment or reimburse patients who paid out of pocket for treatments the department found improperly denied.\u003c/p>\n\u003ch2>A new era for postpartum therapies\u003c/h2>\n\u003cp>Brexanolone came on the market in 2019 with the hope of revolutionizing the treatment of postpartum depression by targeting hormone function instead of the brain’s serotonin system, as typical antidepressants do. \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">In early trials,\u003c/a> women with moderate to severe depression reported relief immediately after the three-day treatment. But brexanolone is expensive, $34,000 per treatment, and must be delivered intravenously during an inpatient hospital stay where patients can be closely monitored for side effects like fainting.\u003c/p>\n\u003cp>Both the price and finding a hospital certified to administer the drug proved to be prohibitive barriers for new mothers pursuing the treatment. Until recently, Kaiser did not have its own certification and had to refer women to one of only three other approved hospitals in California. [aside label='More Stories on health' tag='health']A new, more accessible pill form of the medication, zuranolone, taken once a day at home over 14 days, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression\">was approved by the FDA in August\u003c/a>. In November, Sage Therapeutics, the company that makes both drugs, set the price for zuranolone at $15,900.\u003c/p>\n\u003cp>Since then, less than 1% of health plans have established criteria for when they will cover it, according to \u003ca href=\"https://www.2020mom.org/blog/2023/12/15/zurzuvae-the-new-postpartum-depression-drug-now-available-in-the-us-this-is-how-insurers-have-responded\">an analysis\u003c/a> using data from \u003ca href=\"https://www.policyreporter.com/\">Policy Reporter\u003c/a>, a website that tracks insurance policies. Regulators, lawyers, and advocates are watching closely to see how insurance companies will shape policies for the new drug.\u003c/p>\n\u003cp>“We’ll have to see if insurers cover this drug and what fail-first requirements they put in,” said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who represents patients.\u003c/p>\n\u003cp>These new policies will be written at a time when the regulatory environment around mental health treatment is shifting. The federal Department of Labor is now cracking down more on potential violations of the \u003ca href=\"https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity\">2008 Mental Health Parity and Addiction Equity Act\u003c/a>, which requires insurers to cover psychiatric treatments on par with physical treatments.\u003c/p>\n\u003cp>As of this summer, insurers must comply with new, stricter reporting and auditing requirements that are intended to increase patient access to mental health care and, advocates say, could compel them to be more careful about the policies they write in the first place. [pullquote size=\"medium\" align=\"right\" citation=\"Meiram Bendat, attorney and licensed psychotherapist, who represents patients\"]‘We’ll have to see if insurers cover this drug and what fail-first requirements they put in.’[/pullquote]In California, insurers must also comply with an even broader state mental health parity law from 2021, making sure their coverage policies are aligned with generally accepted standards of care. Highly awaited \u003ca href=\"https://www.kqed.org/science/1984855/is-californias-landmark-mental-health-law-working\">regulations for the law\u003c/a> are expected to be released this spring.\u003c/p>\n\u003cp>Many perinatal psychiatrists told KQED it is imperative to treat postpartum depression as quickly as possible to avoid negative impacts, including cognitive and social problems in the baby, anxiety or depression in the husband or partner, or the death of the mother to suicide, which accounts for \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">up to 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>It’s possible this reasoning is why Kaiser was quick to revise its guidelines for brexanolone for the first time in 2021, Burkhard said, who worked at an insurance company before becoming an advocate. But it is unclear what criteria Kaiser will set for the new pill zuranolone.\u003c/p>\n\u003cp>“We will apply the same evidence-based, expert review process to zuranolone as we do with all medications,” Kaiser said.\u003c/p>\n\u003cp>McDonald is hopeful that women will now have more choices for care in policy and practice, including treatments that work faster and they can access immediately. She doesn’t want them to be forced on a trial-and-error medication merry-go-round like she was and can choose the treatment that’s right for them.\u003c/p>\n\u003cp>“There has to be more options for women,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"California patients are waiting to see what coverage policies insurers will set for the new pill form of the drug, zuranolone.","status":"publish","parent":0,"modified":1705619333,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":1244},"headData":{"title":"Kaiser Eases Restrictions on Postpartum Depression Care After Investigations | KQED","description":"California patients are waiting to see what coverage policies insurers will set for the new pill form of the drug, zuranolone.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/7b44e5c3-5f3a-4063-be7e-b0ec0114f3cc/audio.mp3","sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/science/1985979/kaiser-eases-restrictions-on-postpartum-depression-care-after-investigations","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A year after her son, Nico, was born and she still felt like an empty shell of herself despite multiple attempts to find treatment, Miriam McDonald “came out” as suffering from debilitating postpartum depression, a decision she now says was totally worth it.\u003c/p>\n\u003cp>For months, McDonald battled her health provider and insurer, Kaiser Permanente, which denied her the one and only FDA-approved medication for postpartum depression, brexanolone. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘No woman should suffer like I did after having a child. The policy was completely unfair. I was in purgatory.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Miriam McDonald, mother","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>But since she shared the details of her struggle in a\u003ca href=\"https://www.kqed.org/news/11879309/theres-only-1-drug-for-postpartum-depression-why-does-kaiser-permanente-make-it-so-hard-to-get\"> 2021 KQED investigation\u003c/a>, Kaiser has revamped its coverage guidelines twice, according to internal documents recently obtained by KQED, and federal regulators — citing KQED’s reporting — have launched an investigation into the insurer that is still ongoing.\u003c/p>\n\u003cp>“This will prevent other women from having to go through a year of depression to find something that works,” McDonald said after learning of Kaiser’s policy changes. “No woman should suffer like I did after having a child. The policy was completely unfair. I was in purgatory.”\u003c/p>\n\u003cp>When McDonald experienced her first symptoms of postpartum depression in 2019, including suicidal thoughts, Kaiser’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. But, because the drug was only approved for use up to six months postpartum, experts said this amounted to a blanket denial for all Kaiser patients, a potential violation of state and federal law.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One month after KQED published its investigation, Kaiser overhauled its guidelines, instead recommending women try just one medication before becoming eligible for brexanolone, and if that trial could not be completed before the six-month window expired, women could bypass it and go straight to brexanolone.\u003c/p>\n\u003cp>“Kaiser basically went from having the most restrictive policy to the most robust,” said Joy Burkhard, executive director of the nonprofit\u003ca href=\"https://www.2020mom.org/\"> Policy Center for Maternal Mental Health\u003c/a>. “It’s now a gold standard for the rest of the industry.”\u003c/p>\n\u003ch2>Next, a federal investigation\u003c/h2>\n\u003cp>But the scrutiny over Kaiser didn’t stop there. By late 2022, the federal Department of Labor had launched an investigation into the insurer, according to emails reviewed by KQED. Investigators called McDonald and contacted other patients to discuss the difficulty they had accessing postpartum mental health care, including brexanolone.\u003c/p>\n\u003cp>A few months later, in March 2023, Kaiser revised its brexanolone guidelines again, removing all fail-first recommendations. Patients need only decline a trial of another medication. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Kaiser Permanente statement","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” Kaiser said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”\u003c/p>\n\u003cp>The Department of Labor said in an email to KQED that it “will not confirm or deny the existence of an ongoing investigation” as a matter of policy but added the agency could sue a private insurer and force it to change its policies if they violate federal law. It can also force insurers to provide treatment or reimburse patients who paid out of pocket for treatments the department found improperly denied.\u003c/p>\n\u003ch2>A new era for postpartum therapies\u003c/h2>\n\u003cp>Brexanolone came on the market in 2019 with the hope of revolutionizing the treatment of postpartum depression by targeting hormone function instead of the brain’s serotonin system, as typical antidepressants do. \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression\">In early trials,\u003c/a> women with moderate to severe depression reported relief immediately after the three-day treatment. But brexanolone is expensive, $34,000 per treatment, and must be delivered intravenously during an inpatient hospital stay where patients can be closely monitored for side effects like fainting.\u003c/p>\n\u003cp>Both the price and finding a hospital certified to administer the drug proved to be prohibitive barriers for new mothers pursuing the treatment. Until recently, Kaiser did not have its own certification and had to refer women to one of only three other approved hospitals in California. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on health ","tag":"health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>A new, more accessible pill form of the medication, zuranolone, taken once a day at home over 14 days, \u003ca href=\"https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression\">was approved by the FDA in August\u003c/a>. In November, Sage Therapeutics, the company that makes both drugs, set the price for zuranolone at $15,900.\u003c/p>\n\u003cp>Since then, less than 1% of health plans have established criteria for when they will cover it, according to \u003ca href=\"https://www.2020mom.org/blog/2023/12/15/zurzuvae-the-new-postpartum-depression-drug-now-available-in-the-us-this-is-how-insurers-have-responded\">an analysis\u003c/a> using data from \u003ca href=\"https://www.policyreporter.com/\">Policy Reporter\u003c/a>, a website that tracks insurance policies. Regulators, lawyers, and advocates are watching closely to see how insurance companies will shape policies for the new drug.\u003c/p>\n\u003cp>“We’ll have to see if insurers cover this drug and what fail-first requirements they put in,” said \u003ca href=\"https://psych-appeal.com/meiram-bendat-attorney-founder/\">Meiram Bendat\u003c/a>, an attorney and licensed psychotherapist who represents patients.\u003c/p>\n\u003cp>These new policies will be written at a time when the regulatory environment around mental health treatment is shifting. The federal Department of Labor is now cracking down more on potential violations of the \u003ca href=\"https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity\">2008 Mental Health Parity and Addiction Equity Act\u003c/a>, which requires insurers to cover psychiatric treatments on par with physical treatments.\u003c/p>\n\u003cp>As of this summer, insurers must comply with new, stricter reporting and auditing requirements that are intended to increase patient access to mental health care and, advocates say, could compel them to be more careful about the policies they write in the first place. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We’ll have to see if insurers cover this drug and what fail-first requirements they put in.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Meiram Bendat, attorney and licensed psychotherapist, who represents patients","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>In California, insurers must also comply with an even broader state mental health parity law from 2021, making sure their coverage policies are aligned with generally accepted standards of care. Highly awaited \u003ca href=\"https://www.kqed.org/science/1984855/is-californias-landmark-mental-health-law-working\">regulations for the law\u003c/a> are expected to be released this spring.\u003c/p>\n\u003cp>Many perinatal psychiatrists told KQED it is imperative to treat postpartum depression as quickly as possible to avoid negative impacts, including cognitive and social problems in the baby, anxiety or depression in the husband or partner, or the death of the mother to suicide, which accounts for \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113321/\">up to 20% of maternal deaths\u003c/a>.\u003c/p>\n\u003cp>It’s possible this reasoning is why Kaiser was quick to revise its guidelines for brexanolone for the first time in 2021, Burkhard said, who worked at an insurance company before becoming an advocate. But it is unclear what criteria Kaiser will set for the new pill zuranolone.\u003c/p>\n\u003cp>“We will apply the same evidence-based, expert review process to zuranolone as we do with all medications,” Kaiser said.\u003c/p>\n\u003cp>McDonald is hopeful that women will now have more choices for care in policy and practice, including treatments that work faster and they can access immediately. She doesn’t want them to be forced on a trial-and-error medication merry-go-round like she was and can choose the treatment that’s right for them.\u003c/p>\n\u003cp>“There has to be more options for women,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1985979/kaiser-eases-restrictions-on-postpartum-depression-care-after-investigations","authors":["3205"],"programs":["science_4951"],"categories":["science_39","science_40","science_4450"],"tags":["science_4417","science_4414","science_5181","science_249","science_4277"],"featImg":"science_1985871","label":"science_4951"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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