Even with Insurance, Family of Medically Fragile Child Struggles to Find Home Health Care
California Legislature Approves Revised Health Plan Tax
Brown's Budget Plan: New Managed Care Tax, Increased SSI Benefits, More Medi-Cal Enrollment
In Berkeley, People with Developmental Disabilities Demand More Funding
Developmentally Disabled People Face Losing Access to Services as Closures Hit
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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"korr":{"type":"authors","id":"11200","meta":{"index":"authors_1591205172","id":"11200","found":true},"name":"Katie Orr","firstName":"Katie","lastName":"Orr","slug":"korr","email":"korr@kqed.org","display_author_email":false,"staff_mastheads":[],"title":"KQED Contributor","bio":"Katie Orr was a Sacramento-based reporter for KQED's Politics and Government Desk, covering the state Capitol and a variety of issues including women in politics, voting and elections and legislation. Prior to joining KQED in 2016, Katie was state government reporter for Capital Public Radio in Sacramento. She's also worked for KPBS in San Diego, where she covered City Hall.\r\n\r\nKatie received her masters degree in political science from San Diego State University and holds a Bachelors degree in broadcast journalism from Arizona State University.\r\n\r\nIn 2015 Katie won a national Clarion Award for a series of stories she did on women in California politics. She's been honored by the Society for Professional Journalists and, in 2013, was named by \u003cem>The Washington Post\u003c/em> as one of the country's top state Capitol reporters. She's also reported for the award-winning documentary series \u003cem>The View from Here \u003c/em>and was part of the team that won national PRNDI and Gabriel Awards in 2015. She lives in Sacramento with her husband. Twitter: @1KatieOrr","avatar":"https://secure.gravatar.com/avatar/41a40b25845adc78f50808670860449e?s=600&d=blank&r=g","twitter":"1katieorr","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"stateofhealth","roles":["author"]},{"site":"forum","roles":["author"]}],"headData":{"title":"Katie Orr | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/41a40b25845adc78f50808670860449e?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/41a40b25845adc78f50808670860449e?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/korr"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_218008":{"type":"posts","id":"stateofhealth_218008","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"218008","score":null,"sort":[1469746048000]},"guestAuthors":[],"slug":"even-with-insurance-family-of-medically-fragile-child-struggles-to-find-home-health-care","title":"Even with Insurance, Family of Medically Fragile Child Struggles to Find Home Health Care","publishDate":1469746048,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The number of people at Brian and Laura Smart’s San Jose home has been steadily growing since February.\u003c/p>\n\u003cp>By June, it reached six adults: Brian's parents, Laura's mother and an au pair. They're all part of a makeshift medical team aimed at keeping Noah, Brian and Laura's one-year-old son, alive.\u003c/p>\n\u003cp>Last July, Noah was born with \u003ca href=\"http://www.pted.org/?id=shones1\" target=\"_blank\">Shone’s Complex,\u003c/a> a rare congenital heart disease. In February, he suffered a stroke during a surgical procedure, which further disabled him. Noah is now dependent on a ventilator and a gastric tube, and he takes nine medications every day.\u003c/p>\n\u003cp>“We had this little boy who was rolling over and playing with us and now we have this body that vomits and cries, and it’s torture.” Brian says.\u003c/p>\n\u003cfigure id=\"attachment_218054\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-218054 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/NoahSmart-400x250.jpg\" alt=\"Noah Smart was born in July 2015 with a severe congenital heart disease. \" width=\"400\" height=\"250\">\u003cfigcaption class=\"wp-caption-text\">Noah Smart was born in July 2015 with a severe congenital heart disease. \u003ccite>(Jordan Katz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“What Noah was up until then, Noah is not anymore,” says \u003ca href=\"http://www.stanfordchildrens.org/en/doctor/default?id=meera-sukumaran\" target=\"_blank\">Dr. Meera Sukumaran\u003c/a>. She specializes in pediatric neurodevelopmental disabilities at Stanford, where she treats Noah. After Noah suffered the stroke, he started having seizures and muscles spasms, Sukumaran says. “He would cry out, be very distressed. ... He was having a harder time digesting his milk, so he was throwing up 10 to 20 times a day.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Noah has a feeding pump, a suction machine, and needs oxygen, his father says. These needs are highly complex, and while some members of Noah's makeshift support system have medical skills -- Brian's mother is a retired registered nurse, the au pair has a nursing license from the Philippines -- everyone agrees this care system is not sustainable.\u003c/p>\n\u003cp>\"Ideally, we would want a nurse 24 hours a day,” Brian says, although he also says they’d take even 8-hour support. But trying to access that level of care has been a months-long odyssey.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brian and Laura are both employed full time and have health insurance with United Healthcare through Laura's job at Apple. Despite the insurance, they estimate they're paying $5,000 a month, out-of-pocket, for hired care and copays.\u003c/span>\u003c/p>\n\u003cp>The Smarts applied to get an in-home nurse covered by United Healthcare and were denied. The insurance company claimed the care Noah needed was custodial, meaning it was the same as the care that comes with having any baby. They appealed, and were denied again, even though a home nurse would help them avoid emergency room visits that would quickly cost the insurer more than a home nurse.\u003c/p>\n\u003cfigure id=\"attachment_215866\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-215866\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/SyringesCU-400x267.jpg\" alt=\"Part of the 15 doses of medication Noah Smart will need each day. \" width=\"400\" height=\"267\">\u003cfigcaption class=\"wp-caption-text\">Part of the 15 doses of medication Noah Smart will need each day. \u003ccite>(Jordan Katz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Smarts next turned to Medi-Cal, the state's health insurance generally for people who are low income. Severely disabled children can be deemed eligible for the program, even if their parents’ income exceeds usual limits. This was a waiver the Smarts sought for Noah.\u003c/p>\n\u003cp>But getting a waiver is just the first hurdle and no guarantee Noah will actually be able to get the nursing care he needs. The problem is home health agencies that provide the care have trouble attracting nurses to meet the pressing demand by families, and they blame low Medi-Cal reimbursement rates.\u003c/p>\n\u003cp>“On paper, there are all these pediatric home health agencies,\" says Sherri Sager, chief government and community relations officer of Lucile Packard Children's Hospital at Stanford. “To meet the demand for pediatric home health nurses, the supply is nowhere near what we need.\"\u003c/p>\n\u003cp>At Maxim Healthcare Services, a home health agency that connects families with nurses, Kris Frank says he is finding it harder and harder to recruit and retain registered nurses, because the rates they offer are so low compared to what nurses can earn at hospitals or other skilled nursing facilities.\u003c/p>\n\u003cp>Currently, the average hourly rate for a registered nurse working in the Bay Area is around $65 an hour, according to the \u003ca href=\"http://www.bls.gov/oes/current/oes_41884.htm\" target=\"_blank\">Bureau of Labor Statistics\u003c/a>. The reimbursement rate Maxim says it receives for a registered nurse caring for a Medi-Cal patient is $40.16 an hour.\u003c/p>\n\u003cp>Though Frank says Maxim pays all its nurses the same rate whether the agency is reimbursed by Medi-Cal or another insurer, the net effect of a lower Medi-Cal reimbursement rates to the home health agency is a lower rate overall.\u003c/p>\n\u003cp>“We blend the rates,” Frank explains. \"but costs go up, and we just can’t continue to pay enough for us to fill all the approved shifts.\"\u003c/p>\n\u003cp>Barbara Crane, Maxim's director of clinical services, first came to the agency as a home health nurse after she and her husband moved to the Bay Area from New York. When she arrived, she says she was “taken aback” by the difference in wages.\u003c/p>\n\u003cp>“It was less than half of what I had been making ten years ago in New York,” Crane says. “Caring in the home, where you don’t have other doctors or other nurses around to support your assessment and your decisions, is a bit of a daunting task.\"\u003c/p>\n\u003cp>\"I know this is a different state, but the rates for nursing to be done in the home are just so sub-standard,” she says.\u003c/p>\n\u003cp>Now her job is to convince nurses to work in home health.\u003c/p>\n\u003cp>\"I am in the predicament of trying to get nurses to come here and get them to understand how important home health is, even though it’s not financially rewarding,” Crane says.\u003c/p>\n\u003cp>What’s more, Frank says, the nurses that agencies like Maxim need to recruit are highly-skilled, almost to the level of a hospital neo-natal intensive care unit. “But we’re bringing them in-home,\" he says, \"and some nurses don’t want to work in the home.\" Then when he tells them the rate, he says, they balk. \"They think, ‘Well, heck. I could be making more working as a waitress, or a waiter—a lot more.’”\u003c/p>\n\u003cp>Maxim has been working with Sen. Mike McGuire, D-Healdsburg, to pass legislation that addresses the issue. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB1401\" target=\"_blank\">Senate Bill 1401\u003c/a>, first introduced in March, would establish a three-year pilot program in three regions around California— including the Bay Area. Under the pilot, Medi-Cal reimbursement rates for registered nurses and licensed vocational nurses would be increased 20 percent.\u003c/p>\n\u003cp>In a statement, McGuire pointed out that in-home nursing is cost-effective. “It costs 10 times more each day to care for a child in a hospital,\" he said, \"than it does to care for that child at home.”\u003c/p>\n\u003cp>Tony Cava, spokesman for the Department of Health Care Services which oversees Medi-Cal, said that the agency was \"not aware of any significant access issues\" with home health care for Medi-Cal recipients.\u003c/p>\n\u003cp>If a family is unable to find a home health agency -- or HHA -- to provide prescribed nursing service, Cava said that \"DHCS nurses [would] provide assistance to the family by referring them to other Medi-Cal-approved HHAs, individual nurse providers, and pediatric day health care centers.”\u003c/p>\n\u003cp>But implementing SB 1401 would cost more than $20 million to implement, according to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520160SB1401\" target=\"_blank\">an analysis \u003c/a>presented to the Senate Committee on Appropriations. The bill was ultimately held in the committee earlier this year and cannot be re-introduced until next January.\u003c/p>\n\u003cp>Meanwhile, home health agencies struggle to fill the hours that patients need. “We should be filling 100 percent,\" Frank says, but even when nurses call in sick, \"we have no backup nurses.\"\u003c/p>\n\u003cp>As for the Smarts—after months of phone calls and paperwork, Noah is on track to get Medi-Cal coverage. What's unclear is whether that coverage will make a difference, given the shortage of in-home pediatric nurses.\u003c/p>\n\u003cp>Brian Smart knew that even with coverage, Noah's name might linger on a wait list for care for a year—or more. Still, he decided it was worth a shot.\u003c/p>\n\u003cp>\"I filled out the paperwork as a just-in-case,” Brian says. Even the program coordinator told him it would be a \"long shot\" that he would get an in-home nurse.\u003c/p>\n\u003cp>\"Even if it’s a one-in-a-million chance, at least it’s a chance.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>For now, the Smarts will have to keep waiting.\u003c/p>\n\n","blocks":[],"excerpt":"They were denied coverage with private insurance. Their son qualifies for Medi-Cal, but there simply aren't enough nurses. ","status":"publish","parent":0,"modified":1469756537,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1429},"headData":{"title":"Even with Insurance, Family of Medically Fragile Child Struggles to Find Home Health Care | KQED","description":"They were denied coverage with private insurance. Their son qualifies for Medi-Cal, but there simply aren't enough nurses. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Even with Insurance, Family of Medically Fragile Child Struggles to Find Home Health Care","datePublished":"2016-07-28T22:47:28.000Z","dateModified":"2016-07-29T01:42:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"218008 http://ww2.kqed.org/stateofhealth/?p=218008","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/07/28/even-with-insurance-family-of-medically-fragile-child-struggles-to-find-home-health-care/","disqusTitle":"Even with Insurance, Family of Medically Fragile Child Struggles to Find Home Health Care","nprByline":"Jordan Katz","path":"/stateofhealth/218008/even-with-insurance-family-of-medically-fragile-child-struggles-to-find-home-health-care","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The number of people at Brian and Laura Smart’s San Jose home has been steadily growing since February.\u003c/p>\n\u003cp>By June, it reached six adults: Brian's parents, Laura's mother and an au pair. They're all part of a makeshift medical team aimed at keeping Noah, Brian and Laura's one-year-old son, alive.\u003c/p>\n\u003cp>Last July, Noah was born with \u003ca href=\"http://www.pted.org/?id=shones1\" target=\"_blank\">Shone’s Complex,\u003c/a> a rare congenital heart disease. In February, he suffered a stroke during a surgical procedure, which further disabled him. Noah is now dependent on a ventilator and a gastric tube, and he takes nine medications every day.\u003c/p>\n\u003cp>“We had this little boy who was rolling over and playing with us and now we have this body that vomits and cries, and it’s torture.” Brian says.\u003c/p>\n\u003cfigure id=\"attachment_218054\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-218054 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/NoahSmart-400x250.jpg\" alt=\"Noah Smart was born in July 2015 with a severe congenital heart disease. \" width=\"400\" height=\"250\">\u003cfigcaption class=\"wp-caption-text\">Noah Smart was born in July 2015 with a severe congenital heart disease. \u003ccite>(Jordan Katz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“What Noah was up until then, Noah is not anymore,” says \u003ca href=\"http://www.stanfordchildrens.org/en/doctor/default?id=meera-sukumaran\" target=\"_blank\">Dr. Meera Sukumaran\u003c/a>. She specializes in pediatric neurodevelopmental disabilities at Stanford, where she treats Noah. After Noah suffered the stroke, he started having seizures and muscles spasms, Sukumaran says. “He would cry out, be very distressed. ... He was having a harder time digesting his milk, so he was throwing up 10 to 20 times a day.\"\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>Noah has a feeding pump, a suction machine, and needs oxygen, his father says. These needs are highly complex, and while some members of Noah's makeshift support system have medical skills -- Brian's mother is a retired registered nurse, the au pair has a nursing license from the Philippines -- everyone agrees this care system is not sustainable.\u003c/p>\n\u003cp>\"Ideally, we would want a nurse 24 hours a day,” Brian says, although he also says they’d take even 8-hour support. But trying to access that level of care has been a months-long odyssey.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brian and Laura are both employed full time and have health insurance with United Healthcare through Laura's job at Apple. Despite the insurance, they estimate they're paying $5,000 a month, out-of-pocket, for hired care and copays.\u003c/span>\u003c/p>\n\u003cp>The Smarts applied to get an in-home nurse covered by United Healthcare and were denied. The insurance company claimed the care Noah needed was custodial, meaning it was the same as the care that comes with having any baby. They appealed, and were denied again, even though a home nurse would help them avoid emergency room visits that would quickly cost the insurer more than a home nurse.\u003c/p>\n\u003cfigure id=\"attachment_215866\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-215866\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/07/SyringesCU-400x267.jpg\" alt=\"Part of the 15 doses of medication Noah Smart will need each day. \" width=\"400\" height=\"267\">\u003cfigcaption class=\"wp-caption-text\">Part of the 15 doses of medication Noah Smart will need each day. \u003ccite>(Jordan Katz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Smarts next turned to Medi-Cal, the state's health insurance generally for people who are low income. Severely disabled children can be deemed eligible for the program, even if their parents’ income exceeds usual limits. This was a waiver the Smarts sought for Noah.\u003c/p>\n\u003cp>But getting a waiver is just the first hurdle and no guarantee Noah will actually be able to get the nursing care he needs. The problem is home health agencies that provide the care have trouble attracting nurses to meet the pressing demand by families, and they blame low Medi-Cal reimbursement rates.\u003c/p>\n\u003cp>“On paper, there are all these pediatric home health agencies,\" says Sherri Sager, chief government and community relations officer of Lucile Packard Children's Hospital at Stanford. “To meet the demand for pediatric home health nurses, the supply is nowhere near what we need.\"\u003c/p>\n\u003cp>At Maxim Healthcare Services, a home health agency that connects families with nurses, Kris Frank says he is finding it harder and harder to recruit and retain registered nurses, because the rates they offer are so low compared to what nurses can earn at hospitals or other skilled nursing facilities.\u003c/p>\n\u003cp>Currently, the average hourly rate for a registered nurse working in the Bay Area is around $65 an hour, according to the \u003ca href=\"http://www.bls.gov/oes/current/oes_41884.htm\" target=\"_blank\">Bureau of Labor Statistics\u003c/a>. The reimbursement rate Maxim says it receives for a registered nurse caring for a Medi-Cal patient is $40.16 an hour.\u003c/p>\n\u003cp>Though Frank says Maxim pays all its nurses the same rate whether the agency is reimbursed by Medi-Cal or another insurer, the net effect of a lower Medi-Cal reimbursement rates to the home health agency is a lower rate overall.\u003c/p>\n\u003cp>“We blend the rates,” Frank explains. \"but costs go up, and we just can’t continue to pay enough for us to fill all the approved shifts.\"\u003c/p>\n\u003cp>Barbara Crane, Maxim's director of clinical services, first came to the agency as a home health nurse after she and her husband moved to the Bay Area from New York. When she arrived, she says she was “taken aback” by the difference in wages.\u003c/p>\n\u003cp>“It was less than half of what I had been making ten years ago in New York,” Crane says. “Caring in the home, where you don’t have other doctors or other nurses around to support your assessment and your decisions, is a bit of a daunting task.\"\u003c/p>\n\u003cp>\"I know this is a different state, but the rates for nursing to be done in the home are just so sub-standard,” she says.\u003c/p>\n\u003cp>Now her job is to convince nurses to work in home health.\u003c/p>\n\u003cp>\"I am in the predicament of trying to get nurses to come here and get them to understand how important home health is, even though it’s not financially rewarding,” Crane says.\u003c/p>\n\u003cp>What’s more, Frank says, the nurses that agencies like Maxim need to recruit are highly-skilled, almost to the level of a hospital neo-natal intensive care unit. “But we’re bringing them in-home,\" he says, \"and some nurses don’t want to work in the home.\" Then when he tells them the rate, he says, they balk. \"They think, ‘Well, heck. I could be making more working as a waitress, or a waiter—a lot more.’”\u003c/p>\n\u003cp>Maxim has been working with Sen. Mike McGuire, D-Healdsburg, to pass legislation that addresses the issue. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB1401\" target=\"_blank\">Senate Bill 1401\u003c/a>, first introduced in March, would establish a three-year pilot program in three regions around California— including the Bay Area. Under the pilot, Medi-Cal reimbursement rates for registered nurses and licensed vocational nurses would be increased 20 percent.\u003c/p>\n\u003cp>In a statement, McGuire pointed out that in-home nursing is cost-effective. “It costs 10 times more each day to care for a child in a hospital,\" he said, \"than it does to care for that child at home.”\u003c/p>\n\u003cp>Tony Cava, spokesman for the Department of Health Care Services which oversees Medi-Cal, said that the agency was \"not aware of any significant access issues\" with home health care for Medi-Cal recipients.\u003c/p>\n\u003cp>If a family is unable to find a home health agency -- or HHA -- to provide prescribed nursing service, Cava said that \"DHCS nurses [would] provide assistance to the family by referring them to other Medi-Cal-approved HHAs, individual nurse providers, and pediatric day health care centers.”\u003c/p>\n\u003cp>But implementing SB 1401 would cost more than $20 million to implement, according to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520160SB1401\" target=\"_blank\">an analysis \u003c/a>presented to the Senate Committee on Appropriations. The bill was ultimately held in the committee earlier this year and cannot be re-introduced until next January.\u003c/p>\n\u003cp>Meanwhile, home health agencies struggle to fill the hours that patients need. “We should be filling 100 percent,\" Frank says, but even when nurses call in sick, \"we have no backup nurses.\"\u003c/p>\n\u003cp>As for the Smarts—after months of phone calls and paperwork, Noah is on track to get Medi-Cal coverage. What's unclear is whether that coverage will make a difference, given the shortage of in-home pediatric nurses.\u003c/p>\n\u003cp>Brian Smart knew that even with coverage, Noah's name might linger on a wait list for care for a year—or more. Still, he decided it was worth a shot.\u003c/p>\n\u003cp>\"I filled out the paperwork as a just-in-case,” Brian says. Even the program coordinator told him it would be a \"long shot\" that he would get an in-home nurse.\u003c/p>\n\u003cp>\"Even if it’s a one-in-a-million chance, at least it’s a chance.\"\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>For now, the Smarts will have to keep waiting.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/218008/even-with-insurance-family-of-medically-fragile-child-struggles-to-find-home-health-care","authors":["byline_stateofhealth_218008"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2602","stateofhealth_2808","stateofhealth_99","stateofhealth_2519"],"featImg":"stateofhealth_215870","label":"stateofhealth"},"stateofhealth_155016":{"type":"posts","id":"stateofhealth_155016","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"155016","score":null,"sort":[1456795693000]},"guestAuthors":[],"slug":"california-legislature-approves-revised-health-plan-tax","title":"California Legislature Approves Revised Health Plan Tax","publishDate":1456795693,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After a year of wrangling, California lawmakers Monday approved a reform of a critical tax on health plans designed to keep more than a billion dollars of federal funds flowing to Medi-Cal. The deal includes millions for services for the developmentally disabled.\u003c/p>\n\u003cp>The old tax was set to expire July 1, under new federal rules. The current tax is levied only on plans for Medi-Cal patients. Under the new requirements, all managed care organizations must pay.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, led the effort to pass the legislation.\u003c/p>\n\u003cp>“The proposal provides a stable ongoing funding source for Medi-Cal,\" he said. \"It allows California to maximize its share of existing federal dollars, and we’re always complaining that we don’t get our fair share. It will not negatively impact premiums.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/249691832\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Attempts at a deal last year had failed, first in regular session, then under an \"extraordinary session\" of the Legislature called by the governor in September. But negotiations had continued, and when the governor \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/01/07/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment/\" target=\"_blank\">announced his budget early in January\u003c/a>, he proposed an overall reform package that would reduce the overall tax burden on health plans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The bill had widespread support, including the trade group for health insurance plans.\u003c/p>\n\u003cp>In a statement, Charles Bacchi, CEO of the California Association of Health Plans, said his group appreciated the \"willingness and patience of the Administration and legislative leaders to listen to the challenges posed by earlier formula and for continuing to work with health plans to find a workable solution.\" He said he hoped for quick federal approval of the new tax.\u003c/p>\n\u003cp>Several Republicans joined Democrats to get the tax through the Legislature. But not Sen. Jeff Stone, R-Indio, who said he's not convinced the deal protects consumers.\u003c/p>\n\u003cp>“Will consumers be guaranteed that their rates will not go up? Is there anything written in this bill that will codify the fact there will no increases to any citizens in the state of California? No,\" he said.\u003c/p>\n\u003cp>The legislation includes $300 million in ongoing general fund spending to support services for the developmentally disabled. Coupled with federal matching funds, the developmentally disabled will receive a total of about $500 million a year. Services for the developmentally disabled have withstood more than $1 billion in cuts since the depth of the recession.\u003c/p>\n\u003cp>The money will fund an increase in wages for service providers, who have not received a cost-of-living adjustment in years. When the first outlines of the deal were circulated earlier this month, Eileen Richey, executive director of ARCA, the Association for Regional Centers of California, said she was \"very pleased on quite a few fronts\" with the compromise.\u003c/p>\n\u003cp>Still, she noted that many programs had already closed and others are at risk.\u003c/p>\n\u003cp>\"I do think this is a great step forward,\" she said, \"but it may not be enough to be able to help all programs to stabilize.\"\u003c/p>\n\u003cp>The plan includes a commitment to a rate survey, which was key to many advocates. California's rate structure for services for the developmentally disabled dates to a time when services were far different. People who were developmentally disabled lived in large group homes, as opposed to their own homes, said Tony Anderson, chair of the Lanterman Coalition.\u003c/p>\n\u003cp>\"It's a lot more intensive than it used to be,\" he said. \"It's all about integration now, trying to get people out into the community. They used to be just ... shuttered away.\"\u003c/p>\n\u003cp>The goal of the study is to identify appropriate rates to be paid for these more intensive services. The survey is a three-year process and must be submitted to the Legislature by 2019.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads to the governor's desk next. But it won't be in effect until the Obama administration gives its approval.\u003c/p>\n\n","blocks":[],"excerpt":"California lawmakers have approved legislation that will save more than a billion dollars for Medi-Cal.","status":"publish","parent":0,"modified":1456857692,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":682},"headData":{"title":"California Legislature Approves Revised Health Plan Tax | KQED","description":"California lawmakers have approved legislation that will save more than a billion dollars for Medi-Cal.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Legislature Approves Revised Health Plan Tax","datePublished":"2016-03-01T01:28:13.000Z","dateModified":"2016-03-01T18:41:32.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"155016 http://ww2.kqed.org/stateofhealth/?p=155016","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/02/29/california-legislature-approves-revised-health-plan-tax/","disqusTitle":"California Legislature Approves Revised Health Plan Tax","path":"/stateofhealth/155016/california-legislature-approves-revised-health-plan-tax","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After a year of wrangling, California lawmakers Monday approved a reform of a critical tax on health plans designed to keep more than a billion dollars of federal funds flowing to Medi-Cal. The deal includes millions for services for the developmentally disabled.\u003c/p>\n\u003cp>The old tax was set to expire July 1, under new federal rules. The current tax is levied only on plans for Medi-Cal patients. Under the new requirements, all managed care organizations must pay.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, led the effort to pass the legislation.\u003c/p>\n\u003cp>“The proposal provides a stable ongoing funding source for Medi-Cal,\" he said. \"It allows California to maximize its share of existing federal dollars, and we’re always complaining that we don’t get our fair share. It will not negatively impact premiums.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/249691832&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/249691832'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Attempts at a deal last year had failed, first in regular session, then under an \"extraordinary session\" of the Legislature called by the governor in September. But negotiations had continued, and when the governor \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/01/07/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment/\" target=\"_blank\">announced his budget early in January\u003c/a>, he proposed an overall reform package that would reduce the overall tax burden on health plans.\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 bill had widespread support, including the trade group for health insurance plans.\u003c/p>\n\u003cp>In a statement, Charles Bacchi, CEO of the California Association of Health Plans, said his group appreciated the \"willingness and patience of the Administration and legislative leaders to listen to the challenges posed by earlier formula and for continuing to work with health plans to find a workable solution.\" He said he hoped for quick federal approval of the new tax.\u003c/p>\n\u003cp>Several Republicans joined Democrats to get the tax through the Legislature. But not Sen. Jeff Stone, R-Indio, who said he's not convinced the deal protects consumers.\u003c/p>\n\u003cp>“Will consumers be guaranteed that their rates will not go up? Is there anything written in this bill that will codify the fact there will no increases to any citizens in the state of California? No,\" he said.\u003c/p>\n\u003cp>The legislation includes $300 million in ongoing general fund spending to support services for the developmentally disabled. Coupled with federal matching funds, the developmentally disabled will receive a total of about $500 million a year. Services for the developmentally disabled have withstood more than $1 billion in cuts since the depth of the recession.\u003c/p>\n\u003cp>The money will fund an increase in wages for service providers, who have not received a cost-of-living adjustment in years. When the first outlines of the deal were circulated earlier this month, Eileen Richey, executive director of ARCA, the Association for Regional Centers of California, said she was \"very pleased on quite a few fronts\" with the compromise.\u003c/p>\n\u003cp>Still, she noted that many programs had already closed and others are at risk.\u003c/p>\n\u003cp>\"I do think this is a great step forward,\" she said, \"but it may not be enough to be able to help all programs to stabilize.\"\u003c/p>\n\u003cp>The plan includes a commitment to a rate survey, which was key to many advocates. California's rate structure for services for the developmentally disabled dates to a time when services were far different. People who were developmentally disabled lived in large group homes, as opposed to their own homes, said Tony Anderson, chair of the Lanterman Coalition.\u003c/p>\n\u003cp>\"It's a lot more intensive than it used to be,\" he said. \"It's all about integration now, trying to get people out into the community. They used to be just ... shuttered away.\"\u003c/p>\n\u003cp>The goal of the study is to identify appropriate rates to be paid for these more intensive services. The survey is a three-year process and must be submitted to the Legislature by 2019.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The bill heads to the governor's desk next. But it won't be in effect until the Obama administration gives its approval.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/155016/california-legislature-approves-revised-health-plan-tax","authors":["11200","240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2602","stateofhealth_99","stateofhealth_2519"],"featImg":"stateofhealth_25005","label":"stateofhealth"},"stateofhealth_135833":{"type":"posts","id":"stateofhealth_135833","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"135833","score":null,"sort":[1452204307000]},"guestAuthors":[],"slug":"browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment","title":"Brown's Budget Plan: New Managed Care Tax, Increased SSI Benefits, More Medi-Cal Enrollment","publishDate":1452204307,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Gov. Jerry Brown introduced his \u003ca href=\"http://ww2.kqed.org/news/2016/01/07/browns-budget-mantra-caution\" target=\"_blank\">$122.6 billion general fund budget\u003c/a> in Sacramento on Thursday, including a new approach to replacing a soon-to-expire tax on managed care organizations.\u003c/p>\n\u003cp>The present MCO tax will end on June 30 if legislators cannot agree on a replacement. California faces the loss of $1.1 billion in revenue, including federal match funds. A plan launched last year during a special legislative session on health did not advance.\u003c/p>\n\u003cp>Brown is now proposing an overall reform package on taxes insurers pay that he says will ultimately save them money.\u003c/p>\n\u003cp>\"It's lowering the corporate tax, lowering the premiums tax,\" Brown said, \"and you blend all that together. Because of the way the federal government works, money can flow to us, and it will be net for California.\"\u003c/p>\n\u003cp>Brown said he hoped to get the issue resolved \"in a month,\" but stressed there was no deal as yet with the health plans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.ebudget.ca.gov/FullBudgetSummary.pdf\" target=\"_blank\">Brown's proposal\u003c/a> includes where that money might be spent:\u003c/p>\n\u003cblockquote>\u003cp>The Budget also assumes that revenues from the tax be placed in a special fund and be used to restore the 7‐percent reduction to the In‐Home Supportive Services ($236 million annually). Finally, the Budget assumes the tax is in place for three years starting in 2016‐17.\u003c/p>\u003c/blockquote>\n\u003cp>Charles Bacchi, California Association of Health Plans CEO, said he appreciated new options on an MCO tax. \"I think they've been working very hard, and certainly credit is due to them. At this time, we're still looking at it. We're still trying to confirm it. There will be more discussions this week with the administration.\"\u003c/p>\n\u003cp>Some are already critical of the proposed plan, which earmarks some of the MCO revenue to the Department of Developmental Services.\u003c/p>\n\u003cp>Tim Hornbecker, director of business development for The Arc of Alameda County, believes tying developmental disabilities funding to the MCO tax is the governor’s way of garnering Republican support for the tax -- he needs a two-thirds vote from the Legislature for the tax to pass.\u003c/p>\n\u003cp>“The governor is using people with developmental disabilities as pawns in the system, until he can get his votes from Republicans,” Hornbecker said.\u003c/p>\n\u003cp>Assemblyman Tom Lackey, R-Palmdale, did not approve of the approach.\u003c/p>\n\u003cp>“These folks deserve to be a top consideration in the general funding arena,\" he said. \"And they’ve been an ‘oh, by the way’ consideration, which is deplorable.”\u003c/p>\n\u003cp>\u003cstrong>SSI Increase\u003c/strong>\u003c/p>\n\u003cp>The budget includes a 2.8 percent increase in benefits for people who receive Supplemental Security Income/State Supplementary Payment (SSI/SSP). An estimated 1.3 million people are expected to receive monthly benefits in 2016-17, and their maximum grants will be $889 per month for individuals and $1,496 per month for couples, an increase of $17 and $31 respectively.\u003c/p>\n\u003cp>\u003cstrong>Medi-Cal Enrollment\u003c/strong>\u003c/p>\n\u003cp>The state's Medi-Cal enrollment is expected to reach a new high in the next fiscal year -- 13.5 million people, or more than a third of all Californians.\u003c/p>\n\u003cp>California expanded Medi-Cal as part of the Affordable Care Act. The federal government has been paying 100 percent of the cost of those in the expansion population, but in 2017, California will be responsible for 5 percent of that cost, or $740.2 million in general fund money.\u003c/p>\n\u003cp>The state is responsible for half the cost of those who were always eligible for Medi-Cal but did not sign up until the Affordable Care Act went into effect. Next year, that's expected to be $1.9 billion from the general fund.\u003c/p>\n\u003cp>\u003cstrong>Undocumented Immigrant Health Care\u003c/strong>\u003c/p>\n\u003cp>On May 1, 170,000 \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/17/california-budget-includes-health-coverage-of-undocumented-children-a-first-nationally/\" target=\"_blank\">undocumented children will become eligible \u003c/a>for full Medi-Cal benefits. California is the first state in the country to cover undocumented children. The governor earmarked $145 million in general fund money to cover the new costs.\u003c/p>\n\u003cp>While advocates noted there were no new cuts to programs, they were disappointed that the governor did not go further in restoring funding that was deeply cut in the wake of the 2008 recession.\u003c/p>\n\u003cp>\"This budget proposal largely continues the recession-era cuts to health and human services,\" Anthony Wright, executive director, of Health Access, an advocacy group, said in a statement. \"The [budget] surplus was created in part from $15 billion in HHS cuts; it's high time to restore cuts to Medi-Cal benefits and rates and other public health programs.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>An earlier version of this story incorrectly quoted Gov. Brown who said his revised MCO plan would be \"net for California\" not \"net positive.\" KQED regrets the error.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"In a political move to get a managed care tax passed, advocates say he's using people with developmental disabilities as 'pawns.' ","status":"publish","parent":0,"modified":1452282916,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":779},"headData":{"title":"Brown's Budget Plan: New Managed Care Tax, Increased SSI Benefits, More Medi-Cal Enrollment | KQED","description":"In a political move to get a managed care tax passed, advocates say he's using people with developmental disabilities as 'pawns.' ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Brown's Budget Plan: New Managed Care Tax, Increased SSI Benefits, More Medi-Cal Enrollment","datePublished":"2016-01-07T22:05:07.000Z","dateModified":"2016-01-08T19:55:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"135833 http://ww2.kqed.org/stateofhealth/?p=135833","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/07/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment/","disqusTitle":"Brown's Budget Plan: New Managed Care Tax, Increased SSI Benefits, More Medi-Cal Enrollment","path":"/stateofhealth/135833/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown introduced his \u003ca href=\"http://ww2.kqed.org/news/2016/01/07/browns-budget-mantra-caution\" target=\"_blank\">$122.6 billion general fund budget\u003c/a> in Sacramento on Thursday, including a new approach to replacing a soon-to-expire tax on managed care organizations.\u003c/p>\n\u003cp>The present MCO tax will end on June 30 if legislators cannot agree on a replacement. California faces the loss of $1.1 billion in revenue, including federal match funds. A plan launched last year during a special legislative session on health did not advance.\u003c/p>\n\u003cp>Brown is now proposing an overall reform package on taxes insurers pay that he says will ultimately save them money.\u003c/p>\n\u003cp>\"It's lowering the corporate tax, lowering the premiums tax,\" Brown said, \"and you blend all that together. Because of the way the federal government works, money can flow to us, and it will be net for California.\"\u003c/p>\n\u003cp>Brown said he hoped to get the issue resolved \"in a month,\" but stressed there was no deal as yet with the health plans.\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>\u003ca href=\"http://www.ebudget.ca.gov/FullBudgetSummary.pdf\" target=\"_blank\">Brown's proposal\u003c/a> includes where that money might be spent:\u003c/p>\n\u003cblockquote>\u003cp>The Budget also assumes that revenues from the tax be placed in a special fund and be used to restore the 7‐percent reduction to the In‐Home Supportive Services ($236 million annually). Finally, the Budget assumes the tax is in place for three years starting in 2016‐17.\u003c/p>\u003c/blockquote>\n\u003cp>Charles Bacchi, California Association of Health Plans CEO, said he appreciated new options on an MCO tax. \"I think they've been working very hard, and certainly credit is due to them. At this time, we're still looking at it. We're still trying to confirm it. There will be more discussions this week with the administration.\"\u003c/p>\n\u003cp>Some are already critical of the proposed plan, which earmarks some of the MCO revenue to the Department of Developmental Services.\u003c/p>\n\u003cp>Tim Hornbecker, director of business development for The Arc of Alameda County, believes tying developmental disabilities funding to the MCO tax is the governor’s way of garnering Republican support for the tax -- he needs a two-thirds vote from the Legislature for the tax to pass.\u003c/p>\n\u003cp>“The governor is using people with developmental disabilities as pawns in the system, until he can get his votes from Republicans,” Hornbecker said.\u003c/p>\n\u003cp>Assemblyman Tom Lackey, R-Palmdale, did not approve of the approach.\u003c/p>\n\u003cp>“These folks deserve to be a top consideration in the general funding arena,\" he said. \"And they’ve been an ‘oh, by the way’ consideration, which is deplorable.”\u003c/p>\n\u003cp>\u003cstrong>SSI Increase\u003c/strong>\u003c/p>\n\u003cp>The budget includes a 2.8 percent increase in benefits for people who receive Supplemental Security Income/State Supplementary Payment (SSI/SSP). An estimated 1.3 million people are expected to receive monthly benefits in 2016-17, and their maximum grants will be $889 per month for individuals and $1,496 per month for couples, an increase of $17 and $31 respectively.\u003c/p>\n\u003cp>\u003cstrong>Medi-Cal Enrollment\u003c/strong>\u003c/p>\n\u003cp>The state's Medi-Cal enrollment is expected to reach a new high in the next fiscal year -- 13.5 million people, or more than a third of all Californians.\u003c/p>\n\u003cp>California expanded Medi-Cal as part of the Affordable Care Act. The federal government has been paying 100 percent of the cost of those in the expansion population, but in 2017, California will be responsible for 5 percent of that cost, or $740.2 million in general fund money.\u003c/p>\n\u003cp>The state is responsible for half the cost of those who were always eligible for Medi-Cal but did not sign up until the Affordable Care Act went into effect. Next year, that's expected to be $1.9 billion from the general fund.\u003c/p>\n\u003cp>\u003cstrong>Undocumented Immigrant Health Care\u003c/strong>\u003c/p>\n\u003cp>On May 1, 170,000 \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/17/california-budget-includes-health-coverage-of-undocumented-children-a-first-nationally/\" target=\"_blank\">undocumented children will become eligible \u003c/a>for full Medi-Cal benefits. California is the first state in the country to cover undocumented children. The governor earmarked $145 million in general fund money to cover the new costs.\u003c/p>\n\u003cp>While advocates noted there were no new cuts to programs, they were disappointed that the governor did not go further in restoring funding that was deeply cut in the wake of the 2008 recession.\u003c/p>\n\u003cp>\"This budget proposal largely continues the recession-era cuts to health and human services,\" Anthony Wright, executive director, of Health Access, an advocacy group, said in a statement. \"The [budget] surplus was created in part from $15 billion in HHS cuts; it's high time to restore cuts to Medi-Cal benefits and rates and other public health programs.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>An earlier version of this story incorrectly quoted Gov. Brown who said his revised MCO plan would be \"net for California\" not \"net positive.\" KQED regrets the error.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/135833/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment","authors":["240","3205"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2637","stateofhealth_2602","stateofhealth_99","stateofhealth_2519"],"featImg":"stateofhealth_27563","label":"stateofhealth"},"stateofhealth_121959":{"type":"posts","id":"stateofhealth_121959","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"121959","score":null,"sort":[1449863959000]},"guestAuthors":[],"slug":"berkeley-people-developmental-disabilities-demand-more-funding","title":"In Berkeley, People with Developmental Disabilities Demand More Funding","publishDate":1449863959,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Hundreds of people with developmental disabilities marched in seven cities throughout California Thursday, carrying signs reading “Save Our Programs” and “Keep Your Promise.” They say their services are on the brink of collapse and are asking state lawmakers to increase funding by 10 percent.\u003c/p>\n\u003cp>Workers who care for people with disabilities including autism, down syndrome, and cerebral palsy say they earn less than employees at Burger King and McDonalds.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/237134552\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>“That’s for flipping burgers,” says Tim Hornbecker, business director at The Arc of Alameda County, a service provider. “We have people who literally turn people over. They transfer people from their wheelchair to bed at night. And they get minimum wage of $9.50.”\u003c/p>\n\u003cp>Protestors say provider rates haven’t budged for a decade, at the same time the costs of providing supportive care and job training programs have gone up. Multiple pleas to the governor to increase funding have not resulted in any rate increases in the state budget.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So people took to the streets in San Diego, Bakersfield, Redding, and other cities.\u003c/p>\n\u003cp>Andrew Silliman marched in Berkeley to rally support for a job training program he attends at ToolWorks for people with developmental disabilities.\u003c/p>\n\u003cp>[contextly_sidebar id=\"LgcAvzzlwD7rLJgSAez4hLiWdrnS5GVP\"]\u003c/p>\n\u003cp>“I want to work at Applebee’s,” he says. “I want to do dessert, cook eggs, do your dishes. Everything. It’s cool.”\u003c/p>\n\u003cp>But advocates are worried that if the state doesn’t increase funding for the program for programs like Silliman's job training program, they might close. Several day programs and job-training sites have been shuttered already in recent years, Hornbecker says, adding that his agency loses $200,000 a year.\u003c/p>\n\u003cp>“We’re running on reserves. We’re liquidating property,” he says. “That’s no way to run a business. And, we can’t pay people a living wage.”\u003c/p>\n\u003cp>While the state has passed laws to increase the minimum wage and offer paid sick leave, adding to agencies' labor costs, Hornbecker says they haven't gotten any extra funds to comply with these mandates. Many agencies have simply cut hours, and that’s forced a lot of workers to move on.\u003c/p>\n\u003cp>\"The turnover rate is so high, by the time folks get trained they leave for a better job,\" says Paul King, whose son receives supportive services so he can live independently. \"The turnover rate is destroying these wonderful programs.\"\u003c/p>\n\u003cp>Jerry Brown called for a special legislative session on health care financing this summer, in part, to come up with new revenue streams to support services for people who are developmentally disabled. Lawmakers have proposed taxes on alcoholic beverages and health plans to raise money for the services, but so far, those proposals are floundering.\u003c/p>\n\u003cp>“Democrats and Republicans agree that these are good services,” says Assemblymember Tony Thurmond, D-Richmond. “Not everyone agrees we need to create taxes to support it.”\u003c/p>\n\u003cp>He says he will continue proposing solutions when meetings of the special session resume in January. Thurmond says even these taxes will be cheaper than the alternative.\u003c/p>\n\u003cp>“I would hate to see people going into institutional care, which is more restrictive and more expensive,” he says.\u003c/p>\n\u003cp>California is seen as a leader in providing community-based services that allow people with developmental disabilities to live on their own or with their families. These services were established in 1969, under the Lanterman Act, and are paid for by the state. There are no income thresholds for families.\u003c/p>\n\u003cp>Shira Leeder wants to make sure those rights are preserved. She has cerebral palsy and was at the Berkeley protest in her wheelchair. Without the funding increase, she says, she could end up living in an institution.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“That’s not what we want. We want to be here,” she says. “And we want to have a life, like everybody else.”\u003c/p>\n\n","blocks":[],"excerpt":"The action was part of a series of statewide protests. Rates paid to providers have been frozen for a decade.","status":"publish","parent":0,"modified":1449879620,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":706},"headData":{"title":"In Berkeley, People with Developmental Disabilities Demand More Funding | KQED","description":"The action was part of a series of statewide protests. Rates paid to providers have been frozen for a decade.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Berkeley, People with Developmental Disabilities Demand More Funding","datePublished":"2015-12-11T19:59:19.000Z","dateModified":"2015-12-12T00:20:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"121959 http://ww2.kqed.org/stateofhealth/?p=121959","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/11/berkeley-people-developmental-disabilities-demand-more-funding/","disqusTitle":"In Berkeley, People with Developmental Disabilities Demand More Funding","path":"/stateofhealth/121959/berkeley-people-developmental-disabilities-demand-more-funding","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of people with developmental disabilities marched in seven cities throughout California Thursday, carrying signs reading “Save Our Programs” and “Keep Your Promise.” They say their services are on the brink of collapse and are asking state lawmakers to increase funding by 10 percent.\u003c/p>\n\u003cp>Workers who care for people with disabilities including autism, down syndrome, and cerebral palsy say they earn less than employees at Burger King and McDonalds.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/237134552&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/237134552'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“That’s for flipping burgers,” says Tim Hornbecker, business director at The Arc of Alameda County, a service provider. “We have people who literally turn people over. They transfer people from their wheelchair to bed at night. And they get minimum wage of $9.50.”\u003c/p>\n\u003cp>Protestors say provider rates haven’t budged for a decade, at the same time the costs of providing supportive care and job training programs have gone up. Multiple pleas to the governor to increase funding have not resulted in any rate increases in the state budget.\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>So people took to the streets in San Diego, Bakersfield, Redding, and other cities.\u003c/p>\n\u003cp>Andrew Silliman marched in Berkeley to rally support for a job training program he attends at ToolWorks for people with developmental disabilities.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I want to work at Applebee’s,” he says. “I want to do dessert, cook eggs, do your dishes. Everything. It’s cool.”\u003c/p>\n\u003cp>But advocates are worried that if the state doesn’t increase funding for the program for programs like Silliman's job training program, they might close. Several day programs and job-training sites have been shuttered already in recent years, Hornbecker says, adding that his agency loses $200,000 a year.\u003c/p>\n\u003cp>“We’re running on reserves. We’re liquidating property,” he says. “That’s no way to run a business. And, we can’t pay people a living wage.”\u003c/p>\n\u003cp>While the state has passed laws to increase the minimum wage and offer paid sick leave, adding to agencies' labor costs, Hornbecker says they haven't gotten any extra funds to comply with these mandates. Many agencies have simply cut hours, and that’s forced a lot of workers to move on.\u003c/p>\n\u003cp>\"The turnover rate is so high, by the time folks get trained they leave for a better job,\" says Paul King, whose son receives supportive services so he can live independently. \"The turnover rate is destroying these wonderful programs.\"\u003c/p>\n\u003cp>Jerry Brown called for a special legislative session on health care financing this summer, in part, to come up with new revenue streams to support services for people who are developmentally disabled. Lawmakers have proposed taxes on alcoholic beverages and health plans to raise money for the services, but so far, those proposals are floundering.\u003c/p>\n\u003cp>“Democrats and Republicans agree that these are good services,” says Assemblymember Tony Thurmond, D-Richmond. “Not everyone agrees we need to create taxes to support it.”\u003c/p>\n\u003cp>He says he will continue proposing solutions when meetings of the special session resume in January. Thurmond says even these taxes will be cheaper than the alternative.\u003c/p>\n\u003cp>“I would hate to see people going into institutional care, which is more restrictive and more expensive,” he says.\u003c/p>\n\u003cp>California is seen as a leader in providing community-based services that allow people with developmental disabilities to live on their own or with their families. These services were established in 1969, under the Lanterman Act, and are paid for by the state. There are no income thresholds for families.\u003c/p>\n\u003cp>Shira Leeder wants to make sure those rights are preserved. She has cerebral palsy and was at the Berkeley protest in her wheelchair. Without the funding increase, she says, she could end up living in an institution.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“That’s not what we want. We want to be here,” she says. “And we want to have a life, like everybody else.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/121959/berkeley-people-developmental-disabilities-demand-more-funding","authors":["3205"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2602","stateofhealth_2519"],"featImg":"stateofhealth_121988","label":"stateofhealth"},"stateofhealth_113928":{"type":"posts","id":"stateofhealth_113928","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"113928","score":null,"sort":[1448642347000]},"guestAuthors":[],"slug":"developmentally-disabled-people-face-losing-access-to-services-as-closures-hit","title":"Developmentally Disabled People Face Losing Access to Services as Closures Hit","publishDate":1448642347,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Surrounded by stacks of packages in a brightly lit room, Michael Palone gingerly folded a box and taped it shut. His eyes averted, he shuffled to the front of the warehouse to retrieve scissors, skirting by people and tables in his path.\u003c/p>\n\u003cp>Palone, 26, has mild autism, originally diagnosed as Asperger's syndrome. The condition makes it nearly impossible for him to socialize with others and adjust to the constant changes of a full time job. Instead, he assembles packages with about 40 others at a Union City work center run by The Arc of Alameda County.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If he doesn’t keep going to this program, all of the progress that he’s made over the past two years will just be gone in two weeks.'\u003cbr>\n\u003ccite>Rosemary Palone, mother of 26-year-old son with autism\u003c/cite>\u003c/aside>\n\u003cp>The Arc is a national nonprofit with local chapters across the country, including 21 in California, that offer programs and services for people with developmental disabilities. “It means a lot to me,\" Palone says. \"It gets me out of the house, and it helps me interact with people.\"\u003c/p>\n\u003cp>Before joining the work activity center, Palone mostly stayed at home, in his room, playing computer games all day. He couldn’t complete simple tasks like doing his laundry without his mother’s help. But since he joined The Arc two years ago, his mother, Rosemary, said that the change in his behavior has been remarkable.\u003c/p>\n\u003cp>“When I first found out how good the program was for him, it made me cry,” she said. Now Michael voluntarily joins her on trips to the grocery store, sits with the family in the living room and even washes his own clothes without needing a reminder. Plus, his work is paid. He earns about $300 per month, which he uses to buy magic cards or to treat his niece to lunch. “We talk more now than we ever did throughout his entire childhood,” Rosemary Palone says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But she fears that her son will return to his former, reclusive ways. Due to a lack of funding and the increasing cost of living in the San Francisco Bay Area, The Arc can no longer shoulder the costs of running the program, and plans to close the work center in a few months. Rosemary Palone worries that Michael -- and other clients like him -- will have nowhere else to go. “If he doesn’t keep going to this program, all of the progress that he’s made over the past two years will just be gone in two weeks,” she said.\u003c/p>\n\u003cfigure id=\"attachment_114034\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/IMG_3159-copy-e1448505797296.jpg\">\u003cimg class=\"size-thumbnail wp-image-114034\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/IMG_3159-copy-400x267.jpg\" alt=\"Ron Luter (R) is executive director of The Arc of Alameda County. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ron Luter (R) is executive director of The Arc of Alameda County. \u003ccite>(Melissa Hellmann)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The work activity center is funded through a combination of state and federal money. But Ron Luter, president and CEO of The Arc of Alameda County, says it's not enough to cover costs, and it's hurting the rest of the agency.\u003c/p>\n\u003cp>“The work activity center is really pulling this facility down,” Luter says.\u003cb>\u003ci> \u003c/i>\u003c/b>During its heyday, the workshop bustled with activity as the main co-packager for Ghirardelli Chocolate, but it lost the contract and the additional revenue when the company moved its packaging facility to Modesto several years ago. Now packaging machines sit in the room collecting dust and have been out of operation for years.\u003c/p>\n\u003cp>Although The Arc of Alameda County’s annual budget is $5 million, Luter said that the four centers he heads throughout the East Bay have collectively lost about $1 million over the past three years. To offset the debt, Luter's been running clothing drives and dipping into savings from the sale of two former Arc of Alameda properties, but the pool of extra money will soon run dry, he says.\u003c/p>\n\u003cp>The Arc of Alameda’s plight echoes that of similar organizations across the state. California was once known as a pioneer for spearheading alternatives to confining people with developmental disabilities in state-run institutions that were notoriously overcrowded and separated patients from their loved ones.\u003c/p>\n\u003cp>In 1965 the California legislature passed AB 691, a pilot program that \u003ca href=\"http://www.dds.ca.gov/Publications/HistoricPub/1969_RCsfortheMR_First2Yrs.pdf\" target=\"_blank\">created the first regional centers\u003c/a>. These agencies were designed to coordinate community-based services so people with developmental disabilities could live independently or with their families. Today there are 21 non-profit regional centers across California that handle case management and program development, among many other services.\u003c/p>\n\u003cp>But in the wake of The Great Recession, more than $1 billion in state budget cuts has threatened the system. In a grimly-titled report, \u003cem>\u003ca href=\"http://arcanet.org/wp-content/uploads/2015/02/on-the-brink-of-collapse.pdf\" target=\"_blank\">On the Brink of Collapse\u003c/a>\u003c/em>, the Association of Regional Center Agencies (ARCA) said California “continues to lose ground” and noted that the state has the lowest funding in the country for individuals with a developmental disability who qualify for services.\u003c/p>\n\u003cp>In addition, provider rates for organizations have been frozen \u003ca href=\"http://www.chhs.ca.gov/DCTFDocs/2_Revised%2520Rate%2520Process%2520Overview.pdf\">since 2003\u003c/a>, meaning that agencies are running on a rate model that was created over a decade ago. The situation is especially pronounced in the expensive Bay Area, yet provider rates are the same statewide, despite the varied costs of living.\u003c/p>\n\u003cp>Eileen Richey, executive director of ARCA, says the lack of funding puts Californians with developmental disabilities at continued risk. “All of these challenges now mean that more people have to wait to get into\u003ci> \u003c/i>a\u003ci> \u003c/i>program,” Richey said. “And everyone throughout the system ends up having to do more with less ... continually worsening the quality of life for people with developmental disabilities and their families.”\u003c/p>\n\u003cp>Richey added that it’s nearly impossible to find qualified, long-term staff to work at the rate the organizations offer. Constant staff turnover makes providing quality care even more challenging.\u003c/p>\n\u003cp>\"The turnover rate is so high,\" Luter of The Arc of Alameda says of his dwindling staff. \"We’re competing with people for jobs at In-N-Out Burger. Half of the people who work for me have two jobs just to survive.\" At his work activity center, Luter said that the ratio of clients to staff should be 10 to 1, but it’s currently double that because he can’t afford to pay any more workers.\u003c/p>\n\u003cp>The work activity center at The Arc of Alameda in Union City is just one of the programs in the Bay Area that will be shutting down over the next few months because of funding issues. Luter also plans on closing his child care program in Hayward, where he said deficits have run between $40,000-$100,000 per year since 2010. The center serves children ages 2-5 with mild to moderate disabilities or developmental delays.\u003c/p>\n\u003cp>\u003cstrong>Brentwood Center Closing Monday\u003c/strong>\u003c/p>\n\u003cp>A combination of factors forced Barbara Maizie, executive director of \u003ca href=\"http://www.contracostaarc.com\" target=\"_blank\">Contra Costa ARC\u003c/a>, to decide to close the Lynn Center, a program serving children 15 months to 5 years with developmental delays and autism. Monday will be its last day.\u003c/p>\n\u003cp>Maizie says the low funding levels had already strained her agency. Then the Lynn Center faced relocation when the elementary school housing its program was taken back by the district. Maizie realized that they couldn’t afford the relocation costs and gave up hope.\u003c/p>\n\u003cp>“There have been many challenges to running this program in the past and we were always able to rise to the occasion,\" she says, \"but the funding has just become so impossible that we can’t any longer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'California’s developmental disability system has been struggling for many years – it’s time that system sees some benefit from California’s economic recovery.'\u003cbr>\n\u003ccite>Sen. Ed Hernandez, D-West Covina\u003c/cite>\u003c/aside>\n\u003cp>The staff and 14 remaining children are bracing for the last day. Caseworkers at the East Bay Regional Center are scrambling to find replacement programs for each of the kids, but there’s a chance that some might not find an appropriate match.\u003c/p>\n\u003cp>Lynn Center is the fourth closure her agency has seen over the last year, says Ronke Sodipo, director of community services at the Regional Center of the East Bay. The nonprofit agency works with California's Department of Developmental Services to coordinate programs in Alameda and Contra Costa counties for people with developmental disabilities. Out of the 102 clients in the closed programs, she says, up to half have not yet been placed in another center.\u003c/p>\n\u003cp>Sodipo added that recent changes in labor laws have exacerbated funding issues for the scores of organizations that provide services throughout the East Bay. A new statewide \u003ca href=\"http://www.dir.ca.gov/dlse/Paid_Sick_Leave.htm\" target=\"_blank\">paid sick leave law\u003c/a>, the Affordable Care Act requirement that employers with more than 50 full time employees provide health insurance, an increase in overtime pay and the raised minimum wage in Oakland and Emeryville have all created additional costs for the organizations, Sodipo says.\u003c/p>\n\u003cp>“I don’t know that our service providers would be as severely impacted if their costs were taken into consideration and they were given rate adjustments to absorb some of it,” she said.\u003c/p>\n\u003cp>\u003cstrong>Advocating for Change\u003c/strong>\u003c/p>\n\u003cp>Seeking to address the losses from years of underfunding, \u003ca href=\"http://www.lantermancoalition.org\" target=\"_blank\">The Lanterman Coalition\u003c/a> — an alliance of 20 organizations and businesses including agencies that provide services for those with disabilities and advocacy groups — took action earlier this year and lobbied state legislators for a 10 percent across-the-board funding increase for service providers. The proposal was ultimately removed from the state budget that was signed in June. But Brown then called a \"special session\" of the Legislature, to address this funding question and other particularly challenging fiscal issues.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162SB14\" target=\"_blank\">A bill \u003c/a>proposed by Sen. Ed Hernandez, D-West Covina would impose a $2 per pack tax on cigarettes and provide an annual increase of $230 million for regional centers and service providers. “California’s developmental disability system has been struggling for many years – it’s time that system sees some benefit from California’s economic recovery,” Sen. Hernandez said in an email. “I remain hopeful that we are able to use this special session to provide long overdue relief to the (Department of Developmental Services) community.\"\u003c/p>\n\u003cp>Legislators across party lines seem to be in general agreement that provider rates need to increase, but they differ on how much of an increase is needed -- and strategies for funding it. One issue is that agencies serving people with developmental disabilities have not been required to submit a statement of their annual costs to the regional centers in over 10 years.\u003c/p>\n\u003cp>“That said, it begs the question of: what then is the appropriate rate?” says Mark Newton, a policy analyst from the nonpartisan Legislative Analyst’s Office. “That’s a tough issue in a way, because of a lack of collected and reported cost data that would help address a formulation of an appropriate rate structure.”\u003c/p>\n\u003cp>Although the legislative special session is still open, Legislators have not met since September 11, and there is no sign they will be reconvening before the end of the year. Hernandez's bill to address rate increases for developmental services sits waiting.\u003c/p>\n\u003cp>Luter from The Arc of Alameda County is concerned that programs throughout California will continue to go out of business -- and clients will be turned away -- if the special session remains silent over the next few months.\u003c/p>\n\u003cp>While they wait for the special session to reconvene, \u003ca href=\"http://www.supportedliving.com/page-1149271\" target=\"_blank\">advocates are planning a march\u003c/a> to the state Capitol on Dec. 10. Luter says he will carry a coffin in the protest, symbolizing what he calls the \"death” of the Lanterman Act. “We’re not treating these folks as if they’re part of the fabric of the community,” he says.\u003c/p>\n\u003cp>\u003cstrong>\"Terrified for My Daughter's Future\"\u003c/strong>\u003c/p>\n\u003cp>Valerie deChadenedes, 30, of San Francisco, was diagnosed with Rett syndrome when she was 10. It's a rare neurodevelopmental disorder that inhibits brain growth and motor skills. Her story is a warning for others like Michael Palone in Alameda County or the children from Lynn Center if they’re unable to find other services once their programs close.\u003c/p>\n\u003cfigure id=\"attachment_114035\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/Audreyval2-e1448505857674.jpg\">\u003cimg class=\"size-thumbnail wp-image-114035\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/Audreyval2-400x267.jpg\" alt=\"Valerie deChadenedes (L) with her mother Audrey.\" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Valerie deChadenedes (L) with her mother Audrey. \u003ccite>(Melissa Hellmann)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>DeChadenedes is unable to walk, talk or feed herself and needs assistance for many aspects of her life. But her mother, Audrey, says Valerie does enjoy being social with people her own age. She can put words together into sentences through an eye-tracking communication device mounted on her wheelchair.\u003c/p>\n\u003cp>After she completed school eight years ago, she spent four years on a wait list before being placed into a program that could serve someone with her needs. She took art classes there and learned to be more self-sufficient.\u003c/p>\n\u003cp>But five months ago, she was forced to leave the program when it turned out not to be licensed to provide care for medically fragile clients. Her case manager at the Golden Gate Regional Center said that there is no other day program in San Francisco that will be able to address her needs. While it wasn't budget cuts that forced her out, if it's already hard to find services, one wonders how much worse it will get as other programs shut down.\u003c/p>\n\u003cp>Valerie now spends her days at a self-directed program organized by her mother. “If it weren’t for me, what would happen to Valerie?” Audrey deChadenedes wonders. After she was released from the program, Audrey said that Valerie would continuously say, “I feel lonely,” through her communication device.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Frustrated by what she considered inertia in the legislature, Audrey deChadenedes started writing weekly letters to Gov. Jerry Brown and keeping a blog called \u003ca href=\"https://valeriesweekinreview.wordpress.com/\" target=\"_blank\">\u003ci>Valerie’s Week in Review\u003c/i>\u003c/a>, where she details Valerie’s health and the actions she’s taking to find Valerie a new program and an apartment. In her last blog post on Nov. 3, Audrey closed this way: “As great direct-service people quit to make a living wage, as programs close, as things fall apart all around us, I am terrified for my daughter’s future.”\u003c/p>\n\n","blocks":[],"excerpt":"California has the lowest funding in the nation for people with developmental disabilities.","status":"publish","parent":0,"modified":1449861913,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":42,"wordCount":2387},"headData":{"title":"Developmentally Disabled People Face Losing Access to Services as Closures Hit | KQED","description":"California has the lowest funding in the nation for people with developmental disabilities.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Developmentally Disabled People Face Losing Access to Services as Closures Hit","datePublished":"2015-11-27T16:39:07.000Z","dateModified":"2015-12-11T19:25:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"113928 http://ww2.kqed.org/stateofhealth/?p=113928","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/11/27/developmentally-disabled-people-face-losing-access-to-services-as-closures-hit/","disqusTitle":"Developmentally Disabled People Face Losing Access to Services as Closures Hit","nprByline":"Melissa Hellmann","path":"/stateofhealth/113928/developmentally-disabled-people-face-losing-access-to-services-as-closures-hit","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Surrounded by stacks of packages in a brightly lit room, Michael Palone gingerly folded a box and taped it shut. His eyes averted, he shuffled to the front of the warehouse to retrieve scissors, skirting by people and tables in his path.\u003c/p>\n\u003cp>Palone, 26, has mild autism, originally diagnosed as Asperger's syndrome. The condition makes it nearly impossible for him to socialize with others and adjust to the constant changes of a full time job. Instead, he assembles packages with about 40 others at a Union City work center run by The Arc of Alameda County.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If he doesn’t keep going to this program, all of the progress that he’s made over the past two years will just be gone in two weeks.'\u003cbr>\n\u003ccite>Rosemary Palone, mother of 26-year-old son with autism\u003c/cite>\u003c/aside>\n\u003cp>The Arc is a national nonprofit with local chapters across the country, including 21 in California, that offer programs and services for people with developmental disabilities. “It means a lot to me,\" Palone says. \"It gets me out of the house, and it helps me interact with people.\"\u003c/p>\n\u003cp>Before joining the work activity center, Palone mostly stayed at home, in his room, playing computer games all day. He couldn’t complete simple tasks like doing his laundry without his mother’s help. But since he joined The Arc two years ago, his mother, Rosemary, said that the change in his behavior has been remarkable.\u003c/p>\n\u003cp>“When I first found out how good the program was for him, it made me cry,” she said. Now Michael voluntarily joins her on trips to the grocery store, sits with the family in the living room and even washes his own clothes without needing a reminder. Plus, his work is paid. He earns about $300 per month, which he uses to buy magic cards or to treat his niece to lunch. “We talk more now than we ever did throughout his entire childhood,” Rosemary Palone says.\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>But she fears that her son will return to his former, reclusive ways. Due to a lack of funding and the increasing cost of living in the San Francisco Bay Area, The Arc can no longer shoulder the costs of running the program, and plans to close the work center in a few months. Rosemary Palone worries that Michael -- and other clients like him -- will have nowhere else to go. “If he doesn’t keep going to this program, all of the progress that he’s made over the past two years will just be gone in two weeks,” she said.\u003c/p>\n\u003cfigure id=\"attachment_114034\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/IMG_3159-copy-e1448505797296.jpg\">\u003cimg class=\"size-thumbnail wp-image-114034\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/IMG_3159-copy-400x267.jpg\" alt=\"Ron Luter (R) is executive director of The Arc of Alameda County. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ron Luter (R) is executive director of The Arc of Alameda County. \u003ccite>(Melissa Hellmann)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The work activity center is funded through a combination of state and federal money. But Ron Luter, president and CEO of The Arc of Alameda County, says it's not enough to cover costs, and it's hurting the rest of the agency.\u003c/p>\n\u003cp>“The work activity center is really pulling this facility down,” Luter says.\u003cb>\u003ci> \u003c/i>\u003c/b>During its heyday, the workshop bustled with activity as the main co-packager for Ghirardelli Chocolate, but it lost the contract and the additional revenue when the company moved its packaging facility to Modesto several years ago. Now packaging machines sit in the room collecting dust and have been out of operation for years.\u003c/p>\n\u003cp>Although The Arc of Alameda County’s annual budget is $5 million, Luter said that the four centers he heads throughout the East Bay have collectively lost about $1 million over the past three years. To offset the debt, Luter's been running clothing drives and dipping into savings from the sale of two former Arc of Alameda properties, but the pool of extra money will soon run dry, he says.\u003c/p>\n\u003cp>The Arc of Alameda’s plight echoes that of similar organizations across the state. California was once known as a pioneer for spearheading alternatives to confining people with developmental disabilities in state-run institutions that were notoriously overcrowded and separated patients from their loved ones.\u003c/p>\n\u003cp>In 1965 the California legislature passed AB 691, a pilot program that \u003ca href=\"http://www.dds.ca.gov/Publications/HistoricPub/1969_RCsfortheMR_First2Yrs.pdf\" target=\"_blank\">created the first regional centers\u003c/a>. These agencies were designed to coordinate community-based services so people with developmental disabilities could live independently or with their families. Today there are 21 non-profit regional centers across California that handle case management and program development, among many other services.\u003c/p>\n\u003cp>But in the wake of The Great Recession, more than $1 billion in state budget cuts has threatened the system. In a grimly-titled report, \u003cem>\u003ca href=\"http://arcanet.org/wp-content/uploads/2015/02/on-the-brink-of-collapse.pdf\" target=\"_blank\">On the Brink of Collapse\u003c/a>\u003c/em>, the Association of Regional Center Agencies (ARCA) said California “continues to lose ground” and noted that the state has the lowest funding in the country for individuals with a developmental disability who qualify for services.\u003c/p>\n\u003cp>In addition, provider rates for organizations have been frozen \u003ca href=\"http://www.chhs.ca.gov/DCTFDocs/2_Revised%2520Rate%2520Process%2520Overview.pdf\">since 2003\u003c/a>, meaning that agencies are running on a rate model that was created over a decade ago. The situation is especially pronounced in the expensive Bay Area, yet provider rates are the same statewide, despite the varied costs of living.\u003c/p>\n\u003cp>Eileen Richey, executive director of ARCA, says the lack of funding puts Californians with developmental disabilities at continued risk. “All of these challenges now mean that more people have to wait to get into\u003ci> \u003c/i>a\u003ci> \u003c/i>program,” Richey said. “And everyone throughout the system ends up having to do more with less ... continually worsening the quality of life for people with developmental disabilities and their families.”\u003c/p>\n\u003cp>Richey added that it’s nearly impossible to find qualified, long-term staff to work at the rate the organizations offer. Constant staff turnover makes providing quality care even more challenging.\u003c/p>\n\u003cp>\"The turnover rate is so high,\" Luter of The Arc of Alameda says of his dwindling staff. \"We’re competing with people for jobs at In-N-Out Burger. Half of the people who work for me have two jobs just to survive.\" At his work activity center, Luter said that the ratio of clients to staff should be 10 to 1, but it’s currently double that because he can’t afford to pay any more workers.\u003c/p>\n\u003cp>The work activity center at The Arc of Alameda in Union City is just one of the programs in the Bay Area that will be shutting down over the next few months because of funding issues. Luter also plans on closing his child care program in Hayward, where he said deficits have run between $40,000-$100,000 per year since 2010. The center serves children ages 2-5 with mild to moderate disabilities or developmental delays.\u003c/p>\n\u003cp>\u003cstrong>Brentwood Center Closing Monday\u003c/strong>\u003c/p>\n\u003cp>A combination of factors forced Barbara Maizie, executive director of \u003ca href=\"http://www.contracostaarc.com\" target=\"_blank\">Contra Costa ARC\u003c/a>, to decide to close the Lynn Center, a program serving children 15 months to 5 years with developmental delays and autism. Monday will be its last day.\u003c/p>\n\u003cp>Maizie says the low funding levels had already strained her agency. Then the Lynn Center faced relocation when the elementary school housing its program was taken back by the district. Maizie realized that they couldn’t afford the relocation costs and gave up hope.\u003c/p>\n\u003cp>“There have been many challenges to running this program in the past and we were always able to rise to the occasion,\" she says, \"but the funding has just become so impossible that we can’t any longer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'California’s developmental disability system has been struggling for many years – it’s time that system sees some benefit from California’s economic recovery.'\u003cbr>\n\u003ccite>Sen. Ed Hernandez, D-West Covina\u003c/cite>\u003c/aside>\n\u003cp>The staff and 14 remaining children are bracing for the last day. Caseworkers at the East Bay Regional Center are scrambling to find replacement programs for each of the kids, but there’s a chance that some might not find an appropriate match.\u003c/p>\n\u003cp>Lynn Center is the fourth closure her agency has seen over the last year, says Ronke Sodipo, director of community services at the Regional Center of the East Bay. The nonprofit agency works with California's Department of Developmental Services to coordinate programs in Alameda and Contra Costa counties for people with developmental disabilities. Out of the 102 clients in the closed programs, she says, up to half have not yet been placed in another center.\u003c/p>\n\u003cp>Sodipo added that recent changes in labor laws have exacerbated funding issues for the scores of organizations that provide services throughout the East Bay. A new statewide \u003ca href=\"http://www.dir.ca.gov/dlse/Paid_Sick_Leave.htm\" target=\"_blank\">paid sick leave law\u003c/a>, the Affordable Care Act requirement that employers with more than 50 full time employees provide health insurance, an increase in overtime pay and the raised minimum wage in Oakland and Emeryville have all created additional costs for the organizations, Sodipo says.\u003c/p>\n\u003cp>“I don’t know that our service providers would be as severely impacted if their costs were taken into consideration and they were given rate adjustments to absorb some of it,” she said.\u003c/p>\n\u003cp>\u003cstrong>Advocating for Change\u003c/strong>\u003c/p>\n\u003cp>Seeking to address the losses from years of underfunding, \u003ca href=\"http://www.lantermancoalition.org\" target=\"_blank\">The Lanterman Coalition\u003c/a> — an alliance of 20 organizations and businesses including agencies that provide services for those with disabilities and advocacy groups — took action earlier this year and lobbied state legislators for a 10 percent across-the-board funding increase for service providers. The proposal was ultimately removed from the state budget that was signed in June. But Brown then called a \"special session\" of the Legislature, to address this funding question and other particularly challenging fiscal issues.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162SB14\" target=\"_blank\">A bill \u003c/a>proposed by Sen. Ed Hernandez, D-West Covina would impose a $2 per pack tax on cigarettes and provide an annual increase of $230 million for regional centers and service providers. “California’s developmental disability system has been struggling for many years – it’s time that system sees some benefit from California’s economic recovery,” Sen. Hernandez said in an email. “I remain hopeful that we are able to use this special session to provide long overdue relief to the (Department of Developmental Services) community.\"\u003c/p>\n\u003cp>Legislators across party lines seem to be in general agreement that provider rates need to increase, but they differ on how much of an increase is needed -- and strategies for funding it. One issue is that agencies serving people with developmental disabilities have not been required to submit a statement of their annual costs to the regional centers in over 10 years.\u003c/p>\n\u003cp>“That said, it begs the question of: what then is the appropriate rate?” says Mark Newton, a policy analyst from the nonpartisan Legislative Analyst’s Office. “That’s a tough issue in a way, because of a lack of collected and reported cost data that would help address a formulation of an appropriate rate structure.”\u003c/p>\n\u003cp>Although the legislative special session is still open, Legislators have not met since September 11, and there is no sign they will be reconvening before the end of the year. Hernandez's bill to address rate increases for developmental services sits waiting.\u003c/p>\n\u003cp>Luter from The Arc of Alameda County is concerned that programs throughout California will continue to go out of business -- and clients will be turned away -- if the special session remains silent over the next few months.\u003c/p>\n\u003cp>While they wait for the special session to reconvene, \u003ca href=\"http://www.supportedliving.com/page-1149271\" target=\"_blank\">advocates are planning a march\u003c/a> to the state Capitol on Dec. 10. Luter says he will carry a coffin in the protest, symbolizing what he calls the \"death” of the Lanterman Act. “We’re not treating these folks as if they’re part of the fabric of the community,” he says.\u003c/p>\n\u003cp>\u003cstrong>\"Terrified for My Daughter's Future\"\u003c/strong>\u003c/p>\n\u003cp>Valerie deChadenedes, 30, of San Francisco, was diagnosed with Rett syndrome when she was 10. It's a rare neurodevelopmental disorder that inhibits brain growth and motor skills. Her story is a warning for others like Michael Palone in Alameda County or the children from Lynn Center if they’re unable to find other services once their programs close.\u003c/p>\n\u003cfigure id=\"attachment_114035\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/Audreyval2-e1448505857674.jpg\">\u003cimg class=\"size-thumbnail wp-image-114035\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/Audreyval2-400x267.jpg\" alt=\"Valerie deChadenedes (L) with her mother Audrey.\" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Valerie deChadenedes (L) with her mother Audrey. \u003ccite>(Melissa Hellmann)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>DeChadenedes is unable to walk, talk or feed herself and needs assistance for many aspects of her life. But her mother, Audrey, says Valerie does enjoy being social with people her own age. She can put words together into sentences through an eye-tracking communication device mounted on her wheelchair.\u003c/p>\n\u003cp>After she completed school eight years ago, she spent four years on a wait list before being placed into a program that could serve someone with her needs. She took art classes there and learned to be more self-sufficient.\u003c/p>\n\u003cp>But five months ago, she was forced to leave the program when it turned out not to be licensed to provide care for medically fragile clients. Her case manager at the Golden Gate Regional Center said that there is no other day program in San Francisco that will be able to address her needs. While it wasn't budget cuts that forced her out, if it's already hard to find services, one wonders how much worse it will get as other programs shut down.\u003c/p>\n\u003cp>Valerie now spends her days at a self-directed program organized by her mother. “If it weren’t for me, what would happen to Valerie?” Audrey deChadenedes wonders. After she was released from the program, Audrey said that Valerie would continuously say, “I feel lonely,” through her communication device.\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>Frustrated by what she considered inertia in the legislature, Audrey deChadenedes started writing weekly letters to Gov. Jerry Brown and keeping a blog called \u003ca href=\"https://valeriesweekinreview.wordpress.com/\" target=\"_blank\">\u003ci>Valerie’s Week in Review\u003c/i>\u003c/a>, where she details Valerie’s health and the actions she’s taking to find Valerie a new program and an apartment. In her last blog post on Nov. 3, Audrey closed this way: “As great direct-service people quit to make a living wage, as programs close, as things fall apart all around us, I am terrified for my daughter’s future.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/113928/developmentally-disabled-people-face-losing-access-to-services-as-closures-hit","authors":["byline_stateofhealth_113928"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2602","stateofhealth_2519"],"featImg":"stateofhealth_114033","label":"stateofhealth"}},"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. 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. 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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. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. 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. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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