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She was a 2013 recipient of the NYU Reporting Award, a 2013 Dennis Hunt Health Journalism fellow and a 2015 USC Data Journalism fellow.\r\n\r\nRead her \u003ca href=\"http://science.kqed.org/quest/author/lizagross/\">previous contributions\u003c/a> to \u003ca href=\"science.kqed.org/quest/\">QUEST\u003c/a>, a project dedicated to exploring the Science of Sustainability.","avatar":"https://secure.gravatar.com/avatar/1f7d36efc78088d63466cef5f10c4c7a?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["author"]},{"site":"quest","roles":["subscriber"]}],"headData":{"title":"Liza Gross | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/1f7d36efc78088d63466cef5f10c4c7a?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/1f7d36efc78088d63466cef5f10c4c7a?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lizagross"},"lisafine":{"type":"authors","id":"11105","meta":{"index":"authors_1591205172","id":"11105","found":true},"name":"Lisa Fine","firstName":"Lisa","lastName":"Fine","slug":"lisafine","email":"lisacfine@gmail.com","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Lisa Fine is a veteran journalist who's written for papers including the Washington Post, Philadelphia Inquirer, Richmond (Va.) 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You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n","blocks":[],"excerpt":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","status":"publish","parent":0,"modified":1493338808,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":56,"wordCount":2090},"headData":{"title":"Hype Offers Hope -- and Risks -- to Cancer Patients | KQED","description":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hype Offers Hope -- and Risks -- to Cancer Patients","datePublished":"2017-04-27T17:04:13.000Z","dateModified":"2017-04-28T00:20:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"323065 https://ww2.kqed.org/stateofhealth/?p=323065","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/27/hype-offers-hope-and-risks-to-cancer-patients/","disqusTitle":"Hype Offers Hope -- and Risks -- to Cancer Patients","nprByline":"\u003cstrong>\u003ca href=\"http://khn.org/news/author/liz-szabo/\" target=\"_blank\">Liz Szabo \u003c/strong>\u003c/a>\u003c/br>Kaiser Health News","path":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\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>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\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>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","authors":["byline_stateofhealth_323065"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_3095","stateofhealth_16","stateofhealth_2892","stateofhealth_2808","stateofhealth_73","stateofhealth_3093","stateofhealth_2519","stateofhealth_3094"],"featImg":"stateofhealth_323067","label":"stateofhealth"},"stateofhealth_240260":{"type":"posts","id":"stateofhealth_240260","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"240260","score":null,"sort":[1475506826000]},"guestAuthors":[],"slug":"at-california-psychiatric-hospitals-epidemic-of-patients-assaults-on-staff-goes-untreated","title":"At California Psychiatric Hospitals, Epidemic of Patients’ Assaults on Staff Goes Untreated","publishDate":1475506826,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>California’s network of state psychiatric hospitals is charged with treating people with mental illness who pose a danger to themselves or others, but workers faced with ongoing assaults by patients have struggled to provide a therapeutic environment. In this in-depth account, veteran California journalist Liza Gross reports that injured workers at the five psychiatric hospitals, including Napa State Hospital, have lost tens of thousands of workdays while taxpayers pay millions of dollars in workers' compensation and overtime costs.\u003c/em>\u003c/p>\n\u003cp>Stephen Seager felt lucky when Napa State Hospital offered him a job as staff psychiatrist in the spring of 2011. His wife, also a physician, had already relocated to Northern California from their home in Utah, after cutbacks at their hospitals forced the couple to find new positions.\u003c/p>\n\u003cp>Seager had originally trained as an emergency room physician, but the continual stream of traumas burned him out. He switched to psychiatry for a change of pace. He’d been drawn to medicine to help those in need, and people with severe mental disorders certainly fit the bill.\u003c/p>\n\u003cp>Seager had treated patients in acute psychiatric distress at hospitals in Phoenix, Los Angeles and St. George, Utah, but, like most psychiatrists, he’d never set foot in a state mental hospital. He just knew they treated some of society’s sickest psychiatric patients and that most had been judged incompetent to stand trial or not guilty by reason of insanity. He thought he could help them.\u003c/p>\n\u003cp>When Seager took the job at Napa, he says he didn’t know that even people found to have committed violent acts were free to wander the hospital halls. He also didn’t know that the clinical staff doubled as security guards.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And he didn’t know that seven months before he showed up for work, a veteran psychiatric technician named Donna Gross had been murdered right outside his new office.\u003c/p>\n\u003cp>The exact details of Gross’ death are not known, but police investigators and state occupational safety inspectors were able to piece together the general outlines of what happened, the coroner’s and inspector’s reports show.\u003c/p>\n\u003cp>On Sept. 23, 2010, Gross (no relation to the author) was returning from a break for her second shift of the day, around 5:30 p.m., when she entered the hospital’s secure treatment area, which houses patients deemed criminally insane. She walked across the grounds, where many patients congregated unsupervised. Before she reached her unit, a patient grabbed her and dragged her behind a patio wall. Gross pressed the alarm on her belt, but nobody came to her aid. Staff alarms, according to court records, didn’t work outdoors.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>An hour after the 54-year-old grandmother had passed through security, her colleagues found her sprawled on the courtyard patio, dead. Police quickly determined that Gross had been strangled by Jess Massey, a 37-year-old patient known for his violent history and penchant for stalking.\u003c/p>\n\u003cp>Most patients who assault staff, according to Seager and other staff members, remain on the wards.\u003cstrong> \u003c/strong> After all, many came to California’s state psychiatric facilities because they committed violent crimes. Massey had been sent to Napa after pleading not guilty by reason of insanity after repeatedly stabbing a woman in a Sacramento parking garage. Police investigators said Massey confessed to killing Gross. He pleaded no contest in court and is now serving 25 years to life at Corcoran State Prison.\u003c/p>\n\u003cp>Gross’ murder forced California hospital administrators to respond to increasing pressure from employees who’d long protested perilous conditions at the state’s five psychiatric hospitals. \u003ca href=\"https://www.uapd.com/2010/11/uapd-president-dr-stuart-bussey-speaks-out-on-napa-state-hospital-violence/\" target=\"_blank\">Officials offered\u003c/a> shuttles so Napa employees didn’t have to walk through the grounds, and tightened restrictions on grounds passes.\u003c/p>\n\u003cp>A month before Seager started working at Napa State, the Occupational Safety and Health Administration fined the hospital $100,140 for “serious” and “willful” violations that led to Gross’ death. This time, hospital administrators agreed to deploy security teams to patrol the grounds and lifted a hiring ban.\u003cbr>\nIt wasn’t enough -- not for workers at Napa or the state’s other facilities. Since Gross’ death, employees at California’s five psychiatric hospitals have suffered thousands of assaults a year, resulting in tens of thousands of lost days on the job and costing taxpayers at least $135 million in workers' compensation and overtime.\u003c/p>\n\u003cp>As a new employee, Seager had barely stepped onto his unit when a burly patient batted the slightly built doctor aside like a fly, sending him crashing into a wall. Seager’s head hit with a thwack that split open his scalp. The man then grabbed a heavy wooden chair and smashed it over an older patient’s head. Seager, who’d just turned 61, tried to stanch the blood gushing from the man’s head until paramedics arrived. “I’ve kept up my ER skills as a psychiatrist because I have so many emergency beatings and traumas,” he says.\u003c/p>\n\u003cfigure id=\"attachment_240449\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-240449 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/09/seager-photo-1-800x732.jpg\" width=\"800\" height=\"732\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-800x732.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-400x366.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-768x703.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-1180x1079.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-960x878.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1.jpg 1290w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Stephen Seager\u003c/figcaption>\u003c/figure>\n\u003cp>Seager’s colleagues convinced him to go to the county hospital. It took 10 stitches to close his wound. The patient never returned. Seager heard he’d been flown out to a nearby hospital. He found out the patient died only because a colleague’s relative worked at the hospital where he’d been treated.\u003c/p>\n\u003cp>At Napa State, violence was -- and still is -- just part of the routine, as the signs that are posted twice a week reporting assaults on staff indicate. There are steps officials could take to control the violence at California’s state hospitals, Seager says -- steps that would ultimately save taxpayers money. “But the administration and Sacramento don’t seem to care.”\u003c/p>\n\u003cp>\u003cstrong>Safety Measures Fall Short\u003c/strong>\u003c/p>\n\u003cp>Neither the measures taken before Seager’s arrival, nor those taken since, have stopped the bleeding at California’s five psychiatric hospitals. In the years following Gross’ death, workers at Napa, Patton, Metropolitan, Coalinga and Atascadero state hospitals have suffered on average 2,795 assaults a year, costing California taxpayers over $82.7 million in workers’ compensation claims over the past two fiscal years alone, according to data obtained through state public records requests.\u003c/p>\n\u003cp>Patients at the five hospitals committed nearly 26,000 assaults between 2011 and 2014, the latest year for which data are available, according to aggressive incident report records obtained from the Department of State Hospitals, which oversees the facilities.\u003c/p>\n\u003cp>Staff were the victims of 11,000 — more than 42 percent — of those assaults, the records show. Psychiatric technicians, nurses and their colleagues sustained 2,745 assaults at the five facilities in 2014, nearly 150 more than the year before. In the past two fiscal years, 2013-14 and 2014-15, they lost 105,108 days of work, the equivalent of 473 full-time employees.\u003c/p>\n\u003cp>Workers at Napa State alone endured 880 assaults in 2014, up from 866 the previous year. Employees were routinely kicked in the chest, punched in the face, shoved against walls and knocked to the ground, police logs obtained through public records requests show.\u003c/p>\n\u003cp>If you look at the rate of assaults based on the number of staff working at the facilities, it looks like safety has improved. The chances of an employee getting assaulted peaked at 30 percent in 2012, compared with 24 percent in 2014. But those figures are misleading, union reps say. For one thing, paperwork requirements for assaults increased while hospitals were required to report to a federal monitor (which ended in 2013), and it was not uncommon for assaulted staff to suffer in silence rather than fill out more forms.\u003c/p>\n\u003cp>[assaultsHospitals]\u003c/p>\n\u003cp>But perhaps more importantly, not everyone faces the same risks. Although any staff member runs the risk of a beating, says California Association of Psychiatric Technicians representative Coby Pizzotti, psych techs are especially vulnerable because they have the most contact with patients. The state doesn’t release the number of assaults on staff based on job category.\u003c/p>\n\u003cp>With 3,500 psych techs and over 2,700 assaults in a year, Pizzotti says, “It’s not a matter of if you get assaulted, it’s when you’re going to be assaulted and how severe.”\u003c/p>\n\u003cp>The year Gross was killed, staff at Napa State filed 289 workers' comp claims, according to the\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> L\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\">os\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> Ange\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\">les\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> Times\u003c/a>. Over the past two fiscal years, that number jumped to 517 and 519, state records show. As the abuse continued, Seager says, staff and administrators acted like daily assaults were all in a day’s work. “It’s horrifying to me that no one does anything about it or even talks about it,” he says. “It’s not mentioned. Ever.”\u003c/p>\n\u003cp>Frustrated by this culture of silence and the state’s unwillingness to address the rampant violence in its hospitals, Seager documented the ongoing beatings in a 2014 book, “Behind the Gates of Gomorrah: A Year with the Criminally Insane.” He wrote the book, he says, because he wanted the public to know that the people they send to state hospitals to get treatment can’t get better in the midst of so much violence. And staff can’t deliver the care they were trained to provide when they’re constantly worried about their safety.\u003c/p>\n\u003cp>Hospital administrators weren’t happy about it, Seager says. But they didn’t fire him.\u003c/p>\n\u003cp>“The safety of our patients and staff has always been among our top priorities,” says Ralph Montano, spokesman for the Department of State Hospitals. Among recent safety improvements, Montano points to a new personal alarm system, which alerts police and reveals an employee’s location, indoors or out, and what he describes as key pieces of legislation signed by Gov. Jerry Brown in 2014.\u003c/p>\n\u003cp>The laws were designed to improve safety by giving clinical staff the right to access a patient’s \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201320140AB1960\" target=\"_blank\">criminal history\u003c/a> for violence risk assessment and allowing medication orders to follow patients judged incompetent to stand trial. Patients can spend months in prison or jail without treatment before reaching the hospital, Seager says, increasing their risk for violent behavior.\u003c/p>\n\u003cp>Another law authorizes hospital officials to build enhanced treatment facilities, where the most dangerous patients receive treatment in secured areas as part of a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140AB1340\" target=\"_blank\">pilot program\u003c/a>. The department reported last year that a quarter of patients had been involved in aggressive incidents but only a fraction of them were considered “repeatedly violent patients.” The hope is that segregating those prone to violence will make the hospitals safer.\u003c/p>\n\u003cp>\u003cstrong>Hospitals Take on More Mentally Ill Patients Charged with Crimes\u003c/strong>\u003c/p>\n\u003cp>Napa State wasn’t always such a violent place. When psych tech Michael Jarschke started working at the hospital in 1972, most patients came to Napa because they couldn’t take care of themselves, not because they’d committed a crime. In those days, he’d sometimes get clobbered by patients beset by fits, but brutal beatings were rare.\u003c/p>\n\u003cp>More patients started coming to California’s state hospitals through the criminal justice system in the mid-1990s, Jarschke says, just before Donna Gross hired on at Napa State.\u003c/p>\n\u003cp>To ease overcrowding in prisons and jails, Napa and other state hospitals took on more mentally ill patients charged with crimes. In 1995, forensic patients, who have been convicted or accused of a felony linked to mental illness, made up 60 percent of patients in state facilities, state records show.\u003c/p>\n\u003cp>Today, 96 percent of the state’s psychiatric patients came through criminal courts -- accounting for 37 percent of the nation’s criminally insane.\u003c/p>\n\u003cp>But staff weren’t trained to deal with “prison-minded” patients, says Jarschke, who served as president of the California Association of Psychiatric Technicians' Napa chapter until May. Over time, he’d see more and more patients with gang affiliations, anti-social personality disorders and, like Jess Massey, predatory tendencies.\u003c/p>\n\u003cp>In the old days, Jarschke invited patients to his house for dinner, to help them feel normal. “That’s not happening here,” he says. “It’s not the same. It’ll never be the same.”\u003c/p>\n\u003cp>Jarschke soon realized the tools he used in a bike repair class could turn deadly in the wrong hands. But he felt strongly that he should keep teaching his patients skills that would boost their self-worth, so he set up a wheelchair repair program, thinking it would help them get a job when they got out. Some of his patients had committed monstrous crimes, but to him, they were people with mental problems, not criminals.\u003c/p>\n\u003cp>Jarschke had just set up a wheelchair repair program when Gross was killed. Even the wheelchair program was too risky, he realized. He shut it down.\u003c/p>\n\u003cp>The day after Gross’ murder, Jarschke and his colleagues formed the Safety Now Coalition to protect both staff and patients.\u003c/p>\n\u003cp>One of the first things they did was push for fully functional personal alarms and more security and clinical staff at the hospital. In 2012, administrators added a police substation within the secured treatment area outside, where Massey had cornered Gross. The following year, department spokesman Montano says, they finished implementing the alarm system.\u003c/p>\n\u003cp>But police aren’t on the wards when fights break out, so it’s up to staff, usually psych techs, to intervene. Most psych techs at California’s state hospitals are women who routinely find themselves trying to restrain men twice their size.\u003c/p>\n\u003cp>The alarms don’t prevent assaults, Seager says. “They simply allow people to get you medical help faster. We’ve had social workers have their teeth kicked in and bones broken. We’ve had head injuries where they’ve never come back.”\u003c/p>\n\u003cp>Workers often showed up for a shift having no idea there had just been a brutal assault. Last year, Seager says, “Someone was strangled and left for dead, and [the administration] never said anything about it.”\u003c/p>\n\u003cp>Safety Now asked administrators if staff at Napa could post a sign when a peer suffers an injury that requires more than local first aid, Jarschke says. The request was granted.\u003c/p>\n\u003cp>\u003cstrong>Subsidizing Violence on the Job\u003c/strong>\u003c/p>\n\u003cp>Lupe Alonzo-Diaz, the Department of State Hospitals deputy director of administrative services, acknowledged the risks staff face before a state oversight agency last year. “The potential to be assaulted is a daily threat for nursing staff,” she told the Little Hoover Commission, an independent agency that monitors and proposes improvements to state government operations.\u003c/p>\n\u003cp>The Department of State Hospitals defines aggressive acts as “hitting, pushing, kicking or similar acts directed against another individual to cause potential or actual injury.”\u003c/p>\n\u003cp>Verbal assault is not included in statistics released by the state, even though studies show that workers can suffer greater psychological effects from \u003ca href=\"http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Measurement-and-Monitoring-Worker-Aggression-Exposure.html\" target=\"_blank\">threats of violence than from physical aggression\u003c/a>.\u003c/p>\n\u003cp>With so many battered workers unable to do their jobs (they're out on worker's comp due to the assaults), the Department of State Hospitals has asked psych techs and nurses to work more than 4.7 million hours of overtime — at time and a half — since 2012 to meet legal staffing requirements. Overtime hours for psych techs have increased more than a third since 2012, reaching 1.2 million hours last year at a cost of $53 million, Pizzotti testified before the Little Hoover Commission.\u003c/p>\n\u003cp>[overtimeTech]\u003c/p>\n\u003cp>Nearly 150,000 overtime hours were mandatory during the 2014-15 fiscal year, up from 92,000 the previous year, state records show.\u003c/p>\n\u003cp>The union is fighting mandatory overtime, CAPT’s Pizzotti says, because it leaves workers unable to prepare for an extra shift, by going to bed early the night before or arranging day care for their kids. Sometimes employees don’t know until two hours before they’re scheduled to leave that they have to stay on, he says. “That throws your world into complete upheaval.”\u003c/p>\n\u003cp>California banned mandatory overtime for \u003ca href=\"http://www.seiu1000.org/general-information/local-1000-nurses-call-legislature-stop-mandatory-overtime\" target=\"_blank\">nurses in the private sector\u003c/a> in 2001 because it compromises worker and patient safety. Since then, \u003ca href=\"http://jap.sagepub.com/content/21/1/19.full.pdf+html\" target=\"_blank\">overwhelming evidence\u003c/a> has linked long extended shifts to increased risks of clinical mistakes and \u003ca href=\"https://www.jointcommission.org/assets/1/18/SEA_48.pdf\" target=\"_blank\">higher rates of occupational injury.\u003c/a>\u003c/p>\n\u003cp>Fatigued staff faced with the constant threat of assault are ill-prepared to safeguard their patients. Weak and vulnerable psychiatric patients sustained over 3,400 assaults at the hands of their peers in 2014, state records show. Although the numbers dropped nearly a quarter between 2010 and 2013, they jumped by 100 assaults in the following year.\u003c/p>\n\u003cp>Hospital administrators are forced to rely on mandatory overtime or face serious consequences, such as loss of certification, court sanctions and fines, Alonzo-Diaz told the Little Hoover Commission. It’s difficult to hire new staff, she said, because the risks associated with the work, combined with lower wages compared with private hospitals -- as much as $63,000 less for nurses and $15,000 less for psych techs -- make it hard to attract and retain employees.\u003c/p>\n\u003cp>Pizzotti says the state could solve these problems in part by expediting a hiring process that is so drawn out that job seekers find work elsewhere before they hear if they’re in the running.\u003cbr>\nRelief appeared to be on the horizon in August, when the Legislature passed \u003ca href=\"http://www.psychtechs.net/uploads/eng/sb%20780_introduced.pdf\" target=\"_blank\">SB 780\u003c/a>, a bill prohibiting the state from using mandatory overtime as a staffing tool. But the bill was withdrawn after Gov. Jerry Brown signaled his opposition to the measure, Pizzotti says.\u003c/p>\n\u003cp>“We decided not to move the bill onto his desk, knowing that it would be vetoed,” he says. That means union representatives are back to bargaining with administrators to reduce mandatory overtime.\u003c/p>\n\u003cp>\u003cstrong>‘Everybody’s in the wrong place’\u003c/strong>\u003c/p>\n\u003cp>For psychiatrist Seager, improving safety over the long term requires coming to grips with the systemic failures that left state hospitals ill-equipped to deal with violent criminals. Homeless people with acute psychiatric conditions should be treated in state hospitals, he says, while the nonviolent mentally ill now in prisons and jails should be treated in community treatment centers and people convicted of violent crimes should be treated in prisons.\u003c/p>\n\u003cp>Instead, he says, “Every single person in the mental health care system is in the wrong place.”\u003c/p>\n\u003cp>Even so, the state could implement several reforms now. Every hospital should have enhanced treatment units as soon as possible, staff say, to protect workers and vulnerable patients from the subset of patients who commit the majority of assaults.\u003c/p>\n\u003cp>The state authorized funding for the program this year, and administrators expect to open units at Atascadero and Patton in 2018, says department spokesman Montano.\u003c/p>\n\u003cp>It could be several years before an enhanced unit comes to Napa. “That’s an ominous feeling for us,” says psych tech Jarschke.\u003c/p>\n\u003cp>For now, increasing staffing levels would go a long way toward reducing violence on the wards, union rep Pizzotti says. Last year, the Department of Public Health hit Napa with several citations for failing to protect patients, including one who sustained a head injury and another who suffered a broken jaw. According to police reports and sources, that’s almost inevitable when an alarm draws all hands from one unit, only to leave another unattended. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Taxpayers have been spending tens of millions of dollars a year in overtime that leaves workers exhausted, prone to making mistakes and even more vulnerable to injury, Pizzotti says. Last year, 18.4 million taxpayers filed with the California Franchise Tax Board. The money spent on overtime could have hired hundreds of full-time psych techs, he says, greatly reducing the risk of violence while allowing staff to focus on the therapeutic care they were trained to provide. It would have cost the average taxpayer less than the price of a latte at Starbucks.\u003c/p>\n\u003cp>But those positions remain unstaffed. Meanwhile, Seager says, the assaults at Napa grew bloodier and more frequent.\u003c/p>\n\u003cp>Next month marks the sixth anniversary of Donna Gross’ murder. This will be the first year Seager won’t be there to pay his respects. “I finally had enough of Napa,” he says. Seager left in June to freelance as an emergency services psychiatrist for several Bay Area hospitals.\u003c/p>\n\u003cp>“The medical care at Napa is first rate and the staff is terrific,” Seager says. “It’s just not safe.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was produced with the support of the California Data Fellowship, a program of the Center for Health Journalism at the USC Annenberg School for Communication and Journalism.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Injured workers at the five state hospitals have lost tens of thousands of workdays, costing millions to taxpayers.","status":"publish","parent":0,"modified":1475527656,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":72,"wordCount":3495},"headData":{"title":"At California Psychiatric Hospitals, Epidemic of Patients’ Assaults on Staff Goes Untreated | KQED","description":"Injured workers at the five state hospitals have lost tens of thousands of workdays, costing millions to taxpayers.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"At California Psychiatric Hospitals, Epidemic of Patients’ Assaults on Staff Goes Untreated","datePublished":"2016-10-03T15:00:26.000Z","dateModified":"2016-10-03T20:47:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"240260 http://ww2.kqed.org/stateofhealth/?p=240260","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/10/03/at-california-psychiatric-hospitals-epidemic-of-patients-assaults-on-staff-goes-untreated/","disqusTitle":"At California Psychiatric Hospitals, Epidemic of Patients’ Assaults on Staff Goes Untreated","path":"/stateofhealth/240260/at-california-psychiatric-hospitals-epidemic-of-patients-assaults-on-staff-goes-untreated","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>California’s network of state psychiatric hospitals is charged with treating people with mental illness who pose a danger to themselves or others, but workers faced with ongoing assaults by patients have struggled to provide a therapeutic environment. In this in-depth account, veteran California journalist Liza Gross reports that injured workers at the five psychiatric hospitals, including Napa State Hospital, have lost tens of thousands of workdays while taxpayers pay millions of dollars in workers' compensation and overtime costs.\u003c/em>\u003c/p>\n\u003cp>Stephen Seager felt lucky when Napa State Hospital offered him a job as staff psychiatrist in the spring of 2011. His wife, also a physician, had already relocated to Northern California from their home in Utah, after cutbacks at their hospitals forced the couple to find new positions.\u003c/p>\n\u003cp>Seager had originally trained as an emergency room physician, but the continual stream of traumas burned him out. He switched to psychiatry for a change of pace. He’d been drawn to medicine to help those in need, and people with severe mental disorders certainly fit the bill.\u003c/p>\n\u003cp>Seager had treated patients in acute psychiatric distress at hospitals in Phoenix, Los Angeles and St. George, Utah, but, like most psychiatrists, he’d never set foot in a state mental hospital. He just knew they treated some of society’s sickest psychiatric patients and that most had been judged incompetent to stand trial or not guilty by reason of insanity. He thought he could help them.\u003c/p>\n\u003cp>When Seager took the job at Napa, he says he didn’t know that even people found to have committed violent acts were free to wander the hospital halls. He also didn’t know that the clinical staff doubled as security guards.\u003cstrong>\u003cbr>\n\u003c/strong>\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>And he didn’t know that seven months before he showed up for work, a veteran psychiatric technician named Donna Gross had been murdered right outside his new office.\u003c/p>\n\u003cp>The exact details of Gross’ death are not known, but police investigators and state occupational safety inspectors were able to piece together the general outlines of what happened, the coroner’s and inspector’s reports show.\u003c/p>\n\u003cp>On Sept. 23, 2010, Gross (no relation to the author) was returning from a break for her second shift of the day, around 5:30 p.m., when she entered the hospital’s secure treatment area, which houses patients deemed criminally insane. She walked across the grounds, where many patients congregated unsupervised. Before she reached her unit, a patient grabbed her and dragged her behind a patio wall. Gross pressed the alarm on her belt, but nobody came to her aid. Staff alarms, according to court records, didn’t work outdoors.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>An hour after the 54-year-old grandmother had passed through security, her colleagues found her sprawled on the courtyard patio, dead. Police quickly determined that Gross had been strangled by Jess Massey, a 37-year-old patient known for his violent history and penchant for stalking.\u003c/p>\n\u003cp>Most patients who assault staff, according to Seager and other staff members, remain on the wards.\u003cstrong> \u003c/strong> After all, many came to California’s state psychiatric facilities because they committed violent crimes. Massey had been sent to Napa after pleading not guilty by reason of insanity after repeatedly stabbing a woman in a Sacramento parking garage. Police investigators said Massey confessed to killing Gross. He pleaded no contest in court and is now serving 25 years to life at Corcoran State Prison.\u003c/p>\n\u003cp>Gross’ murder forced California hospital administrators to respond to increasing pressure from employees who’d long protested perilous conditions at the state’s five psychiatric hospitals. \u003ca href=\"https://www.uapd.com/2010/11/uapd-president-dr-stuart-bussey-speaks-out-on-napa-state-hospital-violence/\" target=\"_blank\">Officials offered\u003c/a> shuttles so Napa employees didn’t have to walk through the grounds, and tightened restrictions on grounds passes.\u003c/p>\n\u003cp>A month before Seager started working at Napa State, the Occupational Safety and Health Administration fined the hospital $100,140 for “serious” and “willful” violations that led to Gross’ death. This time, hospital administrators agreed to deploy security teams to patrol the grounds and lifted a hiring ban.\u003cbr>\nIt wasn’t enough -- not for workers at Napa or the state’s other facilities. Since Gross’ death, employees at California’s five psychiatric hospitals have suffered thousands of assaults a year, resulting in tens of thousands of lost days on the job and costing taxpayers at least $135 million in workers' compensation and overtime.\u003c/p>\n\u003cp>As a new employee, Seager had barely stepped onto his unit when a burly patient batted the slightly built doctor aside like a fly, sending him crashing into a wall. Seager’s head hit with a thwack that split open his scalp. The man then grabbed a heavy wooden chair and smashed it over an older patient’s head. Seager, who’d just turned 61, tried to stanch the blood gushing from the man’s head until paramedics arrived. “I’ve kept up my ER skills as a psychiatrist because I have so many emergency beatings and traumas,” he says.\u003c/p>\n\u003cfigure id=\"attachment_240449\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-240449 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/09/seager-photo-1-800x732.jpg\" width=\"800\" height=\"732\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-800x732.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-400x366.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-768x703.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-1180x1079.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1-960x878.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/09/seager-photo-1.jpg 1290w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Stephen Seager\u003c/figcaption>\u003c/figure>\n\u003cp>Seager’s colleagues convinced him to go to the county hospital. It took 10 stitches to close his wound. The patient never returned. Seager heard he’d been flown out to a nearby hospital. He found out the patient died only because a colleague’s relative worked at the hospital where he’d been treated.\u003c/p>\n\u003cp>At Napa State, violence was -- and still is -- just part of the routine, as the signs that are posted twice a week reporting assaults on staff indicate. There are steps officials could take to control the violence at California’s state hospitals, Seager says -- steps that would ultimately save taxpayers money. “But the administration and Sacramento don’t seem to care.”\u003c/p>\n\u003cp>\u003cstrong>Safety Measures Fall Short\u003c/strong>\u003c/p>\n\u003cp>Neither the measures taken before Seager’s arrival, nor those taken since, have stopped the bleeding at California’s five psychiatric hospitals. In the years following Gross’ death, workers at Napa, Patton, Metropolitan, Coalinga and Atascadero state hospitals have suffered on average 2,795 assaults a year, costing California taxpayers over $82.7 million in workers’ compensation claims over the past two fiscal years alone, according to data obtained through state public records requests.\u003c/p>\n\u003cp>Patients at the five hospitals committed nearly 26,000 assaults between 2011 and 2014, the latest year for which data are available, according to aggressive incident report records obtained from the Department of State Hospitals, which oversees the facilities.\u003c/p>\n\u003cp>Staff were the victims of 11,000 — more than 42 percent — of those assaults, the records show. Psychiatric technicians, nurses and their colleagues sustained 2,745 assaults at the five facilities in 2014, nearly 150 more than the year before. In the past two fiscal years, 2013-14 and 2014-15, they lost 105,108 days of work, the equivalent of 473 full-time employees.\u003c/p>\n\u003cp>Workers at Napa State alone endured 880 assaults in 2014, up from 866 the previous year. Employees were routinely kicked in the chest, punched in the face, shoved against walls and knocked to the ground, police logs obtained through public records requests show.\u003c/p>\n\u003cp>If you look at the rate of assaults based on the number of staff working at the facilities, it looks like safety has improved. The chances of an employee getting assaulted peaked at 30 percent in 2012, compared with 24 percent in 2014. But those figures are misleading, union reps say. For one thing, paperwork requirements for assaults increased while hospitals were required to report to a federal monitor (which ended in 2013), and it was not uncommon for assaulted staff to suffer in silence rather than fill out more forms.\u003c/p>\n\u003cp>[assaultsHospitals]\u003c/p>\n\u003cp>But perhaps more importantly, not everyone faces the same risks. Although any staff member runs the risk of a beating, says California Association of Psychiatric Technicians representative Coby Pizzotti, psych techs are especially vulnerable because they have the most contact with patients. The state doesn’t release the number of assaults on staff based on job category.\u003c/p>\n\u003cp>With 3,500 psych techs and over 2,700 assaults in a year, Pizzotti says, “It’s not a matter of if you get assaulted, it’s when you’re going to be assaulted and how severe.”\u003c/p>\n\u003cp>The year Gross was killed, staff at Napa State filed 289 workers' comp claims, according to the\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> L\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\">os\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> Ange\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\">les\u003c/a>\u003ca href=\"http://articles.latimes.com/2011/may/16/local/la-me-hospital-violence-20110516/2\" target=\"_blank\"> Times\u003c/a>. Over the past two fiscal years, that number jumped to 517 and 519, state records show. As the abuse continued, Seager says, staff and administrators acted like daily assaults were all in a day’s work. “It’s horrifying to me that no one does anything about it or even talks about it,” he says. “It’s not mentioned. Ever.”\u003c/p>\n\u003cp>Frustrated by this culture of silence and the state’s unwillingness to address the rampant violence in its hospitals, Seager documented the ongoing beatings in a 2014 book, “Behind the Gates of Gomorrah: A Year with the Criminally Insane.” He wrote the book, he says, because he wanted the public to know that the people they send to state hospitals to get treatment can’t get better in the midst of so much violence. And staff can’t deliver the care they were trained to provide when they’re constantly worried about their safety.\u003c/p>\n\u003cp>Hospital administrators weren’t happy about it, Seager says. But they didn’t fire him.\u003c/p>\n\u003cp>“The safety of our patients and staff has always been among our top priorities,” says Ralph Montano, spokesman for the Department of State Hospitals. Among recent safety improvements, Montano points to a new personal alarm system, which alerts police and reveals an employee’s location, indoors or out, and what he describes as key pieces of legislation signed by Gov. Jerry Brown in 2014.\u003c/p>\n\u003cp>The laws were designed to improve safety by giving clinical staff the right to access a patient’s \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201320140AB1960\" target=\"_blank\">criminal history\u003c/a> for violence risk assessment and allowing medication orders to follow patients judged incompetent to stand trial. Patients can spend months in prison or jail without treatment before reaching the hospital, Seager says, increasing their risk for violent behavior.\u003c/p>\n\u003cp>Another law authorizes hospital officials to build enhanced treatment facilities, where the most dangerous patients receive treatment in secured areas as part of a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140AB1340\" target=\"_blank\">pilot program\u003c/a>. The department reported last year that a quarter of patients had been involved in aggressive incidents but only a fraction of them were considered “repeatedly violent patients.” The hope is that segregating those prone to violence will make the hospitals safer.\u003c/p>\n\u003cp>\u003cstrong>Hospitals Take on More Mentally Ill Patients Charged with Crimes\u003c/strong>\u003c/p>\n\u003cp>Napa State wasn’t always such a violent place. When psych tech Michael Jarschke started working at the hospital in 1972, most patients came to Napa because they couldn’t take care of themselves, not because they’d committed a crime. In those days, he’d sometimes get clobbered by patients beset by fits, but brutal beatings were rare.\u003c/p>\n\u003cp>More patients started coming to California’s state hospitals through the criminal justice system in the mid-1990s, Jarschke says, just before Donna Gross hired on at Napa State.\u003c/p>\n\u003cp>To ease overcrowding in prisons and jails, Napa and other state hospitals took on more mentally ill patients charged with crimes. In 1995, forensic patients, who have been convicted or accused of a felony linked to mental illness, made up 60 percent of patients in state facilities, state records show.\u003c/p>\n\u003cp>Today, 96 percent of the state’s psychiatric patients came through criminal courts -- accounting for 37 percent of the nation’s criminally insane.\u003c/p>\n\u003cp>But staff weren’t trained to deal with “prison-minded” patients, says Jarschke, who served as president of the California Association of Psychiatric Technicians' Napa chapter until May. Over time, he’d see more and more patients with gang affiliations, anti-social personality disorders and, like Jess Massey, predatory tendencies.\u003c/p>\n\u003cp>In the old days, Jarschke invited patients to his house for dinner, to help them feel normal. “That’s not happening here,” he says. “It’s not the same. It’ll never be the same.”\u003c/p>\n\u003cp>Jarschke soon realized the tools he used in a bike repair class could turn deadly in the wrong hands. But he felt strongly that he should keep teaching his patients skills that would boost their self-worth, so he set up a wheelchair repair program, thinking it would help them get a job when they got out. Some of his patients had committed monstrous crimes, but to him, they were people with mental problems, not criminals.\u003c/p>\n\u003cp>Jarschke had just set up a wheelchair repair program when Gross was killed. Even the wheelchair program was too risky, he realized. He shut it down.\u003c/p>\n\u003cp>The day after Gross’ murder, Jarschke and his colleagues formed the Safety Now Coalition to protect both staff and patients.\u003c/p>\n\u003cp>One of the first things they did was push for fully functional personal alarms and more security and clinical staff at the hospital. In 2012, administrators added a police substation within the secured treatment area outside, where Massey had cornered Gross. The following year, department spokesman Montano says, they finished implementing the alarm system.\u003c/p>\n\u003cp>But police aren’t on the wards when fights break out, so it’s up to staff, usually psych techs, to intervene. Most psych techs at California’s state hospitals are women who routinely find themselves trying to restrain men twice their size.\u003c/p>\n\u003cp>The alarms don’t prevent assaults, Seager says. “They simply allow people to get you medical help faster. We’ve had social workers have their teeth kicked in and bones broken. We’ve had head injuries where they’ve never come back.”\u003c/p>\n\u003cp>Workers often showed up for a shift having no idea there had just been a brutal assault. Last year, Seager says, “Someone was strangled and left for dead, and [the administration] never said anything about it.”\u003c/p>\n\u003cp>Safety Now asked administrators if staff at Napa could post a sign when a peer suffers an injury that requires more than local first aid, Jarschke says. The request was granted.\u003c/p>\n\u003cp>\u003cstrong>Subsidizing Violence on the Job\u003c/strong>\u003c/p>\n\u003cp>Lupe Alonzo-Diaz, the Department of State Hospitals deputy director of administrative services, acknowledged the risks staff face before a state oversight agency last year. “The potential to be assaulted is a daily threat for nursing staff,” she told the Little Hoover Commission, an independent agency that monitors and proposes improvements to state government operations.\u003c/p>\n\u003cp>The Department of State Hospitals defines aggressive acts as “hitting, pushing, kicking or similar acts directed against another individual to cause potential or actual injury.”\u003c/p>\n\u003cp>Verbal assault is not included in statistics released by the state, even though studies show that workers can suffer greater psychological effects from \u003ca href=\"http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Measurement-and-Monitoring-Worker-Aggression-Exposure.html\" target=\"_blank\">threats of violence than from physical aggression\u003c/a>.\u003c/p>\n\u003cp>With so many battered workers unable to do their jobs (they're out on worker's comp due to the assaults), the Department of State Hospitals has asked psych techs and nurses to work more than 4.7 million hours of overtime — at time and a half — since 2012 to meet legal staffing requirements. Overtime hours for psych techs have increased more than a third since 2012, reaching 1.2 million hours last year at a cost of $53 million, Pizzotti testified before the Little Hoover Commission.\u003c/p>\n\u003cp>[overtimeTech]\u003c/p>\n\u003cp>Nearly 150,000 overtime hours were mandatory during the 2014-15 fiscal year, up from 92,000 the previous year, state records show.\u003c/p>\n\u003cp>The union is fighting mandatory overtime, CAPT’s Pizzotti says, because it leaves workers unable to prepare for an extra shift, by going to bed early the night before or arranging day care for their kids. Sometimes employees don’t know until two hours before they’re scheduled to leave that they have to stay on, he says. “That throws your world into complete upheaval.”\u003c/p>\n\u003cp>California banned mandatory overtime for \u003ca href=\"http://www.seiu1000.org/general-information/local-1000-nurses-call-legislature-stop-mandatory-overtime\" target=\"_blank\">nurses in the private sector\u003c/a> in 2001 because it compromises worker and patient safety. Since then, \u003ca href=\"http://jap.sagepub.com/content/21/1/19.full.pdf+html\" target=\"_blank\">overwhelming evidence\u003c/a> has linked long extended shifts to increased risks of clinical mistakes and \u003ca href=\"https://www.jointcommission.org/assets/1/18/SEA_48.pdf\" target=\"_blank\">higher rates of occupational injury.\u003c/a>\u003c/p>\n\u003cp>Fatigued staff faced with the constant threat of assault are ill-prepared to safeguard their patients. Weak and vulnerable psychiatric patients sustained over 3,400 assaults at the hands of their peers in 2014, state records show. Although the numbers dropped nearly a quarter between 2010 and 2013, they jumped by 100 assaults in the following year.\u003c/p>\n\u003cp>Hospital administrators are forced to rely on mandatory overtime or face serious consequences, such as loss of certification, court sanctions and fines, Alonzo-Diaz told the Little Hoover Commission. It’s difficult to hire new staff, she said, because the risks associated with the work, combined with lower wages compared with private hospitals -- as much as $63,000 less for nurses and $15,000 less for psych techs -- make it hard to attract and retain employees.\u003c/p>\n\u003cp>Pizzotti says the state could solve these problems in part by expediting a hiring process that is so drawn out that job seekers find work elsewhere before they hear if they’re in the running.\u003cbr>\nRelief appeared to be on the horizon in August, when the Legislature passed \u003ca href=\"http://www.psychtechs.net/uploads/eng/sb%20780_introduced.pdf\" target=\"_blank\">SB 780\u003c/a>, a bill prohibiting the state from using mandatory overtime as a staffing tool. But the bill was withdrawn after Gov. Jerry Brown signaled his opposition to the measure, Pizzotti says.\u003c/p>\n\u003cp>“We decided not to move the bill onto his desk, knowing that it would be vetoed,” he says. That means union representatives are back to bargaining with administrators to reduce mandatory overtime.\u003c/p>\n\u003cp>\u003cstrong>‘Everybody’s in the wrong place’\u003c/strong>\u003c/p>\n\u003cp>For psychiatrist Seager, improving safety over the long term requires coming to grips with the systemic failures that left state hospitals ill-equipped to deal with violent criminals. Homeless people with acute psychiatric conditions should be treated in state hospitals, he says, while the nonviolent mentally ill now in prisons and jails should be treated in community treatment centers and people convicted of violent crimes should be treated in prisons.\u003c/p>\n\u003cp>Instead, he says, “Every single person in the mental health care system is in the wrong place.”\u003c/p>\n\u003cp>Even so, the state could implement several reforms now. Every hospital should have enhanced treatment units as soon as possible, staff say, to protect workers and vulnerable patients from the subset of patients who commit the majority of assaults.\u003c/p>\n\u003cp>The state authorized funding for the program this year, and administrators expect to open units at Atascadero and Patton in 2018, says department spokesman Montano.\u003c/p>\n\u003cp>It could be several years before an enhanced unit comes to Napa. “That’s an ominous feeling for us,” says psych tech Jarschke.\u003c/p>\n\u003cp>For now, increasing staffing levels would go a long way toward reducing violence on the wards, union rep Pizzotti says. Last year, the Department of Public Health hit Napa with several citations for failing to protect patients, including one who sustained a head injury and another who suffered a broken jaw. According to police reports and sources, that’s almost inevitable when an alarm draws all hands from one unit, only to leave another unattended. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Taxpayers have been spending tens of millions of dollars a year in overtime that leaves workers exhausted, prone to making mistakes and even more vulnerable to injury, Pizzotti says. Last year, 18.4 million taxpayers filed with the California Franchise Tax Board. The money spent on overtime could have hired hundreds of full-time psych techs, he says, greatly reducing the risk of violence while allowing staff to focus on the therapeutic care they were trained to provide. It would have cost the average taxpayer less than the price of a latte at Starbucks.\u003c/p>\n\u003cp>But those positions remain unstaffed. Meanwhile, Seager says, the assaults at Napa grew bloodier and more frequent.\u003c/p>\n\u003cp>Next month marks the sixth anniversary of Donna Gross’ murder. This will be the first year Seager won’t be there to pay his respects. “I finally had enough of Napa,” he says. Seager left in June to freelance as an emergency services psychiatrist for several Bay Area hospitals.\u003c/p>\n\u003cp>“The medical care at Napa is first rate and the staff is terrific,” Seager says. “It’s just not safe.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was produced with the support of the California Data Fellowship, a program of the Center for Health Journalism at the USC Annenberg School for Communication and Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/240260/at-california-psychiatric-hospitals-epidemic-of-patients-assaults-on-staff-goes-untreated","authors":["6322"],"categories":["stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_2939","stateofhealth_2938","stateofhealth_2969","stateofhealth_2808","stateofhealth_73","stateofhealth_2937","stateofhealth_2519","stateofhealth_2936","stateofhealth_2940","stateofhealth_2735"],"featImg":"stateofhealth_96497","label":"stateofhealth"},"stateofhealth_237182":{"type":"posts","id":"stateofhealth_237182","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"237182","score":null,"sort":[1473892275000]},"guestAuthors":[],"slug":"california-hospital-considers-allowing-patients-to-use-medical-marijuana","title":"California Hospital Considers Allowing Patients to Use Medical Marijuana","publishDate":1473892275,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Patients may one day soon be able to openly use medical marijuana inside a Northern California hospital.\u003c/p>\n\u003cp>If the hospital's governing board approves the idea, Marin General Hospital would become the first in the state to allow it.\u003c/p>\n\u003cp>On Tuesday evening, the Marin Healthcare District Board took a step in that direction by voting to ask its staff to investigate clinical and legal issues related to patient use of the drug on-site.\u003c/p>\n\u003cp>Medical marijuana is legal in the state, but hospitals haven't yet allowed patients to use it.\u003c/p>\n\u003cp>\u003ca href=\"http://www.marinhealthcare.org/about-us/board-of-directors\" target=\"_blank\">Larry Bedard\u003c/a>, a retired emergency physician and board member who proposed the plan to investigate the issue, says medical marijuana is already used \"under cover\" at hospitals.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Family members and friends sometimes bring medical marijuana to hospital patients who use it at home for their conditions, Bedard said.\u003c/p>\n\u003cp>It's better to be open and transparent about medical marijuana use in the hospital, he said, so doctors have the full picture of all medications the patients are taking.\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>Cannabis use in this hospital is 'don’t ask, don’t tell,.' \" Bedard said. \"So I think there’s a cannabis closet.\"\u003c/p>\n\u003cp>But would allowing open use of medical marijuana mean that patients are lighting up joints in their hospital rooms? Of course not, Bedard said.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/282803262\" 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>Since smoking is prohibited in hospitals, the medical marijuana would be delivered to patients in other forms, such as edible products.\u003c/p>\n\u003cp>Public health advocate Larry Cohen, executive director of the Prevention Institute in Oakland, said hospitals would be ideal for supervising use of medical marijuana.\u003c/p>\n\u003cp>\"It's far better for the medical staff to know what people are using and to ensure the right quality and the right fit with other medications, so this is probably smart,\" Cohen said. \"One of the biggest disadvantages of edibles has to do with unsupervised risk related to children, and clearly this is far less of a concern in a medical institution.\"\u003c/p>\n\u003cp>Medical marijuana use in hospitals has been the subject of public debate in other states.\u003c/p>\n\u003cp>Two states, Connecticut and Maine, passed legislation protecting hospital staff from criminal, civil, or disciplinary action if they administer marijuana to hospital patients, said Paul Armentano,\u003cbr>\ndeputy director of NORML, a marijuana legalization advocacy group based in Washington, D.C.\u003c/p>\n\u003cp>Armentano said it was unclear whether hospitals in those states have changed their polices, but the doors have been open to do so, he said.\u003c/p>\n\u003cp>Medical marijuana use in hospitals in California has already happened unofficially, said Dale Gieringer, director of the California branch of NORML.\u003c/p>\n\u003cp>\"Brownie Mary used to distribute medicated brownies to AIDS patients in San Francisco,\" Gieringer said. \"I remember hearing that she visited hospitals.\"\u003c/p>\n\u003cp>The Marin Healthcare District Board plans to hold a series of public meetings on medical marijuana use, Bedard said.\u003c/p>\n\u003cp>The staff report examining the issue is expected to be concluded in June.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tiffany Camhi and Mina Kim contributed to this report\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Medical marijuana is legal in the state, but hospitals haven't yet allowed patients to use it.\r\n","status":"publish","parent":0,"modified":1473912200,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":532},"headData":{"title":"California Hospital Considers Allowing Patients to Use Medical Marijuana | KQED","description":"Medical marijuana is legal in the state, but hospitals haven't yet allowed patients to use it.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Hospital Considers Allowing Patients to Use Medical Marijuana","datePublished":"2016-09-14T22:31:15.000Z","dateModified":"2016-09-15T04:03:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"237182 http://ww2.kqed.org/stateofhealth/?p=237182","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/09/14/california-hospital-considers-allowing-patients-to-use-medical-marijuana/","disqusTitle":"California Hospital Considers Allowing Patients to Use Medical Marijuana","path":"/stateofhealth/237182/california-hospital-considers-allowing-patients-to-use-medical-marijuana","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Patients may one day soon be able to openly use medical marijuana inside a Northern California hospital.\u003c/p>\n\u003cp>If the hospital's governing board approves the idea, Marin General Hospital would become the first in the state to allow it.\u003c/p>\n\u003cp>On Tuesday evening, the Marin Healthcare District Board took a step in that direction by voting to ask its staff to investigate clinical and legal issues related to patient use of the drug on-site.\u003c/p>\n\u003cp>Medical marijuana is legal in the state, but hospitals haven't yet allowed patients to use it.\u003c/p>\n\u003cp>\u003ca href=\"http://www.marinhealthcare.org/about-us/board-of-directors\" target=\"_blank\">Larry Bedard\u003c/a>, a retired emergency physician and board member who proposed the plan to investigate the issue, says medical marijuana is already used \"under cover\" at hospitals.\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>Family members and friends sometimes bring medical marijuana to hospital patients who use it at home for their conditions, Bedard said.\u003c/p>\n\u003cp>It's better to be open and transparent about medical marijuana use in the hospital, he said, so doctors have the full picture of all medications the patients are taking.\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>Cannabis use in this hospital is 'don’t ask, don’t tell,.' \" Bedard said. \"So I think there’s a cannabis closet.\"\u003c/p>\n\u003cp>But would allowing open use of medical marijuana mean that patients are lighting up joints in their hospital rooms? Of course not, Bedard said.\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/282803262&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/282803262'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Since smoking is prohibited in hospitals, the medical marijuana would be delivered to patients in other forms, such as edible products.\u003c/p>\n\u003cp>Public health advocate Larry Cohen, executive director of the Prevention Institute in Oakland, said hospitals would be ideal for supervising use of medical marijuana.\u003c/p>\n\u003cp>\"It's far better for the medical staff to know what people are using and to ensure the right quality and the right fit with other medications, so this is probably smart,\" Cohen said. \"One of the biggest disadvantages of edibles has to do with unsupervised risk related to children, and clearly this is far less of a concern in a medical institution.\"\u003c/p>\n\u003cp>Medical marijuana use in hospitals has been the subject of public debate in other states.\u003c/p>\n\u003cp>Two states, Connecticut and Maine, passed legislation protecting hospital staff from criminal, civil, or disciplinary action if they administer marijuana to hospital patients, said Paul Armentano,\u003cbr>\ndeputy director of NORML, a marijuana legalization advocacy group based in Washington, D.C.\u003c/p>\n\u003cp>Armentano said it was unclear whether hospitals in those states have changed their polices, but the doors have been open to do so, he said.\u003c/p>\n\u003cp>Medical marijuana use in hospitals in California has already happened unofficially, said Dale Gieringer, director of the California branch of NORML.\u003c/p>\n\u003cp>\"Brownie Mary used to distribute medicated brownies to AIDS patients in San Francisco,\" Gieringer said. \"I remember hearing that she visited hospitals.\"\u003c/p>\n\u003cp>The Marin Healthcare District Board plans to hold a series of public meetings on medical marijuana use, Bedard said.\u003c/p>\n\u003cp>The staff report examining the issue is expected to be concluded in June.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Tiffany Camhi and Mina Kim contributed to this report\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/237182/california-hospital-considers-allowing-patients-to-use-medical-marijuana","authors":["11105"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2808","stateofhealth_73","stateofhealth_2911","stateofhealth_2519","stateofhealth_2912"],"featImg":"stateofhealth_237183","label":"stateofhealth"},"stateofhealth_233886":{"type":"posts","id":"stateofhealth_233886","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"233886","score":null,"sort":[1473179688000]},"guestAuthors":[],"slug":"study-hospitals-waste-millions-of-dollars-a-year-by-throwing-away-unused-surgical-supplies","title":"Study: Hospitals Waste Millions of Dollars a Year By Throwing Away Unused Surgical Supplies","publishDate":1473179688,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>It’s long been a problem for the nation’s hospitals: A staggering number of medical supplies — from surgical gloves to sponges to medications — go unused and are discarded after surgeries.\u003c/p>\n\u003cp>A recent study by researchers at the University of California, San Francisco has put a price tag on that waste: almost $1,000 per procedure examined at the academic medical center.\u003c/p>\n\u003cp>The research, published in May in the Journal of Neurosurgery, examined 58 neurosurgeries performed by 14 different surgeons at UCSF Medical Center, a leading academic hospital.\u003c/p>\n\u003cp>Among the most unused and discarded supplies were sponges, blue towels and gloves. The most expensive item wasted, according to the study, was “surgifoam,” a sponge used to stop bleeding. One such sponge can cost close to $4,000.\u003c/p>\n\u003cp>The researchers projected that wasted supplies could cost $2.9 million a year in UCSF’s neurosurgery department alone.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And that might be an underestimate: Nurses reported they were less likely to open disposable supplies when they knew they were under observation for the study. Unopened supplies can be reused, but once they are opened they must be used or thrown away.\u003c/p>\n\u003cp>As health care costs continue to skyrocket, it is important to look for ways to contain them, said Dr. Michael Lawton, a neurosurgeon at UCSF and one of the study’s authors.\u003c/p>\n\u003cp>Lawton, who was also one of the 14 surgeons observed in the study, said he performs about 400 surgeries per year. If nearly $1,000 per procedure is being wasted on potentially reusable supplies, about $400,000 could be saved per year — for just one surgeon.\u003c/p>\n\u003cp>“These savings could translate into teaching and research opportunities, and also allow more patients to come in” for treatment, Lawton said.\u003c/p>\n\u003cp>James Yoon, one of the principal UCSF researchers on the study, said they weren’t only looking at costs but also at the environmental impact of wasted supplies.\u003c/p>\n\u003cp>Operating rooms in the U.S. produce more than 2,000 tons of waste per day, he said. Some of it is biological and must be safely disposed of. Part of the research involved identifying which surgeries generated the most waste. Spinal procedures, for example, are among the most wasteful, the researchers found.\u003c/p>\n\u003cp>They also learned that the length of a surgeon’s experience bore no relation to the volume of squandered supplies. More experienced surgeons were not necessarily more frugal.\u003c/p>\n\u003cp>There is little agreement on how hospitals should address operating room wastefulness. Each hospital or hospital system handles waste in its own way, Yoon explained.\u003c/p>\n\u003cp>The researchers also recommend price transparency for surgeons. A “feedback system,” Lawton explained, would allow them to compare where they stand relative to their peers in terms of cost per procedure. While not available yet, such a system could encourage better management of operating room supplies, he said.\u003c/p>\n\u003cp>Another potential way to limit waste is to review surgeons’ “preference cards” — the list of instruments and other items they request for each procedure, Yoon said. Removing unnecessary items from the list and clarifying which ones should be opened at the beginning of a procedure could help save supplies, he explained.\u003c/p>\n\u003cp>All three of UCSF’s hospitals have been working to reduce waste, said Gail Lee, the director of sustainability for the hospitals and the UCSF campus.\u003c/p>\n\u003cp>Some medical devices, whether used or unused during surgery, can be reprocessed by an FDA-approved third party company and sold back to the hospital for about half the original sales price, Lee explained. This allows hospitals to save money and cut down on the volume of disposable supplies that end up in landfill.\u003c/p>\n\u003cp>This strategy saved UCSF hospitals about $1.1 million over the past year, Lee said.\u003c/p>\n\u003cp>In fiscal year 2011-12, UCSF hospitals diverted 14,000 pounds of would-be waste from landfill by reprocessing both surgery and patient care devices. By last year, that amount had more than quadrupled to 62,000 pounds, Lee said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We continue to do better each year,” she said, “but we recognize there is always opportunity to improve.”\u003c/p>\n\n","blocks":[],"excerpt":"Unused, discarded supplies cost almost $1,000 per procedure, University of California San Francisco researchers found.","status":"publish","parent":0,"modified":1473183125,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":700},"headData":{"title":"Study: Hospitals Waste Millions of Dollars a Year By Throwing Away Unused Surgical Supplies | KQED","description":"Unused, discarded supplies cost almost $1,000 per procedure, University of California San Francisco researchers found.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Study: Hospitals Waste Millions of Dollars a Year By Throwing Away Unused Surgical Supplies","datePublished":"2016-09-06T16:34:48.000Z","dateModified":"2016-09-06T17:32:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"233886 http://ww2.kqed.org/stateofhealth/?p=233886","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/09/06/study-hospitals-waste-millions-of-dollars-a-year-by-throwing-away-unused-surgical-supplies/","disqusTitle":"Study: Hospitals Waste Millions of Dollars a Year By Throwing Away Unused Surgical Supplies","nprByline":"\u003cstrong>Ana B. Ibarra\u003cbr />\u003ca href=\"http://californiahealthline.org\"/> California Healthline\u003c/a>\u003c/strong>","path":"/stateofhealth/233886/study-hospitals-waste-millions-of-dollars-a-year-by-throwing-away-unused-surgical-supplies","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s long been a problem for the nation’s hospitals: A staggering number of medical supplies — from surgical gloves to sponges to medications — go unused and are discarded after surgeries.\u003c/p>\n\u003cp>A recent study by researchers at the University of California, San Francisco has put a price tag on that waste: almost $1,000 per procedure examined at the academic medical center.\u003c/p>\n\u003cp>The research, published in May in the Journal of Neurosurgery, examined 58 neurosurgeries performed by 14 different surgeons at UCSF Medical Center, a leading academic hospital.\u003c/p>\n\u003cp>Among the most unused and discarded supplies were sponges, blue towels and gloves. The most expensive item wasted, according to the study, was “surgifoam,” a sponge used to stop bleeding. One such sponge can cost close to $4,000.\u003c/p>\n\u003cp>The researchers projected that wasted supplies could cost $2.9 million a year in UCSF’s neurosurgery department alone.\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>And that might be an underestimate: Nurses reported they were less likely to open disposable supplies when they knew they were under observation for the study. Unopened supplies can be reused, but once they are opened they must be used or thrown away.\u003c/p>\n\u003cp>As health care costs continue to skyrocket, it is important to look for ways to contain them, said Dr. Michael Lawton, a neurosurgeon at UCSF and one of the study’s authors.\u003c/p>\n\u003cp>Lawton, who was also one of the 14 surgeons observed in the study, said he performs about 400 surgeries per year. If nearly $1,000 per procedure is being wasted on potentially reusable supplies, about $400,000 could be saved per year — for just one surgeon.\u003c/p>\n\u003cp>“These savings could translate into teaching and research opportunities, and also allow more patients to come in” for treatment, Lawton said.\u003c/p>\n\u003cp>James Yoon, one of the principal UCSF researchers on the study, said they weren’t only looking at costs but also at the environmental impact of wasted supplies.\u003c/p>\n\u003cp>Operating rooms in the U.S. produce more than 2,000 tons of waste per day, he said. Some of it is biological and must be safely disposed of. Part of the research involved identifying which surgeries generated the most waste. Spinal procedures, for example, are among the most wasteful, the researchers found.\u003c/p>\n\u003cp>They also learned that the length of a surgeon’s experience bore no relation to the volume of squandered supplies. More experienced surgeons were not necessarily more frugal.\u003c/p>\n\u003cp>There is little agreement on how hospitals should address operating room wastefulness. Each hospital or hospital system handles waste in its own way, Yoon explained.\u003c/p>\n\u003cp>The researchers also recommend price transparency for surgeons. A “feedback system,” Lawton explained, would allow them to compare where they stand relative to their peers in terms of cost per procedure. While not available yet, such a system could encourage better management of operating room supplies, he said.\u003c/p>\n\u003cp>Another potential way to limit waste is to review surgeons’ “preference cards” — the list of instruments and other items they request for each procedure, Yoon said. Removing unnecessary items from the list and clarifying which ones should be opened at the beginning of a procedure could help save supplies, he explained.\u003c/p>\n\u003cp>All three of UCSF’s hospitals have been working to reduce waste, said Gail Lee, the director of sustainability for the hospitals and the UCSF campus.\u003c/p>\n\u003cp>Some medical devices, whether used or unused during surgery, can be reprocessed by an FDA-approved third party company and sold back to the hospital for about half the original sales price, Lee explained. This allows hospitals to save money and cut down on the volume of disposable supplies that end up in landfill.\u003c/p>\n\u003cp>This strategy saved UCSF hospitals about $1.1 million over the past year, Lee said.\u003c/p>\n\u003cp>In fiscal year 2011-12, UCSF hospitals diverted 14,000 pounds of would-be waste from landfill by reprocessing both surgery and patient care devices. By last year, that amount had more than quadrupled to 62,000 pounds, Lee said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We continue to do better each year,” she said, “but we recognize there is always opportunity to improve.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/233886/study-hospitals-waste-millions-of-dollars-a-year-by-throwing-away-unused-surgical-supplies","authors":["byline_stateofhealth_233886"],"categories":["stateofhealth_1"],"tags":["stateofhealth_2808","stateofhealth_73","stateofhealth_2879","stateofhealth_2519","stateofhealth_2878","stateofhealth_2877","stateofhealth_2880"],"featImg":"stateofhealth_233887","label":"stateofhealth"},"stateofhealth_211925":{"type":"posts","id":"stateofhealth_211925","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"211925","score":null,"sort":[1468431031000]},"guestAuthors":[],"slug":"berkeley-city-council-resolution-would-oppose-alta-bates-hospital-closure","title":"Berkeley City Council Unanimously Opposes Alta Bates Hospital Closure","publishDate":1468431031,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>Update July 13, 2016\u003c/strong>: The Berkeley City Council unanimously approved the resolution opposing the closure of the Alta Bates hospital and emergency room at Tuesday night's meeting.\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Three members of the Berkeley City Council are backing a resolution to oppose the planned closure of the Alta Bates Medical Center emergency room and inpatient hospital. The full council will vote on the issue at its meeting Tuesday night.\u003c/p>\n\u003cp>Sutter Health, which owns Alta Bates, said last fall that it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">close the acute care hospital and emergency department\u003c/a> sometime before 2030. That's when tough \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/29/finally-long-overdue-progress-in-hospital-seismic-safety/\" target=\"_blank\">California seismic standards\u003c/a> kick in. Sutter said it would consolidate emergency and inpatient services at its Oakland Summit Medical Center and make Alta Bates an outpatient hub.\u003c/p>\n\u003cp>\"Sutter made this decision unilaterally without consulting the city of Berkeley,\" said council member Jessie Arreguin, one of the authors of the resolution. \"We need to speak out, and we need to fight back.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement, Sutter says the closure of the hospital and ER \"is not new information. We began discussion about this important transition with civic leaders several years ago.\"\u003c/p>\n\u003cp>Alta Bates maintains the only emergency department in Berkeley, but ramification of its closure would be felt well beyond the city's borders. Last year Doctors Medical Center in San Pablo \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\">closed\u003c/a>, including its inpatient hospital and emergency department. People north of Berkeley to Vallejo had relied on this safety-net hospital.\u003c/p>\n\u003cp>If Alta Bates were to close, that would leave Kaiser Richmond with the only emergency room between Richmond and Oakland.\u003c/p>\n\u003cp>Arreguin said he wants to work with Sutter to try to find a solution to keep Alta Bates open. He said he supports efforts to try to retrofit the existing hospital to meet the new standards.\u003c/p>\n\u003cp>\"But it's going to take building a broad coalition,\" he said, \"and we need to start that process.\"\u003c/p>\n\u003cp>Berkeley council members Kriss Worthington and Max Anderson are co-authors with Arreguin of the draft resolution to be introduced tonight, which says in part:\u003c/p>\n\u003cblockquote>\u003cp>(T)he Mayor and City Council of the City of Berkeley oppose Sutter Health Corporation’s plan to close its acute care services at Alta Bates Hospital and calls upon Sutter Health to cease and desist all actions in furtherance of any and all plans to close Alta Bates.\u003c/p>\u003c/blockquote>\n\u003cp>The resolution further hints at possible legal action, saying that the mayor and council \"request the City Attorney to investigate the actions taken by Sutter Health and initiate proceedings, whenever warranted, under relevant statues.\"\u003c/p>\n\u003cp>In its statement, Sutter said it is \"committed to a strong medical presence in the City of Berkeley,\" but that \"increasing demand for outpatient services and procedures decreases the need for inpatient care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sutter's Summit Medical Center and Alta Bates are three miles apart. Sutter said that \"if we are to remain viable as an organization and affordable to our patients, we cannot operate two full-service hospitals\" in such close proximity.\u003c/p>\n\n","blocks":[],"excerpt":"Sutter Health, which owns the hospital, has said it will close the medical center and its ER sometime before 2030. ","status":"publish","parent":0,"modified":1468431671,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":502},"headData":{"title":"Berkeley City Council Unanimously Opposes Alta Bates Hospital Closure | KQED","description":"Sutter Health, which owns the hospital, has said it will close the medical center and its ER sometime before 2030. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Berkeley City Council Unanimously Opposes Alta Bates Hospital Closure","datePublished":"2016-07-13T17:30:31.000Z","dateModified":"2016-07-13T17:41:11.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"211925 http://ww2.kqed.org/stateofhealth/?p=211925","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/07/13/berkeley-city-council-resolution-would-oppose-alta-bates-hospital-closure/","disqusTitle":"Berkeley City Council Unanimously Opposes Alta Bates Hospital Closure","customPermalink":"2016/07/12/berkeley-city-council-resolution-would-oppose-alta-bates-hospital-closure/","path":"/stateofhealth/211925/berkeley-city-council-resolution-would-oppose-alta-bates-hospital-closure","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update July 13, 2016\u003c/strong>: The Berkeley City Council unanimously approved the resolution opposing the closure of the Alta Bates hospital and emergency room at Tuesday night's meeting.\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Three members of the Berkeley City Council are backing a resolution to oppose the planned closure of the Alta Bates Medical Center emergency room and inpatient hospital. The full council will vote on the issue at its meeting Tuesday night.\u003c/p>\n\u003cp>Sutter Health, which owns Alta Bates, said last fall that it would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">close the acute care hospital and emergency department\u003c/a> sometime before 2030. That's when tough \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/29/finally-long-overdue-progress-in-hospital-seismic-safety/\" target=\"_blank\">California seismic standards\u003c/a> kick in. Sutter said it would consolidate emergency and inpatient services at its Oakland Summit Medical Center and make Alta Bates an outpatient hub.\u003c/p>\n\u003cp>\"Sutter made this decision unilaterally without consulting the city of Berkeley,\" said council member Jessie Arreguin, one of the authors of the resolution. \"We need to speak out, and we need to fight back.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a statement, Sutter says the closure of the hospital and ER \"is not new information. We began discussion about this important transition with civic leaders several years ago.\"\u003c/p>\n\u003cp>Alta Bates maintains the only emergency department in Berkeley, but ramification of its closure would be felt well beyond the city's borders. Last year Doctors Medical Center in San Pablo \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\">closed\u003c/a>, including its inpatient hospital and emergency department. People north of Berkeley to Vallejo had relied on this safety-net hospital.\u003c/p>\n\u003cp>If Alta Bates were to close, that would leave Kaiser Richmond with the only emergency room between Richmond and Oakland.\u003c/p>\n\u003cp>Arreguin said he wants to work with Sutter to try to find a solution to keep Alta Bates open. He said he supports efforts to try to retrofit the existing hospital to meet the new standards.\u003c/p>\n\u003cp>\"But it's going to take building a broad coalition,\" he said, \"and we need to start that process.\"\u003c/p>\n\u003cp>Berkeley council members Kriss Worthington and Max Anderson are co-authors with Arreguin of the draft resolution to be introduced tonight, which says in part:\u003c/p>\n\u003cblockquote>\u003cp>(T)he Mayor and City Council of the City of Berkeley oppose Sutter Health Corporation’s plan to close its acute care services at Alta Bates Hospital and calls upon Sutter Health to cease and desist all actions in furtherance of any and all plans to close Alta Bates.\u003c/p>\u003c/blockquote>\n\u003cp>The resolution further hints at possible legal action, saying that the mayor and council \"request the City Attorney to investigate the actions taken by Sutter Health and initiate proceedings, whenever warranted, under relevant statues.\"\u003c/p>\n\u003cp>In its statement, Sutter said it is \"committed to a strong medical presence in the City of Berkeley,\" but that \"increasing demand for outpatient services and procedures decreases the need for inpatient care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sutter's Summit Medical Center and Alta Bates are three miles apart. Sutter said that \"if we are to remain viable as an organization and affordable to our patients, we cannot operate two full-service hospitals\" in such close proximity.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/211925/berkeley-city-council-resolution-would-oppose-alta-bates-hospital-closure","authors":["240"],"categories":["stateofhealth_2746"],"tags":["stateofhealth_2819","stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_177899","label":"stateofhealth"},"stateofhealth_178042":{"type":"posts","id":"stateofhealth_178042","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"178042","score":null,"sort":[1461933537000]},"guestAuthors":[],"slug":"finally-long-overdue-progress-in-hospital-seismic-safety","title":"Finally, Long Overdue Progress in Hospital Seismic Safety","publishDate":1461933537,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After years of delay, retrofitting and rebuilding, more than 90 percent of California’s acute care hospital buildings are no longer at risk of collapse during an earthquake, according to the most recent data from the state’s Office of Statewide Health Planning and Development (OSHPD).\u003c/p>\n\u003cp>But the remaining hospitals \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SeisPerfRatings-v3-2.html\" target=\"_blank\">still need to meet\u003c/a> the state’s tough seismic safety requirements, or close buildings that are not up to standard by 2030. Buildings at six rural “critical access” hospitals remain on the state’s list of structures most likely to collapse in an earthquake, and their administrators face challenges keeping them open.\u003c/p>\n\u003cp>“I am very pleased with the progress that has been made,” said Robert David, director of OSHPD, which oversees hospital earthquake safety. “Based on information and schedules provided by the hospitals … the remaining acute care buildings appear to be on track to meet the state deadline to withstand a major earthquake or be removed from service.”\u003c/p>\n\u003cp>An estimated 251 buildings are still rated “SPC-1,” the highest risk category — down from more than 1,000 in 2001, according to OSPHD spokesman David Byrnes.\u003c/p>\n\u003cp>Another 629 buildings are rated “SPC-2,” the second highest risk. Not all of those buildings house patients; some may hold administrative offices, for example. But state law requires all buildings in the top two risk categories to close by 2030 unless they have been repaired or replaced. In addition, all SPC-1 buildings must be retrofitted to meet at least SPC-2 requirements by 2020 unless a hospital has received a specific deadline extension from OSPHD.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It has taken years for hospitals to get this far.\u003c/p>\n\u003cp>After the magnitude 6.7 Northridge earthquake crippled local hospitals in 1994, state lawmakers toughened up 1973 legislation that required hospitals in danger of collapse or significant damage in an earthquake to make repairs or rebuild -- or face closure.\u003c/p>\n\u003cp>At the time, the new deadline was set for 2008. But the state’s hospital industry group, citing high construction costs, successfully pushed back many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.\u003c/p>\n\u003cp>There’s a 93 percent chance that a 7.0 magnitude earthquake could strike the Bay Area in the next 30 years, according to the most recent \u003ca href=\"http://pubs.usgs.gov/fs/2015/3009/pdf/fs2015-3009.pdf\" target=\"_blank\">estimate\u003c/a> by the U.S. Geological Survey.\u003c/p>\n\u003cp>While many hospitals around the state have spent millions on retrofitting or replacing unsafe buildings, some have chosen to shut down non-compliant facilities before the final 2030 deadline. Sutter-owned Alta Bates Hospital \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">recently determined\u003c/a> that it plans to close acute care and emergency services in Berkeley before 2030 because of the earthquake safety requirements. Some critics say Sutter is using those requirements \u003ca href=\"http://www.eastbaytimes.com/breaking-news/ci_29811598/sutter-plans-future-closing-berkeley-emergency-services\" target=\"_blank\">as an excuse\u003c/a> to consolidate some of its services.\u003c/p>\n\u003cp>A number of hospitals still face difficulty getting the money they need to replace aging buildings, and they’re hoping to get the needed capital through bond measures, tax hikes and other means.\u003c/p>\n\u003cp>In Fort Bragg, the Mendocino County District Hospital is trying to figure how best to keep its main hospital open. It’s \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SPCNPCList.pdf\" target=\"_blank\">got the second highest risk rating\u003c/a> and would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/11/06/the-mendocino-coast-fears-losing-its-only-hospital/\" target=\"_blank\">need to close\u003c/a> by 2030 unless improved or replaced. But the 25-bed critical access hospital declared bankruptcy in 2012, and amid staff turmoil, its financing options are limited.\u003c/p>\n\u003cp>The hospital’s board is considering a parcel tax, and its CEO has floated the idea of \u003ca href=\"http://www.advocate-news.com/general-news/20160407/private-non-profit-option-considered\" target=\"_blank\">converting the public hospital to private nonprofit status\u003c/a> to draw more funds.\u003c/p>\n\u003cp>Wade Sturgeon, the hospital district’s chief financial officer, said that reports of the hospital’s potential demise have been exaggerated. “We’ve been able to improve a lot of things. We are having conversations about what do we do going forward,” Sturgeon said. He added that \u003ca href=\"http://www.oshpd.ca.gov/FDD/seismic_compliance/SB1953/SPC-4D_Regulations.html\" target=\"_blank\">new state building regulations\u003c/a> taking effect in 2017 may allow his hospital to stay open past 2030 with some retrofits.\u003c/p>\n\u003cp>While hospitals are finally making progress since the tighter earthquake safety regulations took effect more than 20 years ago, the delays haven’t been good for patients or hospital staff, said Stephanie Roberson, legislative advocate for the California Nurses Association. The association is a persistent critic of what it has seen as hospital foot-dragging.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We need to make sure these hospitals are held accountable,” Roberson said. “We saw what happened in Northridge – the loss of life and property to the tune of billions of dollars. Hospitals are supposed to be that beacon of light in the community, and if we have a seismic catastrophe they are centers for the public to take refuge.”\u003c/p>\n\n","blocks":[],"excerpt":"Many California hospitals now meet stringent seismic standards, but nearly 10 percent of hospitals remain at high risk.","status":"publish","parent":0,"modified":1461933537,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":804},"headData":{"title":"Finally, Long Overdue Progress in Hospital Seismic Safety | KQED","description":"Many California hospitals now meet stringent seismic standards, but nearly 10 percent of hospitals remain at high risk.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Finally, Long Overdue Progress in Hospital Seismic Safety","datePublished":"2016-04-29T12:38:57.000Z","dateModified":"2016-04-29T12:38:57.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"178042 http://ww2.kqed.org/stateofhealth/?p=178042","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/29/finally-long-overdue-progress-in-hospital-seismic-safety/","disqusTitle":"Finally, Long Overdue Progress in Hospital Seismic Safety","nprByline":"Barbara Feder Ostrov, California Healthline","path":"/stateofhealth/178042/finally-long-overdue-progress-in-hospital-seismic-safety","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of delay, retrofitting and rebuilding, more than 90 percent of California’s acute care hospital buildings are no longer at risk of collapse during an earthquake, according to the most recent data from the state’s Office of Statewide Health Planning and Development (OSHPD).\u003c/p>\n\u003cp>But the remaining hospitals \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SeisPerfRatings-v3-2.html\" target=\"_blank\">still need to meet\u003c/a> the state’s tough seismic safety requirements, or close buildings that are not up to standard by 2030. Buildings at six rural “critical access” hospitals remain on the state’s list of structures most likely to collapse in an earthquake, and their administrators face challenges keeping them open.\u003c/p>\n\u003cp>“I am very pleased with the progress that has been made,” said Robert David, director of OSHPD, which oversees hospital earthquake safety. “Based on information and schedules provided by the hospitals … the remaining acute care buildings appear to be on track to meet the state deadline to withstand a major earthquake or be removed from service.”\u003c/p>\n\u003cp>An estimated 251 buildings are still rated “SPC-1,” the highest risk category — down from more than 1,000 in 2001, according to OSPHD spokesman David Byrnes.\u003c/p>\n\u003cp>Another 629 buildings are rated “SPC-2,” the second highest risk. Not all of those buildings house patients; some may hold administrative offices, for example. But state law requires all buildings in the top two risk categories to close by 2030 unless they have been repaired or replaced. In addition, all SPC-1 buildings must be retrofitted to meet at least SPC-2 requirements by 2020 unless a hospital has received a specific deadline extension from OSPHD.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It has taken years for hospitals to get this far.\u003c/p>\n\u003cp>After the magnitude 6.7 Northridge earthquake crippled local hospitals in 1994, state lawmakers toughened up 1973 legislation that required hospitals in danger of collapse or significant damage in an earthquake to make repairs or rebuild -- or face closure.\u003c/p>\n\u003cp>At the time, the new deadline was set for 2008. But the state’s hospital industry group, citing high construction costs, successfully pushed back many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.\u003c/p>\n\u003cp>There’s a 93 percent chance that a 7.0 magnitude earthquake could strike the Bay Area in the next 30 years, according to the most recent \u003ca href=\"http://pubs.usgs.gov/fs/2015/3009/pdf/fs2015-3009.pdf\" target=\"_blank\">estimate\u003c/a> by the U.S. Geological Survey.\u003c/p>\n\u003cp>While many hospitals around the state have spent millions on retrofitting or replacing unsafe buildings, some have chosen to shut down non-compliant facilities before the final 2030 deadline. Sutter-owned Alta Bates Hospital \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/\" target=\"_blank\">recently determined\u003c/a> that it plans to close acute care and emergency services in Berkeley before 2030 because of the earthquake safety requirements. Some critics say Sutter is using those requirements \u003ca href=\"http://www.eastbaytimes.com/breaking-news/ci_29811598/sutter-plans-future-closing-berkeley-emergency-services\" target=\"_blank\">as an excuse\u003c/a> to consolidate some of its services.\u003c/p>\n\u003cp>A number of hospitals still face difficulty getting the money they need to replace aging buildings, and they’re hoping to get the needed capital through bond measures, tax hikes and other means.\u003c/p>\n\u003cp>In Fort Bragg, the Mendocino County District Hospital is trying to figure how best to keep its main hospital open. It’s \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/SPCNPCList.pdf\" target=\"_blank\">got the second highest risk rating\u003c/a> and would \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/11/06/the-mendocino-coast-fears-losing-its-only-hospital/\" target=\"_blank\">need to close\u003c/a> by 2030 unless improved or replaced. But the 25-bed critical access hospital declared bankruptcy in 2012, and amid staff turmoil, its financing options are limited.\u003c/p>\n\u003cp>The hospital’s board is considering a parcel tax, and its CEO has floated the idea of \u003ca href=\"http://www.advocate-news.com/general-news/20160407/private-non-profit-option-considered\" target=\"_blank\">converting the public hospital to private nonprofit status\u003c/a> to draw more funds.\u003c/p>\n\u003cp>Wade Sturgeon, the hospital district’s chief financial officer, said that reports of the hospital’s potential demise have been exaggerated. “We’ve been able to improve a lot of things. We are having conversations about what do we do going forward,” Sturgeon said. He added that \u003ca href=\"http://www.oshpd.ca.gov/FDD/seismic_compliance/SB1953/SPC-4D_Regulations.html\" target=\"_blank\">new state building regulations\u003c/a> taking effect in 2017 may allow his hospital to stay open past 2030 with some retrofits.\u003c/p>\n\u003cp>While hospitals are finally making progress since the tighter earthquake safety regulations took effect more than 20 years ago, the delays haven’t been good for patients or hospital staff, said Stephanie Roberson, legislative advocate for the California Nurses Association. The association is a persistent critic of what it has seen as hospital foot-dragging.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We need to make sure these hospitals are held accountable,” Roberson said. “We saw what happened in Northridge – the loss of life and property to the tune of billions of dollars. Hospitals are supposed to be that beacon of light in the community, and if we have a seismic catastrophe they are centers for the public to take refuge.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/178042/finally-long-overdue-progress-in-hospital-seismic-safety","authors":["byline_stateofhealth_178042"],"categories":["stateofhealth_14"],"tags":["stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_178046","label":"stateofhealth"},"stateofhealth_177802":{"type":"posts","id":"stateofhealth_177802","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"177802","score":null,"sort":[1461897291000]},"guestAuthors":[],"slug":"sutter-plans-closure-of-berkeleys-alta-bates-hospital-er","title":"Sutter Plans Closure of Berkeley's Alta Bates Hospital, ER","publishDate":1461897291,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After years of speculation in Berkeley, the future closure of Alta Bates Hospital appears to be certain.\u003c/p>\n\u003cp>Sutter Health, owner of Alta Bates, said it will close the inpatient hospital and its emergency department sometime in advance of 2030, when state seismic standards kick in. Those standards require that all inpatient hospitals are built both to withstand a major quake and to remain fully operational after the event.\u003c/p>\n\u003cp>In a statement, Sutter said that Alta Bates is \"not seismically compliant\" with the law, \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/\" target=\"_blank\">SB1953\u003c/a>. It plans to consolidate inpatient and emergency facilities at its Summit campus in Oakland.\u003c/p>\n\u003cp>Berkeley officials are concerned about the closure of its only emergency department. The Berkeley Fire Department and paramedics transported more than 5,000 patients to Alta Bates in the last year. Taking them to Summit in Oakland, 3 miles away, is expected to add 24 minutes to calls, fire officials say.\u003c/p>\n\u003cp>\"It increases the amount of time that (paramedics) have to spend transporting patients to the hospital,\" said Berkeley City Councilman Jesse Arreguin. \"It potentially puts people's lives at risk.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Sutter Health, a nonprofit based in Sacramento, runs more than 25 hospitals across Northern California. The 110-year-old Alta Bates Hospital merged with Summit, part of Sutter Health's chain, in 1999.\u003c/p>\n\u003cp>Many hospital systems are choosing to completely rebuild their inpatient facilities to be compliant with state seismic standards. But Alta Bates is in a residential neighborhood in south Berkeley, and Sutter said that the hospital can't be rebuilt at its current location because \"the existing facility would need to be closed and demolished to make room for a replacement, which would result in loss of care to the community for a decade.\"\u003c/p>\n\u003cp>Instead, Sutter says it plans to make the Alta Bates campus a hub for outpatient services, which are not subject to the strict seismic standards that inpatient facilities are.\u003c/p>\n\u003cp>The ramifications of Alta Bates' closure will be felt well beyond Berkeley and Alameda County. Last year at this time in the Contra Costa County city of San Pablo,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\"> Doctors Medical Center closed\u003c/a> and took more than 20 emergency department beds with it. People north of Berkeley from Richmond to Vallejo had relied on the safety-net hospital.\u003c/p>\n\u003cp>One of the hospitals that absorbed patients after the shutdown was Alta Bates, already a distance for people who live in heavily trafficked communities on the Interstate 80 corridor.\u003c/p>\n\u003cp>Contra Costa Supervisor John Gioia echoed Arreguin's concerns about timely care.\u003c/p>\n\u003cp>\"It basically will mean for some patients, it will take longer to receive hospital care,\" he says. \"It could have negative outcomes in the case of those who need to be in the hospital quicker. Every minute counts, right?\"\u003c/p>\n\u003cp>In its statement, Sutter pointed out that Summit was \"less than 3 miles away\" from Alta Bates. But Alta Bates is on Berkeley's southern edge -- easily a 20-minute drive for people who live on the north side, much farther still for people coming from 10 miles north in Richmond.\u003c/p>\n\u003cp>\"(Sutter) is looking at this from the standpoint of those two hospitals alone,\" Gioia says, \"but the emergency medical system is just that, a system, and this closure will definitely impact the emergency medical systems in Alameda County and also West Contra Costa County.\"\u003c/p>\n\u003cp>Over the last several years, Sutter has moved Alta Bates' cardiac, stroke and rehabilitation services to its Summit Oakland campus.\u003c/p>\n\u003cp>The Berkeley City Council has directed both its Community Health Commission and the Disaster and Fire Safety Commission to assess the impact of Alta Bates' closure and make recommendations to the council.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Amy Mostafa contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Sutter blames tough seismic standards for hospitals, will close Alta Bates before the 2030 deadline.","status":"publish","parent":0,"modified":1468364848,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":613},"headData":{"title":"Sutter Plans Closure of Berkeley's Alta Bates Hospital, ER | KQED","description":"Sutter blames tough seismic standards for hospitals, will close Alta Bates before the 2030 deadline.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Sutter Plans Closure of Berkeley's Alta Bates Hospital, ER","datePublished":"2016-04-29T02:34:51.000Z","dateModified":"2016-07-12T23:07:28.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"177802 http://ww2.kqed.org/stateofhealth/?p=177802","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/28/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er/","disqusTitle":"Sutter Plans Closure of Berkeley's Alta Bates Hospital, ER","path":"/stateofhealth/177802/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of speculation in Berkeley, the future closure of Alta Bates Hospital appears to be certain.\u003c/p>\n\u003cp>Sutter Health, owner of Alta Bates, said it will close the inpatient hospital and its emergency department sometime in advance of 2030, when state seismic standards kick in. Those standards require that all inpatient hospitals are built both to withstand a major quake and to remain fully operational after the event.\u003c/p>\n\u003cp>In a statement, Sutter said that Alta Bates is \"not seismically compliant\" with the law, \u003ca href=\"http://www.oshpd.ca.gov/fdd/seismic_compliance/SB1953/\" target=\"_blank\">SB1953\u003c/a>. It plans to consolidate inpatient and emergency facilities at its Summit campus in Oakland.\u003c/p>\n\u003cp>Berkeley officials are concerned about the closure of its only emergency department. The Berkeley Fire Department and paramedics transported more than 5,000 patients to Alta Bates in the last year. Taking them to Summit in Oakland, 3 miles away, is expected to add 24 minutes to calls, fire officials say.\u003c/p>\n\u003cp>\"It increases the amount of time that (paramedics) have to spend transporting patients to the hospital,\" said Berkeley City Councilman Jesse Arreguin. \"It potentially puts people's lives at risk.\"\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>Sutter Health, a nonprofit based in Sacramento, runs more than 25 hospitals across Northern California. The 110-year-old Alta Bates Hospital merged with Summit, part of Sutter Health's chain, in 1999.\u003c/p>\n\u003cp>Many hospital systems are choosing to completely rebuild their inpatient facilities to be compliant with state seismic standards. But Alta Bates is in a residential neighborhood in south Berkeley, and Sutter said that the hospital can't be rebuilt at its current location because \"the existing facility would need to be closed and demolished to make room for a replacement, which would result in loss of care to the community for a decade.\"\u003c/p>\n\u003cp>Instead, Sutter says it plans to make the Alta Bates campus a hub for outpatient services, which are not subject to the strict seismic standards that inpatient facilities are.\u003c/p>\n\u003cp>The ramifications of Alta Bates' closure will be felt well beyond Berkeley and Alameda County. Last year at this time in the Contra Costa County city of San Pablo,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/20/san-pablos-doctors-medical-center-to-close-tuesday/\" target=\"_blank\"> Doctors Medical Center closed\u003c/a> and took more than 20 emergency department beds with it. People north of Berkeley from Richmond to Vallejo had relied on the safety-net hospital.\u003c/p>\n\u003cp>One of the hospitals that absorbed patients after the shutdown was Alta Bates, already a distance for people who live in heavily trafficked communities on the Interstate 80 corridor.\u003c/p>\n\u003cp>Contra Costa Supervisor John Gioia echoed Arreguin's concerns about timely care.\u003c/p>\n\u003cp>\"It basically will mean for some patients, it will take longer to receive hospital care,\" he says. \"It could have negative outcomes in the case of those who need to be in the hospital quicker. Every minute counts, right?\"\u003c/p>\n\u003cp>In its statement, Sutter pointed out that Summit was \"less than 3 miles away\" from Alta Bates. But Alta Bates is on Berkeley's southern edge -- easily a 20-minute drive for people who live on the north side, much farther still for people coming from 10 miles north in Richmond.\u003c/p>\n\u003cp>\"(Sutter) is looking at this from the standpoint of those two hospitals alone,\" Gioia says, \"but the emergency medical system is just that, a system, and this closure will definitely impact the emergency medical systems in Alameda County and also West Contra Costa County.\"\u003c/p>\n\u003cp>Over the last several years, Sutter has moved Alta Bates' cardiac, stroke and rehabilitation services to its Summit Oakland campus.\u003c/p>\n\u003cp>The Berkeley City Council has directed both its Community Health Commission and the Disaster and Fire Safety Commission to assess the impact of Alta Bates' closure and make recommendations to the council.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Amy Mostafa contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/177802/sutter-plans-closure-of-berkeleys-alta-bates-hospital-er","authors":["240"],"categories":["stateofhealth_2746"],"tags":["stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_177899","label":"stateofhealth"},"stateofhealth_171345":{"type":"posts","id":"stateofhealth_171345","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"171345","score":null,"sort":[1460395988000]},"guestAuthors":[],"slug":"california-lawmakers-reviewing-proposal-to-speed-hospital-admissions-for-patients-in-pscyhiatric-crisis","title":"California's Dire Shortage of Hospital Beds for Patients in Psychiatric Crisis","publishDate":1460395988,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>When \u003ca href=\"http://californiahealthline.org/news/saving-amanda-one-familys-struggle-to-deal-with-a-daughters-mental-illness/\" target=\"_blank\">Pam Lipp’s 18-year-old daughter Amanda\u003c/a> needed to be admitted to a psychiatric hospital in 2010, she thought it would be easy to find her a bed.\u003c/p>\n\u003cp>Instead, Lipp says, “It was a nightmare.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go.'\u003cbr>\n\u003ccite> Pam Lipp\u003c/cite>\u003c/aside>\n\u003cp>Her daughter had been admitted to a psychiatric crisis center during an episode of psychosis but she could only stay there for 72 hours. Lipp asked the crisis center for help finding her a bed and was told she was on her own.\u003c/p>\n\u003cp>So Lipp plugged her phone into the wall in the waiting room and started calling one hospital after the next. They were all full. They wouldn’t reserve a spot when a bed opened, nor would they call to let her know. So she called each one every half hour to check. After eight hours, she found her daughter an open bed near their home in Fair Oaks, California.\u003c/p>\n\u003cp>Usually, it’s an emergency room staff or medical providers making such calls, rather than a patient or caregiver. The result, however, is the same: Finding an available inpatient psychiatric bed in the state of California can be extremely difficult. Many patients with acute psychiatric conditions spend days \u003ca href=\"http://www.npr.org/2011/04/13/135351760/mentally-ill-languish-in-hospital-emergency-rooms\" target=\"_blank\">deteriorating in hospital emergency departments\u003c/a> while they wait.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But how exactly to solve the problem has become a controversy in Sacramento.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2743\" target=\"_blank\">An Assembly bill \u003c/a>backed by the California Psychiatric Association and the Steinberg Institute, a mental health policy organization, seeks to improve the process by establishing an online registry to collect and display information to help medical providers find psychiatric beds. But the California Hospital Association is staunchly opposed, saying that finding the right placement for a patient is much more complex than identifying an empty bed, and a registry could actually hinder efforts to get patients appropriate treatment.\u003c/p>\n\u003cp>The Assembly’s Committee on Health plans to hold the first hearing on the bill on April 12.\u003c/p>\n\u003cp>[contextly_sidebar id=\"3DVVdSD0eUzVhPbKvw2SFfjlfM0rBqT8\"]Under the proposed legislation, AB2743, facilities with psychiatric beds would be required to update the registry as the beds became available, and emergency medical providers would be able to log on to search for openings.\u003c/p>\n\u003cp>“A bed registry would eliminate the need for rounds and rounds of calls over hours and hours. Why not just cut that time out and go straight to the source?” asks Anna Hasselblad, public policy director at the Steinberg Institute.\u003c/p>\n\u003cp>California is facing a serious shortage of psychiatric beds, said Randall Hagar, director of government affairs for the California Psychiatric Association. As of 2013, there were 6,680 beds in the state — about 17 per 100,000 residents, according to a \u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">report from the hospital association\u003c/a>. Psychiatric experts recommend a minimum of 50 beds per 100,000. In 25 counties in the state, there were no psychiatric beds at all.\u003c/p>\n\u003cp>Adding beds is a long-term goal for many mental health advocates, but it’s a huge task that could take years.\u003c/p>\n\u003cp>“We have to use the beds we do have and we have to know where they are. It can be a hit or miss process. It needs to be more reliable,” said Hagar. “We’ve heard instances where people were told there were no beds when in fact it turns out later that there were. An online registry would fix that issue.”\u003c/p>\n\u003cp>It would also provide data on exactly what types of additional beds are needed and where, he said.\u003c/p>\n\u003cp>The hospital association is not convinced it would work.\u003c/p>\n\u003cp>“On first blush, if you are not in the trenches, it seems like the best and easiest solution in the entire world. But the reality is that the bill will really increase the amount of time and the frustration people have trying to locate psychiatric acute-levels of care in our state,” said Sheree Lowe, the hospital association’s vice president of behavioral health.\u003c/p>\n\u003cp>Beyond finding an open bed, staffers must also factor in the age, gender, illness and acuity of the patient.\u003c/p>\n\u003cp>“You have to take under consideration your staffing needs, the needs of the other patients, and the therapeutic milieu for the safety of all patients and all staff. And that’s not something you can put into a drop-down menu,” said Lowe.\u003c/p>\n\u003cp>Requiring hospital staffers to report all those changing dynamics in an online registry, she added, would be yet another administrative burden that could cut into hands-on patient care.\u003c/p>\n\u003cp>\u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">Many states \u003c/a>have some sort of computerized tracking system for psychiatric beds, but few are mandatory. Lowe points to a recent effort in Virginia to create a mandatory registry similar to the one being proposed in California as evidence that they don’t work.\u003c/p>\n\u003cp>In January, the \u003ca href=\"https://osig.virginia.gov/media/5277/2016-bhds-001-acute-psychiatric-and-community-services-board-bed-registry.pdf\" target=\"_blank\">Virginia state inspector general reported \u003c/a>that more than half of users of the online registry said it takes longer to find a bed for a patient than it did before the registry was established, in part because hospitals were not accurately updating information about their beds.\u003c/p>\n\u003cp>Hasselblad of the Steinberg Institute, however, said the issues with the Virginia system “is a little bit of a self-fulfilling prophesy. We have to get the buy-in from the people who will be updating the registry, because if you don’t believe it’s going to be useful to you, it’s not going to be useful to you.”\u003c/p>\n\u003cp>One solution, she said, would be to include a fine in the bill for hospitals that do not keep the registry updated. “Hospitals aren’t going to do this unless they’re absolutely mandated to.”\u003c/p>\n\u003cp>Despite the opposition of the hospital association, the emergency room doctors who staff their facilities are generally supportive of the bill. Holding psychiatric patients for days in the emergency department is “a worst case scenario for everyone involved,” said Elena Lopez-Gusman, executive director of the California chapter of the American College of Emergency Physicians.\u003c/p>\n\u003cp>And she said the hospitals with psychiatric beds may be making the problem worse by trying to reserve beds for patients with private insurance.\u003c/p>\n\u003cp>“Our physician members have reported a significant level of difficulty in getting what they feel is an accurate assessment of bed availability,” said Lopez-Gusman. “They might call the same facility in a short time for two different patients with different types of insurance, and get different answers on whether or not there’s a bed available. So our thought is that more transparency reduces the hospitals’ ability to hide available beds.”\u003c/p>\n\u003cp>Lowe of the hospital association denies that psychiatric hospitals are holding beds, which would be a violation of federal law.\u003c/p>\n\u003cp>Assemblymember Susan Talamantes Eggman, the Stockton Democrat who wrote the bill, said she believes the bill has a good chance of passing.\u003c/p>\n\u003cp>“We are very hopeful. There’s a good coalition, and everyone is talking about mental health these days,” she said. “This is a practical, small step we can take. It’s hard to argue against it.”\u003c/p>\n\u003cp>Pam Lipp, who struggled to find a bed for her daughter, said the idea of establishing a registry is “absolutely phenomenal.”\u003c/p>\n\u003cp>“Our situation is exactly the kind of situation that hopefully this bill will help,” she said.\u003c/p>\n\u003cp>“If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go, and we would have just repeated the cycle again. Maybe she wouldn’t have survived.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"A mandatory online registry would help doctors find open beds, but the hospital industry opposes it.","status":"publish","parent":0,"modified":1460578286,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1323},"headData":{"title":"California's Dire Shortage of Hospital Beds for Patients in Psychiatric Crisis | KQED","description":"A mandatory online registry would help doctors find open beds, but the hospital industry opposes it.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California's Dire Shortage of Hospital Beds for Patients in Psychiatric Crisis","datePublished":"2016-04-11T17:33:08.000Z","dateModified":"2016-04-13T20:11:26.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"171345 http://ww2.kqed.org/stateofhealth/?p=171345","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/11/california-lawmakers-reviewing-proposal-to-speed-hospital-admissions-for-patients-in-pscyhiatric-crisis/","disqusTitle":"California's Dire Shortage of Hospital Beds for Patients in Psychiatric Crisis","nprByline":"Jenny Gold\u003cbr />\u003ca href=\"http://californiahealthline.org/\">California Healthline\u003c/a>","path":"/stateofhealth/171345/california-lawmakers-reviewing-proposal-to-speed-hospital-admissions-for-patients-in-pscyhiatric-crisis","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When \u003ca href=\"http://californiahealthline.org/news/saving-amanda-one-familys-struggle-to-deal-with-a-daughters-mental-illness/\" target=\"_blank\">Pam Lipp’s 18-year-old daughter Amanda\u003c/a> needed to be admitted to a psychiatric hospital in 2010, she thought it would be easy to find her a bed.\u003c/p>\n\u003cp>Instead, Lipp says, “It was a nightmare.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go.'\u003cbr>\n\u003ccite> Pam Lipp\u003c/cite>\u003c/aside>\n\u003cp>Her daughter had been admitted to a psychiatric crisis center during an episode of psychosis but she could only stay there for 72 hours. Lipp asked the crisis center for help finding her a bed and was told she was on her own.\u003c/p>\n\u003cp>So Lipp plugged her phone into the wall in the waiting room and started calling one hospital after the next. They were all full. They wouldn’t reserve a spot when a bed opened, nor would they call to let her know. So she called each one every half hour to check. After eight hours, she found her daughter an open bed near their home in Fair Oaks, California.\u003c/p>\n\u003cp>Usually, it’s an emergency room staff or medical providers making such calls, rather than a patient or caregiver. The result, however, is the same: Finding an available inpatient psychiatric bed in the state of California can be extremely difficult. Many patients with acute psychiatric conditions spend days \u003ca href=\"http://www.npr.org/2011/04/13/135351760/mentally-ill-languish-in-hospital-emergency-rooms\" target=\"_blank\">deteriorating in hospital emergency departments\u003c/a> while they wait.\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 how exactly to solve the problem has become a controversy in Sacramento.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2743\" target=\"_blank\">An Assembly bill \u003c/a>backed by the California Psychiatric Association and the Steinberg Institute, a mental health policy organization, seeks to improve the process by establishing an online registry to collect and display information to help medical providers find psychiatric beds. But the California Hospital Association is staunchly opposed, saying that finding the right placement for a patient is much more complex than identifying an empty bed, and a registry could actually hinder efforts to get patients appropriate treatment.\u003c/p>\n\u003cp>The Assembly’s Committee on Health plans to hold the first hearing on the bill on April 12.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Under the proposed legislation, AB2743, facilities with psychiatric beds would be required to update the registry as the beds became available, and emergency medical providers would be able to log on to search for openings.\u003c/p>\n\u003cp>“A bed registry would eliminate the need for rounds and rounds of calls over hours and hours. Why not just cut that time out and go straight to the source?” asks Anna Hasselblad, public policy director at the Steinberg Institute.\u003c/p>\n\u003cp>California is facing a serious shortage of psychiatric beds, said Randall Hagar, director of government affairs for the California Psychiatric Association. As of 2013, there were 6,680 beds in the state — about 17 per 100,000 residents, according to a \u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">report from the hospital association\u003c/a>. Psychiatric experts recommend a minimum of 50 beds per 100,000. In 25 counties in the state, there were no psychiatric beds at all.\u003c/p>\n\u003cp>Adding beds is a long-term goal for many mental health advocates, but it’s a huge task that could take years.\u003c/p>\n\u003cp>“We have to use the beds we do have and we have to know where they are. It can be a hit or miss process. It needs to be more reliable,” said Hagar. “We’ve heard instances where people were told there were no beds when in fact it turns out later that there were. An online registry would fix that issue.”\u003c/p>\n\u003cp>It would also provide data on exactly what types of additional beds are needed and where, he said.\u003c/p>\n\u003cp>The hospital association is not convinced it would work.\u003c/p>\n\u003cp>“On first blush, if you are not in the trenches, it seems like the best and easiest solution in the entire world. But the reality is that the bill will really increase the amount of time and the frustration people have trying to locate psychiatric acute-levels of care in our state,” said Sheree Lowe, the hospital association’s vice president of behavioral health.\u003c/p>\n\u003cp>Beyond finding an open bed, staffers must also factor in the age, gender, illness and acuity of the patient.\u003c/p>\n\u003cp>“You have to take under consideration your staffing needs, the needs of the other patients, and the therapeutic milieu for the safety of all patients and all staff. And that’s not something you can put into a drop-down menu,” said Lowe.\u003c/p>\n\u003cp>Requiring hospital staffers to report all those changing dynamics in an online registry, she added, would be yet another administrative burden that could cut into hands-on patient care.\u003c/p>\n\u003cp>\u003ca href=\"http://www.calhospital.org/sites/main/files/file-attachments/6_-_psychbeddata.pdf\" target=\"_blank\">Many states \u003c/a>have some sort of computerized tracking system for psychiatric beds, but few are mandatory. Lowe points to a recent effort in Virginia to create a mandatory registry similar to the one being proposed in California as evidence that they don’t work.\u003c/p>\n\u003cp>In January, the \u003ca href=\"https://osig.virginia.gov/media/5277/2016-bhds-001-acute-psychiatric-and-community-services-board-bed-registry.pdf\" target=\"_blank\">Virginia state inspector general reported \u003c/a>that more than half of users of the online registry said it takes longer to find a bed for a patient than it did before the registry was established, in part because hospitals were not accurately updating information about their beds.\u003c/p>\n\u003cp>Hasselblad of the Steinberg Institute, however, said the issues with the Virginia system “is a little bit of a self-fulfilling prophesy. We have to get the buy-in from the people who will be updating the registry, because if you don’t believe it’s going to be useful to you, it’s not going to be useful to you.”\u003c/p>\n\u003cp>One solution, she said, would be to include a fine in the bill for hospitals that do not keep the registry updated. “Hospitals aren’t going to do this unless they’re absolutely mandated to.”\u003c/p>\n\u003cp>Despite the opposition of the hospital association, the emergency room doctors who staff their facilities are generally supportive of the bill. Holding psychiatric patients for days in the emergency department is “a worst case scenario for everyone involved,” said Elena Lopez-Gusman, executive director of the California chapter of the American College of Emergency Physicians.\u003c/p>\n\u003cp>And she said the hospitals with psychiatric beds may be making the problem worse by trying to reserve beds for patients with private insurance.\u003c/p>\n\u003cp>“Our physician members have reported a significant level of difficulty in getting what they feel is an accurate assessment of bed availability,” said Lopez-Gusman. “They might call the same facility in a short time for two different patients with different types of insurance, and get different answers on whether or not there’s a bed available. So our thought is that more transparency reduces the hospitals’ ability to hide available beds.”\u003c/p>\n\u003cp>Lowe of the hospital association denies that psychiatric hospitals are holding beds, which would be a violation of federal law.\u003c/p>\n\u003cp>Assemblymember Susan Talamantes Eggman, the Stockton Democrat who wrote the bill, said she believes the bill has a good chance of passing.\u003c/p>\n\u003cp>“We are very hopeful. There’s a good coalition, and everyone is talking about mental health these days,” she said. “This is a practical, small step we can take. It’s hard to argue against it.”\u003c/p>\n\u003cp>Pam Lipp, who struggled to find a bed for her daughter, said the idea of establishing a registry is “absolutely phenomenal.”\u003c/p>\n\u003cp>“Our situation is exactly the kind of situation that hopefully this bill will help,” she said.\u003c/p>\n\u003cp>“If I hadn’t done what I did, our daughter would most likely have been discharged, back on the street with nowhere to go, and we would have just repeated the cycle again. Maybe she wouldn’t have survived.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/171345/california-lawmakers-reviewing-proposal-to-speed-hospital-admissions-for-patients-in-pscyhiatric-crisis","authors":["byline_stateofhealth_171345"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2721","stateofhealth_2722","stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_171476","label":"stateofhealth"},"stateofhealth_138635":{"type":"posts","id":"stateofhealth_138635","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"138635","score":null,"sort":[1452758539000]},"guestAuthors":[],"slug":"as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","title":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","publishDate":1452758539,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The Bay Area's health care systems -- think Stanford, Sutter, John Muir and more -- are continuing to align and consolidate in different ways to expand across the region, \u003ca href=\"http://stage.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\">a new analysis shows\u003c/a>, and it's unclear if this will lead to lower or higher health care costs.\u003c/p>\n\u003cp>The report, from the Oakland-based California HealthCare Foundation (CHCF), serves as a summary of the transformation in the Bay Area's health care market over the last few years since the foundation's last report on the subject in 2012.\u003c/p>\n\u003cp>Maribeth Shannon, director at CHCF, referred to \"an arms race.\"\u003c/p>\n\u003cp>\"Providers see health plans consolidating and they want to have a similar level of leverage when they negotiate\" with health insurers, she said. \"The idea [is] that you have to be strong to get a good price in this market.\"\u003c/p>\n\u003cp>The analysis, conducted for the foundation by Mathematica Policy Research, called out three specific health system regionalization efforts and the different ways they were achieving their goals:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Stanford Health Care\u003c/strong> reached across San Francisco Bay to acquire ValleyCare, based in Pleasanton. The goal of such an expansion, the report says, is for Stanford \"to support an expansion of its health plan.\"\u003c/li>\n\u003cli>\u003cstrong>UCSF and John Muir Health\u003c/strong> -- also on opposite sides of San Francisco Bay -- formed a partnership aimed at building a \"network large enough to compete with systems like Kaiser and Sutter\" throughout the Bay Area.\u003c/li>\n\u003cli>\u003cstrong>Sutter Health,\u003c/strong> meanwhile, is consolidating its own operations. The foundation's report cites multiple rounds of reorganization over the past few years, and says Sutter now is attempting to merge its three Bay Area foundations with the goal of extending the successful Palo Alto Medical Foundation model to other sites. But the analysts predict that will be a tall order, given the foundations' different \"histories and physician cultures.\"\u003c/li>\n\u003c/ul>\n\u003cp>And what of patients? Ha Tu, senior health researcher of Mathematica Policy Research and lead author of the study, predicts the increasing consolidation, \"at least in the short term, will result in more provider competition and more choices for consumers, but over the longer term, it remains to be seen whether it's a sustainable thing.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Glenn Melnick, a health economist at USC, flatly rejects that the consolidation will ever benefit consumers.\u003c/p>\n\u003cp>\"What's happening,\" he said, \"is they're getting together to negotiate contracts, and that's it. I'm very cynical.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\" rel=\"attachment wp-att-138796\">\u003cimg class=\"alignright wp-image-138796 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/EmpireBuildingByBayTeaser.jpg\" alt=\"\" width=\"291\" height=\"400\">\u003c/a>Northern California as a whole has \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">long had higher health care prices\u003c/a> than Southern California. Melnick described \"monstrous health care enterprises who are just building on existing market power to expand and protect it in the future.\"\u003c/p>\n\u003cp>Both the foundation's Shannon and lead author Tu stressed that future cost savings are unknown. While more consolidation can lead to higher prices, efficiencies can improve, Shannon said, but she added it's not clear now if those efficiencies would be robust enough to offset price hikes.\u003c/p>\n\u003cp>Tu pointed to a desire by many health systems to be more competitive against health giant Kaiser.\u003c/p>\n\u003cp>At both Sutter and UCSF/John Muir \"they are very well aware they need to lower their cost structures significantly and do population health effectively,\" Tu said in reference to the push to move away from fee-for-service medicine, which can lead to unnecessary care and waste. \"Whether they can do that is a big challenge and an open question.\"\u003c/p>\n\u003cp>In the report, analysts also looked at safety net providers and the challenge posed by increased demand as millions more Californians have coverage, in the wake of the full implementation of the Affordable Care Act. Just over \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\">one-third of Californians are now covered by Medi-Cal\u003c/a>, and primary care providers are in short supply, the report said.\u003c/p>\n\u003cp>\"The primary care physicians that are needed to serve that population just don't exist,\" Shannon said. \"What we need are innovative ways of meeting the health care needs of that population.\"\u003c/p>\n\u003cp>Providing behavioral health care to patients in the face of expanded health insurance access and regulations requiring coverage \"\u003ca href=\"http://www.dol.gov/ebsa/mentalhealthparity/\" target=\"_blank\">parity\u003c/a>\" -- that health insurers \u003ca href=\"https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Health-Insurance/What-is-Mental-Health-Parity\" target=\"_blank\">must provide equal coverage\u003c/a> for mental health conditions -- is an \"enormous problem,\" Shannon said, and many patients are facing long wait times to access care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a significant problem,\" she said, \"and it's long been simmering, it's been below the surface for a long time, and now parity has brought it up to the top.\"\u003c/p>\n\n","blocks":[],"excerpt":"New report shows increasingly regionalization may lead to short-run cost savings. But in the long run, no one knows.","status":"publish","parent":0,"modified":1452819481,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":738},"headData":{"title":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down? | KQED","description":"New report shows increasingly regionalization may lead to short-run cost savings. But in the long run, no one knows.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","datePublished":"2016-01-14T08:02:19.000Z","dateModified":"2016-01-15T00:58:01.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"138635 http://ww2.kqed.org/stateofhealth/?p=138635","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/14/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down/","disqusTitle":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","path":"/stateofhealth/138635/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Bay Area's health care systems -- think Stanford, Sutter, John Muir and more -- are continuing to align and consolidate in different ways to expand across the region, \u003ca href=\"http://stage.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\">a new analysis shows\u003c/a>, and it's unclear if this will lead to lower or higher health care costs.\u003c/p>\n\u003cp>The report, from the Oakland-based California HealthCare Foundation (CHCF), serves as a summary of the transformation in the Bay Area's health care market over the last few years since the foundation's last report on the subject in 2012.\u003c/p>\n\u003cp>Maribeth Shannon, director at CHCF, referred to \"an arms race.\"\u003c/p>\n\u003cp>\"Providers see health plans consolidating and they want to have a similar level of leverage when they negotiate\" with health insurers, she said. \"The idea [is] that you have to be strong to get a good price in this market.\"\u003c/p>\n\u003cp>The analysis, conducted for the foundation by Mathematica Policy Research, called out three specific health system regionalization efforts and the different ways they were achieving their goals:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Stanford Health Care\u003c/strong> reached across San Francisco Bay to acquire ValleyCare, based in Pleasanton. The goal of such an expansion, the report says, is for Stanford \"to support an expansion of its health plan.\"\u003c/li>\n\u003cli>\u003cstrong>UCSF and John Muir Health\u003c/strong> -- also on opposite sides of San Francisco Bay -- formed a partnership aimed at building a \"network large enough to compete with systems like Kaiser and Sutter\" throughout the Bay Area.\u003c/li>\n\u003cli>\u003cstrong>Sutter Health,\u003c/strong> meanwhile, is consolidating its own operations. The foundation's report cites multiple rounds of reorganization over the past few years, and says Sutter now is attempting to merge its three Bay Area foundations with the goal of extending the successful Palo Alto Medical Foundation model to other sites. But the analysts predict that will be a tall order, given the foundations' different \"histories and physician cultures.\"\u003c/li>\n\u003c/ul>\n\u003cp>And what of patients? Ha Tu, senior health researcher of Mathematica Policy Research and lead author of the study, predicts the increasing consolidation, \"at least in the short term, will result in more provider competition and more choices for consumers, but over the longer term, it remains to be seen whether it's a sustainable thing.\"\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>Glenn Melnick, a health economist at USC, flatly rejects that the consolidation will ever benefit consumers.\u003c/p>\n\u003cp>\"What's happening,\" he said, \"is they're getting together to negotiate contracts, and that's it. I'm very cynical.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\" rel=\"attachment wp-att-138796\">\u003cimg class=\"alignright wp-image-138796 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/EmpireBuildingByBayTeaser.jpg\" alt=\"\" width=\"291\" height=\"400\">\u003c/a>Northern California as a whole has \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">long had higher health care prices\u003c/a> than Southern California. Melnick described \"monstrous health care enterprises who are just building on existing market power to expand and protect it in the future.\"\u003c/p>\n\u003cp>Both the foundation's Shannon and lead author Tu stressed that future cost savings are unknown. While more consolidation can lead to higher prices, efficiencies can improve, Shannon said, but she added it's not clear now if those efficiencies would be robust enough to offset price hikes.\u003c/p>\n\u003cp>Tu pointed to a desire by many health systems to be more competitive against health giant Kaiser.\u003c/p>\n\u003cp>At both Sutter and UCSF/John Muir \"they are very well aware they need to lower their cost structures significantly and do population health effectively,\" Tu said in reference to the push to move away from fee-for-service medicine, which can lead to unnecessary care and waste. \"Whether they can do that is a big challenge and an open question.\"\u003c/p>\n\u003cp>In the report, analysts also looked at safety net providers and the challenge posed by increased demand as millions more Californians have coverage, in the wake of the full implementation of the Affordable Care Act. Just over \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\">one-third of Californians are now covered by Medi-Cal\u003c/a>, and primary care providers are in short supply, the report said.\u003c/p>\n\u003cp>\"The primary care physicians that are needed to serve that population just don't exist,\" Shannon said. \"What we need are innovative ways of meeting the health care needs of that population.\"\u003c/p>\n\u003cp>Providing behavioral health care to patients in the face of expanded health insurance access and regulations requiring coverage \"\u003ca href=\"http://www.dol.gov/ebsa/mentalhealthparity/\" target=\"_blank\">parity\u003c/a>\" -- that health insurers \u003ca href=\"https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Health-Insurance/What-is-Mental-Health-Parity\" target=\"_blank\">must provide equal coverage\u003c/a> for mental health conditions -- is an \"enormous problem,\" Shannon said, and many patients are facing long wait times to access care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a significant problem,\" she said, \"and it's long been simmering, it's been below the surface for a long time, and now parity has brought it up to the top.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/138635/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_482","stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_138795","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. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. 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. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png","officialWebsiteLink":"http://freakonomics.com/","airtime":"SUN 1am-2am, SAT 3pm-4pm","meta":{"site":"radio","source":"WNYC"},"link":"/radio/program/freakonomics-radio","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519","tuneIn":"https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/","rss":"https://feeds.feedburner.com/freakonomicsradio"}},"fresh-air":{"id":"fresh-air","title":"Fresh Air","info":"Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.","airtime":"MON-FRI 7pm-8pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/fresh-air/","meta":{"site":"radio","source":"npr"},"link":"/radio/program/fresh-air","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Fresh-Air-p17/","rss":"https://feeds.npr.org/381444908/podcast.xml"}},"here-and-now":{"id":"here-and-now","title":"Here & Now","info":"A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.","airtime":"MON-THU 11am-12pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"http://www.wbur.org/hereandnow","meta":{"site":"news","source":"npr"},"link":"/radio/program/here-and-now","subsdcribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=426698661","tuneIn":"https://tunein.com/radio/Here--Now-p211/","rss":"https://feeds.npr.org/510051/podcast.xml"}},"how-i-built-this":{"id":"how-i-built-this","title":"How I Built This with Guy Raz","info":"Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png","officialWebsiteLink":"https://www.npr.org/podcasts/510313/how-i-built-this","airtime":"SUN 7:30pm-8pm","meta":{"site":"news","source":"npr"},"link":"/radio/program/how-i-built-this","subscribe":{"npr":"https://rpb3r.app.goo.gl/3zxy","apple":"https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2","tuneIn":"https://tunein.com/podcasts/Arts--Culture-Podcasts/How-I-Built-This-p910896/","rss":"https://feeds.npr.org/510313/podcast.xml"}},"inside-europe":{"id":"inside-europe","title":"Inside Europe","info":"Inside Europe, a one-hour weekly news magazine hosted by Helen Seeney and Keith Walker, explores the topical issues shaping the continent. No other part of the globe has experienced such dynamic political and social change in recent years.","airtime":"SAT 3am-4am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Inside-Europe-Podcast-Tile-300x300-1.jpg","meta":{"site":"news","source":"Deutsche Welle"},"link":"/radio/program/inside-europe","subscribe":{"apple":"https://itunes.apple.com/us/podcast/inside-europe/id80106806?mt=2","tuneIn":"https://tunein.com/radio/Inside-Europe-p731/","rss":"https://partner.dw.com/xml/podcast_inside-europe"}},"latino-usa":{"id":"latino-usa","title":"Latino USA","airtime":"MON 1am-2am, SUN 6pm-7pm","info":"Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg","officialWebsiteLink":"http://latinousa.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/latino-usa","subscribe":{"npr":"https://rpb3r.app.goo.gl/xtTd","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Latino-USA-p621/","rss":"https://feeds.npr.org/510016/podcast.xml"}},"live-from-here-highlights":{"id":"live-from-here-highlights","title":"Live from Here Highlights","info":"Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. 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Updated Monday through Friday at about 3:30 p.m. PT.","airtime":"MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.marketplace.org/","meta":{"site":"news","source":"American Public Media"},"link":"/radio/program/marketplace","subscribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201853034&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/APM-Marketplace-p88/","rss":"https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"}},"mindshift":{"id":"mindshift","title":"MindShift","tagline":"A podcast about the future of learning and how we raise our kids","info":"The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. 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. 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