Impact Projects
Almost two decades ago, the state made Sacramento County the testing ground for a new model of delivering dental care to poor children. Officials envisioned a managed care system that would control costs and improve children’s ability to see a dentist. Today that model persists – but state data shows that the county has consistently produced one of California’s worst records for care. In 2010, only 30 percent of more than 110,000 Sacramento children with Medi-Cal – the government insurance program for the poor – saw a dentist, according to state data. By comparison, nearly half of their Medi-Cal peers statewide visited a dental office.
Residents in the Northern California town of Clearlake have been having two common heart procedures at five and six times the state average. Rates are also high across a wide swath of the Central Valley. These elevated numbers are partly a result of widespread health problems that show up in the population. But a new study suggests that the high rates go well beyond that, and researchers say the biggest cause may be clinical practice decisions made by doctors. The findings could have enormous implications for health costs and the quality of care.
A flawed Medicare policy has contributed to the suffering of American kidney patients for decades. While the federal entitlement program covers a lifetime of costly dialysis treatments, it provides only 36 months of anti-rejection medications that kidney transplant recipients need the rest of their lives. Without the drugs, the kidney fails and recipients return to the dialysis regimen, sometimes waiting years for the next kidney transplant. The counter-intuitive policy keeps patients in a U.S. dialysis system with some of the worst mortality rates in the world, and wastes the precious resource of donated kidneys. It can cost taxpayers millions more in the long run.
California consumers were urged not to read too much into its first-ever report on hospital-acquired infections. In fact, though, the report suggests some wide differences in performance, and interviews with hospital officials show that many medical centers are working intensely to reduce their infection numbers. In some places, these efforts appear to be paying off.
In January 2011, California becomes the last of the big states to disclose the incidence of hospital-caused infections. Hospital infections kill an estimated 13,500 Californians a year, but critics say the state’s hospitals and health department remain far behind other states in waging war against this largely preventable scourge.
The foreclosure of a home is more than a financial transaction. It also is a hidden human drama. Merced County ranked first in California for foreclosure filings in 2009, and sixth among counties nationwide. With one in seven county homes foreclosed on since September 2006, we examine the psychological problems, including anxiety, sleeplessness and depression, wreaked by the local foreclosure crisis, which shows no sign of abating.
Health reform will have its largest impact in California four years from now. But in the wake of historic passage by Congress, the health overhaul will have multiple immediate effects. Here’s a look. (Also published in the Merced Sun-Star, the Modesto Bee, the Sacramento Bee and the San Luis Obispo Tribune).
Santa Cruz’s Healthy Kids program was wildly successful until 2009, when the battered economy threatened its funding. Like 28 other programs in California, the county’s Healthy Kids program was lauded for providing health coverage for virtually every poor child who was not otherwise insured, regardless of immigration status. By early 2010, however, the program had reached a crossroads: it was forced to freeze enrollment and faced financial struggle.
The nation’s 75 million baby boomers, it turns out, are not immune from the crisis in health care. Economic problems are hitting many Ventura County middle-class baby boomers with loss of jobs and health insurance, and the safety net they paid into during better times was not designed to help them. Uninsured patients ages 45-64 nearly doubled at county hospitals and clinics between 2005 and 2009.
In the winter, Butte County suffers from a number of bad air quality days that have serious health consequences for the elderly and those with respiratory conditions. We examine the politics and science behind the debate over whether wood stove-generated smoke pollution constitutes a threat to residents’ health. In a county with a long history of heavy dependence on stoves as a source of heat and a bountiful supply of inexpensive wood, this is a heated question.
Health reform will offer special incentives to small businesses who continue coverage for their employees – tax cuts covering up to 35 percent of their costs. But that’s of little consolation to many business owners, many of whom are getting rate increases that exceed the tax credits. Some think it’s fishy. (Also published in the Ventura County Star).
There is hope at last for tens of thousands of Californians unable to get health coverage because of pre-existing conditions. The state is establishing a new high-risk pool with more than $750 million in federal money to widen coverage. The new program is a bridge to 2014, when denials of coverage based on pre-existing conditions will be banned.
What are prospects for bringing a medical school to the University of California’s newest and smallest campus, and to a valley population of 3 million burdened by poverty and lack of access to care? We survey politicians, university officials, representatives of the valley business community, health care workers and farm workers to look at the implications such a school would have on valley health, as well as the impediments the proposal faces.
In the past two years, many of Santa Cruz County’s elderly and disabled patients have been shut out from a primary care system that has no room for them. Fed up with the low reimbursement rates paid by the federal insurance program for the elderly and disabled, many Santa Cruz County-based doctors have refused to accept new Medicare patients. The series investigates the breakdown in care and the prospects for fixing it.
The smoke inhalation from long-burning forest fires in northern California extracts a huge, frightening toll on residents’ respiratory health. We measure the ill effects and suggest potential remedies.
The call comes in and, for the 10th, 12th, or 20th time, paramedics take a middle-aged man from the streets to the ER. Such frequent users cost the emergency medical system millions, yet don't get the help they need.
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Part 1: The problem
Part 2: The streets
Part 3: The emergency room
Part 4: A new model
Part 5: Frequent Users - Joan Kloh
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