California Watch Daily Report en Bill seeks to limit school police in discipline matters <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/susan-ferriss" title="View user profile." class="fn">Susan Ferriss</a></span> and <span class="author vcard"><a href="/user/ben-wieder" title="View user profile." class="fn">Ben Wieder</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/CPI-LA-citations-protest.jpg" title="Students protest last year in Los Angeles against school police tickets issued heavily at middle schools, low-income schools." /> <span class="image-insert-photo-credit"><a class="image-insert-photo-credit-url" href="" target="_blank">Vanessa Romo/</a></span> <span class="image-insert-description"> Students protest last year in Los Angeles against school police tickets issued heavily at middle schools, low-income schools.&nbsp;</span></p> <p>As the national debate grows louder over&nbsp;<a href="">deploying police in schools</a>, the largest state in the union &shy;&ndash; California &ndash; is considering a bill that would require schools to set &ldquo;clear guidelines&rdquo; defining the role of school police and limit their involvement in disciplinary matters.</p> <p>The Golden State joins Texas and Connecticut &shy;&shy;&shy;&ndash; home of the December Newtown school shootings &ndash; in considering legislation that would set limits on how schools involve police officers in discipline. Colorado adopted limits last year.</p> <p>The proposals come amid burgeoning concern nationally over harsh school punishment policies, and police involvement in seemingly routine discipline. Police presence on campuses nationwide has grown steadily since two teens went on a killing spree at Columbine High School outside Denver in 1999. But a growing group of&nbsp;<a href="">juvenile-justice researchers and judges</a>&nbsp;argue that putting students into conflict with officers over minor infractions &ndash; and needlessly placing kids in the justice system &ndash; increases risks students will drop out and get into more serious trouble.</p> <p>Since last December, lawmakers in various states and school administrators have rushed to fortify security in reaction to a young adult&rsquo;s shooting rampage, which killed 20 first-graders and six educators in Newtown, Conn. President Barack Obama and California&rsquo;s own senator, Democrat Barbara Boxer, have urged appropriating money to schools that want to increase security.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>California State Assemblyman Reginald Jones-Sawyer, a Democrat from Los Angeles, introduced the state school police bill, <a href=";search_keywords=">AB 549</a>, to &ldquo;get out in front,&rdquo; he said, of the drive to put more security personnel in schools. A first hearing on the bill is set for Wednesday before the Assembly Education Committee.</p> <p>California lawmakers are considering restricting other discipline practices critics say have become counterproductive, including suspensions that remove pupils from school for days at a time, often causing them to fall behind in classwork and leaving them unsupervised at home. The Assembly education panel&nbsp;recently approved a bill April 17 that would restrict out-of-school student suspensions and expulsions for &ldquo;<a href=";search_keywords=">willful defiance</a>,&rdquo;&nbsp;the basis of almost half of all suspensions in 2011-2012,&nbsp;<a href=";cType=ALL&amp;cCDS=34673143432572&amp;cName=Statewide&amp;cLevel=State&amp;cChoice=DefByEth">new state data</a>&nbsp;shows.</p> <p>The Jones-Sawyer bill faces opposition from the Association of California School Administrators. Laura Preston, the group&rsquo;s legislative advocate, told the Center that the proposal takes too much control away from local districts and schools because it limits what they can do with school safety dollars.</p> <p>In an April 29 letter, the group argued that the bill&rsquo;s requirements to put police guidelines in school safety plans added up to an imposition &ldquo;without regard&rdquo; for &ldquo;the additional time needed to do this work.&rdquo; Preston suggested &ldquo;a conversation&rdquo; about improving school police training could be an alternative to Jones-Sawyer&rsquo;s bill.</p> <p>Jones-Sawyer&rsquo;s bill does have support from the California Federation of Teachers, the union representing many Los Angeles teachers. That support helps it over one major political hurdle. The California Teachers Association, an even larger union, has no position yet.</p> <p>&ldquo;This is not anti-police. I do believe there is a role for public safety on campuses,&rdquo; Jones-Sawyer said of his bill. &ldquo;But before we get the guns and guards out, let&rsquo;s get some mental health (care) in there for students.&rdquo;</p> <p>&ldquo;There should be guidelines for when you&nbsp;don&rsquo;t&nbsp;need police involved in discipline,&rdquo; he said.</p> <p><strong>Troubling history</strong></p> <p>Last year, the&nbsp;<a href="">Center for Public Integrity</a>&nbsp;documented the ticketing of about 10,000 mostly black and Latino students a year,&nbsp;<a href="">including middle-school-age children</a>,&nbsp;in lower-income neighborhoods in the&nbsp;<a href="">Los Angeles Unified School District</a>. L.A. Unified is the nation&rsquo;s second-biggest school district, and with more than 300 officers and additional security guards, it has the country&rsquo;s largest district-controlled school police agency. At one point, school police were issuing about 1,000 tickets, or court citations, a month in 2011.</p> <p><a href="">New York City police</a>&nbsp;in schools, by comparison, issued 1,666 tickets to students during the entire 2011-2012 school year, according to records obtained by the American Civil Liberties Union. The ACLU is suing New York City police for alleged abusive treatment of students, which the department denies.</p> <p>Arguing that citations had spiraled out of control, community activists and juvenile-court judges have in recent months&nbsp;<a href="">pressured L.A. Unified and police</a>&nbsp;to seek other ways of handling some seemingly minor allegations &ndash; allegations like vandalism or possession of a marker to commit vandalism, trespassing, marijuana and tobacco possession, daytime-curfew violations and many charges of disturbing the peace or public fighting.</p> <p>Fresh data obtained by the Center shows that L.A. Unified&rsquo;s tickets have fallen sharply, driven mostly by a drop in daytime-curfew and tardiness violations. Between January and March, about 60 students were ticketed for minor cases of tardiness, or skipping school. The truant or tardy students were referred directly to counseling under a new agreement.</p> <p>For other alleged legal violations, L.A school police issued 316 tickets this past January, 454 in February and 282 in March.</p> <p>In January of last year, by comparison, officers issued more than 650 tickets.</p> <p>Despite the decline, the new data also shows that certain L.A. Unified middle schools in lower-income areas continue to remain hot spots for ticketing pupils who are almost all black or Latino. The most frequent allegation for younger students is disturbing the peace &ndash; a charge that often stems from student fights, shouting matches or allegations of threats to fight.</p> <p>Out of 1,590 tickets issued from last November through March, half went to children 14 and younger.</p> <p>In fact, if ages are considered separately, fewer 16- and 17-year-olds were cited than students who were 13, 14 or 15 years old. Black students represent 10 percent of the district&rsquo;s enrollment, but were more than 37 percent of those ticketed for disturbing the peace. And 56 percent of black students cited for this infraction were between 11 and 14 years old.</p> <p>L.A. Unified officials did not respond to a request for comment on the Center&rsquo;s new findings or Jones-Sawyer&rsquo;s proposal. Last December, the district said it was continuing &ldquo;to work&nbsp;with our internal and external stakeholders to identify and evaluate non-penal alternatives to various minor violations.&rdquo;</p> <p><strong>Another way?</strong></p> <p>Jones-Sawyer, 56, attended L.A. Unified schools and remembers kids who scuffled being taken into the office of a vice principal, who put an arm around their shoulders and talked through problems. &ldquo;We have to find out why kids are angry,&rdquo; the assemblyman said. Reprimands were not in the form of police citations back then, he said.</p> <p>He acknowledged educators&rsquo; complaints that California&rsquo;s school counselor ranks have been decimated by budget cuts, leaving schools less able to deal with kids&rsquo; conflicts. Compared with a national average of&nbsp;<a href="">457 students for every counselor</a>, California&rsquo;s ratio of 814 students for every counselor in 2008-2009 was rock bottom among the states, according to data gathered by the&nbsp;<a href="">American School Counselor Association</a>.</p> <p>Nonetheless, critics of involving officers in discipline matters say peer counseling, intermediate steps prior to police involvement and other cost-effective alternatives exist and are practiced in other states, and in schools in Oakland and San Francisco now as well.</p> <p>Jones-Sawyer&rsquo;s bill says schools&nbsp;&ldquo;shall consider existing strategies and model approaches to minimize the involvement of law enforcement in pupil conduct and minor offenses that do not rise to the level of a serious and immediate threat to physical safety.&rdquo;</p> <p>In addition to requiring that schools&rsquo; mandatory safety plans define police roles, the bill would also require schools to &ldquo;prioritize&rdquo; federal and state public-safety funding on mental-health aid and other supportive behavioral-intervention programs &ndash; not just police. Schools would also have to publicly develop &ldquo;memorandum of understanding&rdquo; about officers&rsquo; duties.</p> <p>&ldquo;I think this bill is a huge shift in how we are talking about school safety,&rdquo; said&nbsp;<a href="">Zoe Rawson</a>, a lawyer with the Labor/Community Strategy Center, a community group listed as a nonlegislative &ldquo;sponsor&rdquo; of Jones-Sawyer&rsquo;s bill. The Strategy Center has represented students who received tickets and is negotiating with L.A. Unified and school police on standards that limit police involvement on district campuses.</p> <p>The legislation gives &ldquo;leverage&rdquo; to local communities to set standards, Rawson said. &ldquo;Right now, there is nothing required around police having frequent contact with young people.&rdquo;</p> <p>Any district in California with a school police force, or school resource officers, would be affected by Jones-Sawyer&rsquo;s bill. Oakland&rsquo;s district has its own school police, as does the Central Valley&rsquo;s Kern Union High School District, which has more than two dozen high school campuses in Kern County.&nbsp;</p> <p>After the Newtown massacre, the Obama administration proposed allocating $150 million in federal funds for schools to&nbsp;<a href="">hire police or counselors or install bullet-proof glass</a>&nbsp;or other security technology. The recommendations are in the 2014 Obama budget proposal now winding its way through the budget process.&nbsp;</p> <p>Boxer, a California Democrat, introduced a bill to&nbsp;<a href="">bring back federal funding cut in recent years for school police</a>&nbsp;and offer grants to schools in need from a pool of at least $40 million a year. The measure was folded into the gun bill that stalled in the Senate on April 17, but Boxer is expected to revive it.</p> <p>Various states are also considering how to fund more school police through property taxes or by tapping other state coffers.</p> <p><strong>Urging caution</strong></p> <p>Los Angeles County Presiding Juvenile Court Judge Michael Nash is so concerned about the rush to put police in schools that he wrote &ndash; as president of a national judges&rsquo; group &ndash; to Vice President Joe Biden, who was chairing a post-Newton gun-violence task force.</p> <p>Penned by Nash as president of the&nbsp;<a href="">National Council of Juvenile and Family Court Judges</a>, the January letter warns that &ldquo;the influx of police in schools&rdquo; in recent years is already &ldquo;one of the main contributors&rdquo; to minors sent unnecessarily into the criminal justice system.</p> <p>Nash told the Center he supports Jones-Sawyer&rsquo;s bill.</p> <p>&ldquo;I like this bill,&rdquo; he said. &ldquo;I have been asserting that, in considering school safety&nbsp;and enlisting personnel to maintain safety, we have to be clear in differentiating between security and discipline.&rdquo;</p> <p><a href="">Colorado</a>&nbsp;&ndash; the state that was shaken by the 1999 Columbine High School massacre &ndash; enacted reforms last year that require police to &ldquo;de-escalate&rdquo; student fights and for schools to ease up on referrals of students to law enforcement due to &ldquo;zero tolerance&rdquo; policies.&nbsp;<a href="">Denver public school discipline data</a>&nbsp;shows a 71 percent increase in referrals of students to police between 2000 and 2004, with 7 percent of referrals for serious offenses like carrying a weapon, according to analysis by the nonprofit Advancement Project.</p> <p><a href="">Texas legislators</a>&nbsp;are considering a bill that requires schools with police to adopt &ldquo;graduated sanctions&rdquo; and other means rather than having officers send children to court for disruption and disorderly conduct. The bill, which has bipartisan support, also requires school staff to submit sworn statements and prove steps were taken to counsel students before police referral to court. The state Senate has already approved the bill, which is now before its House of Representatives.</p> <p>In&nbsp;<a href="">Connecticut</a>, where legislators are trying to balance new calls for security with concerns about over-policing,&nbsp;the legislature&rsquo;s joint Committee of the Judiciary on April 19 voted overwhelmingly, 40-4, to approve a proposal requiring school boards to draft memorandum of understanding with police to limit their use in disciplinary responses. The proposal says agreements should spell out the need for &ldquo;a graduated response model&rdquo; to discipline problems.&nbsp;The bill is now before the state&rsquo;s House of Representatives and, if approved, will go to the state Senate.</p> <p>A Senate bill in&nbsp;<a href="">Florida</a>&nbsp;that would have required that schools refrain from referring students to law enforcement for &ldquo;petty acts of misconduct&rdquo; or misdemeanors &ndash; without written explanations &ndash; died when it failed to get out of legislative committees this spring.</p> <p><strong>Making changes</strong></p> <p>In March, the U.S. Justice Department&rsquo;s civil rights office reached a court-sanctioned agreement stemming from a federal investigation into alleged excessive involvement of police in discipline meted out in Meridian, Miss.</p> <p>The agreement with the district of 6,100 students in Meridian essentially&nbsp;<a href="">regulates school police on the district&rsquo;s campuses</a>. The district is required to train school police officers in &ldquo;bias-free&rdquo; policing and stop involving police in minor behavioral disputes in the majority-black district. Civil rights investigators said police in Meridian told them they were ferrying students to jail on allegations of defiance and disrespect at schools.</p> <p>L.A. Unified, last summer, started referring most tickets not to court but directly to the Los Angeles County Probation Department. Because of a budget crisis, the county had to close its lower-level juvenile courts, where parents and students were usually summoned to answer to citations school police issued that carried hundreds of dollars in fines.</p> <p>Judges and civil rights advocates saw the closure as an opportunity to keep most students out of court, and instead first divert students, through probation officers, to community-based counseling or other family treatment.</p> <p>Between November and March, the big three infractions students were cited for were allegations of possessing or using less than an ounce of marijuana &ndash; 514 tickets &ndash; and disturbing the peace, for which 496 students were cited. Tobacco or smoking &ldquo;paraphernalia&rdquo; was next with 252 tickets.</p> <p>Rawson, with the Labor/Community Strategy Center, said it is a positive step that most ticketed students at L.A. Unified are no longer sent directly into court.</p> <p>But as a lawyer who has represented students, she&rsquo;s concerned that black and Latino students in lower-income neighborhood schools are &ldquo;over-policed&rdquo; compared to students in more affluent areas. L.A. Unified&rsquo;s school police chief,&nbsp;<a href="">Steven Zipperman</a>, told the Center last year that officers are generally evenly distributed to schools &ndash; mostly high schools &ndash; but that schools of all grade levels can request that officers be dispatched to intervene in a problem.</p> <p>Conflict with police officers, Rawson said, can leave students with a sense that their citation is a first step toward future clashes with law enforcement. The youngest student cited between March and December was a 9-year-old accused of vandalism.</p> <p><em>The Center for Public Integrity is a nonprofit, independent investigative news outlet. For more of its stories on this topic go to <a href=""></a>.</em></p> <!-- Place with body copy. Can go at bottom if story is not paginated. If story is paginated, please put on every page. --><!-- Place with body copy. Can go at bottom if story is not paginated. If story is paginated, please put on every page. --><div id="cpi_widget">&nbsp;</div> <script type="text/javascript"> (function() { document.getElementById('cpi_widget').innerHTML = '<iframe src=\"'+escape(window.location.hostname)+'&href='+escape(window.location.href)+'&referrer='+escape(document.referrer)+'\" width=\"0\" height=\"0\" frameBorder=\"0\" style=\"border: none; background: transparent; width: 0px; height: 0px;\"></iframe>' })(); </script> K–12 Daily Report citations Los Angeles Unified School District police school discipline Tue, 30 Apr 2013 10:05:02 +0000 Susan Ferriss Ben Wieder 18867 at To mark 1906 quake, resources to teach kids about disaster safety <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/kelly-chen" title="View user profile." class="fn">Kelly Chen</a></span> </div> </div> </div> <p>To commemorate the 1906 San Francisco earthquake and fire and follow up on our investigation into the seismic safety of California&rsquo;s schools, the Center for Investigate Reporting is teaming up with the American Red Cross Bay Area Chapter today for a &ldquo;prep rally&rdquo; on seismic preparedness. The event at the California Academy of Sciences will provide resources and tips for families on what to do in an earthquake. It will also feature appearances by sports stars Jerry Rice and Kristi Yamaguchi. Activities begin at 9:30 a.m. <a href="" target="_blank">Click here</a> for more details.</p> <p><object height="300" width="400"><param name="flashvars" value="offsite=true&amp;lang=en-us&amp;page_show_url=%2Fgroups%2Fcaliforniaearthquakes%2Fpool%2Fshow%2F&amp;page_show_back_url=%2Fgroups%2Fcaliforniaearthquakes%2Fpool%2F&amp;&#103;&#114;&#111;&#117;&#112;&#95;&#105;&#100;&#61;&#49;&#54;&#54;&#50;&#53;&#56;&#53;&#64;&#78;&#50;&#51;&amp;jump_to=&amp;start_index=" /><param name="movie" value="" /><param name="allowFullScreen" value="true" /><embed allowfullscreen="true" flashvars="offsite=true&amp;lang=en-us&amp;page_show_url=%2Fgroups%2Fcaliforniaearthquakes%2Fpool%2Fshow%2F&amp;page_show_back_url=%2Fgroups%2Fcaliforniaearthquakes%2Fpool%2F&amp;&#103;&#114;&#111;&#117;&#112;&#95;&#105;&#100;&#61;&#49;&#54;&#54;&#50;&#53;&#56;&#53;&#64;&#78;&#50;&#51;&amp;jump_to=&amp;start_index=" height="300" src="" type="application/x-shockwave-flash" width="400"></embed></object></p> <p><em><a href="" target="_blank">Photos of major earthquakes</a> in California since 1906 </em></p> <p>We also have some great resources for children:</p> <ul> <li>In our <a href="" target="_blank">&ldquo;Ready to Rumble&rdquo; coloring book</a>, watchdog Sunny teaches kids what to do during an earthquake. You can color online or order books for your school.</li> <li>Our new Junior Watchdog video explains what you should have in your emergency kit.<br /> English version:<iframe allowfullscreen="" frameborder="0" height="360" src="" width="600"></iframe> <p>Spanish version:<iframe allowfullscreen="" frameborder="0" height="360" src="" width="600"></iframe><a href="" target="_blank">Watch more of our finger puppet videos for kids here</a>.</p></li> <li>Is your school located along a fault? <a href="" target="_blank">California Watch</a>, which CIR founded in 2009, <a href="" target="_blank">conducted an investigation</a> that revealed state regulators failed to enforce earthquake safety laws in public schools. <a href="" target="_blank">Our interactive map</a> shows you seismic dangers near California schools in your neighborhood.</li> <li>Want to take this information with you? Download our <a href="" target="_blank">myFault iPhone app</a>. It uses official maps and data to identify potential seismic dangers and hazards around your home, school or workplace.</li> </ul> <p>For the complete investigation of earthquake safety standards in California public schools, check out our series <a href="" target="_blank">On Shaky Ground</a>.</p> Health and Welfare Daily Report children disaster earthquakes Junior Watchdogs On Shaky Ground On Shaky Ground followup On Shaky Ground Thu, 18 Apr 2013 07:05:02 +0000 Kelly Chen 18863 at Bullet train bidder has history of cost overruns <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard">Anonymous</span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/high_speed_rail_8.jpg" title="" /> <span class="image-insert-photo-credit">California High-Speed Rail Authority</span> <span class="image-insert-description"> </span></p> <p>SACRAMENTO &ndash; The lowest-bidding partnership for the first segment of California&rsquo;s high-speed rail line includes a firm with a history of cost overruns and costly lawsuits.</p> <p>The California High-Speed Rail Authority on Friday announced that the American joint venture of Tutor Perini/Zachry/Parsons was the &ldquo;best apparent value&rdquo; with a low bid of $985 million &ndash; below the $1.09 billion bid by the next-lowest bidder.</p> <p>On construction projects in California, the lowest bidder has a strong advantage in the eventual selection process. Rob Wilcox, a spokesman for the authority, declined to comment on bidders as the matter is finding its way to the authority&rsquo;s board of directors.</p> <p>&ldquo;Five world-class teams competed for this opportunity, and the process is ongoing,&rdquo; Wilcox said.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>The first segment of the estimated $68 billion system is proposed to run 28 miles from Madera to Fresno in the San Joaquin Valley.</p> <p>According to <a href="" target="_blank">an August report</a> by <a href="" target="_blank">The Bay Citizen</a>, sister site of California Watch, 11 major projects in the San Francisco Bay Area completed by Tutor in the last dozen years cost local governments $765 million more than they expected, or 40 percent above the initial bids.</p> <p>A company spokesman did not return a message seeking comment. CEO Ron Tutor said in the August report that attacks against him were unfounded and overruns were caused by contracting agencies changing the projects in midstream.</p> <p>At San Francisco International Airport, the city alleged in a 2002 lawsuit that the company purposely bid low to win a $626 million expansion contract, then charged $980 million for the job. Tutor said there wasn&rsquo;t &ldquo;a single fact&rdquo; justifying the city&rsquo;s position but eventually agreed to pay $19 million to settle.</p> <p>The company&rsquo;s list of projects includes an extension of Bay Area Rapid Transit to the San Francisco airport, the Alameda Corridor rail line and the San Diego Convention Center.</p> <p>In 1993, the Port of San Diego paid the company $17 million to settle a $53 million lawsuit over the convention center project. In the lawsuit, the company blamed port-hired construction managers for delays that cost the company money.</p> <p>Kevin Williams, a former San Francisco contracting officer who has testified in court against Tutor, said his experience with the company goes back decades.</p> <p>&ldquo;Tom Bradley, the late mayor of Los Angeles, said it best: Ron Tutor was the change-order artist, the king, and he&rsquo;s proven himself to be just that,&rdquo; Williams told U-T San Diego on Monday.</p> <p>Williams said Tutor &ldquo;is going to make up the difference somehow by lowballing. That is as old as history itself in the construction industry.&rdquo;</p> <p>Kevin Dayton, president and chief executive of Labor Issues Solutions and a critic of the bullet train project, said the rail authority is going to have to monitor change-order requests very closely.</p> <p>&ldquo;People are always accusing each other in the construction industry of pulling the change-order racket: winning the low bid and then piling up costs afterward,&rdquo; said Dayton, a former lobbyist for Associated Builders and Contractors Inc. &ldquo;Sometimes, it is a matter of architectural errors, but everyone always blames everybody else for it, saying, &lsquo;The drawings were bad; the engineering was bad, et cetera.&rsquo; &rdquo;</p> <p>Dayton also questioned whether the four losing teams &ndash; who are eligible to be paid a $2 million stipend to cover their costs for seeking the contract &ndash; might now be required to sign statements agreeing not to publicly challenge the process.</p> <p>The next-lowest bidder was Dragados/Samsung/Pulice. Officials there could not be reached for comment.</p> <p>In a statement posted on its website before the announcement, the team said with a combined value of $8 billion in executed design-build projects in the last five years, it offers the authority and building communities &ldquo;a proven successful record of compliance, execution and on time delivery of complex infrastructure projects all over the world.&rdquo;</p> <p>Five teams submitted proposals to design and build the first segment. The proposals were evaluated and ranked based 70 percent on cost and the remainder for technical merit. Officials said factors such as an understanding of the project, schedule capability, approach and safety were part of the technical scoring.</p> <p>The lowest-bidding partnership &ndash; Tutor Perini Corp. of Sylmar, Zachry Construction Corp. of Texas and Parsons Corp. of Pasadena &ndash; received the highest overall score of 90.55 out of 100.</p> <p>The trio received a perfect 70 percent for its price proposal and received the lowest score &ndash; 20.55 &ndash; for its technical proposal.</p> <p>Rail officials say they expect to present a contract to their board of directors in the coming weeks. The agency&rsquo;s cost estimate for the first segment was $1.2 billion to $1.8 billion.</p> <p>If they are unable to award the contract to the best-value bidder, they may proceed with the next most highly ranked, officials said.</p> <p><em>This story resulted from a partnership among California news organizations following the state&#39;s high-speed rail program, including The Fresno Bee, The Sacramento Bee, California Watch, The Bakersfield Californian, The Orange County Register, the San Francisco Chronicle, The (Riverside) Press-Enterprise, U-T San Diego, KQED, the Merced Sun-Star, The Tribune of San Luis Obispo and The Modesto Bee.</em></p> Money and Politics Daily Report California High-Speed Rail Authority construction high-speed rail Ron Tutor High-speed rail Tue, 16 Apr 2013 17:24:26 +0000 Christopher Cadelago 18862 at Winning bid to start high-speed rail far below estimates <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/tim-sheehan" title="View user profile." class="fn">Tim Sheehan</a></span> </div> </div> </div> <p class="image-insert" style="width: 300px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/high_speed_rail_5_2.jpg" title="" /> <span class="image-insert-photo-credit">High-Speed Rail Authority</span> <span class="image-insert-description"> </span></p> <p>A trio of American companies outbid four other teams of contractors vying for the contract to build the first segment of California&#39;s proposed high-speed train system in the San Joaquin Valley &ndash; and for several hundred million dollars less than state engineers estimated.</p> <p>The consortium of Tutor Perini Corp. of Sylmar, Zachry Construction Corp. of Texas and Parsons Corp. of Pasadena offered the low bid of less than $1 billion. Five construction teams submitted bids in January to the California High-Speed Rail Authority for the first stretch of the rail line from east of Madera to the south end of Fresno.</p> <p>Engineers for the rail authority &ndash; the state agency in charge of developing the statewide train system &ndash; had at one time estimated that the 28-mile portion would cost between $1.5 billion and $2 billion to design and build. More recent estimates suggested the bids would likely come in at $1.2 billion to $1.8 billion.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>The Tutor Perini/Zachry/Parsons bid of $985,142,530 was deemed the &quot;apparent best value&quot; by the rail authority, based on a total score that considered both the price and the technical expertise of the competing companies. While Tutor/Perini/Parsons had the lowest technical score of the five bids &ndash; 20.55 out of 30 possible points &ndash; it also racked up 70 out of 70 points in the financial assessment.</p> <p>The other four bids were:</p> <ul> <li>$1,085,111,111 by Dragados/Samsung/Pulice, a joint venture of Dragados SA of Spain; Samsung C&amp;T America, a subsidiary of South Korean multinational Samsung Group; and Pulice Construction Inc. of Arizona</li> <li>$1,263,309,632 by California High-Speed Rail Partners, composed of Fluor Corp. of Texas, Swedish-based Skanska and PCL Constructors of Canada</li> <li>$1,365,770,098 by California Backbone Builders, a consortium of two Spanish construction firms: Ferrovial Agroman and Acciona</li> <li>$1,537,049,000 by California High-Speed Ventures, made up of Kiewit Corp. of Nebraska, Granite Construction of Watsonville and Comsa EMTE of Spain</li> </ul> <div>Rob Wilcox, a spokesman for the rail authority, said a contract proposal will be presented to the agency&#39;s board within weeks in anticipation of awarding a contract in time for construction to begin this summer. <p>&nbsp;</p> <p>By that time, Wilcox said, the rail authority expects to have begun acquiring the land it needs for the right of way. About 75 parcels are needed by the end of September, and a total of 356 pieces of property will be needed &ndash; in whole or in part &ndash; for the entire Madera-Fresno section.</p> <p>Once a contract is awarded, he added, &quot;there will be a ramp-up of hiring&quot; by the contractor for workers. Detailed reports from 2011 estimated that rail construction would be directly responsible for about 1,300 jobs each year in the Valley during the four- to five-year construction period, with additional spin-off jobs resulting from the activity.</p> <p>One component of the contract will be a goal adopted by the rail authority that small businesses &ndash; including companies owned by minorities, women and disabled veterans &ndash; be hired as subcontractors to perform 30 percent of the work.</p> <p>The Tutor Perini/Zachry/Parsons bid pencils out to about $35.2 million per mile from Avenue 17 near the BNSF Railway freight tracks east of Madera to American Avenue at the south end of Fresno. The construction section will include a bridge over the San Joaquin River; elevated tracks over Herndon Avenue; a tunnel under Belmont Avenue, Highway 180 and a freight railroad line; an elevated railway to cross over Highway 99 at the south end of Fresno; and 12 street or road overpasses.</p> <p>Not included in the contract is the relocation of a 2.5-mile stretch of Highway 99 between Ashlan and Clinton avenues through west-central Fresno. That&#39;s where the six-lane freeway snuggles up against a Union Pacific Railroad yard, leaving no room to shoehorn the new high-speed tracks into their planned route. The rail authority has agreed to pay Caltrans up to $226 million to handle the chore of moving the freeway 100 feet to the west.</p> <p>The Madera-Fresno section is the first of five major construction contracts for the high-speed railroad infrastructure in the San Joaquin Valley. The next three contracts cover pushing the line to the northwestern outskirts of Bakersfield, and the fifth pays for laying steel rails spanning the entire 130-mile Madera-Bakersfield section. Together, the five construction packages were originally estimated to cost about $6 billion &ndash; including more than $3 billion in federal stimulus and transportation money from the Obama administration that must be spent by Sept. 30, 2017.</p> <p>For months, rail authority CEO Jeff Morales and other officials with the agency expressed hope that a competitive construction climate would bring bids that were lower than engineers&#39; estimates. Last month, Morales suggested that if those hopes materialized, there could be enough money left to extend construction of the Valley section northward to downtown Merced.</p> <p>The Merced-Bakersfield line is proposed to be the backbone of a 520-mile, $68 billion passenger rail system linking San Francisco and Los Angeles with electric trains capable of traveling at up to 220 mph. Trains are not expected to carry passengers until 2022 at the earliest, when the authority hopes to operate between Los Angeles and Merced, where passengers would connect on existing Amtrak or other commuter train lines to the Bay Area.</p> <p>Obstacles remain in the railroad&#39;s path, however. Two lawsuits are pending against the rail authority in Sacramento County Superior Court. The first, which will be heard by a judge Friday, alleges that the agency violated the California Environmental Quality Act in May 2012 when it approved the Merced-Fresno section. That suit was filed by the Farm Bureau organizations in Madera and Merced counties, the Chowchilla Water District, the grassroots agriculture organization Preserve Our Heritage, and the Fagundes farming family which owns land in Madera and Merced counties.</p> <p>The second case, lodged by Kings County, farmer John Tos and Hanford resident Aaron Fukuda, charges that the rail authority&#39;s plans are illegal under Proposition 1A, the $9.9 billion high-speed rail bond measure approved by California voters in 2008. That suit, which hopes to block the sale of bonds, will be heard in Sacramento in late May.</p> <p><em>The reporter can be reached at 559-441-6319, <a href="&#109;&#97;&#105;&#108;&#116;&#111;&#58;&#116;&#115;&#104;&#101;&#101;&#104;&#97;&#110;&#64;&#102;&#114;&#101;&#115;&#110;&#111;&#98;&#101;&#101;&#46;&#99;&#111;&#109;" target="_blank">&#116;&#115;&#104;&#101;&#101;&#104;&#97;&#110;&#64;&#102;&#114;&#101;&#115;&#110;&#111;&#98;&#101;&#101;&#46;&#99;&#111;&#109;</a> or @tsheehan on Twitter. This story resulted from a partnership among California news organizations following the state&#39;s high-speed rail program, including The Fresno Bee, The Sacramento Bee, California Watch, The Bakersfield Californian, The Orange County Register, the San Francisco Chronicle, The (Riverside) Press-Enterprise, U-T San Diego, KQED, the Merced Sun-Star, The Tribune of San Luis Obispo and The Modesto Bee.</em></p> </div> Money and Politics Daily Report California High-Speed Rail Authority high-speed rail High-speed rail Mon, 15 Apr 2013 17:14:02 +0000 Tim Sheehan 18861 at Lawmakers mull next steps for developmental centers <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/amy-julia-harris" title="View user profile." class="fn">Amy Julia Harris</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/DCprotest_05-1000px_0.jpg" title="People with development disabilities and their supporters call on lawmakers to shut down the state's developmental centers." /> <span class="image-insert-photo-credit">Max Whittaker/For California Watch</span> <span class="image-insert-description"> People with developmental disabilities and their supporters call on lawmakers to shut down the state&#39;s developmental centers.&nbsp;</span></p> <p>SACRAMENTO &ndash; State lawmakers weighed today whether to appoint an inspector general to oversee state centers for the developmentally disabled and close a center in Sonoma where patients suffered the worst instances of abuse, neglect and sexual assaults.</p> <p>During a daylong hearing, members of a Senate budget subcommittee on health and human services heard testimony from state officials and advocates for the developmentally disabled but did not indicate what action they might take.</p> <p>The proposal to create an inspector general met with opposition from the Department of Developmental Services, which objected to its cost. The idea also found little support among advocates and family members of the disabled, who say the state-run centers should be shut down.</p> <p>The influential state&nbsp;<a href="" target="_blank">Legislative Analyst&rsquo;s Office recommended</a>&nbsp;in its budget analysis that the Legislature create an independent Office of Inspector General to oversee the five developmental centers at a cost of $500,000 to $1 million. The inspector general would have the authority to review patient complaints, conduct audits, investigate allegations of wrongdoing and help prosecute individuals who threaten patients or staff.</p> <p>Shawn Martin, representing the Legislative Analyst&#39;s Office, testified that a new layer of oversight is needed because having the Department of Developmental Services responsible for its own facilities hasn&#39;t worked.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>&ldquo;They have to be independent in order to be effective,&rdquo; Martin said.</p> <p>But Sen. Mark DeSaulnier, D-Concord, the most outspoken member of the Senate budget subcommittee, indicated he would favor shutting the troubled Sonoma Developmental Center and moving patients to a new center.&nbsp;</p> <p>&ldquo;We really need to look at Sonoma&rsquo;s facility,&rdquo; he said. &ldquo;For both the existing clientele and future residents, it&rsquo;s worth considering whether to sell and move the center to another location.&rdquo;</p> <p>His comments drew cheers from dozens of families of people with disabilities who packed the Capitol meeting room for the hearing.</p> <p>The senators were debating the future of the state&rsquo;s five developmental centers after an 18-month investigation by California Watch detailed chronic abuse and a breakdown in oversight. The centers house about 1,600 patients with cerebral palsy, mental retardation and severe autism.</p> <p>The California Watch investigation found 36 cases of alleged rape and molestation at the centers, with one-third of the rapes occurring at the Sonoma Developmental Center, the largest board-and-care center in the state.</p> <p>The Office of Protective Services, the internal police force assigned to protect residents of the state facilities, routinely mishandled cases by failing to collect evidence, waiting too long to interview witnesses or suspects, and not ordering rape kits in cases of alleged sexual assault, California Watch found.</p> <p>The stories prompted&nbsp;a <a href="" target="_blank">citation by the U.S. Department of Justice&#39;s Civil Rights Division</a>&nbsp;and caused the state to strip the Sonoma Developmental Center of its primary license to operate in December. The loss of state certification in Sonoma means California taxpayers will lose tens of millions of dollars in federal funding that is contingent on assurances the facility is properly managed.</p> <p>Among those who testified at the budget hearing was Terri Delgadillo, director of the Department of Developmental Services, which oversees the five centers.</p> <p>She told the crowded hearing room that her department made major changes in overseeing the Sonoma center after the abuses came to light, including replacing top officials in Sonoma. She said&nbsp;46 employees have been disciplined as a result of complaints, the center has created a new electronic incident reporting system and staff members have been trained on sexual assault response.&nbsp;</p> <p>&quot;We&rsquo;re heading in the right direction and feeling positive, but there&rsquo;s still a lot to be done,&quot; she said.</p> <p>Nevertheless, she opposed the appointment of an inspector general, saying the department could not afford it within its proposed $4.9 billion annual budget.</p> <p>&ldquo;There is a lot of oversight today &ndash; state licensing, federal licensing, disability rights groups audits, professional licensing boards,&rdquo; she said. &ldquo;I do struggle with how we will pay for (an inspector general). The way we got to the problems at Sonoma today was unallocated reductions in our budget. I don&rsquo;t know where you get the resources.&rdquo;</p> <p>Before the hearing, more than 100 protesters wearing painted T-shirts and signs emblazoned with the words &ldquo;equality for all&rdquo; gathered on the steps of the Capitol and called on the Legislature to shut down the centers.</p> <p>&ldquo;It is stunning and spine-chilling to know the state allows &ndash; and taxpayers fund &ndash; this outrageous abuse,&rdquo; said Kiara Hedglin, an advocate with the group Seeking Equality through Education and Demonstration who has developmental disabilities. &ldquo;To fix the problems, the state must shut down the developmental centers. They are decaying institutions with an alarming record of abuse that demonstrates an astounding, appalling and atrocious standard of care.&rdquo;&nbsp;</p> <p>While disability rights advocates lauded the push for heightened oversight of the developmental centers, they said it was not enough. The only solution, they argued, was shutting the centers.</p> <p>Kim Williams, who has cerebral palsy, said she was born in a state-run institution and lived at the Sonoma Developmental Center for five years. She told her story of her time at Sonoma on the steps of the state Capitol, calling Sonoma a &ldquo;hellhole.&rdquo;</p> <p>&ldquo;I felt like a prisoner, but I never committed any crime,&rdquo; Williams said, communicating through a speaking device. &ldquo;I knew I wanted freedom, and I knew I had to leave. If I had to go back, I&rsquo;d take my own life.&quot;&nbsp;&nbsp;</p> <p>After the hearing, DeSaulnier was more direct in calling for an end to the state-run centers.</p> <p>&quot;Personally, I would do away with the developmental centers,&quot; he told California Watch. &quot;They are a big investment based on a 1950s model. They&#39;re not working.&quot;&nbsp;</p> <p>He said the Sonoma Developmental Center should be shut down and relocated to a facility that was less costly and better able to provide care to patients.&nbsp;</p> <p>&quot;When you have a campus like Sonoma that is a huge fixed asset for the state that is only half-used, it makes no sense financially,&quot; DeSaulnier said. &quot;And when you factor in the other problems like abuse and neglect, it&#39;s just stupid to keep it open as is.&quot;&nbsp;</p> Health and Welfare Daily Report Department of Developmental Services Office of Protective Services patient abuse Sonoma Developmental Center Broken Shield Fri, 12 Apr 2013 02:09:00 +0000 Amy Julia Harris 18858 at Independent oversight proposed for developmental centers <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/amy-julia-harris" title="View user profile." class="fn">Amy Julia Harris</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/GNC_4598.jpg" title="The Office of Protective Services is an in-house police force at California's developmental centers." /> <span class="image-insert-photo-credit">Monica Lam/California Watch</span> <span class="image-insert-description"> The Office of Protective Services is an in-house police force at California&#39;s developmental centers. </span></p> <p>The state&rsquo;s influential legislative analyst is recommending that the California Legislature create an independent Office of Inspector General to monitor state developmental centers where police failed to properly investigate patient deaths, abuse, sexual assault and neglect.</p> <p>The proposal from the Legislative Analyst&rsquo;s Office comes in response to an 18-month investigation by California Watch into rapes and other instances of patient abuse at the Sonoma Developmental Center and four other board-and-care centers around the state.</p> <p>&ldquo;Given the vulnerable nature of the population served by the Developmental Centers, and the ongoing nature of the health and safety problems that have plagued the Developmental Centers for more than a decade, we believe such additional oversight in the form of an Office of Inspector General is warranted,&rdquo; the analyst&rsquo;s office said in its budget analysis for the coming fiscal year.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>A Senate budget subcommittee on health and human services is scheduled to discuss the proposal Thursday.</p> <p>In its investigation, California Watch found 36 cases of alleged rape and molestation at the centers, which house more than 1,600 patients with severe disabilities. The investigation also uncovered allegations that a state worker used a Taser to inflict burns on a dozen patients at the Sonoma Developmental Center.</p> <p>The Office of Protective Services, the internal police force assigned to protect residents of the state facilities, routinely mishandled cases by failing to collect evidence, waiting too long to interview witnesses or suspects, and not ordering rape kits in cases of alleged sexual assault.</p> <p>&ldquo;In 2012, a series of reports by California Watch reported suspicious investigative practices that were conducted in response to major crime investigations, including of suspicious deaths, at a number of Developmental Centers,&rdquo; the legislative analyst&rsquo;s office said. &ldquo;The series brought into question the training and qualifications of the Office of Protective Services&rsquo; investigators and their ability to handle DC (developmental center) cases.&rdquo;</p> <p>The analyst&rsquo;s office recommended the creation of an Office of Inspector General to address breakdowns in oversight and &ldquo;safeguard the integrity of the state&rsquo;s developmental center system.&rdquo;</p> <p>The new office would cost $500,000 to $1 million, the analyst&rsquo;s office estimated. The inspector general would have the authority to conduct a formal review of patient complaints at developmental centers, investigate allegations of wrongdoing and work with local law enforcement to prosecute individuals who threaten patients or staff.</p> <p>The Office of Protective Services declined to comment on the proposal and referred questions to the Department of Developmental Services, which oversees the centers. A spokeswoman for the department had no comment.</p> <p>Only one other department in California, the Department of Corrections and Rehabilitation, has an independent oversight agency.</p> <p>The series of stories by California Watch prompted the state to adopt stricter policies to protect patients, install a new top administrator at the Sonoma Developmental Center and assign the California Highway Patrol to oversee policing of that center.</p> <p>Also in response to the articles, Gov. Jerry Brown signed two laws aimed at better protecting patients living in the centers. A third bill, which passed the Senate Human Services Committee on Tuesday, would mandate that rape kit examinations be conducted if a patient at any state-operated institution accuses an employee of sexual assault.</p> Health and Welfare Daily Report Department of Developmental Services Office of Protective Services Sonoma Developmental Center Broken Shield Thu, 11 Apr 2013 00:19:46 +0000 Amy Julia Harris 18856 at Doctors claim Prime hospital kept them from patients <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/christina-jewett" title="View user profile." class="fn">Christina Jewett</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/PrimeHealth_HQ_tonedforweb_600px.jpg" title="" /> <span class="image-insert-photo-credit">Monica Lam/California Watch</span></p> <p>A dozen Southern California doctors are accusing the leadership of a Prime Healthcare Services hospital of refusing to notify them about their patients because they won&rsquo;t engage in profit-driven practices, according to a request for a restraining order filed this week.</p> <p>The San Bernardino County physician group suing Chino Valley Medical Center and its director say it has been asked to needlessly admit patients from the emergency room into hospital beds, <a href="" target="_blank">according to the lawsuit filed Wednesday</a> in San Bernardino County Superior Court. The group&rsquo;s doctors also have been urged to document patient conditions as more complex or severe than they are, the filing says.</p> <p><a href="" target="_blank">The doctors suing the hospital maintain</a> that both practices are meant to drive up hospital bills. The result of their refusal to go along, they say, is that they&rsquo;re not receiving what they characterize as legally mandated notifications when their patients land in the hospital.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>The physicians have asked the judge to lift the alleged freeze in communication, saying it puts fragile patients in danger. A hearing is set for April 19 on the temporary restraining order.</p> <p>Prime spokesman Edward Barrera <a href="" target="_blank">released a statement Thursday</a> saying Chino Valley expects to prevail and the lawsuit &ldquo;has no merit and is a regurgitation of unproven allegations voiced by critics over the past three years.&rdquo;<span style="font-size: 0.813em; line-height: 1.385em;">&nbsp;</span></p> <p>The statement says Chino Valley routinely contacts primary care doctors when their patients come to the ER, and it calls the plaintiff doctors &ldquo;upon request of patients themselves.&rdquo; It also says Prime complies with state law and notifies health plans when their patients arrive in the ER and their medical conditions are stabilized.&nbsp;</p> <p>&ldquo;Plaintiff&rsquo;s lawsuit attempts to rewrite (the law) so as to require a hospital to contact a HMO and the HMO&rsquo;s contracted physician,&rdquo; Prime&rsquo;s statement says. &ldquo;There is no requirement to contact the HMO&rsquo;s contracted physicians.&rdquo;</p> <p>California&rsquo;s largest health plan is locked in a legal battle with Prime, accusing the hospital chain of shirking the same notification requirement. <a href="" target="_blank">Kaiser Permanente has accused the hospital chain</a> in Los Angeles County Superior Court of &ldquo;trapping&rdquo; Kaiser patients in Prime hospitals, failing to notify Kaiser doctors and upcoding patient diagnoses for profit.&nbsp;</p> <p>The suit by the Inland Pulmonary Medical Group marks the first time that a small group of doctors has stepped forward in court to criticize a Prime hospital&rsquo;s practices.&nbsp;</p> <p>&ldquo;It&rsquo;s interfering with the care of the patient,&rdquo; said Michael Amir, a Los Angeles attorney representing the doctors. &ldquo;Patients go to the hospital &ndash; a lot of times they want to talk to the doctor who&rsquo;s been treating them for years, and they&rsquo;re being prevented from seeing their doctors, from doctors even knowing they&rsquo;re in the ER.&rdquo;</p> <p>The seven physician plaintiffs in the Inland group say that together they&rsquo;ve lost $150,000 in income as a result of Chino Valley&rsquo;s actions. Five other area doctors filed declarations in support of the case but are not plaintiffs.</p> <p>One of the supporters, Dr. Gerardo General, said his patients routinely are admitted to Chino Valley without his knowledge and given batteries of tests and drug prescriptions.&nbsp;</p> <p>&ldquo;They go upstairs (into the hospital), and they expect to see my face. They don&rsquo;t see me,&rdquo; General said. &ldquo;This is abuse; we can&rsquo;t take it anymore.&rdquo;</p> <p>The lawsuit alleges that the communication cutoff endangers patients. It claims one patient with a serious breathing condition was admitted without her doctor&rsquo;s knowledge. During her stay, Chino Valley staff operated to remove her gallbladder.</p> <p>&ldquo;Because (Inland) was not contacted, no doctor gave the required pulmonary clearance nor did the patient receive proper respiratory treatment prior to surgery,&rdquo; the lawsuit says.</p> <p>The suit alleges that such practices put patients &ldquo;at serious risk of injury and even death.&rdquo;&nbsp;</p> <p><a href="" target="_blank">A yearlong California Watch series</a> documented high rates of lucrative and severe medical conditions at Prime hospitals, as well as an aggressive approach to admitting ER patients into hospitals, rather than treating them in the ER and sending them home.</p> <p>State hospital data analyzed by California Watch showed that Prime hospitals <a href="" target="_blank">admitted about 63 percent of Medicare-funded ER patients</a> into hospitals in 2009, compared with 39 percent at the state&rsquo;s other leading for-profit chain, Tenet Healthcare Corp. In response, Prime said the analysis &ldquo;utterly fails to consider the medical basis for admissions.&rdquo;</p> <p>The U.S. Justice Department is investigating Prime&rsquo;s billing practices, <a href="" target="_blank">according to a document the chain filed</a> as part of a hospital purchase plan. Dr. Prem Reddy, founder of the Ontario, Calif.-based chain, has overseen rapid growth since Prime&rsquo;s 2001 start as the company expanded into a coast-to-coast 21-hospital chain.</p> <p>Chino Valley was among the first hospitals the chain bought. It is bound by state laws that say hospitals must notify health plans to discuss post-emergency hospital care decisions for their patients. Federal regulations also say patients have the right to have their doctor &ldquo;notified promptly of his or her admission to the hospital.&rdquo;&nbsp;</p> <p>The physician group suing Chino Valley holds contracts with about a dozen managed care firms that expect group doctors to handle local members&rsquo; care in the case of a hospitalization.</p> <p>The Inland doctors say that instead, they&rsquo;ve been stonewalled. In their lawsuit, they say the silence is a result of their refusal to follow the direction of the hospital&rsquo;s president and chief medical officer, Dr. James Lally, a defendant in the case.</p> <p>Lally suggested that the physicians document serious medical conditions, such as a certain type of pneumonia that Medicare pays hospitals a premium to treat, the suit says.</p> <p>Lally also discouraged doctors from putting patients on &ldquo;observation&rdquo; status, according to the suit. That means a doctor will monitor a patient&rsquo;s condition, rather than sending him or her home or admitting the patient to a hospital bed.&nbsp;</p> <p>The lawsuit alleges that Lally prefers doctors to admit patients into the hospital so the hospital can receive &ldquo;significantly higher Medicare reimbursements.&rdquo;</p> <p>Lally did not return a call for comment. Chino Emergency Medical Associates also is named in the case, accused of failing to call patients&rsquo; doctors. Dr. Val Warhaft, chief risk officer of Chino EMA, declined to comment.</p> <p>Prime Healthcare has been criticized for aggressively admitting paying patients since its founding. <a href="" target="_blank">Reddy once referred to an ER as a &ldquo;gold mine,&rdquo;</a> according to court testimony from the medical director of the first hospital taken over by the Prime founder. The reference, which the medical director said during a 2005 trial, was to numerous Kaiser and Medicare patients who could be admitted for further care.</p> <p>Another doctor told the Orange County Board of Supervisors in 2006 that when Prime took over Huntington Beach Hospital, doctors were urged to admit insured patients with maladies as minor as a headache.</p> <p>Prime also has been accused previously of stonewalling managed care doctors.</p> <p>In early 2012, a Kaiser physician testified before a California legislative hearing into Prime Healthcare&rsquo;s practices. <a href="" target="_blank">Dr. John Shohfi told lawmakers</a> that after Prime took over a number of hospitals, they stopped contacting a 24-hour call center where Kaiser doctors coordinate care for members who land in out-of-network hospitals.&nbsp;</p> <p>He said the practice means doctors are treating patients with little knowledge of their medical history or prior and ongoing care.</p> <p>In turn, lawmakers drafted a bill that would have limited the number of out-of-network patients a hospital can admit before health plans can pay the hospital lower rates.</p> <p>Gov. Jerry Brown vetoed the bill in September, acknowledging the problem but saying he was not convinced that the rate setting prescribed in the bill &ldquo;has it right.&rdquo;</p> <p>&ldquo;Extraordinary hospital billings are harmful to the health care system as a whole, including patients,&rdquo; the veto message said. &ldquo;If found to be as widespread and as excessive as some claim, such practices will invite an appropriate regulatory response.&rdquo;</p> Health and Welfare Daily Report Decoding Prime Prime Healthcare Decoding Prime Fri, 29 Mar 2013 07:05:03 +0000 Christina Jewett 18850 at Cambodian youth confront ‘historical forgetting’ <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/patricia-leigh-brown" title="View user profile." class="fn">Patricia Leigh Brown</a></span> </div> </div> </div> <p class="image-full-width" style="width: 600px;"><img alt="" class="imagecache-image-full-width" src="/files/imagecache/image-full-width/CIR01.jpg" title="Community organizer Ashley Uyeda, second from left, listens during a group +++" /> <span class="image-insert-photo-credit">Richard Hartog/California Watch</span> <span class="image-insert-description"> Community organizer Ashley Uyeda, second from left, listens during a group youth session at the Khmer Girls in Action offices in Long Beach with Christine Sam, 16, in yellow, Malin Ouk, 17, and Kunthea Sin, 18.</span></p> <p>LONG BEACH &ndash; Youthful rebellion can come in many guises, from being anti-Google to defending animal rights. But for an all-female group of Cambodian American teens in Long Beach, home to the country&rsquo;s largest Cambodian community, the target of their adolescent disaffection is their parents&rsquo; generational hopelessness.</p> <p>&ldquo;We felt the word &lsquo;action&rsquo; was important,&rdquo; said Sophya Chum, an organizer for Khmer Girls in Action, an activist group whose members, young Cambodian American women, surveyed some 500 of their 1.5-generation (those who immigrated to the U.S. as children) and second-generation peers to better understand the issues affecting their lives. Their findings are the basis of Show Youth the Love, a health and wellness forum held last month.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>The survey, completed two years ago, shed light on the ricochet effect of trauma on refugee families &ndash; families &ldquo;caught in the process of historical forgetting,&rdquo; in the words of Jonathan H.X. Lee, an assistant professor of Asian American studies at San Francisco State University. Many of the girls&rsquo; parents arrived in Long Beach in the early 1980s after fleeing the &ldquo;killing fields&rdquo; of the Khmer Rouge regime, a genocide that resulted in an estimated 1.7 to 2 million deaths. Survivors of unimaginable horror, many have kept their stories untold, creating a generation of silence that has taken a profound toll on their children.</p> <p>The peer survey revealed some sobering statistics. Nearly half of the respondents reported symptoms of depression, including loneliness, fear, insomnia, cutting and other self-harming acts. Most &ndash; especially young males &ndash; said they experienced discriminatory treatment at school, with 1 in 3 saying they were frequently stopped or pulled over by police. The survey also addressed cultural stigmas about safe sex and pregnancy prevention.</p> <p>&ldquo;Stuff about our body is kind of taboo to talk about with your family,&rdquo; said 16-year-old Amanda Em. &ldquo;We&rsquo;re kind of reserved. It&rsquo;s awkward to bring up, so everyone ignores it.&rdquo;</p> <p>Khmer girls face a particular set of challenges, frequently juggling multiple roles within the family. Young women often serve as translators for non-English-speaking parents, helping them navigate doctors&rsquo; appointments, Social Security and the like, and also are expected to take care of younger siblings. The pressure to maintain &ldquo;Khmerness&rdquo; &ndash; as well as do well in school &ndash; can cause intense stress.</p> <p>&ldquo;We&rsquo;re having to balance all these ways of having to be,&rdquo; said Sada Ang, a 16-year-old KGA member.</p> <p>The group&rsquo;s boisterous headquarters is close to Anaheim Street, the main drag of Cambodian Long Beach, where sumptuous banquet halls serving sour catfish soup stand alongside with pawn shops, jewelry stores and centers for Cambodian dance and martial arts. Cambodia Town, officially recognized by the Long Beach City Council in 2007, is a hub for the approximately 44,000 Cambodians living in Los Angeles and Orange counties.</p> <p>The city has been the unofficial Cambodian Capital of America since the late 1950s and early 1960s, when Long Beach State University, now CSU Long Beach, hosted more than 100 engineering students from Cambodia. As political instability grew at home, dozens moved permanently to Long Beach, establishing a familial toehold. By the mid-1980s, the city had at least 35,000 Cambodian residents, making it the largest Cambodian community outside Cambodia.</p> <p>It has not been an easy road: A study that appeared in the Journal of the American Medical Association in 2005, the first and only psychiatric survey of Cambodian refugees two decades after resettlement, reported that 62 percent of first-generation Cambodian refugees in Long Beach suffered from post-traumatic stress disorder. According to the Asian Pacific American Legal Center, 36 percent of Cambodians in Southern California live below the federal poverty line. They also have the highest rate of being uninsured of any Southeast Asian ethnic group.</p> <p>The consequences for children have been profound: Cambodian American youth have had high rates of teen pregnancy, truancy and gang involvement. Linda Trinh Vo, an associate professor at UC Irvine, observes that PTSD and severe depression &ldquo;impacts both parents&rsquo; ability to make a living and engage in their children&rsquo;s lives.&rdquo; The result, she said, as the KGA study points out, can be depression that often goes untreated.</p> <p>Like many parents, professor Lee&rsquo;s parents did not want to verbally relive the past. Lee said the couple never got a chance to properly grieve the death of his fourth sister, who died while the family was en route to refugee camps in Thailand and Hong Kong.</p> <p>Although a small wave of Cambodians arrived from 1975 to 1978, the majority settled later in dilapidated public housing projects and were &ldquo;left to fend for themselves,&rdquo; Lee said. In the 1980s, racial tensions between young Cambodians and Latinos in Long Beach resulted in much-publicized gang violence. As a result, he said, &ldquo;many young people disassociated themselves from their own ethnic heritage and identity. They called themselves &lsquo;Asian American&rsquo; if they wanted to succeed.&rdquo;</p> <p>Darith Ung, a Khmer language teacher at Wilson Classical High School, where about 300 of the 4,000 students are Cambodian American, talks to students about the &ldquo;killing fields,&rdquo; a subject that is off-limits in many families. He tells them about the murders of intellectuals and teachers, about children like himself torn away from their families and villages to work in child labor camps. At age 12, he was forced to work in the fields without food, hunting for grasshoppers and snails at night.</p> <p>&ldquo;For four years, we were always hungry,&rdquo; he tells his students. &ldquo;The animals were our competition.&rdquo;</p> <p>Many young people are surprised to hear these stories, which help explain what has been left unsaid at home.</p> <p>&ldquo;We&rsquo;re young,&rdquo; Em said. &ldquo;We&rsquo;re supposed to be having fun. But when I see my parents or grandparents down in the dumps, it makes me cry at night.&rdquo;</p> <p>Khmer Girls in Action was founded to provide a warm, safe space &ndash; with &ldquo;powerful sisterhood&rdquo; posters on the walls &ndash; for women to support each other and gain leadership skills. Its members are campaigning for on-site high school wellness centers and are planning a youth health fair this spring.</p> <p>&ldquo;There&rsquo;s a huge need, particularly around mental health,&rdquo; said Justine May Calma, a staff member. Many young people do not have access to transportation, she noted, which makes it difficult to seek help.</p> <p>&ldquo;There has been a lack of a sense of ownership of our community,&rdquo; said Lian Cheun, the group&rsquo;s executive director. &ldquo;We&rsquo;re tired of hopelessness.&rdquo;</p> <p>Vichet Chhuon, an assistant professor at the University of Minnesota, who lived in Long Beach, said young activists like the members of KGA and EM3 (Educated Men with Meaningful Messages), an all-male group that successfully lobbied city officials to improve sidewalks, pedestrian crossings and traffic lights near schools, are radically redefining what it means to be a Cambodian American youth.</p> <p>&ldquo;It used to mean being poor and being seen as a dropout or a gangster,&rdquo; Chhuon said. &ldquo;But to these young people, being Cambodian means being a survivor, an activist, coming from an incredibly resilient tradition of people.&rdquo;</p> <p>Monique Ung, 18, a senior at Wilson High, considers KGA an anchoring presence. Her KGA sisters encouraged her to apply to college and helped with application and financial aid forms.</p> <p>&ldquo;Without KGA, I can&rsquo;t even picture myself,&rdquo; she said. &ldquo;It&rsquo;s helped me find out who I really am.&rdquo;</p> <p><em>This story was edited by Robert Salladay and copy edited by Nikki Frick and Christine Lee.</em></p> Health and Welfare Daily Report California Lost community health refugees California Lost Thu, 28 Mar 2013 13:05:02 +0000 Patricia Leigh Brown 18848 at Unincorporated neighborhood finally getting sewer service <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/bernice-yeung" title="View user profile." class="fn">Bernice Yeung</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/unincorporated_083_500px_0.jpg" title="Arleen Hernandez frequently has to unclog her backed-up shower because of the aging septic tank at her Parklawn home." /> <span class="image-insert-photo-credit">Max Whittaker/Prime</span> <span class="image-insert-description"> Arleen Hernandez frequently has to unclog her backed-up shower because of the aging septic tank at her Parklawn home. </span></p> <p>The unincorporated neighborhood of Parklawn, one of hundreds of impoverished California communities that lack basic services, celebrated a breakthrough this month when Stanislaus County broke ground on a new sewer line connecting the district to the city of Modesto.</p> <p>Parklawn, which has grappled with deficient septic tanks for about 60 years, is an unincorporated island of county territory nearly surrounded by Modesto. Around the state, such densely populated <a href="" target="_blank">unincorporated neighborhoods on county land</a> have long suffered from government neglect and lack some combination of sewer systems, clean drinking water, sidewalks, streetlights and storm drains.</p> <p>&ldquo;After decades of struggling with failing septic systems, Parklawn will finally realize a dream that most of us take for granted &ndash; an adequate wastewater system,&rdquo; said Phoebe Seaton of California Rural Legal Assistance&rsquo;s Community Equity Initiative. &ldquo;Individual septic systems have proven grossly inadequate. Leaking and leaching wastewater threatens the groundwater and human health, damages homes and hurts property values.&rdquo;</p> <p>The organization sued the Stanislaus County in 2004 on behalf of <a href="" target="_blank">Parklawn residents </a>and later worked with the county to find funds to upgrade the neighborhood&rsquo;s antiquated infrastructure.</p> <p>Without access to a sewer system, wastewater in the neighborhood of 328 homes pools in yards and backs up into bathtubs, residents said.</p> <p>Construction of the sewer line will cost $5.5 million. So far, the county has secured $1.2 million in federal funds. State redevelopment funds earmarked for the project were rescinded after the state&#39;s <a href="" target="_blank">redevelopment agencies were dissolved</a> last year. The county will seek additional funds from the state and is considering whether to create a local assessment district to complete the project.</p> <p>Parklawn is the last unincorporated residential community in South Modesto to receive a connection to city sewer services, said Stanislaus County Supervisor Jim DeMartini, who represents Parklawn.</p> <p>&ldquo;I&rsquo;m so relieved that it got started,&rdquo; he told California Watch. &ldquo;We are committed to getting this thing done.&rdquo;</p> <p>DeMartini said the sewer connection will help improve the neighborhood&rsquo;s infrastructure so that it eventually can become a part of Modesto and receive all city services. &ldquo;Annexation is the goal,&rdquo; he said.</p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/health-and-welfare/neglected-decades-unincorporated-communities-lack-basic-public-services-15635">Neglected for decades, unincorporated communities lack basic public services</a> </div> <div class="field-item even"> <a href="/data/map-learn-more-about-4-unincorporated-communities">Map: Learn more about 4 unincorporated communities</a> </div> <div class="field-item odd"> <a href="/health-and-welfare/video-unincorporated-california-15614">Video: Unincorporated California</a> </div> </div> </div> Health and Welfare Daily Report California Lost Parklawn sewer unincorporated unincorporated communities wastewater California Lost Wed, 27 Mar 2013 20:26:17 +0000 Bernice Yeung 18849 at What's at stake as community colleges face budget cuts? <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/kelly-chen" title="View user profile." class="fn">Kelly Chen</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/PPIC_fees1.png" title="Fee increase at California community colleges over time" /> <span class="image-insert-photo-credit"><a class="image-insert-photo-credit-url" href="" target="_blank">Public Policy Institute of California </a></span> <span class="image-insert-description"> Fee increase at California community colleges over time </span></p> <p>A new report by the Public Policy Institute of California examines how nearly $1.5 billion in budget cuts in recent years has limited access to the state&rsquo;s community college system.</p> <p>I asked California Watch&rsquo;s higher education reporter, Erica Perez, to help break down what the changes mean for the 2.4 million students who attend community colleges. Below are excerpts of our conversation.</p> <p><strong>California community colleges have experienced a cut of nearly $1.5 billion between 2007-08 and 2011-12. </strong></p> <p>The <a href="" target="_blank">Public Policy Institute of California report</a> states: &ldquo;Student enrollment rates in California&rsquo;s community colleges have dropped to a 20-year low in the wake of unprecedented cuts in state funding. Colleges have reduced staff, cut courses, and increased class sizes &ndash; all of which have led to declines in student access.&rdquo;</p> <p>According to a recent <a href="" target="_blank">California Watch report</a>, fees have risen 130 percent in the past five years, and students are unable to get into the classes they need.</p> <p class="image-insert-right-align" style="width: 304px;"><img alt="" class="imagecache-image-insert-right-align" src="/files/imagecache/image-insert-right-align/PPIC_enrollment.png" title="Changes in student enrollment at California community colleges over time" /> <span class="image-insert-photo-credit"><a class="image-insert-photo-credit-url" href="" target="_blank">Public Policy Institute of California </a></span> <span class="image-insert-description"> Changes in student enrollment at California community colleges over time </span></p> <p><strong>Community college enrollment rates in California are at an all-time low. </strong></p> <p>Community colleges have cut classes, instructors and other resources, meaning fewer students are able to enroll.</p> <p><strong>Despite budget cuts, more community college students are transferring to four-year colleges. </strong></p> <p>&ldquo;The increases are modest (only a percentage or two), but they suggest that budget cuts have not hurt student transfer rates,&rdquo; the report says.</p> <p><strong>The mission of community colleges has changed. </strong></p> <p>The traditional mission of community colleges is providing access to state residents who have a high school diploma or have shown an ability to benefit from education. The reality now is not everyone who wants to take a class at a community college can.</p> <p><strong>Are community colleges &ldquo;rationing&rdquo; education? </strong></p> <p>Perez explained that some community college leaders describe it this way: &ldquo;If we only have a limited amount of spots, then we should give it to the people who benefit the most.&rdquo;</p> <p>The community college mission is increasingly focused on students who want to transfer to four-year colleges or who want to get associate degrees and certificates as opposed to those who want to take classes for enrichment or who don&rsquo;t have as firm an academic plan.</p> <p><strong>Who are the changes hurting most? Who is getting shut out?</strong></p> <p>Several types of students are getting pushed out: those looking to enrich themselves by taking an aerobics or music class, first-time students, those who are fresh out of high school and those trying to return later in life to get an education.</p> <p><strong>Community colleges have fewer resources to help students navigate the system. </strong></p> <p>As resources have been cut, community colleges have less capacity to help students who have not established an academic plan. Community colleges now have fewer counselors and less flexibility to spend one-on-one time helping students through the system.</p> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/PPIC_CW_info.png" title="" /> <span class="image-insert-photo-credit"><a class="image-insert-photo-credit-url" href="" target="_blank">Lauren Rabaino/California Watch</a></span> <span class="image-insert-description"> </span></p> <p><strong>Consolidating community colleges could help cut costs, but that entails a complicated political process. </strong></p> <p>A recent <a href="">California Watch investigation</a> found that community colleges could save millions of dollars if they got rid of duplicative administrative costs. But doing so requires a political process that needs to be approved by the local boards of trustees &ndash; a move that could put some of those board members out of a job. Even after rounds of approval, it would take two years to lay off administrators, which means the cost savings would not be immediate.</p> <p>This <a href="" target="_blank">California Watch infographic</a> explains the costs and complications.&nbsp;</p> <p><strong>Wasn&rsquo;t Proposition 30 supposed to fix budget problems for community colleges? </strong></p> <p>Prop. 30 provided additional funding, but it didn&rsquo;t make up for the budget shortfall. Some districts were worried that they&rsquo;d face financial ruin if Prop. 30 didn&rsquo;t pass. For other districts in better shape, Prop. 30 helped but didn&rsquo;t make up the gap in funding.</p> <p><strong>What are other solutions?</strong></p> <p>Several studies show community colleges are missing out on millions of dollars of federal funding. Students eligible for a waiver of the $46-per-unit fee at community colleges could in theory qualify for federal financial aid. By changing these requirements, they could bring in federal dollars and spend them at community colleges, which would mean that instead of the state paying, the federal government would pay.</p> <p><strong>More students are attending for-profit colleges. </strong></p> <p>Although difficult to track, some students who can&rsquo;t get into community colleges go to for-profit colleges, which are adept at attracting them via online marketing. Despite much higher tuition, students usually are eligible for federal financial aid, loans and grants. However, once they leave the school, they are saddled with tens of thousands of dollars in debt.</p> <p>How should California&rsquo;s community colleges handle future enrollment? Share your views below:</p> <p><iframe frameborder="0" height="532" src="" title="Should community colleges give priority to students planning to transfer to four-year colleges? - Yes and here's why - No and here's why not" width="454"></iframe></p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/higher-ed/infographic-look-administrative-costs-across-community-colleges-18837">Infographic: A look at administrative costs across community colleges</a> </div> </div> </div> Higher Ed Daily Report california community colleges community colleges Wed, 27 Mar 2013 13:05:03 +0000 Kelly Chen 18847 at Join our discussion on Pomona's developmental center <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/marie-mcintosh" title="View user profile." class="fn">Marie McIntosh</a></span> </div> </div> </div> <p>California Watch invites you to share your insights and experiences regarding the Lanterman Developmental Center in Pomona. On April 3, reporter Ryan Gabrielson, who has covered the state&rsquo;s developmental centers in his series <a href="">Broken Shield</a>, will participate in a discussion on topics ranging from the closure of the Lanterman Developmental Center to soaring overtime pay for the centers&#39; police force.</p> <p>What does this development&nbsp;mean for the city of Pomona, the developmental&nbsp;center and its patients,&nbsp;and the people who live&nbsp;in surrounding&nbsp;communities?</p> <p>We invite stakeholders to discuss this and other questions. The conversation will be moderated by Joaquin Alvarado, chief strategy officer for the <a href="" target="_blank">Center for Investigative Reporting</a>, the parent organization of California Watch. Gabrielson will discuss his investigative findings and answer questions.</p> <p><strong>Details</strong></p> <p><strong>When:</strong> April 3, 6:30-8:30 p.m.</p> <p><strong>Where:</strong> UC Riverside Extension campus, Conference Room A</p> <p>1200 University Ave., Riverside</p> <p>$5 parking on-site</p> <p><strong>RSVP:</strong>&nbsp;This event is free to the public, but registration is required:&nbsp;<a href="" target="_blank"></a>.</p> Health and Welfare Daily Report Department of Developmental Services Office of Protective Services patient abuse Broken Shield Tue, 26 Mar 2013 01:20:48 +0000 Marie McIntosh 18845 at For East African women, moving from Cheetos to mushmush <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/patricia-leigh-brown" title="View user profile." class="fn">Patricia Leigh Brown</a></span> </div> </div> </div> <p class="image-full-width" style="width: 640px;"><img alt="" class="imagecache-image-full-width" src="/files/imagecache/image-full-width/DSC_6594_somali_food(12).jpg" style="width: 640px;" title="The gatherings are meant to help daughters of East African women to understand their heritage and to encourage mothers to adapt " /> <span class="image-insert-photo-credit">Carlos A. Moreno/California Watch</span> <span class="image-insert-description">The gatherings are meant to help daughters of East African women to understand their heritage and to encourage mothers to adapt healthy versions of American favorites like quiche and pizza.</span></p> <p>SAN DIEGO &ndash; For many daughters, the kitchen contains their mother&rsquo;s secrets. In the tumult of pots and pans, the pinches of sugar and salt, reside recipes perfected over time without cookbooks, experience and intuition the only guides.</p> <p>For East African daughters in City Heights, a neighborhood that is a major West Coast portal for refugees, the opportunity to cook twice a month as a group with their mothers is a chance to steep themselves in Somali, Ethiopian and Eritrean culinary traditions, passed down orally through generations.</p> <p>&ldquo;We have a common goal: to learn from each other,&rdquo; said Ayan Sheikh, a recent graduate of CSU Bakersfield and a nurse, who missed the cooking group so much at school that she asked her aunt to post the sessions on YouTube.</p> <p>The gatherings started two years ago with 10 mothers and daughters; today, there are more than 30 regulars. The group has multiple goals: helping daughters growing up in the U.S. to understand their heritage while encouraging mothers to adapt healthy versions of American favorites like quiche and pizza.</p> <p>&ldquo;Mothers were saying, &lsquo;I&rsquo;m losing my daughter; she&rsquo;s not eating my food,&rsquo; &rdquo; said Sahra Abdi, founder of United Women of East Africa, which sponsors the classes and provides mental health services and leadership skills for refugee women. &ldquo;And the daughters were saying, &lsquo;We see food on the table, and we don&rsquo;t know how to make it.&rsquo; &rdquo;</p> <p>For young women like Sheikh, who was born in Mogadishu, Somalia, and whose family lived in Kenya, Yemen, Atlanta, and Ohio before settling in San Diego, the kinship between mothers and daughters is more important than achieving the perfect sambusa (called a samosa in Indian cooking).</p> <p>&ldquo;When you&rsquo;re in the kitchen, you talk about everything,&rdquo; Sheikh said. In the kitchen&rsquo;s culinary whirlwind, conversations can turn quickly from the benefits of a wooden spoon to who has a cold and whose wedding is coming up.</p> <p>The lingua franca is English rather than Somali, Amharic or Tigrinya. In this relaxed setting, women feel more comfortable sharing concerns, whether it is anxiety about seeing a doctor or how to read a prescription.</p> <p>&ldquo;In the kitchen,&rdquo; Abdi said, &ldquo;we can tell them, &lsquo;Hang in there,&rsquo; or, &lsquo;This happened to me.&rsquo; &rdquo;</p> <p>The City Heights neighborhood, where residents speak more than 30 languages and 80 dialects, is one of the densest and most diverse in the state. Since the end of the Vietnam War, it has been a magnet for refugees fleeing brutal conflicts, including Somalians, Eritreans, Sudanese, Somali Bantus, Kurds and ethnic Albanians from Kosovo.</p> <p>It is the unofficial capital of San Diego&rsquo;s East African diaspora, home to three major mosques, Islamic after-school programs and halal markets. But the neighborhood also has four times more fast food restaurants near schools than other San Diego neighborhoods and some of the highest concentrations of crime and poverty in the region, according to the Mid-City Community Advocacy Network.</p> <p>Perhaps predictably, East African families have begun to experience chronic diseases like hypertension and diabetes. In Africa, notes Michelle Zive, a dietitian and executive director of the Network for a Healthy California, daily life involved intense physical activity. In the U.S., children from East African families are leading more sedentary lives, particularly young women, whose exercise options are limited by modesty issues.</p> <p class="image-insert-right-align" style="width: 304px;"><img alt="" class="imagecache-image-insert-right-align" src="/files/imagecache/image-insert-right-align/_DSC7393_Somali_Cooking(1).jpg" title="Ayan Sheikh, 24, helps make sambusas, a Somali dessert stuffed with cream cheese and coconut. Today, the group is using large to" /> <span class="image-insert-photo-credit">Carlos A. Moreno/California Watch</span><span class="image-insert-description">Ayan Sheikh, 24, helps make sambusas, a Somali dessert stuffed with cream cheese and coconut. Today, the group is using large tortillas cut into triangles for the wrappers.</span></p> <p>Over huge pots of Ethiopian lentils spiced with hot berbere, women are addressing health challenges together, modifying the quantities of sugar and oil in some &ndash; though not all &ndash; traditional dishes. (Mushmush, a doughy sweet, is next on the hit list.)</p> <p>&ldquo;The young girls are eating Cheetos,&rdquo; said Amina Sheik Mohamed, a Network for a Healthy California regional director and cooking group leader. &ldquo;Some of the ladies were getting high blood pressure and getting sick.&rdquo;</p> <p>The group&rsquo;s mission includes transforming supermarket staples like bottled spaghetti sauce to be healthier and more culturally attuned (just add potatoes, cooked spinach and hot sauce).</p> <p>Adina Batnitzky,a sociologist at the University of San Diego, recently did a focus group on nutrition patterns among East African women with Theresa Sinicrope Talley, a marine biologist with the Scripps Institution of Oceanography at UC San Diego. They found a diet heavy on halal meat and lacking in fresh fish and seafood, which are plentiful back home but difficult to find in halal stores. Many women said they had never laid eyes on the Pacific Ocean, only miles away. In Africa, there were no freezers or processed foods, they observed, and families would eat every meal together rather than &ldquo;at their own time and place,&rdquo; as one woman put it.</p> <p>Yet strong social ties, as evidenced by the cooking group, are a major health asset, Batnitzky said.</p> <p>&ldquo;It&rsquo;s about connection,&rdquo; explained Abdi, the mother of two. &ldquo;When you&rsquo;re around other women, you feel valued and supported. You get a lot of positive vibes.&rdquo;</p> <p>Those vibes were on abundant display on a recent Saturday, as more than two dozen women in kaleidoscopic headscarves gathered at a member&rsquo;s house in suburban Lemon Grove.</p> <p>In the kitchen, Halimo Farah flipped sabayad in an iron skillet, demonstrating how the naan-like snack gets brown and puffy. Saffron tilapia grilled on the patio as little brothers zigzagged around on scooters. A group of daughters sat around a huge bowl, mixing cream cheese and coconut for sambusas, stuffed triangles made this day with tortillas.&nbsp;&nbsp; &nbsp;</p> <p>&ldquo;It&rsquo;s like folding origami with food inside,&rdquo; said 10-year-old Mona Adam.</p> <p>The completed dishes were laid out ceremoniously on a long carpet &ndash; injera, the spongy sour Ethiopian flatbread; mesir wat, the Ethiopian red lentil stew; sweet and savory sambusas; pilafs; the sabayad; the mushmush; and a traditional silver bowl and pitcher for washing hands.</p> <p>Mona compared the Saturdays to &ldquo;having Thanksgiving every day&rdquo; before joining the girls in hand-clapping games.</p> <p>Beholding the feast, which never includes alcohol, Abdi reflected on the moment.&nbsp;</p> <p>&ldquo;We don&rsquo;t have happy hours,&rdquo; she said. &ldquo;But this is a happy hour for us.&rdquo;</p> <p><em>This story was edited by Robert Salladay and copy edited by Nikki Frick and Christine Lee.</em></p> Health and Welfare Daily Report cooking East Africa food San Diego traditional arts Mon, 25 Mar 2013 07:00:00 +0000 Patricia Leigh Brown 18844 at Stories to make you rethink your relationship to water <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/kelly-chen" title="View user profile." class="fn">Kelly Chen</a></span> </div> </div> </div> <p>We drink it, we bathe with it, we even swim in it &ndash; but we may not often think about water. What is the source of the water we&#39;re drinking? What happens when whole communities don&#39;t have access to clean water? Here are four stories that explore how we interact with water.</p> <p><strong>We spend $11 billion a year on bottled water, but we don&rsquo;t really know where it comes from</strong></p> <p>Kate Sheppard of Mother Jones reports most of us don&rsquo;t know <a href="" target="_blank">where our water comes from</a>, due, in part, to regulations around bottled water. &ldquo;In order to be called &lsquo;spring water,&rsquo; according to the EPA, a product has to be either &lsquo;collected at the point where water flows naturally to the earth&rsquo;s surface or from a borehole that taps into the underground source,&rsquo; &rdquo; Sheppard writes. &ldquo;Glacier water&rdquo; and &ldquo;mountain water&rdquo; aren&rsquo;t regulated by the EPA.</p> <p><strong>In some parts of unincorporated California, wastewater backs up into toilets, sinks and showers </strong></p> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/unincorporated_087500px.jpg" title="Francisco González pours bleach into pits where he diverts his washing machine and kitchen sink." /> <span class="image-insert-photo-credit">Max Whittaker/Prime</span> <span class="image-insert-description"> Francisco González pours bleach into pits where he diverts his washing machine and kitchen sink.&nbsp;</span></p> <p>California Watch reporter Bernice Yeung examined some <a href="" target="_blank">unincorporated communities&rsquo; basic access to water</a> and other services. According to census data analyzed by PolicyLink, hundreds of communities in California &ndash; with an estimated 1.8 million people &ndash; lack basic infrastructure.</p> <p>In areas like Parklawn, located in central California, residents are accustomed to aging septic tanks that back up into toilets and showers. As a quick fix, residents like Francisco González would &ldquo;divert water from their sinks and washing machines&rdquo; into their yards, forming pools of water that attract rats, mosquitos and cockroaches (which González treats with bleach).</p> <p><strong>31 of 35 cities tested positive for chromium</strong></p> <p>PBS NewsHour and the Center for Public Integrity released a report this week on chromium-contaminated water in the U.S. A 2010 study found the cancer-relatedtoxin in 31 of 35 cities tested.</p> <p>Science correspondent Miles O&rsquo;Brien visited the desert town of Hinkley, Calif. &ndash; which was featured in the film &ldquo;Erin Brockovich&rdquo; &ndash; for a checkup and found the water was still contaminated. Despite a $333 million settlement from PG&amp;E, the company responsible for dumping &ldquo;26 tons of a coolant made of chromium-6 into unlined retaining ponds&rdquo; in the 1950s and 1960s.</p> <p><a href="" target="_blank">Watch</a> the report.</p> <p><iframe allowfullscreen="" frameborder="0" height="315" src="" width="560"></iframe></p> <p><strong>Thinking globally</strong></p> <p>Internationally, irrigation water is in high demand. While we drink on average a few quarts of water each day, 85 to 95 percent of the water supply in developing countries is used for agriculture. The U.N. Food and Agriculture Organization estimates that by 2025, 1.8 billion people will be living in water scarce regions.</p> <p>Our Food for 9 Billion project took us to the dry hills of Rajasthan, India, where Rajendra Singh turned to water harvesting &ndash; &ldquo;a practice that goes back hundreds of years, but was largely abandoned with the arrival of tube wells and electric pumps,&rdquo; Jon Miller reports.</p> <p><a href="" target="_blank">Listen</a> to the report.</p> <p><iframe height="200" scrolling="no" src="" width="600"></iframe></p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/dailyreport/mobile-home-park-residents-sue-owner-over-sewage-electricity-18114">Mobile home park residents sue owner over sewage, electricity</a> </div> <div class="field-item even"> <a href="/health-and-welfare/neglected-decades-unincorporated-communities-lack-basic-public-services-15635">Neglected for decades, unincorporated communities lack basic public services</a> </div> </div> </div> Environment Daily Report drinking water groundwater polluted water Fri, 15 Mar 2013 20:50:12 +0000 Kelly Chen 18838 at Some Calif. retirement trustees cancel Hawaii conference plans <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/jennifer-gollan" title="View user profile." class="fn">Jennifer Gollan</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/Hilton_pool.jpg" title="The Hilton Hawaiian Village Waikiki Beach Resort, site of this year's National Conference on Public Employee Retirement Systems, has five swimming pools." /> <span class="image-insert-photo-credit"><a class="image-insert-photo-credit-url" href="" target="_blank">nemuneko.jc/</a></span><span class="image-insert-description">The Hilton Hawaiian Village Waikiki Beach Resort, site of this year&#39;s National Conference on Public Employee Retirement Systems, has five swimming pools.</span></p> <p>At least three board members overseeing underfunded municipal retirement systems in California have scrapped plans to attend a conference in Hawaii even as conference organizers defended the gathering after a recent California Watch report revealed that some pension funds planned to send as many as five board members each at public expense.</p> <p>Conference organizers also removed from their website a &ldquo;<a href="">2013 Attendance Justification Tool Kit</a>,&rdquo; which suggested that pension trustees rationalize their attendance at the conference as a way to network and boost their pension funds.&nbsp;</p> <p>The moves follow a <a href="">Feb. 27 story</a> by California Watch, which reported that four of the state&rsquo;s 24 largest independent municipal retirement systems intended to send board members to the conference in Waikiki in May. The plans collectively are grappling with a multibillion-dollar shortfall for pension benefits owed to current and future retirees.&nbsp;</p> <p>Board members who canceled their trips last week include Debora Allen and Jerry Telles from the Contra Costa County Employees&rsquo; Retirement Association and Herman Santos, chairman of the Board of Investments for the Los Angeles County Employees Retirement Association.</p> <p>Telles and Santos did not return calls seeking comment on why they decided not to attend the conference after all. Trustees from the Los Angeles City Employees&rsquo; Retirement System and the San Diego County Employees Retirement Association did not return several calls and emails to determine whether they still plan to attend. Attendance will cost $2,600 or more per trustee, by some estimates.&nbsp;</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>&ldquo;I didn&rsquo;t see the full agenda before I volunteered to go,&rdquo; said Allen, adding that when she reviewed the agenda last week, she decided it was not worth the system&rsquo;s money to attend.</p> <p>Richard Cabral, also from the&nbsp;<a href="">Contra Costa County Employees&rsquo; Retirement Association</a>, said he still plans to attend the conference to network.</p> <p>Santos, an attorney in the Los Angeles County public defender&rsquo;s office, canceled his trip the day after the story appeared to work on a trial scheduled during the week of the conference, said Gregg Rademacher, chief executive of the Los Angeles County Employees Retirement Association.</p> <p>&ldquo;Mr. Santos is a public defender and does his best to coordinate the judicial calendar with his retirement plan commitments,&rdquo; Rademacher wrote in an email.&nbsp;</p> <p>No fees were incurred as a result of the cancellations, officials in Contra Costa and Los Angeles counties said.&nbsp;</p> <p>Hank Kim, executive director and counsel for the trade association organizing the national conference, did not return messages requesting comment.</p> <p>But in an <a href="">open letter posted Tuesday</a> on the conference website, organizers defended their decision to gather money managers, consultants and pension administrators in Honolulu.</p> <p>&ldquo;Our current President grew up there,&rdquo; the letter said, referring to President Barack Obama. In addition, organizers wrote, &ldquo;Honolulu is as economical as it is beautiful. The cost of lodging and food is lower than in many places on the mainland, and airfares from anywhere in the U.S. are competitively priced.&rdquo;</p> <p>The letter continued:<strong> </strong>&ldquo;Objecting to Honolulu because it has beautiful beaches &ndash; something you&rsquo;ll also find in popular convention cities in California and Florida &ndash; is like objecting to New York because it has Broadway and Times Square or objecting to New Orleans because it has jazz clubs and great food.&rdquo;</p> <p>In an <a href="">open letter posted on the website</a> of the San Diego County Employees Retirement Association, officials also defended the conference.&nbsp;</p> <p>&ldquo;Continued and reasonable education is a small investment when compared to the increased value it provides to the $9 billion fund and our members,&rdquo; officials wrote in the Feb. 27 letter.</p> <p>Joe Nation, a professor of the practice of public policy at Stanford University, who researches public employee pensions, said traveling to Hawaii does not send the right message and praised the trustees who pulled out of the conference.</p> <p>&ldquo;It&rsquo;s better for everyone because it looked like a junket to me,&rdquo; Nation said. &ldquo;The point is for them to manage money and to run a system for retirees. If someone really wants to travel, they should be a flight attendant.&rdquo;</p> Money and Politics Daily Report California pensions hawaii pensions Fri, 08 Mar 2013 08:05:02 +0000 Jennifer Gollan 18828 at New director to take over troubled Sonoma disability center <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/amy-julia-harris" title="View user profile." class="fn">Amy Julia Harris</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/sonoma_253mk-350px.jpg" title="Giant palm trees stand at the main gate of the Sonoma Developmental Center, which houses about 500 patients." /> <span class="image-insert-photo-credit">Mike Kepka/San Francisco Chronicle</span> <span class="image-insert-description"> Giant palm trees stand at the main gate of the Sonoma Developmental Center, which houses about 500 patients.&nbsp;</span></p> <p>A former employee of the Sonoma Developmental Center has been tapped to head California&rsquo;s largest full-time care facility for the severely disabled, at a time when the institution is struggling to reinvent itself in the wake of patient abuse scandals.</p> <p>The Department of Developmental Services announced Wednesday that Karen Faria, who worked at the Sonoma Developmental Center from 1985 to 2005, will become the embattled facility&#39;s latest executive director starting April 1.</p> <p>The appointment comes in the wake of a <a href="" target="_blank">California Watch series</a>&nbsp;that uncovered serious allegations of patient abuse at the Sonoma Developmental Center. The reported abuses included cases of rape and molestation as well as allegations that a state worker used a Taser to inflict burns on a dozen patients.</p> <p>The California Watch investigation exposed these cases and focused on failures of an internal police force to get to the bottom of the abuses. One-third of the 36 alleged rapes occurred at the Sonoma board-and-care center &ndash; one of five such facilities in California that house about 1,600 patients with severe disabilities.</p> <p>But the state Office of Protective Services, a unique internal police force set up exclusively to protect residents of these state centers, routinely mishandled cases &ndash; waiting too long to interview witnesses or suspects and failing to collect evidence. In the alleged sex assaults reported at these state facilities, the police force never ordered a &ldquo;rape kit,&rdquo; a standard law enforcement investigatory tool. After a state worker was accused of using a stun gun to inflict burns on a dozen severely autistic male patients, the police force waited at least nine days to interview the suspect, who was never charged with a crime.</p> <p>The series sparked new polices, a complete retraining of the police force, leadership changes and a criminal investigation by the Sonoma County district attorney&rsquo;s office into the stun gun abuses.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>The series also led to two new laws signed by Gov. Jerry Brown designed to bring greater protections to the severely disabled living in these state centers. A third bill, introduced last month, would mandate that rape kit examinations be conducted if a patient at any state-operated institution accuses an employee of sexual assault.</p> <p>SB 651 written by Sen. Fran Pavley, D-Agoura Hills, and Sen. Mark Leno, D-San Francisco, would require the exam be performed &ldquo;at an appropriate facility off the grounds of the developmental center or state hospital.&quot;</p> <p>In addition,&nbsp;the state revoked the Sonoma facility&#39;s primary license to operate, threatening a loss of millions of dollars in federal support.&nbsp;</p> <p>Faria&#39;s appointment is the latest move to make changes at the center.</p> <p>&ldquo;I am thrilled that Ms. Faria is returning to lead Sonoma Developmental Center and continue implementation of necessary reforms at the facility,&rdquo; said California Health and Human Services Secretary Diana S. Dooley.</p> <p>But some are already expressing concern about the appointment. Former employees of the Sonoma center say that Faria was&nbsp;part of the administrative old guard that knew of patient abuse and tried to suppress investigations into wrongdoing at the center. One former doctor at the facility was particularly critical of the appointment.</p> <p>&quot;Her appointment is an amazing bit of duplicity,&rdquo; said Dr. Van Peña, a physician at the Sonoma Developmental Center from 1990 to 2000. &ldquo;She is totally party line, so I don&rsquo;t know how she&rsquo;s going to right the ship.&rdquo;</p> <p>Faria could not be reached for comment today.</p> <p>Faria began at the Sonoma center as a recreation therapist in 1985 and rose through the ranks as the clients&rsquo; rights advocate, quality assurance program director and clinical director from 2000 to 2005.</p> <p>Peña said Faria&rsquo;s success at the center came from keeping her head down and not questioning authority, even when patient safety was on the line.</p> <p>&ldquo;She is not an independent thinker,&rdquo; Peña said. &ldquo;If someone above her told her to do this or that, she would do it. That&rsquo;s why that place had such abysmal care &ndash; because those instructions didn&rsquo;t help patients, they helped people keep their jobs.&rdquo;</p> <p>Peña is suing the Department of Developmental Services, alleging officials at the Sonoma center fired him for reporting suspicious injuries to outside regulators and to law enforcement. The state denies the claim and has fought the doctor&#39;s lawsuit for a decade. It is scheduled to go to trial in federal court later this year.</p> <p>Nancy Lungren, a spokeswoman for the Department of Developmental Services, which oversees the state&#39;s five developmental centers, said Faria&#39;s background was carefully reviewed before the selection was made.&nbsp;</p> <p>&quot;These background checks indicated Ms. Faria would be a strong leader committed to client protection,&quot; Lungren said.</p> <p>The Sonoma center is appealing the loss of its license with state public health officials. In January, the Department of Developmental Services agreed to forfeit more than $1 million a month in federal funding for failing to protect severely disabled patients from abuse at some of the center&rsquo;s housing units. The federal funds cover as much as half of the treatment costs for patients who qualify for the federal program.</p> <p>The state has taken what it calls &ldquo;aggressive actions&rdquo; to correct problems at Sonoma, including having the California Highway Patrol oversee the law enforcement, establishing an independent on-site monitor and enhancing staff training. &nbsp;</p> <p>&ldquo;With her extensive experience, Ms. Faria will be able to provide the strong leadership needed to improve services and ensure that residents are living in a healthy and safe environment,&rdquo; said Terri Delgadillo, the department&#39;s director.</p> <p>Faria assumes her new position April 1 with an annual salary of $108,564, according to the Department of Developmental Services.</p> <p>But Peña doubted Faria could now protect patients.</p> <p>&ldquo;Unless she was locked in a closet with bricks all those years, the physicians and nurses would have seen incident reports of patient neglect and abuse,&rdquo; said Peña. &ldquo;She would have known about the incident reports.&rdquo;</p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/dailyreport/sonoma-disability-center-staff-weighs-abuse-claims-18799">Sonoma disability center staff weighs in on abuse claims</a> </div> <div class="field-item even"> <a href="/dailyreport/developmental-centers-police-need-immediate-fixes-state-officials-say-15297">Developmental centers&#039; police need immediate fixes, state officials say</a> </div> </div> </div> Health and Welfare Public Safety Daily Report Department of Developmental Services developmentally disabled patient abuse Sonoma Developmental Center Broken Shield Fri, 08 Mar 2013 01:38:16 +0000 Amy Julia Harris 18827 at What's driving privatization of public transit? <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/kelly-chen" title="View user profile." class="fn">Kelly Chen</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/fastbus.jpg" title="In Fairfield, officials have outsourced the city's public bus service to MV Transportation. " /> <span class="image-insert-photo-credit">Michael Short/California Watch</span> <span class="image-insert-description"> In Fairfield, officials have outsourced the city&#39;s public bus service to MV Transportation.&nbsp;</span></p> <p>As more cities turn to private companies to run public transit systems,&nbsp;<a href="" target="_blank">our recent investigation</a> shows that privatization may not be the silver bullet that cash-strapped municipalities were hoping for.</p> <p>In Fairfield, where the city&rsquo;s suburban landscape makes it difficult to provide reliable and comprehensive bus service, local officials are finding it hard to hold its contractor, MV Transportation, accountable. Transit reporter Zusha Elinson found that &ldquo;over a two-year period beginning in 2008, the company was fined 295 times for a total of $164,000&rdquo; for late arrival times and drivers speeding, being out of uniform and&nbsp;using cellphones while driving.</p> <p>Behind the fines, however, is a much larger ideological debate: Is privatization of certain industries like transit, which some traditionally consider to be public domain, a good thing?</p> <p>We asked Elinson to break it down for us.</p> <p><strong>Q: Why are more cities turning to private companies to run their public transit systems?</strong></p> <p><strong>A:</strong>&nbsp;Privatization started under (President Ronald) Reagan, who championed public-private partnerships in favor of smaller government. But the trend really accelerated during the (recent) recession because a lot of municipalities and transit agencies don&rsquo;t have enough money to maintain these services. The one thing that outsourcing your public transit does is save money.</p> <p>Across the country, very large cities are going this route:&nbsp;<a href="">Austin</a>&nbsp;recently outsourced all their bus services;&nbsp;<a href="" target="_blank">New Orleans</a>&nbsp;handed over its entire public transportation to a private company, including its management; Nassau County in Long Island did the same.</p> <p>A lot of times these deals will be sold as saving the taxpayers this many millions of dollars. But looking at a couple of different situations in&nbsp;<a href="">San Diego</a>&nbsp;and New Orleans, the money being saved has been quite a bit less than advertised. That&rsquo;s not to say they haven&rsquo;t been saving money. Often they&rsquo;ll tout savings that are quite far above than what is being saved.</p> <p><strong>Q: Who benefits? Who loses?</strong></p> <p><strong>A:</strong>&nbsp;One of the biggest costs for public transit is labor. When they contract to private companies, they can winnow away labor costs by not offering pensions and cutting health benefits. So naturally, bus driver unions don&rsquo;t like these arrangements because it means their wages and benefits will be cut.</p> <p>For example, a few years ago in northern San Diego County when the North County Transit District brought in a private company, the starting wage for a bus driver went from $14 to $10.50 an hour. One general concern that comes with paying drivers less is safety &ndash; maybe you have more inexperienced drivers. This isn&rsquo;t the case for every company, but it&rsquo;s a concern.</p> <p><strong>Q: What does the case in Fairfield teach us?</strong></p> <p><strong>A:</strong>&nbsp;Supposedly the benefit of doing this is that you have a contract with the company to make them do what you want. But the story in Fairfield shows that it&rsquo;s not so. For example, in Fairfield, MV Transportation officials actually had quite a bit of political sway to squash efforts to keep them in line. So it was difficult, at least for (former) Transit Manager George Fink, to hold them accountable.</p> <p>(Our investigation found that MV Transportation made a $10,000 campaign donation to then-City Councilman Chuck Timm in 2007. In 2009, Jon Monson, then the company&rsquo;s board chairman, made $10,000 campaign donations to City Councilman John Mraz and City Councilwoman Catherine Moy.)</p> <p>People can take lessons from this situation: You need to really take a look at which company you&rsquo;re hiring and make sure they comply with the contract. Can people holding them accountable really do that? While many transit agencies are run very inefficiently and can be improved, you don&rsquo;t have to worry about influencing politicians or people taking measures just for profit margins when the system is run by public agencies.</p> <p><strong>Q: Can this happen in big cities like San Francisco?</strong></p> <p><strong>A:</strong>&nbsp;A leader of the Muni drivers union in San Francisco, a very strong union, laughed when I asked him that. He said no way. So, likely it wouldn&rsquo;t come to a big city with a strong union presence, but it could be the fact that other large cities continue to do this. Maybe not SF, but some other big cities.</p> <p>In the Bay Area, as we mention in our article, they&rsquo;re considering contracting out some routes in southern Alameda County, where AC Transit has provided the bus service for many, many years. That&rsquo;ll be a really big fight if that happens because the bus drivers union is quite strong in the East Bay. But I think it just shows the trend that even in the Bay Area, where the unions are really strong, this is even being considered.</p> <p><strong>Q: Does the public even know who runs its public transit system? Do riders feel the impact?</strong></p> <p><strong>A:</strong>&nbsp;Transit officials tend to say that people don&rsquo;t really know who&rsquo;s running their bus lines, but I don&rsquo;t think that&rsquo;s actually true. In talking with people in Long Island, they were really wary of this situation in Nassau County. In fact, in Nassau County, where (nearly) everyone is a commuter to the city, their transit was outsourced to a big French company. For the first time ever, they formed the&nbsp;<a href="">Long Island Bus Riders Union</a>. It showed that bus riders were really concerned about what might happen. There&rsquo;s always two sides to the story: The company says it saved a lot of money and provided services more efficiently. But at the same time, it cut service, which people are upset about.</p> <p><em>This interview has been edited and condensed.</em></p> <p><em style="font-size: 13px; line-height: 18px; background-color: rgb(255, 255, 255);"><strong>Correction:</strong>&nbsp;A previous version of this story misstated an effect of Nassau County outsourcing its transit. Service was cut.</em></p> General Assignment Daily Report AC Transit budget public transportation Thu, 07 Mar 2013 14:05:02 +0000 Kelly Chen 18826 at How NASA scientists are turning LA into one big climate change lab <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard">Anonymous</span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img above="" alt="" as="" atmosphere="" atop="" clars="" class="imagecache-image-insert" from="" monitoring="" more="" remotely="" seen="" src="/files/imagecache/image-insert/LA climate desk.jpg" tests="" the="" title="Los Angeles on a " which="" /> <span class="image-insert-photo-credit">John Metcalfe/The Atlantic</span> <span class="image-insert-description"> Los Angeles on a &quot;clear&quot; day, as seen from atop the CLARS monitoring station, which remotely tests the atmosphere above more than two dozen points in the Los Angeles Basin.</span></p> <p>Southern California&rsquo;s Mount Wilson is a lonesome, hostile peak &ndash; prone to sudden rock falls, sometimes ringed by wildfire &ndash; that nevertheless has attracted some of the greatest minds in modern science.</p> <p>Today, <a href="">Mount Wilson</a> is the site of a more terrestrial but no less ambitious endeavor. Scientists from NASA&rsquo;s Jet Propulsion Laboratory in Pasadena and elsewhere are turning the entire Los Angeles metro region into a state-of-the-art climate laboratory. From the ridgeline, they deploy a mechanical lung that senses airborne chemicals and a unique sunbeam analyzer that scans the skies over the&nbsp;<a href="">Los Angeles</a>&nbsp;Basin. At a sister site at the California Institute of Technology, researchers slice the clouds with a shimmering green laser, trap air samples in glass flasks and stare at the sun with a massive mirrored contraption that looks like God&rsquo;s own microscope.</p> <p>George Ellery Hale, one of the godfathers of astrophysics, founded the Mount Wilson Observatory in 1904 and divined that sunspots were magnetic. His acolyte Edwin Hubble used a huge telescope, dragged up by mule train, to prove the universe was expanding. Even Albert Einstein made a pilgrimage in the 1930s to hobnob with the astronomers (and suffered a terrible hair day, a&nbsp;<a href="">photo shows</a>).</p> <p>These folks are the foot soldiers in an ambitious, interagency initiative called the&nbsp;<a href="">Megacities Carbon Project</a>. They&rsquo;ve been probing L.A.&rsquo;s airspace for more than a year, with the help of big-name sponsors like the National Institute of Standards and Technology, the Keck Institute for Space Studies and the California Air Resources Board. If all goes well, by 2015, the Megacities crew and colleagues working in smaller cities such as Indianapolis and Boston will have pinned down a slippery piece of&nbsp;<a href="">climate science</a>: an empirical measurement of a city&rsquo;s carbon footprint.</p> <p>If that doesn&rsquo;t sound like something Einstein would scarf down energy bars and hoof up a mountain to check out, give it time. It promises to be a groundbreaking development in the worldwide fight against global warming.</p> <div id="caw-inset-1-placeholder"></div> <p>Historically, researchers have tried to understand anthropogenic global warming by looking at it from the big picture &ndash; first across the planet, then by regions and countries. But two things happened in the past few years that turned their frame of reference. First, they realized that the emissions of a large landmass are extremely difficult to measure. The signal from fossil fuels gets tangled up in a bunch of other things, such as byproducts from the natural ecosystem and agriculture.</p> <p>Second, they encountered a rash of enthusiasm-killing gridlock in the United States government, with the&nbsp;<a href="">2009 Copenhagen climate talks</a>&nbsp;ending in a muddle and a 2010 cap-and-trade bill dying in the Senate. It became clear to environmental stakeholders that if any policy was going to happen on cutting emissions, it was going to be at the scale of states and cities.</p> <p>So climate scientists began to sniff around megalopolises. It makes sense: That&rsquo;s where all the people and resources are. They now suspect that cities are some of the worst offenders when it comes to generating greenhouse gases, especially so-called megacities with more than 10 million residents, like Los Angeles, New York, Tokyo, and Mumbai. Urban areas and their enabling power plants are thought to pump out about 70 percent of humankind&rsquo;s total fossil-fuel emissions.</p> <p>Cities will only become more important in the climate debate as the years roll by. With the world&rsquo;s urban population expected to nearly double by 2050, the boom in development could release a flood of greenhouse gas, as more city dwellers torch colossal quantities of coal and oil to power their cars, feed their stoves and crank their air conditioners. Of course, many studies indicate that city dwellers create a lesser environmental footprint per person than their suburban counterparts, as urbanites tend to take mass transit and live in smaller homes. But cities, being small and potent geysers of greenhouse gases, are an ideal place to target solutions.</p> <p>That&rsquo;s why we should have begun studying urban emissions yesterday, says Riley Duren, chief systems engineer at the Jet Propulsion Lab and manager of the Megacities project. In his past life, the Alabama native helped in the hunt for Earth-like planets on NASA&rsquo;s Kepler mission. But a period of soul searching told him it would be better to focus on the home planet. &ldquo;I was becoming increasingly motivated by climate change inaction,&rdquo; he says. &ldquo;I just convinced myself ... that this was the biggest thing an engineer could work on.&rdquo;</p> <p>It&rsquo;s a complex problem. A major issue is that governments estimate the volume of emissions with indirect measurements, such as tracking the carbon output of power plants or surveying the number of people riding mass transit or buying gasoline. Nobody is really testing greenhouse gases above cities on a focused, long-term basis, which is crucial in verifying whether the measurements urban governments use to make policy decisions are accurate.</p> <p>To control and reduce fossil-fuel emissions, &ldquo;you have to be able to know what you&rsquo;re emitting to keep track,&rdquo; says Ralph Keeling, director of the&nbsp;<a href="">Scripps CO2 Program</a>&nbsp;at the Scripps Institution of Oceanography. &ldquo;There are various ways to do that, but they&rsquo;re all fraught with uncertainties. ... An attractive way to do it is to see what&rsquo;s happening in the atmosphere. The atmosphere can&rsquo;t lie.&rdquo;</p> <p>Los Angeles&rsquo; municipal government has a natural interest in this line of inquiry. Since it adopted a climate plan in 2007, the city has&nbsp;<a href="">met Kyoto Protocol reduction targets</a>&nbsp;in part by taking thousands of diesel trucks off the road and screwing energy-saving LED bulbs into 140,000 streetlights. Officials want to cut emissions 35 percent from 1990 levels by 2030, and to do that, they&rsquo;re going to need a good verification system.</p> <p>The Megacities project &ldquo;will show that there is a significant impact in what we do,&rdquo; says Romel Pascual, Los Angeles&rsquo; deputy mayor for the environment. &ldquo;When we talk about L.A. being green, people roll their eyes. They won&rsquo;t believe it, right? That&rsquo;s because of the history of L.A. But when you look at the numbers of us hitting major milestones, L.A. is near the top.&rdquo;</p> <p>One morning in January, I pile into a Toyota Prius with Duren and Megacities colleagues Stan Sander and Eric Kort and take a spin up the rock-strewn roads of Mount Wilson. The trees are all scorched and leafless from the last forest fire, so there&rsquo;s an excellent view of the smog. It looks like a volcano vomited up an ocean of brown foulness that spread over the L.A. Basin and now is lapping against the foothills of the San Gabriel Mountains.</p> <p>In many ways, Los Angeles is an excellent place to kick off a new campaign to heal our feverish atmosphere. The city&rsquo;s terrible air quality has long cried out for intervention. When the first major smog crisis appeared during World War II, it was so bad that people thought the Japanese were bombarding them with poison gas. &ldquo;Your lungs would completely ache. It would take hours for the pain to go away,&rdquo; remembers Sander, who grew up nearby. &ldquo;It was so bad that rubber tires would crack, because ozone attacks rubber.&rdquo;</p> <p>The greater Los Angeles area of the 21st century is home to 19 million people living among 34,000 square miles of clunky concrete buildings, griddle-hot parking lots and sad spits of green space. It&rsquo;s not only America&rsquo;s smoggiest region, but also a breeder reactor for greenhouse gases. Prodigious plumes of carbon dioxide waft up from car-clotted highways and belch from factory smokestacks. Methane pours from landfills, sewage treatment plants and&nbsp;<a href="">large dairies</a>&nbsp;to the east (a contented cow can produce hundreds of liters of methane daily). And although they&rsquo;ve cut emissions greatly, the ports of Los Angeles and Long Beach are still powerful emitters, with their bunker fuel-burning cargo ships, bulky loading cranes and busy dockside traffic.</p> <p>On a typical morning, ocean breezes blow this noxious chemical gumbo into the mountains to the east. There, at the pinnacle of Mount Wilson, the vapors seethe at the doorstep of a curious object called the California Laboratory for Atmospheric Remote Sensing, or&nbsp;<a href="">CLARS</a>.</p> <p>In its constant roving, CLARS is building a map of how emissions move throughout the city. Its efficiency is hard to fault. &ldquo;The advantage is, I can point to anywhere and get a map of the whole basin essentially in an hour and a half,&rdquo; says Sander, who oversees the machine, &ldquo;whereas if you had a network of ground monitoring stations, you&rsquo;d have to have 50 or some large number of them to get similar information.&rdquo;</p> <p>The observatory is a big white dome with a furry black fringe running around its base, like a mustachioed R2-D2, sitting atop a shipping container. The container was dropped onto the mountaintop several years ago by helicopter, and today, it&rsquo;s outfitted with scads of high-priced equipment and a technician who lurks in the gloom. Every couple of minutes, the dome whirs and spins to point at a distant target below. A mirror in its curvature reflects a sliver of sunlight downward, where a spectrometer dissects it into different elements. The dome then whirs to the next point in its 27-spot rotation around the basin.</p> <p>Scientists had expected emissions to be fairly uniform, given the region&rsquo;s flat topography. But CLARS picked up a number of hot spots with abnormally high concentrations of methane &ndash; an incredibly potent climate change agent &ndash; in north Orange County and the City of Industry. The Megacities people are just beginning to identify the vapor sources for these anomalous zones.</p> <p>&ldquo;The L.A. Basin is very geologically active,&rdquo; Sander says. &ldquo;You&rsquo;ve probably heard of the La Brea tar pits? That&rsquo;s an area where there are a lot of organisms that anaerobically produce methane.&rdquo; Methane escaping through these ground seeps is one theory, anyway. Sander also suspects the labyrinthine network of tubes that ferries natural gas through town. &ldquo;There are millions of miles of little pipes that go from distribution stations to people&rsquo;s houses,&rdquo; he says. A lot of them leak, and &ldquo;the leaks can be very substantial.&rdquo;</p> <p>Emissions of questionable origin are called fugitive emissions, and they account for a decent-sized hunk of any city&rsquo;s overall greenhouse gas output. L.A. officials estimate that the city&rsquo;s yearly carbon footprint weighs 39 million tons, with this breakdown: 43 percent vehicle emissions, 21 percent commercial buildings, 19 percent municipal energy use, 16 percent &ldquo;industrial fugitive or other&rdquo; and 1 percent wastewater.</p> <p>That 16 percent is a little fuzzy because, again, emitters are judging their output using models. &ldquo;That&rsquo;s the best they can do,&rdquo; Duren says. &ldquo;Then we might come along with atmospheric measurements and go, &lsquo;Oh, actually you&rsquo;re underestimating it by a factor of two.&rsquo; &rdquo;</p> <p>Behind the CLARS facility is a rattling, wheezing shed that houses a Picarro, an air-sampling device that displays real-time readings of ambient gases. Sander looks concerned over a sudden spike in CO2 on the machine&rsquo;s monitor, then realizes it&rsquo;s simply us, exhaling.</p> <p>This is another component of Megacities&rsquo; full-court press: a network of a dozen or so Picarros going up this year in different L.A. neighborhoods, where they will ceaselessly inspect the air for greenhouse gas. A planned satellite component adds another layer of detection.</p> <p>Only one spacecraft in orbit right now is monitoring greenhouse gases, Japan&rsquo;s&nbsp;<a href="">Gosat</a>&nbsp;(Greenhouse Gases Observing Satellite), and its resolution isn&rsquo;t good enough to give an accurate picture of a city&rsquo;s emissions. But in the next few years, NASA plans to launch the&nbsp;<a href="">Orbiting Carbon Observatory</a>&nbsp;(OCO-2) satellite and install a new instrument (OCO-3) on the International Space Station. Both devices will periodically take snapshots of the &ldquo;chemical weather&rdquo; over population centers. &ldquo;OCO-3 will have a &lsquo;city mode&rsquo; where it rapidly starts sweeping back and forth like a whisk broom,&rdquo; Duren says. He expects the satellite to take some 3,000 samples over a city in just a few seconds.</p> <p>With this bulging grab bag of equipment, the Megacities team hopes to sculpt a model of L.A.&rsquo;s emissions so detailed that they&rsquo;ll be able to pull out individual signatures, such as exactly what and how much is spewing from rush-hour traffic or the port system or large landfills. Once they get an emissions baseline for Los Angeles, they hope to assist other cities in starting their own climate-reading networks.</p> <p>Duren&rsquo;s team is already coordinating with French scientists running a Megacities sister project in Paris. (Researchers had to move a Picarro on the Eiffel Tower because its readings were skewed by steamy tourist lung vapors.) The Americans are also trying to link up with a third group in São Paulo, Brazil, which has long battled heavy air pollution.</p> <p>The idea is to prepare a set of climate archetypes that can be applied to different megacities. The L.A. area is on the ocean, ringed by mountains, and often holds emissions in place like a lidded bowl. Perhaps what the Megacities team learns about emissions here will also apply in Mumbai, India, which has a similar geography. In contrast, Paris&rsquo; layout makes emissions rise in a wind-blown plume.</p> <p>&ldquo;The idea for the project is, we pick a representative number of cities that are these different archetypes,&rdquo; Duren says, &ldquo;and if we can characterize them with this giant laboratory, if you will ... you&rsquo;ve got a system that you can apply with confidence, everywhere.&rdquo;</p> <p>To what end, ultimately?</p> <p>The goal is to one day have a comprehensive network for sensing greenhouse gases in&nbsp;all&nbsp;the major cities across America or even the world. With that in place, an obvious application would be capping sources of fugitive emissions. An eagle-eyed satellite might detect roiling leaks in natural-gas pipes caused by aging infrastructure, or disasters like hurricanes and earthquakes. Then cities could prioritize repair crews accordingly.</p> <p>If the researchers can extract the signature of freeway traffic, it could instruct a municipality how and where to build future roads, enact tolls or allot carpool lanes. It could also alter the dialogue of commuting: If you reside in the suburbs but drive through a city every day to work, are you somehow on the hook financially or morally for spewing fumes into the greater urban cloud? That issue matters in Los Angeles, where regional commuters arguably bear environmental responsibilities &ldquo;even if they don&rsquo;t live in L.A.,&rdquo; says Pascual of the mayor&rsquo;s office.</p> <p>As the outlines of our individual footprints become clearer, perhaps the Megacities legacy could even motivate some of us to pull the old bike out of storage instead of reaching for the car keys.</p> <p>&ldquo;I guess people are aware that when they use their cars, there&rsquo;s something coming out of the exhaust pipes. But because they can&rsquo;t see it, they don&rsquo;t really have a feeling for how much is coming out,&rdquo; says Scripps&rsquo; Keeling. &ldquo;That&rsquo;s created a bit of complacency.&rdquo;</p> <p><em>This essay appears in the ebook&nbsp;<a href="">&quot;City 2.0: The Habitat of the Future and How to Get There,&quot;</a>&nbsp;co-produced in partnership by&nbsp;<a href="">The Atlantic Cities</a>&nbsp;and&nbsp;<a href="">TED Books</a>.&nbsp;This story is courtesy of <a href="" target="_blank">The Atlantic</a>&nbsp;as part of Climate Desk, a&nbsp;journalistic collaboration among The Atlantic, the Center for Investigative Reporting,&nbsp;Grist,&nbsp;The Guardian,&nbsp;Mother Jones,&nbsp;Slate,&nbsp;Wired&nbsp;and PBS.</em></p> Environment Daily Report climate change Los Angeles Mon, 04 Mar 2013 19:49:53 +0000 John Metcalfe 18819 at In one Calif. school district, teachers help teachers get better <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard">Anonymous</span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/Hechinger Long Beach teacher 1.jpg" title="Writing coach Jandella Faulkner helps students at Edison Elementary School in Long Beach use thinking maps to tell a story." /> <span class="image-insert-photo-credit">Stephen Smith/The Hechinger Report</span> <span class="image-insert-description"> Writing coach Jandella Faulkner helps students at Edison Elementary School in Long Beach use &quot;thinking maps&quot; to tell a story.&nbsp;</span></p> <p>LONG BEACH &ndash; Jandella Faulkner crouches beside a table of busy third-graders in Jennifer Larsen&rsquo;s class at Edison Elementary School. The students have pencils in hand, outlines spread around them, and a story about penguins and otters in progress.</p> <p>Faulkner stands to call across the room: &ldquo;Loving how this group is already talking, Ms. Larsen.&rdquo; Then she swoops down on another table of young authors.</p> <p>Faulkner is a teaching coach in the Long Beach school district. Her job is to train a select group of teachers at Edison Elementary, including Jennifer Larsen, in a new literacy curriculum called <a href="">Write From The Beginning</a>. It&rsquo;s part of a districtwide training system that relies on teachers working with each other to improve classroom practices. So, with Faulkner&rsquo;s help, Larsen and the other site coaches at Edison train their colleagues at the school how to use Write From The Beginning in their own classrooms.</p> <p>Many American school districts rely heavily on outside experts, professional conferences and traveling consultants to conduct on-the-job training (also known as professional development). New York, the nation&rsquo;s largest school district, spent about $100 million last year on professional development consultants. In most cases, there&rsquo;s little evidence to show whether the outside groups are helping schools improve, says&nbsp;Pamela Grossman, a professor at Stanford University&rsquo;s Graduate School of Education.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>&ldquo;There is a lot of money spent on professional development that does not really support teachers in learning how to improve,&rdquo; Grossman says.</p> <p>Long Beach creates its own training teams. For years, the Long Beach Unified School District has had one of the nation&rsquo;s best-regarded professional development programs for new and veteran teachers, according to Stephanie Hirsh, executive director of Learning Forward, a national nonprofit organization focused on teacher education.</p> <p>&ldquo;Our system is really invested in building internal capacity,&rdquo; says Jill Baker, the district&rsquo;s assistant superintendent for elementary and K-8 and its chief academic officer. &ldquo;What that means is teachers become leaders and trainers. We&rsquo;re not bringing someone in from the outside. We&rsquo;re teaching teachers within to go back to their school sites to train others.&rdquo;</p> <p>Professional development is seen as a critical component of many education reform initiatives. National studies show that good training programs are especially important in high-poverty districts like Long Beach, according to Learning Forward. With some 84,000 students, Long Beach is California&rsquo;s third-largest district. Most of the students are from families of color. Some 70 percent qualify for free or reduced-price lunch, an indication that families live at or below the poverty level.</p> <p>Education experts say that good, independent research on what constitutes professional development for teachers is relatively scarce. Even so, more than $1 billion is spent on teachers&rsquo; on-the-job training each year in the United States, according to an <a href="">analysis</a> of data collected by the U.S. Department of Education.</p> <p>The Long Beach district is &ldquo;ahead of the curve,&rdquo; Grossman says.</p> <p>&ldquo;Professional development that&rsquo;s embedded in teaching and embedded in practice is likely to have more impact on what teachers do,&rdquo; Grossman says. &ldquo;A model where coaches are familiar with the schools, the districts and the curriculum &ndash; and are therefore able to offer fairly tailored coaching &ndash; has a better chance of moving practice along.&rdquo;</p> <p>Long Beach administrators credit the Write From The Beginning curriculum &ndash; and the teacher training that accompanies it &ndash; with turning around dismal test scores at many of the participating schools. District figures show that schools scoring at or below 20 percent proficiency in state writing tests have boosted their numbers above 50 percent since 2007. Some once-struggling schools have posted writing test results above 80 percent.</p> <p>Long Beach administrators say there have been no independent, peer-reviewed studies of its professional development program. But the district has been a winner, and a five-time finalist, of the prestigious <a href="">Broad Prize</a>, given by the California-based Broad Foundation to recognize urban school districts that improve student academic performance and narrow achievement gaps between poor and more affluent students.</p> <p>The Broad Foundation cited the district&rsquo;s professional development program as an essential element in Long Beach&rsquo;s ability to outperform other high-poverty school districts in student achievement. (Disclaimer: The Broad Foundation is among the <a href="">funders</a> of The Hechinger Report.)</p> <p class="image-insert-right-align" style="width: 304px;"><img alt="" class="imagecache-image-insert-right-align" src="/files/imagecache/image-insert-right-align/Hechinger Long Beach students.jpg" title="Third-graders at Signal Hill Elementary School in Long Beach work on a writing assignment." /> <span class="image-insert-photo-credit">Stephen Smith/The Hechinger Report</span> <span class="image-insert-description"> Third-graders at Signal Hill Elementary School in Long Beach work on a writing assignment.&nbsp;</span></p> <p>At Signal Hill Elementary, another Long Beach school, Principal Lauren Price points out that elementary school teachers must master a range of subjects, while middle and high school teachers specialize in single subject areas. Professional development is essential to keep teachers up to speed, she says.</p> <p>&ldquo;Every year, researchers are learning more about the way kids learn and grow and develop,&rdquo; Price says. &ldquo;There are new and different ways to do things.&rdquo;</p> <p>The principal at Edison Elementary enlisted Larsen and her colleagues, Kevin Quinn and Ruby Gaytan, to be the Edison site coaches for writing. They&rsquo;re veteran teachers; all have been in the classroom 15 years or more. Each member gets 48 hours of training in the curriculum, starting with a summer workshop. Faulkner visits their classrooms about once a month. The Write From The Beginning curriculum was developed by Thinking Maps, a North Carolina education company.</p> <p>&ldquo;Writing was something that had been neglected for so many years because it was so difficult to teach,&rdquo; Larsen says. &ldquo;I saw this as something the kids really need.&rdquo; Long Beach writing teachers are being trained to use graphical organizers &ndash; the so-called &ldquo;thinking maps&rdquo; &ndash; to help students organize their thoughts, describe characters, marshal evidence, come up with key words and plot other writing elements.</p> <p>Fourth-grade teacher Ruby Gaytan points to a thinking map projected on her classroom wall with a list of qualities that describe Ivan, a character her students are writing about. He wants to sell salt but is thwarted by a greedy king. How to describe Ivan?</p> <p>&ldquo;Broke, no money!&rdquo; one student calls out.</p> <p>&ldquo;Determined!&rdquo; another declares.</p> <p>Gaytan directs her students to use their freshly minted list of adjectives in Ivan&rsquo;s story of struggle. &ldquo;If you can think it &hellip; &rdquo; Gaytan prompts.</p> <p>&ldquo;You can say it,&rdquo; the class responds in unison.</p> <p>Gaytan says the off-hours training she gets with the writing curriculum keeps her fresh in the classroom. &ldquo;The majority of teachers love to learn; that&rsquo;s why we teach. It keeps me motivated,&rdquo; she says.</p> <p>Kevin Quinn, also a fourth-grade teacher, says the training will help teachers stay &ldquo;ahead of the game,&rdquo; as Common Core State Standards are adopted by California schools in 2014. The Common Core curriculum puts a heavy emphasis on student achievement in writing.</p> <p>Larsen says the curriculum and coaching have made her both a better writer and a better writing teacher. &ldquo;I&rsquo;m more aware when I&rsquo;m reading aloud to the kids of all the great descriptions and the vivid language in every text,&rdquo; Larsen says. &ldquo;When I model writing for them, I express myself better.&rdquo;</p> <p>Coaches and teachers get paid for the time they spend on professional development, but Quinn and others describe it as &quot;minimal compensation.&rdquo; Meanwhile, budget woes and accompanying teacher layoffs of recent years mean that Larsen, Gaytan and Quinn face classrooms of 30 children every day instead of 20.</p> <p>&ldquo;Whereas the majority of our staff wants to participate in the professional development, there is a lot of burnout,&rdquo; Quinn says. &ldquo;My workload has increased, my accountability has increased, but my discretionary time has not increased. So it becomes very difficult.&rdquo;</p> <p>Lisa Worsham, head of English curriculum for K-5 schools in Long Beach, acknowledges that teachers are under stress. But she says professional development can help overcome the sense of isolation a busy teacher can feel.</p> <p>&ldquo;There are a lot of us in the building, but we show up for work, we close our door, we teach all day, we&rsquo;re exhausted, we leave the classroom and go home,&rdquo; Worsham says. Without signing up for training, &ldquo;there&rsquo;s not a lot of opportunity to sit down with five other teachers and collaborate,&rdquo; she says.</p> <p>In addition to the in-class training, local site coaches meet four times a year with Jandella Faulkner at the district&rsquo;s training center. Faulkner&rsquo;s classroom is stocked with flip charts, baskets of colorful markers and a small mountain of sticky notes &ndash; the raw materials of professional development workshops. A tall and magnetic figure, Faulkner encourages a group of nine site coaches to swap stories about what is working &ndash; and what&rsquo;s floundering &ndash; back in their respective schools.</p> <p>Faulkner holds up a training notebook. &ldquo;When do you have the time to open up this binder and say, &lsquo;What does my site need?&rsquo; This is your time to do it,&rdquo; she declares.</p> <p>Coaching one&rsquo;s colleagues can be a politically tricky enterprise. &ldquo;It&rsquo;s about having a rapport, really forming a relationship with each individual teacher,&rdquo; says Jeff Lamperts of Willard Elementary.</p> <p>Cheryl Hubert of Starr King Elementary, another site coach, says being a teacher in the local trenches gives her more credibility with her peers than an outside consultant who parachutes in. &ldquo;They know who I am,&rdquo; Hubert says. &ldquo;They feel more comfortable with me than someone from a business (where they) think, what are they selling?&rdquo;</p> <p>Faulkner says many Long Beach teachers are eager to take up the new writing techniques that she&rsquo;s helping to spread across the district &ndash;&nbsp;but not all. &ldquo;We have teachers at the end of their careers say, &lsquo;I&rsquo;m not trying anything new.&rsquo; And convincing them to try something is a huge challenge,&rdquo; Faulkner says.</p> <p>At Lindsey Middle School, the language arts staff is using a similar literacy curriculum called Write For The Future And Beyond. The local site coaches at Lindsey get released from class nine days during a year for ongoing training. The district also sends teaching coaches to the school for in-class visits once a month or more, depending on how well the writing program takes hold, according to Stacy Casanave, a middle school literacy coach.</p> <p>Lindsey teacher Shauna Hutchinson says the fat curriculum binder looked overwhelming at first. &ldquo;But once you went to training, they broke it down for you,&rdquo; she says.</p> <p>Another facet of the Long Beach professional development program is a close, long-standing relationship with the College of Education at CSU Long Beach. School personnel help with teaching and research at CSU, and CSU students do their student teaching in Long Beach schools.</p> <p>Historically, most of the district&rsquo;s beginning teachers have been CSU graduates, according to Jill Baker, the district&rsquo;s assistant superintendent. The district requires newly minted teachers to go through a prescribed on-the-job training program in their first years. But California&rsquo;s fiscal crisis and the recession have caused the Long Beach school district to slash hundreds of millions of dollars from its budget, laying off hundreds of teachers and cutting programs. Newer teachers were the first to go. Few beginners get hired.</p> <p>Long Beach spends $5.4 million a year on professional development, less than 1 percent of the district&rsquo;s $691 million budget. Professional development was cut nearly in half during and after the recession. In fiscal year 2006-07, 4,546 employees attended 11,763 training sessions. In fiscal 2011-12, 1,945 employees attended 6,982 sessions. Baker says the district has focused teacher training on areas that can have the most impact on how students learn. These include writing, mathematics and school behavior programs. There is less opportunity for individual teachers to select workshops or training programs in other areas such as creative arts and social studies.</p> <p>&ldquo;We&rsquo;ve had to take a lot of things that we liked to do in the past and really narrow it down to what your students are showing us they need,&rdquo; Baker says. &ldquo;Professional development for teachers, and for principals as well, has been at the core of the work that we&rsquo;ve done that has garnered results. It&rsquo;s part of the district culture, and it continues to work over time.&rdquo;</p> <p><em>This story was produced by <a href="" target="_blank">American RadioWorks</a> and&nbsp;<a href="" style="text-decoration: none; color: rgb(48, 140, 170); font-weight: bold; ">The Hechinger Report</a></em><em>, a nonprofit, nonpartisan education-news outlet based at Teachers College, Columbia University.</em></p> K–12 Daily Report CSU Long Beach teacher training teachers Tue, 19 Feb 2013 18:07:37 +0000 Stephen Smith 18813 at Prime hospital chain acknowledges it faces 2 federal investigations <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/lance-williams" title="View user profile." class="fn">Lance Williams</a></span> </div> </div> </div> <p class="image-insert" style="width: 304px;"><img alt="" class="imagecache-image-insert" src="/files/imagecache/image-insert/reddyl_500px.jpg" title="Prem Reddy, a cardiologist and founder of Prime Healthcare Services, was said to have called emergencies rooms &quot;a gold mine.&quot;" /> <span class="image-insert-photo-credit">Ana Venegas/The Orange County Register</span> <span class="image-insert-description">Dr. Prem Reddy, founder of Prime Healthcare Services, recently gave a presentation on Medicare billing practices to doctors at a Texas hospital that Prime&rsquo;s nonprofit foundation acquired.</span></p> <p>The Prime Healthcare Services hospital chain has acknowledged it is the target of two federal investigations: a U.S. Justice Department probe of its Medicare billings and an inquiry into alleged violations of patient confidentiality laws.</p> <p>The San Bernardino County-based company disclosed the investigations in a Jan. 2 filing with the state health department in Rhode Island, where Prime hopes to buy its 22nd hospital.</p> <p>Prime&rsquo;s filing marked the first time the company has said it is facing a federal investigation. Until now, the company has steadfastly denied being the subject of any such probes.</p> <p>Prime claims its Medicare billings are legal and proper, and the company shows little sign of backing away from the kind of aggressive billing practices that have made it the focus of official scrutiny.</p> <p>As <a href="" target="_blank">California Watch has reported</a>, Prime hospitals have billed Medicare for treating extremely high rates of some difficult medical conditions, including septicemia, or blood poisoning, and <a href="" target="_blank">kwashiorkor</a>, a form of malnutrition seen among children in African famines. The billings have made Prime eligible for millions of dollars in Medicare bonus payments, according to federal records.</p> <p>In June, the Justice Department subpoenaed documents concerning Prime&rsquo;s billings for septicemia and malnutrition, the company said in the Rhode Island filing.</p> <div id="caw-inset-1-placeholder">&nbsp;</div> <p>In a letter in response to California Watch&rsquo;s request for comment, Prime lawyer Anthony Glassman said the company had been targeted for federal investigation because of &ldquo;false allegations&rdquo; made by the Service Employees International Union, which represents many Prime workers and has butted heads with the company over labor contracts.</p> <p>He suggested the probe began because the union in 2010 distributed an analysis showing Prime&rsquo;s septicemia rates were triple the national average. Citing the analysis, two California congressmen &ndash; Rep. Henry Waxman, D-Los Angeles, and then-Rep. Fortney &ldquo;Pete&rdquo; Stark, D-Fremont &ndash; asked Medicare <a href="" target="_blank">to investigate Prime</a> for possible Medicare fraud, records show.</p> <p>California Watch previously reported that FBI agents had <a href="" target="_blank">interviewed former Prime employees</a> about Medicare billing issues.</p> <p>Prime also said it is being investigated by the U.S. Department of Health and Human Services&rsquo; Office for Civil Rights. That probe concerns Prime&rsquo;s 2011 disclosure of the medical files of a patient who was treated for complications of diabetes at a Prime hospital in Redding.</p> <p>Federal records show Prime obtained a Medicare bonus payment of more than $6,000 after reporting it had treated the patient for kwashiorkor, a form of malnutrition that usually afflicts children in sub-Saharan Africa.</p> <p>Over two years, the hospital claimed to have treated more than 1,000 Medicare patients for the ailment, records show &ndash; a rate more than 60 times the state average.</p> <p>In an <a href="" target="_blank">interview with California Watch</a>, the patient denied being malnourished and said she was never treated for kwashiorkor. In an attempt to rebut a California Watch news story about the issue, Prime officials shared the patient&rsquo;s medical files with the local newspaper and with hundreds of hospital employees, records show.</p> <p>In November, California regulators <a href="" target="_blank">fined Prime $95,000</a> for violating state confidentiality laws in the case. Disclosing a patient&rsquo;s medical records without consent also violates federal law. The chain denies wrongdoing and is confident it will win on appeal, wrote Glassman, Prime&rsquo;s lawyer. He also contended that the SEIU had urged the patient to complain about her diagnosis.</p> <p>As late as last March, Prime said it was unaware of any federal probes. In 2011, it threatened to sue California Watch for defamation for reporting that the company&nbsp;was facing a federal probe.&nbsp;Prime threatened to sue because the company did not yet know it was &ldquo;being unfairly targeted by government agencies,&rdquo; Glassman wrote.</p> <p>Prime&rsquo;s disclosure about the investigation was attached to its application to buy Landmark Medical Center, a 214-bed hospital in the Rhode Island town of Woonsocket. The filing was marked confidential, but it can be downloaded from the health department&rsquo;s <a href="" target="_blank">website</a>.</p> <p>Soon after Prime made the filing in Rhode Island, the company&rsquo;s founder gave a presentation to doctors at a south Texas hospital that Prime&rsquo;s nonprofit foundation recently acquired. A person who was present <a href="" target="_blank">made a one-hour recording</a> of the session and shared it with California Watch.</p> <p>According to the recording, Dr. Prem Reddy, Prime&rsquo;s CEO and the foundation&rsquo;s president, told the doctors how to boost the hospital&rsquo;s Medicare payouts by employing some of the same billing strategies now being investigated.</p> <p>In the meeting at Knapp Medical Center in Weslaco, Texas, Reddy encouraged the doctors to augment their patients&rsquo; charts with multiple secondary diagnoses that would qualify for Medicare treatment bonus payments.</p> <p>Reddy also urged the doctors to find reasons to admit Medicare patients to the hospital rather than treating them as outpatients, saying the Medicare payouts would triple.</p> <p>Reddy told the Texas doctors that Medicare&rsquo;s billing rules were a game &ldquo;devised by bureaucrats.&rdquo; Physicians need to &ldquo;understand the rules of the game and improve our scores,&rdquo; he said.</p> <p>Also in the session, Reddy said Medicare had never successfully challenged a Prime billing, saying the company appeals whenever a billing is rejected.</p> <p>&ldquo;We never lose a case yet,&rdquo; Reddy said. &ldquo;We fight on every case and we win.&rdquo;</p> <p>In his letter, Glassman wrote that Reddy&rsquo;s presentation &ldquo;focused on complex clinical information,&rdquo; including &ldquo;evolving Medicare reimbursement models for physicians and hospitals.&rdquo;</p> <p>&ldquo;Dr. Reddy was not instructing his doctors on methods for cheating Medicare,&rdquo; the lawyer wrote.</p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/dailyreport/former-patient-claims-confidentiality-breach-prime-healthcare-lawsuit-18788">Former patient claims confidentiality breach in Prime Healthcare lawsuit</a> </div> <div class="field-item even"> <a href="/dailyreport/prime-hospital-abruptly-stops-billing-medicare-rare-ailment-18751">Prime hospital abruptly stops billing Medicare for rare ailment</a> </div> </div> </div> Health and Welfare Daily Report kwashiorkor medicare patient confidentiality Prime Healthcare Services Decoding Prime Wed, 06 Feb 2013 08:05:03 +0000 Lance Williams 18801 at Excerpts from Reddy’s presentation to Texas doctors <div class="field field-type-userreference field-field-authors"> <div class="field-items"> <div class="field-item odd"> <span class="author vcard"><a href="/user/lance-williams" title="View user profile." class="fn">Lance Williams</a></span> </div> </div> </div> <p>On Jan. 2, Knapp Medical Center in Weslaco, Texas, was bought by a nonprofit foundation associated with Prime Healthcare Services, a fast-growing California-based hospital chain that is under federal investigation for aggressive Medicare billings.</p> <p>Soon after, Dr. Prem Reddy, Prime&rsquo;s founder and CEO and the foundation&rsquo;s president, instructed Knapp&rsquo;s doctors on how to boost their Medicare payouts using the same controversial strategies that have made his company the target of federal scrutiny.</p> <p>According to an hour-long recording of his presentation, Reddy encouraged the doctors to augment their patients&rsquo; charts with multiple secondary diagnoses for what he called &ldquo;comorbid conditions.&rdquo; Medicare pays hefty treatment bonuses worth thousands of dollars per case for treating patients who suffer from specified &ldquo;major complications and comorbidities,&rdquo; federal records show.</p> <p>Reddy also urged the doctors to find reasons to admit Medicare patients to the hospital rather than treating them as outpatients, saying the Medicare payouts would triple.</p> <p>More than two years ago, two California congressmen <strong><a href="">asked Medicare to investigate</a>&nbsp;</strong>Prime, saying they suspected the chain was committing a form of Medicare fraud called &ldquo;upcoding,&rdquo; or exaggerated diagnoses. Millions may have been lost, the lawmakers wrote in a letter. On Jan. 2, Prime disclosed to health care regulators in Rhode Island that it is facing a U.S. Justice Department probe over its billing practices.</p> <p>But Reddy denied improprieties in connection with the Medicare billings that have attracted investigators&rsquo; attention &ndash; rates for a form of blood poisoning called septicemia that were triple the national average and for a rare form of malnutrition called kwashiorkor that were <strong><a href="">nearly 70 times</a>&nbsp;</strong>California&rsquo;s state average.</p> <p>Reddy, an Indian-born physician who has become a multimillionaire health care entrepreneur, told the Texas doctors that Medicare&rsquo;s billing rules were a game &ldquo;devised by bureaucrats.&rdquo; Physicians need to &ldquo;understand the rules of the game and improve our scores,&rdquo; he said.</p> <p>In a letter in response to a request for comment, Prime lawyer Anthony Glassman said Reddy&rsquo;s presentation &ldquo;focused on complex clinical information,&rdquo; including &ldquo;evolving Medicare reimbursement models for physicians and hospitals.&rdquo;</p> <p>&ldquo;Dr. Reddy was not instructing his doctors on methods for cheating Medicare,&rdquo; the lawyer wrote.</p> <p>Here are excerpts, including some audio clips, of Reddy&#39;s remarks.</p> <p><strong>&lsquo;Scratching the surface&rsquo;</strong></p> <p><em>Early on, Reddy encouraged the physicians to diagnose their patients with complications called &ldquo;comorbid conditions&rdquo; that qualify for thousands of dollars of Medicare bonus payments. He urged them to avoid secondary diagnoses that don&rsquo;t qualify for the payout.</em></p> <div style="float:left; width:50%; margin: 0 10px 10px 0;"><iframe frameborder="no" height="166" scrolling="no" src=";color=f88d00&amp;auto_play=false&amp;show_artwork=true" width="100%"></iframe></div> <p>&ldquo;I am just only scratching the surface of giving you how what you write in the charts is going to make a lot more difference going forward, both for doctors and for the hospital. &hellip;</p> <p>&ldquo;For example, I am a cardiologist, So I can tell (you) atrial fibrillation (an irregular heartbeat) should be a comorbid condition, but they (Medicare) removed it a few years ago, three years ago.</p> <p>&ldquo;But atrial flutter (an abnormal heart rhythm) is still a comorbid condition. ...</p> <p>&ldquo;So now knowing the rules of the game of atrial fibrillation, you now know how to document it.</p> <p>&ldquo;For surgeons, for example, each time you write &ldquo;post op&rdquo; (short for &ldquo;post-operative,&rdquo; a term that means following an operation), it&rsquo;s a complication (for Medicare billing purposes).</p> <p>&ldquo;Let&rsquo;s say you wrote &lsquo;post op. fever.&rsquo; It&rsquo;s a complication. If you wrote &lsquo;fever,&rsquo; it&rsquo;s not a complication. Now, (if) you wrote &lsquo;post op. bleeding,&rsquo; it&rsquo;s a complication &ndash; the word for that is &lsquo;post hemorrhagic anemia. &hellip;&rsquo;</p> <p>&ldquo;It&rsquo;s the same thing, but how do you document is important.</p> <p>&ldquo;Anything &lsquo;post op.,&rsquo; &lsquo;post op. ileus&rsquo; (bowel obstruction) is a complication, but if you write the ileus, it&rsquo;s not a complication. So remember some of these things. &hellip;</p> <p>&ldquo;Because that&rsquo;s really important for you to understand. Because your future &ndash; and not monetarily, monetarily is only a small part &ndash; but quality-wise, your perception, your reputation in the community is dependent on it.&rdquo;</p> <p><strong>&lsquo;The negative side&rsquo;</strong></p> <p><em>Reddy blamed the Service Employees International Union, which represents many Prime workers and has butted heads with Prime over labor contracts, for persuading California Attorney General Kamala Harris </em><strong><em><a href="">to block Prime&rsquo;s purchase</a>&nbsp;</em></strong><em>of Victor Valley Community Hospital in San Bernardino County.</em></p> <p>&ldquo;Some circumstances which I am going to tell on the negative side of Prime Healthcare Systems. I tried to buy a not-for-profit hospital in California, but the attorney general did not give her consent.</p> <p>&ldquo;It&rsquo;s a lady.</p> <p>&ldquo;Because we are in a big legal fight with the union called SEIU. Thank God you don&rsquo;t have to deal with unions! SEIU is a very big union and how they do recruitment of the employees is not by going to the employees.</p> <p>&ldquo;They intimidate owners, whether it&rsquo;s a hospital system or a system of nursing homes, so they do what is called a corporate campaign.</p> <p>&ldquo;In the corporate campaign, they pull out some of the (company&rsquo;s health care) data and twist it and create a big sensation and have their political friends write to all kinds of agencies trying to bring focus so that the employer, the owner, gets intimidated and says, &lsquo;OK, I&rsquo;ll sign with you.&rsquo; &hellip; So you&rsquo;re giving up all your hospitals to the union.&rdquo;</p> <p><strong>Addressing septicemia rates</strong></p> <p><em>Reddy claimed his hospital chain&rsquo;s high septicemia rates &ndash; triple the national average, according to an SEIU computer study &ndash; were legitimate. Two Democratic California congressmen, Rep. Henry Waxman of Los Angeles and former Rep. Fortney Stark of Fremont, had cited the septicemia rates in </em><strong><em><a href="">advocating for a probe</a>&nbsp;</em></strong><em>of Prime.</em></p> <p>&ldquo;True, we have high incidence of septicemia because we diagnose septicemia. &hellip;</p> <p>&ldquo;Septicemia has seven criteria, but if you diagnose them early and treat them aggressively early on, you save lives.</p> <p>&ldquo;So for example, when we took over a hospital, a large inner city hospital in Los Angeles (an apparent reference to Centinela Hospital Medical Center in Inglewood), the mortality rate was something like 2 percent, which was not high but high enough.</p> <p>&ldquo;And after we&rsquo;re done three years later &hellip; the mortality rate for septicemia is minus 28 percent.</p> <p>&ldquo;That means you could kill 28 more patients, and you would be normal.</p> <p>&ldquo;I&rsquo;m not saying that &ndash; I&rsquo;m just trying to make fun of that.</p> <p>&ldquo;So you could bring it (septicemia) down substantially by properly diagnosing and treating early.</p> <p>&ldquo;So, however, the union story says either the hospitals are inundated with bugs that are resistant to antibiotics &hellip;</p> <p>&ldquo;Or they will say we are committing Medicare fraud by diagnosing septicemia where there is no septicemia, so naturally, we get investigated by hundreds of agencies.&rdquo;</p> <p><strong>&lsquo;Bad rumors&rsquo;</strong></p> <p><em>California Watch reported that a Prime hospital in Redding had billed Medicare for treating extremely high rates of a form of malnutrition called kwashiorkor, which is usually seen in developing nations. The hospital ceased the practice after the </em><strong><em><a href="">story</a>&nbsp;</em></strong><em>was published in 2011. Reddy said the diagnosis was required by Medicare billing software.</em></p> <p>&ldquo;So, similarly, they publish about having unusual nutrition condition called Kwashiorkor.</p> <p>&ldquo;None of our doctors really wrote Kwashiorkor in the charts. &hellip; The doctors would write protein deficiency, but protein deficiency will be coded if you go thru 3M (billing software) as Kwashiorkor.</p> <p>&ldquo;So it&rsquo;s medically allowed &hellip; so we never (have) been sanctioned, we never had any negative from the agencies. But there&rsquo;s a publication out there, we diagnose with Kwashiorkor &hellip;</p> <p>&ldquo;But that was done in only one hospital. So those are the bad rumors that were circulating.&rdquo;</p> <p><strong>&lsquo;We fight every case&rsquo;</strong></p> <p><em>Reddy said that when Medicare&rsquo;s Recovery Audit Contractor Program, an entity that provides financial oversight, objects to a Medicare billing, Prime appeals &ndash; and always wins.</em></p> <div style="float:right; width:50%; margin: 0 0 10px 10px;"><iframe frameborder="no" height="166" scrolling="no" src=";color=f88d00&amp;auto_play=false&amp;show_artwork=true" width="100%"></iframe></div> <p>&ldquo;As chairman and CEO, I will tell you that so far, we have not paid a single penny and as a matter of fact, on our RAC (Recovery Audit Contractor) audits, we never lose a case yet. We fight on every case and we win. It&rsquo;s all in your documentation. &hellip;</p> <p>&ldquo;What happens is, RAC denies (a billing) &hellip; and then you appeal it to Medicare intermediary (also called the &ldquo;fiscal intermediary,&rdquo; another part of Medicare&rsquo;s oversight system) and they deny it too &hellip; and then you appeal.</p> <p>&ldquo;The second appeal goes to an administrative law judge, a lay person.</p> <p>&ldquo;For the lay person, all you have to say is, &lsquo;The physician who (has) actually seen and examined the patient has documented (the) patient needed hospitalization because of these comorbid conditions.&rsquo; &hellip;</p> <p>&ldquo;So you have &lsquo;hypertensive heart disease.&rsquo; Or &lsquo;diabetes uncontrolled,&rsquo; or &lsquo;diabetic &ndash; other conditions&rsquo; &ndash; neuropathy (nerve damage), vasculopathy (disorder of the blood vessels), nephropathy (kidney disease).</p> <p>&ldquo;Elderly patients have all these, you know, comorbid conditions.</p> <p>&ldquo;You know, sometimes I am reading many of these reports from the administrative law judges. Whatever they think (of a) condition, they think it&rsquo;s a serious condition. &hellip;</p> <p>&ldquo;That means, the more the better.</p> <p>&ldquo;And they&rsquo;ll say, &lsquo;This patient has too many conditions to do it as an outpatient. He should be admitted.&rsquo;</p> <p>&ldquo;So every judgment to date has been in our favor.</p> <p>&ldquo;And in your hospital, whatever has been refused you have not appealed and are letting it go, and you are probably losing, I don&rsquo;t know, $600,000 to $1 million per year, which we&rsquo;re going to appeal on your behalf.&rdquo;</p> <p><strong>&lsquo;More inpatients&rsquo;</strong></p> <p><em>Reddy urged the doctors to find ways to admit more Medicare patients to the hospital. Outpatient care doesn&rsquo;t pay, he said</em>.</p> <div style="float:left; width:50%; margin: 0 10px 10px 0;"><iframe frameborder="no" height="166" scrolling="no" src=";color=f88d00&amp;auto_play=false&amp;show_artwork=true" width="100%"></iframe></div> <p>&ldquo;Outpatient reimbursement for Medicare and Medicaid is small, negligible compared to inpatient. For example, that&rsquo;s not the reason to admit a patient, but it is a knowledge tool you have to assess.</p> <p>&ldquo;For example, in your hospital, if you are treating a patient (as an) outpatient, for Medicare, reimbursement is about 10 percent of your billing charges. Whereas, if it is inpatient, it is 30 percent. So just remember it is three times different.</p> <p>&ldquo;If it is Medicaid, it is even worse &ndash; your hospital&rsquo;s Medicaid reimbursement outpatient is 6 percent, whereas inpatient is 25 percent. I am giving you just rough numbers.</p> <p>&ldquo;Let me give you a practical example. A 75-year-old patient came to the ER (emergency room), came in with chest pain and has multiple comorbid conditions.</p> <p>&ldquo;If we admit this patient for observation, you are performing an EKG (electrocardiogram test) and discharging the patient and lab tests, EKG stay overnight &ndash; you could do for every case like that, pretty much. What would you think the Medicare reimbursement would be for that stay, approximately? Anybody?</p> <p>&ldquo;$300 to $500 ...</p> <p>&ldquo;Medicare doesn&rsquo;t reimburse for the stay, zero, so (Medicare) he pays you for EKG, $10- $15, so three EKGs, three (times) $15, and then a lab maybe $30, OK, an X-ray, chest, keep adding small numbers, it never comes to more than $400-$500.</p> <p>&ldquo;Whereas inpatient, the same patient, same treatment, you could justify because of comorbid conditions &ndash; the reimbursement would be &ndash; anybody know? $3,500 &hellip;</p> <p>&ldquo;So there is unfair pricing for inpatient versus outpatient, so either Medicare has to change it and improve it or we have to learn how to cope with that kind of disparity.&rdquo;</p> <p><strong>&lsquo;Not profitable</strong><em>&rsquo;</em></p> <p><em>Knapp Medical Center is a charity hospital, and it was acquired by the nonprofit Prime Healthcare Services Foundation. Reddy, president of the foundation, said the hospital&rsquo;s bottom line was a concern.</em></p> <p>&ldquo;I am only here trying to keep this hospital going. When they were trying to sell this hospital, the board &ndash; I don&rsquo;t know if they know all of the factors &ndash; they were saying, &lsquo;This is a very profitable hospital.&rsquo;</p> <p>&ldquo;And I believe, &lsquo;Oh, it is a profitable hospital.&rsquo;</p> <p>&ldquo;But really, when you look at the numbers, you do lose about a few million dollars a year. So it&rsquo;s definitely not a profitable hospital.&rdquo;</p> <div class="field field-type-nodereference field-field-explore"> <div class="field-items"> <div class="field-item odd"> <a href="/dailyreport/prime-hospital-chain-acknowledges-it-faces-2-federal-investigations-18801">Prime hospital chain acknowledges it faces 2 federal investigations</a> </div> </div> </div> Health and Welfare Daily Report Dr. Prem Reddy medicare Prime Healthcare Services Decoding Prime Wed, 06 Feb 2013 08:05:03 +0000 Lance Williams 18802 at