Daily Report: Health and Welfare

U.S. Census Bureau

California lawmakers are moving to crack down on taxpayer-funded health care districts that have banked tens of millions of dollars at the expense of funding community-health projects.

A bill moving through the Legislature targets the spending habits of these little-known governmental agencies that were created to run hospitals, which many of them no longer do. These districts are run by publicly elected boards that have power over multimillion-dollar budgets.

New legislation in Sacramento would require the districts to spend at least 95 percent of their annual tax revenue on community programs and services. Districts would have to report their spending annually to local officials, including their county boards of supervisors.

Some of these districts have banked tens of millions of dollars and diverted resources to administrative and overhead costs.

“We really felt that there were three things that we wanted to see from these districts: transparency, accountability and responsibility,” said Assemblyman Rich Gordon, D-Menlo Park who co-authored the legislation, AB 2418, with Assemblyman Roger Dickinson, D-Sacramento...

YouraPechkin/istockphoto.com

Roughly three million poor and disabled Californians had their coverage for dental services cut three years ago, and community dental clinics have struggled to cover preventative services ever since.

“It was not something we wanted to do,” says Robert Isman, a consultant with the Dental Program for California Department of Health Services. “We knew that there would be repercussions and there have been.

Dental services aren’t mandated under the federal Medicaid program and California, with a program called Denti-Cal, was once one of the few states to cover non-emergency services for adults. But with the state budget crisis, legislators cut the non-mandatory services.

Community clinics are quick to offer painful examples of clients who need help with their teeth since their benefits were slashed.

For instance, an elderly patient at Asian Health Services in Oakland’s Chinatown had all his teeth pulled so he could get dentures. Then the Denti-Cal cuts went into effect, and dentures were no longer covered. He was left with no replacement teeth.

His daughter called Huong Le, AHS’s Dental Director to ask for help. “He was losing weight. He couldn’t eat because he didn’t have his teeth – the physicians were really concerned about his health condition,” Le said...

Bernice Yeung/California Watch A former pool hall stands abandoned in South Dos Palos. 

Once a thriving rural community with a nearly equal number of bars and churches, South Dos Palos, an unincorporated area in Merced County, has been in decline for decades.

But it’s still possible to make out the contours of the community from a time when it was a growing place. On the edge of town, which borders the city of Dos Palos, there’s an abandoned reddish-trimmed building that used to be a popular pool hall.

The railroad station a few blocks away is now dark and defunct, and it's not far from the skeleton of the produce packing shed where workers used to give melons to local kids. The textile mill is now an empty edifice, a disintegrating monument to a more prosperous past.

Technological advances in farming and manufacturing, coupled with the economic downturn, have created fewer jobs in the area, said Jerry O’Banion, the county supervisor who represents South Dos Palos. “Basically, it’s gone the way of rural America,” he said. “Having the community out in a farming area is not a viable structure as far as being able to survive.”

Despite ongoing efforts to revitalize South Dos Palos, as a poor and unincorporated community, development has been hampered by a...

|Mahin|/Flickr

Tobacco marketing is targeting California's low-income and African American youth, according to researchers who examined advertising throughout the state.

Academic researchers funded by the state’s Tobacco-Related Disease Research Program found that there was greater visibility of menthol cigarette advertising at retailers near high schools where there are larger African American student populations.

According to the most recent statistics issued by the Federal Trade Commission, the tobacco industry spent $10 billion on marketing in 2008.

“There is a systematic targeting (of disadvantaged communities) by the tobacco industry, which is an extraordinary public health problem,” said Lisa Henriksen of the Stanford Prevention Research Center, who presented the research at a legislative briefing in Sacramento last week. “The addition of menthol to cigarettes makes it easier to smoke and more difficult to quit.”...

Flickr/PinkMoose

“I don’t know how any senior can handle all of this stuff,” sighs Mary Anne Humphrey, 68, who suffers from limited mobility due to a spinal cord injury.

Humphrey is explaining the endless paperwork, social services, doctor appointments, benefit plans and medications she juggles as a disabled senior.

Fortunately, Humphrey is one of 1,200 San Francisco County residents who have received help over the past five years from a unique Bay Area program that keeps older adults and the disabled living independently: the Community Living Fund.

“They just must be overloaded with the paperwork and ins and outs and ‘sign this’ and ‘do that,’ ” she says. “CLF helps with that, with a real comfort. It takes away a lot of stress.”

Spawned in 2007 by the county, the fund is a collaboration with the city of San Francisco and the local Institute on Aging with a single focus: help San Franciscans survive independently outside the four walls of institutional living.

Besides coordinating complex medical care and social services, more specific assistance by case managers includes arranging transportation to doctors, preparing meals, paying bills, installing ramps, buying electric wheelchairs or any other help needed to keep clients...

Courtesy of Bob WeisenbachPotawot Health Village in Arcata

To walk into the central gathering space of the Potawot Health Village in Arcata, a multi-tribal health clinic, is to be made instantly aware of the concept of traditional native food as medicine. “Got Acorns?” reads a poster. “Got salmon?” “Got seaweed?”  

Built, administered and owned by American Indians, Potawot is at the front line of a national resurgence among native peoples to address the link between the loss of ancestral native foods and disproportionate rates of diabetes and other chronic diseases.

California is home to more American Indians and Alaska Natives than any other state, with 107 federally recognized tribes, making diabetes a major community health issue. The statistics are sobering: According to the Centers for Disease Control and Prevention, from 1994 to 2004, there was a 68 percent increase in diabetes among native youth ages 15 to 19 across the country and a doubling of the diabetes rate among those 35 and younger...

Katharine Mieszkowski/The Bay Citizen Lisa Santora, chief medical officer of the Beach Cities Health District, and Lawrence Cappel, board treasurer of the Peninsula Health Care District, testify at an Assembly committee hearing on hospital districts.

Taxpayer-funded health care districts should reduce their administrative costs, spend more on public health programs and stop stockpiling money for dubious projects, critics told a state legislative oversight committee today.

Public health officials and taxpayer groups urged lawmakers to demand more accountability from the roughly 30 health care districts in California that no longer run hospitals, in a departure from their original mission.

“What government function is performed by health care districts that do not run hospitals in this day and age?” said Jean Fraser, San Mateo County's health system chief. “Most people don’t even know the districts exist.”

Health care districts were created after World War II, when the state allowed communities to levy taxes to build hospitals in rural and low-income areas. Critics said those districts are part of a sprawling, anachronistic bureaucracy that has long outlived its purpose...

BrianAJackson/istockphoto.com

A Long Beach-based health plan seeking new contracts to serve 54,000 Southern California low-income seniors has set aside $125 million to resolve claims by state and federal authorities that it overbilled Medi-Cal and Medicare.

In applications submitted in February to California’s Medi-Cal agency, the SCAN Health Plan detailed the course of civil and criminal investigations by the California attorney general’s office, saying they could lead to “substantial financial payments.” Federal authorities from the Health and Human Services and Justice departments also are investigating, the reports say.

Investigators are examining whether SCAN drew funds from both health care programs to care for the same pool of patients and intentionally hid the matter from overseers. At worst, the cases could conclude with the company banned from serving Medi-Cal or Medicare patients, the document says...

Monkey Business Images/Shutterstock

At the Blue Oak School in Chico, where 60 percent of the charter school's student body comes from low-income households, it’s a source of school pride that the soft tacos and chicken pot pies served at lunch are made from organic and locally sourced ingredients. 

The meals are delivered every day, ready to eat, in reusable bento boxes that generate minimal trash. Depending on the child’s family income, the lunches cost anywhere from nothing to $3.

“The kids are getting the nutrition they need, they like the food, and it has made the school a better place,” said Marc Kessler, Charter Council chairman of the nonprofit elementary and junior high school.

But not all California charter school students are on the receiving end of a warm meal at lunchtime.

Charter schools are exempt from many requirements of the state Education Code, including the state law that says public schools “need to provide each needy...