California Watch - Health and Welfare http://californiawatch.org/topic/health-and-welfare en Hospital chain to pay $275,000 to settle federal patient-privacy case http://californiawatch.org/health-and-welfare/hospital-chain-pay-275000-settle-federal-patient-privacy-case-18868 <fieldset class="fieldgroup group-credits"><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> </fieldset> Health and Welfare Prime Healthcare Decoding Prime Wed, 12 Jun 2013 18:05:57 +0000 Lance Williams 18868 at http://californiawatch.org To mark 1906 quake, resources to teach kids about disaster safety http://californiawatch.org/dailyreport/mark-1906-quake-resources-teach-kids-about-disaster-safety-18863 <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="http://www.redcross.org/news/event/Make-Your-Game-Plan-Prep-Rally-in-San-Francisco" 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="http://www.flickr.com/apps/slideshow/show.swf?v=124984" /><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="http://www.flickr.com/apps/slideshow/show.swf?v=124984" type="application/x-shockwave-flash" width="400"></embed></object></p> <p><em><a href="http://californiawatch.org/node/9606" 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="http://californiawatch.org/k-12/coloring-book-helps-kids-prepare-earthquake-9660" 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="http://www.youtube.com/embed/3k2Pz7clV5E" width="600"></iframe> <p>Spanish version:<iframe allowfullscreen="" frameborder="0" height="360" src="http://www.youtube.com/embed/yCM-4FDlPns" width="600"></iframe><a href="http://californiawatch.org/kids/video" 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="http://californiawatch.org" target="_blank">California Watch</a>, which CIR founded in 2009, <a href="http://californiawatch.org/earthquakes" target="_blank">conducted an investigation</a> that revealed state regulators failed to enforce earthquake safety laws in public schools. <a href="http://seismic.apps.cironline.org/" 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="http://myfaultapp.com/" 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="http://californiawatch.org/earthquakes" 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 http://californiawatch.org Lawmakers mull next steps for developmental centers http://californiawatch.org/dailyreport/lawmakers-mull-next-steps-developmental-centers-18858 <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="http://www.lao.ca.gov/analysis/2013/ss/hhs/health-human-services-022713.aspx#Department_of_Developmental_Services" 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="https://www.documentcloud.org/documents/256286-justicedept-lanterman-findings.html#document/p11/a35580" 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 http://californiawatch.org Independent oversight proposed for developmental centers http://californiawatch.org/dailyreport/independent-oversight-proposed-developmental-centers-18856 <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 http://californiawatch.org Doctors claim Prime hospital kept them from patients http://californiawatch.org/dailyreport/doctors-claim-prime-hospital-kept-them-patients-18850 <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="https://www.documentcloud.org/documents/628144-prime-case-ex-parte-app-for-tro-03-27-13.html" 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="https://www.documentcloud.org/documents/628145-prime-complaint-03-26-13.html" 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="https://www.documentcloud.org/documents/628401-cvmc-lawsuit-response.html" 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="https://www.documentcloud.org/documents/102262-kaiser-cross.html" 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="http://californiawatch.org/prime" 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="http://californiawatch.org/health-and-welfare/chain-profits-admitting-er-patients-11561" 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="http://californiawatch.org/dailyreport/prime-hospital-chain-acknowledges-it-faces-2-federal-investigations-18801" 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="http://californiawatch.org/health-and-welfare/their-own-words-making-emergency-care-profitable-10738" 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="http://californiawatch.org/dailyreport/lawmakers-alarmed-hospital-chains-practices-15010" 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 http://californiawatch.org Cambodian youth confront ‘historical forgetting’ http://californiawatch.org/dailyreport/cambodian-youth-confront-historical-forgetting-18848 <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 http://californiawatch.org Unincorporated neighborhood finally getting sewer service http://californiawatch.org/dailyreport/unincorporated-neighborhood-finally-getting-sewer-service-18849 <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="http://californiawatch.org/health-and-welfare/neglected-decades-unincorporated-communities-lack-basic-public-services-15635" 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="http://californiawatch.org/data/map-learn-more-about-4-unincorporated-communities" 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="http://californiawatch.org/dailyreport/explainer-end-redevelopment-agencies-14624" 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 http://californiawatch.org Join our discussion on Pomona's developmental center http://californiawatch.org/dailyreport/join-our-discussion-pomonas-developmental-center-18845 <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="http://californiawatch.org/broken-shield">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="http://www.cironline.org" 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="http://lantermandc.eventbrite.com/" target="_blank">http://lantermandc.eventbrite.com</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 http://californiawatch.org For East African women, moving from Cheetos to mushmush http://californiawatch.org/dailyreport/east-african-women-moving-cheetos-mushmush-18844 <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 http://californiawatch.org Who Owns the Fish? http://californiawatch.org/health-and-welfare/who-owns-fish-18832 <fieldset class="fieldgroup group-credits"><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/ariane-wu" title="View user profile." class="fn">Ariane Wu</a></span>, <span class="author vcard"><a href="/user/arthur-jones" title="View user profile." class="fn">Arthur Jones</a></span> and <span class="author vcard"><a href="/user/susanne-rust" title="View user profile." class="fn">Susanne Rust</a></span> </div> </div> </div> </fieldset> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>Any commercial fisherman used to be able to fish in U.S. seas. Not anymore. Today, the right to fish belongs to a number of private individuals who have traded, bought and sold these rights in unregulated markets. This system, called &quot;catch shares,&quot; favors large fishing fleets and has cut out thousands of smaller-scale fishermen. How did this happen?</p> </div> </div> </div> Health and Welfare Environment catch shares fish fisheries Tue, 12 Mar 2013 07:00:00 +0000 Ariane Wu Arthur Jones Susanne Rust 18832 at http://californiawatch.org