HealthyCal.org

By Daniel Weintraub

Children with special needs are far more likely than others to be the victims of bullies, according to a new report from AbilityPath.org, an online community for parents of children with disabilities and the professionals who help them.

The group is using the report’s release today to launch a nationwide campaign to educate parents, educators and others about a problem that is widespread but not often discussed.

Actress Lauren Potter, a 20-year-old woman with Down Syndrome and a member of the cast of “Glee,” will a spokeswoman for the campaign and appear in an online public service announcement.

“Bullying is every parent’s fear,” Sheryl Young, CEO of Community Gatepath, the nonprofit organization which created AbilityPath.org, said in a statement released with the report. “For parents of children with special needs that fear is exacerbated. This report and guide were developed to include children with special needs in the national dialogue and to raise the level of awareness about bullying, cyberbullying and the devastating developmental effects it can have upon children with special needs.”

The report is filled with stories from children and the parents of children who have been bullied. It also reviews several studies that have documented the increased incidence of bullying involving children with special needs.
These children, the authors said, are often isolated, ridiculed, verbally abused, and cyber bullied. Some have been tied to flag poles, other report being tripped, kicked, and forced to consume alcohol or even dog food.

To see the full report, go to www.abilitypath.org

By Daniel Weintraub

Californians who are well off, highly educated, white and insured generally feel good about their health, but others are more likely to say their health is not good, according to a new independent poll released this week.

The survey by the Public Policy Institute of California found that about 8 in 10 state residents describe their health as excellent or good. But those numbers belie a deep disparity within demographic groups.

About 70 percent of Calfornians who earn $70,000 or more per year say their health is very good or excellent. But only 48 percent of middle income residents and 31 percent of low-income people, earning less than $40,000 a year, describe their health as very good or excellent.

The same gap can be seen among people with different levels of education. Among college graduates, 67 percent say their health is very good or excellent. For those who have completed some college, the number drops to 56 percent. And only 28 percent of those with a high school education or less are very satisfied with their health.

Whites, meanwhile, are the only ethnic group in which a majority (58 percent) say their health is excellent or good. Among Asians, it’s 45 percent. For blacks, it is 38 percent. And just 31 percent of California Latinos rate their health as very good or excellent.

Finally, about half (51 percent) of people with health insurance say their health is very good or excellent, compared to 31 percent for those without coverage.

Research increasingly links health and place — where you live correlates with how healthy you are and how long you will live — and about half of California residents see that connection as a positive influence on their own health. About 30 percent see a somewhat positive effect, and 19 percent say their community has a very positive effect on their health. Ten percent see a negative effect, and 4 percent said their community had a very negative effect on their health.

Most Californians recognize that their health is tied to more than doctors, hospitals and health insurance coverage. They say that jobs, schooling, and safe places to walk, bike and get exercise play a major role. They also cite safety from violent street crime, and access to healthy food choices as important factors in their health.

As for the health care system itself, 60 percent say they would like to see more emphasis on prevention. Twenty one percent want more emphasis on treatment.

The survey of more than 2,500 California adults has a margin of error of 2.9 percent in either direction. The poll was financed by The California Endowment. The Endowment is also the initial funder of www.healthycal.org.

To see the entire survey, click here.

By Daniel Weintraub

A second federal judge has ruled that the federal health reform law passed last year violates the US Constitution, matching the two judges who have affirmed the law’s legality. The dueling opinions all but ensure that the matter will be decided in the Supreme Court.

Federal District Judge Roger Vinson in Florida ruled that the law’s provision requiring most Americans to buy insurance coverage violates the Commerce clause of the Constitution because it would regulate not what people buy but what they decide not to buy. If Congress can require Americans to buy a product when they prefer not to, Vinson wrote, than the federal government’s powers would be essentially unlimited.

Vinson allowed the law to remain in effect while the appeals to his ruling are heard, but he also wrote that if his opinion stands, the entire law, not just the mandate to buy insurance, would be struck down. Without the mandate, he said, the rest of the law would not work.

The case was brought by the attorneys general of 26 states, not including California, which has been a leader in implementing the law’s earliest provisions. The mandate to purchase insurance that was at issue in the Florida case would not take effect until 2014.

California consumer advocates reacted harshly to the ruling.

“Judge Vinson has produced a stunningly ideological and extreme opinion, legislating from the bench to reopen the health care debate by going well beyond precedent,” said Anthony Wright, director of Health Access California. “Fortunately, the judge’s partisan findings are of limited impact because the U.S. Supreme Court will have the final say on the legal challenge to the Affordable Care Act.”

Michael Russo, a health care advocate for CALPIRG, called the ruling just “one step” in a long legal process.

“Consumers and small businesses would face significantly higher insurance premiums, if higher courts ultimately uphold Judge’s Vinson ruling to reverse last year’s federal health care law,” he said. He said his group’s research suggests that consumers who buy their own coverage would face premiums up to 20 percent higher per-employee cost of providing employer-sponsored insurance would be $3,000 a year higher by the end of the decade.

Many parts of the law are already in effect.

One provision allows parents to keep their children on their family policy until age 26. Another sets new standards for when insurance companies can rescind coverage. Carriers must now sell families insurance for their children without regard to pre-existing conditions, and adults who can’t find coverage because of their medical histories have new options through a state-run high-risk pool. Small businesses that cover their workers are eligible for new tax credits, and seniors have more help paying for prescription drugs.

California was the first state in the nation to create a new Health Insurance Exchange, which beginning in 2014 will offer a regulated clearing house for health plans for individuals and small businesses that don’t buy their coverage through a large group plan.

“What’s important for patients to know is that the consumer protections under the new federal law are still in place, and are likely to stay,” Wright said. “The implementation of the new federal law will and should continue, especially in California, where we need all the help with our health system we can get.”

The latest study on hospital breastfeeding rates is out, and advocates say California still has a long way to go toward ensuring that every new mom who wants to breastfeed is given the support she needs to make that happen.

According to the WIC Association — a network of nutrition programs for mothers and infants — and the UC Davis Human Lactation Center, breastfeeding is a “crucial first step” in protecting the health of mothers and infants.

Hospitals that have followed baby-friendly practices, including offering formula supplements only as directed by a physician, have the highest rates of breastfeeding. Those hospitals that do not have these policies, including many serving the state’s poorest families, tend to have the lowest rates.

“Nearly 90 percent of California mothers have made the decision to exclusively breastfeed, yet only about half are breastfeeding exclusively upon hospital discharge,” said a statement accompanying the report. “Breastfeeding success is dependent on the support of hospital staff support during those first critical 24 to 72 hours. If exclusive breastfeeding is undermined in the hospital, then it is next to impossible for mothers to sustain exclusive breastfeeding when they go home.”

In data from 2009, three California hospitals had more than 90 percent of new mothers using breast milk exclusively when they were discharged. Those hospitals were El Camino Hospital in Santa Clara County (97.4 percent), Kaiser Walnut Creek in Contra Costa County (92.1 percent), and Kaiser Hayward in Alameda County (90.8 percent).

Twenty two hospitals had more than 75 percent of their mothers using supplemental formulas at the time of discharge.

At Pacific Alliance Medical Center in Los Angeles County, 99 percent of mothers used formula. At Monterey Park hospital, 96 percent used it. And at Delano Regional Medical Center in Kern County, 96 percent of mothers used a formula supplement.

Even women who plan to give both breast milk and formula after leaving the hospital should not give formula until their milk supply is established,” said the report. “Supplementing with formula so soon after birth will compromise successful breastfeeding.”

According to the World Health Organization, here are the ten steps hospitals can follow to promote successful breastfeeding:

Maintain a written breastfeeding policy that is routinely communicated to all health care staff.
Train all health care staff in skills necessary to implement this policy.
Inform all pregnant women about the benefits and management of breastfeeding.
Help mothers initiate breastfeeding within one hour of birth.
Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
Give infants no food or drink other than breast milk, unless medically indicated.
Practice “rooming in” – allow mothers and infants to remain together 24 hours a day.
Encourage unrestricted breastfeeding.
Give no pacifiers or artificial nipples to breastfeeding infants.
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge
from the hospital or clinic.

Click here to download the latest report on California hosptials.

–Daniel Weintraub

By Daniel Weintraub

California’s welfare-to-work program, known as CalWorks, would take a major hit if the budget proposed by Gov. Jerry Brown becomes law.

While the program has long been a symbol of “big government” and even lent its name to what some call the “welfare state,” welfare has changed significantly since the 1990s. It is no longer an open-ended entitlement and its grants have been restructured, reduced and connected to education and job training. The program serves far fewer families today than it did 15 years ago, and spending on welfare has shrunk, in real terms and as a share of the state budget. Today, the CalWorks program accounts for about 3 cents of every dollar spent from the state’s general fund.

But Brown would reduce that spending even further. His cuts would reduce the state’s general fund spending on the program by $1.5 billion, or 50 percent.

The governor has proposed reducing grants by 13 percent, from $694 to $604 for a family of three in high-cost counties. This cut would bring grant levels to about what they were 20 years ago, without even factoring in the impact of rising costs over the past two decades. Counting food stamps, or CalFresh as that program is now known, a family of three in the program would receive assistance equivalent to 71 percent of the federal poverty level, down 5 percent from the current level of aid. The grant reduction, on a percentage basis, would be more than twice as large as any previous cut adopted by California.

That’s not all. Brown also proposes to cap participation in the program at 48 months, rather than the current 60 months. The 48-month limit would be retroactive. And under his plan, all aid would be cut off at that point to most families. Currently, when a family hits the five-year maximum, only the parents’ portion of the grant is eliminated. The children remain on public assistance. That would no longer be the case, except when the parents were still meeting federal work requirements.

The state estimates that about 115,000 families and 234,000 children would lose their aid under this proposal.

Brown also proposes to continue a $377 million reduction in assistance to counties for the cost of job training and child care services for welfare recipients moving into the workforce. Along with this, counties would be allowed to exempt some recipients from job training requirements. The state expects this to result in fewer people moving from welfare into the workforce.

The state’s non-partisan Legislative Analyst has suggested that the grant cut be phased in with two smaller cuts spaced six months apart, and that the state increase funding for subsidized jobs. The analyst also recommends a change in a rule that allows families to keep a share of their earned income without losing welfare benefits. Currently, the first $225 of a family’s income, and 50 percent of every dollar after that, are excluded from calculations to determine eligibility. The analyst suggests excluding 50 percent of income starting from the first dollar. This would reduce grants for about 140,000 families and remove about 5,600 families from the program altogether.