Monday, 18 March 2024

Health

The California Department of Public Health has launched the Take on Alzheimer’s campaign, an education and awareness campaign aimed toward all Californians to promote healthy brains, knowledge about the difference between aging and dementia, and improve conversations with loved ones and health care providers.

“With more people living longer lives, the number of Californians living with Alzheimer’s Disease and Related Dementias is projected to double over the next 20 years, even as the percent of older adults with dementia declines,” said CDPH Director and State Public Health Officer, Dr. Tomás J. Aragón. “This campaign will empower our diverse communities to support brain health, better understand the difference between signs of aging and symptoms of dementia, and encourage individuals to have important conversations with their loved ones and health care providers."

Many Californians avoid seeking help for Alzheimer’s due to unawareness, fear, and stigma.

Take On Alzheimer’s will counter hesitation and delays by increasing education and encouraging conversations across all communities. It educates diverse communities about signs, risk factors, and ways to promote brain health.

The primary risk factor for Alzheimer’s is age, and California is home to more adults aged 65 and older than any other state.

While the majority of older adults will never experience dementia, 11% of the nation’s Alzheimer’s cases reside in California and that number is projected to double between 2019 and 2040, highlighting the need for awareness, education, and preparation.

Declining rates of dementia, and emerging treatments, provide hope.

“California’s Master Plan for Aging has included ‘Dementia in Focus’ as part of Goal Two: Health Reimagined since its launch in 2021. It’s critical to build dementia expertise into programs and services supporting our state’s increasingly diverse older adult population, including family caregivers and our workforce,” said Susan DeMarois, Director of the California Department of Aging. “Widespread prevention, screening and detection will enable more families to make important social, medical, financial, and personal decisions and we want our aging network to be well equipped to meet their needs.”

Women are especially impacted by the disease, making up nearly two-thirds of diagnosed Americans.

Other disproportionately impacted groups include older Black Americans, who are two times more likely to develop the disease, and Latinos, who are one-and-a-half times more likely to develop Alzheimer’s than white older adults.

California is one of the most diverse states in the nation, with six counties ranking in the top 20 most racially and ethnically diverse counties in the nation, further emphasizing the need for continued ADRD prevention efforts.

The Take on Alzheimer’s campaign will:

Reach diverse communities like those mentioned above through multilingual and multicultural advertising, partnerships with community-based organizations and engaging trusted ethnic media journalists.

Educate these communities about brain health, the signs of aging, and the symptoms of ADRD to be able to make a positive difference for them and their loved ones when it comes to fostering brain health and benefiting from early detection and diagnosis.

Start a conversation. Honest and empathetic conversations with friends, loved ones or a healthcare provider can be critical to improving outcomes and combating fear and stigma associated with Alzheimer’s Disease and Related Dementias, or ADRD.

Steer the community to learn more at TakeonALZ.com to understand ways they can help reduce their risk and take charge of their brain health before or after an ADRD diagnosis.

SACRAMENTO – The California Department of Public Health, or CDPH, is warning consumers not to eat multiple varieties of Shamshad Food’s jarred food items because they were produced outside of the CDPH Cannery Program oversight, making them susceptible to contamination with Clostridium botulinum.

Ingestion of botulism toxin from improperly processed jarred and canned foods may lead to serious illness and death.

The following varieties of Shemshad Food jarred products should not be consumed:

Litteh Pickle
Pickled Diced Vegetables (all lot codes except SD31123125)
Pickled Eggplants (all lot codes)
Pickled Garlic (all lot codes except SG31223125)
Pickled HaftBijar (all lot codes)
The food products were sold at grocery stores in southern California including Woodland Hills Market in Woodland Hills, Q Market in Van Nuys, and Wholesome Choice Market in Irvine. Consumers that observe the product being offered for sale are encouraged to report the activity to the CDPH toll free complaint line at (800) 495-3232.

CDPH issued a notice of violation to Shemshad in January 2024 and the result of the ongoing investigation may subject the firm to further action up to and including license revocation.

At this time, Shemshad, based in Los Angeles, is voluntarily recalling its Litteh Pickle and Pickeled Diced Vegetables, Eggplant, Garlic, and HaftBijar products. These products are under the Shemshad brand name in 16 ounce glass jars with screw-on metal lids. 

Botulism toxin is odorless and colorless, so consumers will be unable to determine if their product is affected. Consumers who have any of this product or any foods made with this product should discard them immediately.

Double bag the jars in plastic bags that are tightly closed then place in a trash receptacle for non-recyclable trash outside of the home.

Consumers should wear rubber or latex gloves if possible, when handling these products or wash your hands with soap and running water for at least two minutes after handling any food or containers that may be contaminated.

Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinum. The initial symptoms frequently experienced are double or blurred vision, drooping eyelids, and dry or sore throat. Progressive descending paralysis, usually symmetrical, may follow.

Additional symptoms may include slurred speech, difficulty swallowing, inability of the neck muscles to support the head, paralysis of the extremities and respiratory muscles may occur. Infants with botulism appear lethargic, feed poorly, are constipated, have a weak cry, and poor muscle tone.

CDPH recommends consumers experiencing any ill effects after consuming these products should consult their health care provider.

California Attorney General Rob Bonta on Wednesday announced a settlement with Quest Diagnostics, Inc., resolving allegations that the diagnostic laboratory company unlawfully disposed of hazardous waste, medical waste, and protected health information at its facilities statewide.

As part of the settlement, Quest Diagnostics will be required to pay nearly $5 million for penalties, costs and supplemental environmental projects and make significant changes to its operations and practices at its California facilities.

Attorney General Bonta is joined by the district attorneys of Alameda, Los Angeles, Monterey, Orange, Sacramento, San Bernardino, San Joaquin, San Mateo, Ventura and Yolo counties in the settlement.

“Quest Diagnostics’ illegal disposal of hazardous and medical waste and patient information put families and communities at risk and endangered our environment,” Bonta said Wednesday. “Let today’s settlement send a clear message that my office will hold corporations, including medical services providers, accountable for violations of state environmental and privacy laws. I appreciate the partnership of the district attorneys’ offices across our state that led to this critical settlement.”

“This settlement demonstrates the commitment of my Consumer Justice Bureau to protect the residents of Alameda County against identity theft and ensure that such violations do not occur again,” said Alameda County District Attorney Pamela Price. “Our continued ability to collaborate with the Attorney General and other District Attorney’s offices to protect public safety for all California residents is a testament to our team and the progress under my administration.”

“This settlement will help ensure that patients’ personally identifiable and private health information is protected and will protect worker safety and human health by ensuring that hazardous and medical wastes are properly managed and disposed of,” said Monterey County District Attorney Jeannine Pacioni.

“We will not allow the public’s health to be jeopardized by laboratories who prioritized cutting corners over protecting the health of the very people they were supposed to be caring for,” said Orange County District Attorney Todd Spitzer. “This was not an isolated incident by a single Quest Diagnostics testing facility; this was Quest Diagnostics laboratories and testing facilities across the state skirting California’s hazardous waste laws while ignoring the very real environmental and health impacts of these illegal actions. I want to thank Attorney General Rob Bonta and the San Joaquin District Attorney’s Office for their leadership in this collaborative effort to hold companies accountable for violating our environmental laws and endangering the safety of Californians.”

"This settlement is the result of a successful collaboration between District Attorney’s Offices and the state Attorney General's Office to protect California's environment and its health consumers," said Sacramento County District Attorney Thien Ho. "Thanks to the joint efforts of our Consumer and Environmental Protection Unit and prosecutors across the state, the financial penalty and permanent injunction will deter Quest Diagnostics from violating hazardous waste, medical waste and protected health information laws. Sacramento County will receive a total of $259,440 from the settlement, which will reimburse the cost of prosecuting this case and increase the enforcement of consumer and environmental protection laws."

“We take very seriously violations regarding medical waste, hazardous waste, and patient confidentiality,” said San Bernardino County District Attorney Jason Anderson. “We are thankful for the cooperation of Quest, and the diligent work of our Consumer and Environmental Protection Unit in securing this settlement. With judgments like these, we can ensure proper disposal of medical and hazardous waste which protects the public and the environment, while safeguarding the privacy of San Bernardino County residents.”

"Through our meticulous waste audits, it came to light that Quest Diagnostics may have encountered challenges in properly managing confidential patient data, medical waste, and hazardous materials. Our initial inquiry in San Joaquin County prompted us to engage with the Attorney General's office and other relevant parties,” said San Joaquin County District Attorney Ron Freitas. “Subsequent audits conducted at Quest's laboratories shed further light on potential mismanagement issues. This underscores the significance of maintaining robust waste management practices in healthcare to uphold patient confidentiality and ensure public safety."

“The Simi Valley Landfill & Recycling Center and Ventura County residents were negatively impacted by Quest’s illegal disposal of hazardous waste, medical waste, and protected patient information,” said Ventura County District Attorney Erik Nasarenko. “Thanks to the hard work of the California Attorney General’s office, the District Attorney’s offices and our partner agencies, this settlement will ensure that Quest complies with the law and implements strong measures to protect the health, safety, and privacy of our residents.”

The settlement is the result of over 30 inspections conducted by the district attorneys' offices at Quest Diagnostics laboratories and Patient Service Centers statewide.

During those inspections, the district attorneys' offices reviewed the contents of Quest Diagnostics’ compactors and dumpsters and found hundreds of containers of chemicals, as well as bleach, reagents, batteries, and electronic waste; unredacted medical information; medical waste such as used specimen containers for blood and urine; and hazardous waste such as used batteries, solvents, and flammable liquids.

The unlawful disposals are alleged to violate the Hazardous Waste Control Law, Medical Waste Management Act, Unfair Competition Law, and civil laws prohibiting the unauthorized disclosure of personal health information.

After being notified of the investigations, Quest Diagnostics implemented numerous changes to bring its facilities into compliance with California law, including hiring an independent environmental auditor to review the disposal of waste at its facilities and modifying its operating and training procedures to improve its handling, storage, and disposal of hazardous waste, medical waste, and personal health information at all four laboratories and over 600 PSCs in California.

The settlement resolves the allegations above and requires Quest Diagnostics to pay $3,999,500 in civil penalties, $700,000 in costs, and $300,000 for a Supplemental Environmental Project to support environmental training and enforcement in California.

The settlement also imposes injunctive terms, including requirements that Quest Diagnostics maintain an environmental compliance program, including hiring a third-party waste auditor, and report annually on its progress.

California Attorney General Rob Bonta, Senator Monique Limón (D- Santa Barbara), and a coalition of prominent consumer advocacy organizations have unveiled Senate Bill 1061 (SB 1061), legislation seeking to protect consumers from having their credit ruined by prohibiting medical debt from being reported on credit reports.

Credit reports are meant to gauge an individual’s ability to repay future debt. Medical debt is often unforeseen and not a reliable indicator of financial risk, yet it can unfairly prevent consumers from getting loans, renting an apartment, or getting a job.

“California families should not need to suffer from the harmful and unnecessary impacts resulting from having their credit damaged by medical debt. We have a straightforward solution and need to implement it here in California, just as we have seen some of our sister states do successfully,” said Bonta. “There is no need for medical debt to appear on credit reports and we can stop the harmful spiral where people have unforeseen, catastrophic medical debt and become unhoused, unemployed, or without a vehicle to get to work. To reduce homelessness, to reduce food insecurity, and to address many of California’s other systemic issues, we must utilize upstream interventions that get to the crux of these problems. This is exactly what SB 1061 does.”

“Today a staggering 1 in 5 Californians has reported having medical debt with a disproportionate impact on women and mothers. This debt negatively impacts Californians credit history making it harder to secure a loan, buy a house, or be approved for a credit card,” said Sen. Limón. “Without a robust health care system that covers necessary and often lifesaving medical expenses in a timely, accurate and comprehensive manner, medical debt should not be included on consumer's credit reports.”

“We’ve known for years that medical debt doesn’t predict credit defaults, nor does it accurately predict a person’s desire and willingness to pay off loans,” said Jenn Engstrom, state director of CALPIRG. “We’re hopeful that the legislation introduced by Senator Limón and sponsored by Attorney General Bonta will help create a fair credit system that doesn’t penalize people for life events they can’t control like getting sick.”

"Frontline nurses know that patients with medical debt, especially low-income Californians, delay or avoid medical care because they worry about the impact on their credit reports," said California Nurses Association President Cathy Kennedy, RN. "SB 1061 will help to ensure patients will get the care they need by removing medical debt from credit reports. Then we will have a fair credit system that will not penalize patients when they get the care they need and deserve."

“People can’t control when they will get sick or hurt, and they can’t control when billing disputes and insurance problems will cause debts for expensive medical care to end up in collections,” said Chi Chi Wu, senior attorney at the National Consumer Law Center. “This law is necessary to protect consumers from unmanageable and unpredictable medical debts and to address the disparate impact of medical debt on Black households.”

"Getting hit with medical debt isn't like taking out a loan," noted Ted Mermin, director of the California Low-Income Consumer Coalition. "It's not voluntary, it doesn't predict how creditworthy you are, and all too often the amount you're charged is something the healthcare provider basically made up. But there's nothing fictional about the serious negative impact medical debt can have on consumers' credit reports."

"The Consumer Federation of California is pleased to be a co-sponsor of SB 1061 and work with Senator Limón, Attorney General Bonta and all the other fine groups working to enhance consumer protection when it comes to medical debt," said Robert Herrell, Executive Director of the Consumer Federation of California. "Simply put, California is falling behind in consumer protection in this area. States like New York and Colorado are leading the way. Those states have realized that medical debt shouldn't be an anchor dragging consumers down, both personally and via their credit worthiness. California must do better for consumers and this bill is an important step in that direction. This bill will put California back at the front of the line when it comes to consumer protection against medical debt ruining their lives."

"Health care costs are rising, forcing more and more Californians to delay or skip care in fear of getting an expensive medical bill that can lead to debt,” said Katie Van Deynze, policy and legislative advocate for Health Access California, a co-sponsor of the bill. "Black, Latino and low-income Californians disproportionately have medical debt, and counting it against credit exacerbates inequities in health, housing, employment and more. SB 1061 will give all Californians more peace of mind to seek the care they need knowing it will not negatively affect their credit and their future."

The bill sponsored by Attorney General Rob Bonta, the National Consumer Law Center, the CA Nurses Association, Health Access CA, Consumer Federation of CA, CA Low Income Consumer Coalition, Cal-PIRG, and authored by Senator Limón states that:

• Health care providers should not provide information regarding a patient’s medical debt to a credit reporting agency.
• Health care providers should include a provision in any contract entered into with a collection agency that prohibits the reporting of any information regarding a patient’s medical debt to a consumer credit reporting agency.
• Credit reporting agencies should not accept, store, or disclose any information concerning a medical debt.
• Medical debt continues to increase and is a barrier to employment, housing, and the promotion of health care access and equity. The Urban Institute reported 7.8% of California consumers with a credit report had a medical debt listed on it, increasing to 8.5% for Black Californians.
• People with medical debt are more likely to say debt has caused them to be turned down for a rental or a mortgage than people with student loans or credit card debt, increasing their risk of homelessness or being forced to live in substandard housing. Debt can also create barriers for finding employment as employers often use credit reports as a basis for hiring decisions, which in turn, makes it even more difficult to pay off medical debt. Both Colorado and New York have passed laws that prohibit medical debt from appearing on credit reports. In September 2023, the Consumer Financial Protection Bureau announced a rulemaking process to remove medical bills from consumers' credit reports.

Forty-seven percent of health care workers nationwide have witnessed discrimination against patients in their facilities, and 52 percent say racism against patients is a crisis or major problem, according to a new report from The Commonwealth Fund and The African American Research Collaborative, or AARC.

Younger health care workers and health care workers of color were more likely than their older or white counterparts to say they witnessed discrimination.

The report, Revealing Disparities: Health Care Workers’ Observations of Discrimination Against Patients, is based on findings from a nationwide survey of more than 3,000 health care workers aimed at understanding the impact discrimination and racism have on health care professionals and patients.

“The study shines a light on the discrimination and racism health care workers observe and the implications for negative health outcomes of patients in many communities,” said Henry Fernandez, CEO of AARC and the report’s lead author. “Understanding this connection at a national level is critical to measuring and addressing discrimination in the health care system to mitigate harm to patients and produce better health outcomes overall.”

Other key report findings include:

• Patients are treated differently based on their race and ethnicity. More than half of health care workers (57%) witnessed discrimination against patients who predominantly speak a language other than English. About half (48%) stated that medical providers are more accepting when white patients self-advocate than when Black patients do so.
• Discrimination creates stress for health care workers. Just under half (47%) of all health care workers indicated that dealing with discrimination at work causes them stress.
• Health care workers at facilities with more patients of color are more likely to witness discrimination. Seventy percent of workers at facilities with predominantly Black patients and 61 percent of those working in facilities with mostly Latino patients witnessed discrimination compared with only 43 percent at facilities with mostly white patients.

While the report focuses on the impact of discrimination on patients, the full survey examined racism and discrimination in health care settings more broadly, including discrimination toward health care professionals, as well as employers’ role in addressing these issues.

Notable findings from the larger survey include:

• Workplace racism is prevalent in health care.
• Forty-four percent of all health care workers have observed coworkers subjected to racism in the workplace. When provided with examples of potential workplace discrimination, two-thirds indicate they have seen at least one of the examples.
• A majority of Black health care workers (58%) and more than four of 10 Latino (49%) and Asian American and Pacific Islander (AAPI, 44%) health care workers indicate they have been discriminated against in their workplaces because of their race or ethnicity.
• Health care workers fear retaliation. While majorities of health care workers see positive efforts from employers to address discrimination, a majority of Black, Latino, and AAPI health care workers worry about retaliation if they raise discrimination concerns.

When asked about potential solutions, more than two-thirds of health care workers thought the following steps could help:

• Providing an easy way to anonymously report situations involving racism or discrimination.
• Creating opportunities to listen to patients of color and health care professionals of color.
• Examining treatment of non-English-speaking patients.
• Training at professional schools or health care staff to spot discrimination.

“If we are going to build truly equitable health care systems, we have to start by listening to voices of those on the front lines,” said Dr. Laurie Zephyrin, M.D., Senior Vice President for Advancing Health Equity at The Commonwealth Fund and report co-author. “Understanding what health care workers are experiencing, and what they want and need from their employers and colleagues to address discrimination, is critical to successful and sustainable change.”

The full report can be found here.

Covered California announced this week that it will give consumers until Feb. 9 to sign up for coverage in 2024.

“We’ve seen record-breaking enrollment nationally, and Covered California is surging with heightened demand,” said Covered California Executive Director Jessica Altman. “We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.”

In addition to the increased demand, consumers looking to enroll in recent days may have encountered challenges reaching Covered California representatives over the phone, and many this week have experienced longer than expected wait times. This was due in part to a disruption to Covered California’s service center, which was temporarily taken offline in immediate response to a cybersecurity incident affecting a third-party vendor that supports its phone lines.

This incident was limited to Covered California’s telephone systems, and enrollment and eligibility systems were unaffected. At this time, there is no indication that any personal information was compromised.

The deadline extension will give consumers who are trying to sign up for coverage the time and assistance they need.

Consumers will have until midnight on Friday, Feb. 9, to apply for coverage that would be effective Feb. 1.

They can visit CoveredCA.com and get free and confidential help from one of the more than 14,000 certified enrollers throughout the state who can help them sign up, including individuals who can assist in other languages.

In addition, consumers can reach the Covered California service center at 800-300-1506.

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