Vacaville Reporter speaks out about SB 94 and AB 629 - 10/17/07

Here is an excellent editorial from the Vacaville Reporter on how the Governor's signing SB 94 and AB 629 will help reduce the number of sexually transmitted infections that have recently been growing amongst teens.

Eye-opening accuracy
New legislation may address STD rates
Vacaville Reporter
Article Launched: 10/16/2007 07:56:18 AM PDT

The figures are astounding: Nearly a quarter of Solano County's high school and college age residents may have suffered new cases of sexually transmitted diseases in 2005, according to a study released last week by the California Public Health Institute.

Researchers were quick to point out that the figures don't necessarily represent any increase in disease rates - just more accurate calculations.

By applying the federal Centers for Disease Control and Prevention's new method of calculating STD rates to California and its counties, researchers estimated that 20.6 percent of the state's 15- to 24-year-olds suffered more than 1.1 million new infections that year - more than 10 times higher than previously believed. The cases represent a lifetime treatment cost of $1 billion.
The new calculations showed that in Solano County, the 15,440 STD cases were equivalent to 23.8 percent of the young population. Lifetime treatments costs were estimated at $13 million.

The study focused on eight major STDs: chlamydia, gonorrhea, syphilis, genital herpes, HPV, hepatitis B, trichomoniasis and HIV. Health care providers are required to report to the state some diseases, such as HIV. Others, such as HPV, or human papillomavirus, which may account for more than half of the estimated cases in the new report, are not subject to mandatory reporting. Hence the need to find better ways to estimate their frequency.

Researchers hope that developing a more realistic outlook on the frequency of STDs might result in more practical measures to detect, treat and prevent their spread.

It is fitting, then, that among the bills signed into law by Gov. Arnold Schwarzenegger this past weekend were two that could have some effect on this problem.

Senate Bill 94 will increase the amount that MediCal pays to providers of family planning services - services that include identifying and treating STDs. The additional $24 million going to those providers may bring up to $64 million in additional federal funds to the clinics, enabling them to resume services that have been cut in recent years as they struggled to make do on a reimbursement rate that hadn't changed since 1985. To his credit, Solano's own state Sen. Michael Machado helped push this bill through the Legislature.

Assembly Bill 629, the "Sexual Health Education Accountability Act," requires that sex education in all public schools be comprehensive, medically accurate and age appropriate. Accurate education has helped California make good progress in reducing the teenage pregnancy rate. Perhaps more attention on STDs in the curriculum can help slow their spread.

Unfortunately, the governor chose to veto Assembly Bill 1429, a measure carried by Solano County Assemblywoman Noreen Evans that would have required most insurance companies to cover the costs of vaccinating women against HPV, which can lead to cervical cancer. The vaccine is essential to reducing future rates of HPV.

In a signing statement attached to the veto, the governor said: "While I support increased access to preventive services, I cannot support this bill as it may contribute to rising premiums. Further, a mandate is not necessary as this vaccine is already routinely provided by health plans and insurers. Mandating its coverage is unnecessary, restrictive and may increase costs." It's questionable reasoning, though. If health care providers are already providing this vaccine, then there should be no increase in costs.

Still, two out of three isn't bad. And with a better picture of the STD situation among young people, coupled with funds and mandates to address it, perhaps California can reduce the infection rate.

U.S. death rates from cancer falling - prevention, early detection credited - 10/16/07

Did you know that Planned Parenthood is the largest cancer screener in the country?

Here is an article from the San Francisco Chronicle about how early detection and prevention is credited for lower cancer death rates.

U.S. death rates from cancer falling - prevention, early detection credited

Denise Grady, New York Times

Monday, October 15, 2007

Death rates from cancer have been dropping by an average of 2.1 percent a year recently in the United States, a near doubling of decreases that began in 1993, researchers are reporting.

"Every 1 percent is 5,000 people who aren't dying," said Dr. Richard Schilsky, a professor of medicine at the University of Chicago and president-elect of the American Society of Clinical Oncology. "That's a huge sense of progress at this point."

Much of the progress comes not from miracle cures, but from more mundane improvements in prevention, early detection and treatment of some of the leading causes of cancer death - lung, colorectal, breast and prostate tumors. Years of nagging and pleading by health officials are finally beginning to pay off, experts say, in smoking cessation and increased use of mammograms, colonoscopies and other screening tests for colorectal and prostate cancer.

But the new statistics also contain bad news: American Indians and Alaska Natives in some regions are not benefiting from the same improvements as the rest of the population, and have higher rates of preventable cancers and late-stage tumors that would have had a better prognosis had they been detected sooner. Some groups within those populations have high rates of smoking. Researchers attribute the problems to poverty, lower education levels, and lack of insurance and access to medical care.

About 1.8 million of the 3.3 million American Indians and Alaska Natives receive their medical care through the Indian Health Service, but its facilities generally do not treat cancer. Outside contractors provide cancer treatment, but to get it, patients may have to navigate complicated rules and restrictions.

"The concern we have is that much of the progress we've attained in reducing death rates comes from tobacco control, screening and access to timely and high-quality treatment, and those positive effects are not being seen in all populations in the U.S.," said Elizabeth Ward, director of cancer surveillance for the American Cancer Society.

The new information, in an annual report from the cancer society, the National Cancer Institute and others, is being published online today - at www.interscience.wiley.com/cancer/report2007 - and in the Nov. 15 issue of the journal Cancer.

In the United States, cancer remains the second leading cause of death after heart disease, with 559,650 deaths expected this year.

But overall, death rates from cancer have been dropping by an average of 1.1 percent a year since 1993.

The report, using a statistical technique to analyze death rates, finds that the rate of decline deepened recently, averaging 2.1 percent a year from 2002 to 2004, the latest dates for which statistics are available.

"I'm hopeful that these improvements will serve to at least partially satisfy the cynics who have questioned whether the investment in cancer treatment has borne fruit," said Dr. Neal Meropol, director of the gastrointestinal cancer program at Fox Chase Cancer Center in Philadelphia. "In my view, these numbers are starting to highlight the advances that have been made."

In men, death rates decreased for most cancers, but went up for esophageal and liver cancer.

In women, death rates also dropped for most common cancers, but increased for liver and lung cancer. Lung cancer rates are still increasing for women because they started smoking, and quit, later than men did. But the death rate in women is increasing more slowly than in the past.

"What we think the statistics show now is that the epidemic of lung cancer in women has peaked, and we hope we'll start seeing a downturn," Ward said.

The report found that the incidence of both breast and ovarian cancer has decreased in the past few years. Researchers think the decline may be attributable in part to a sharp drop in hormone use after menopause, a response to a landmark study in 2002 that found the drugs increased the risk of breast cancer.

The American Cancer Society has said that lack of access to medical care is a major obstacle to reducing death rates. It recently began an advertising campaign to publicize the problem.

"Access to care truly is the message," said Dr. Patricia Ganz, director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at UCLA.

Meropol of the Fox Chase Cancer Center said: "What jumps out is that we really still have a long way to go.

"In spite of improvements, it's still a minority of individuals in our country that undergo screening for colon cancer," he said. "If everyone were screened appropriately, these incidence numbers would fall even more dramatically annually."

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/10/15/MNNFSPVIL.DTL

This article appeared on page A - 4 of the San Francisco Chronicle

Governor Signs TWO Critical Pieces of Legislation - 10/15/07

Good News! Governor Schwarzenegger signed two critical pieces of legislation affecting Planned Parenthood!

SB 94 ensures Planned Parenthood can continue to provide quality healthcare to those who need it by increasing Medi-Cal provider reimbursement rates for vital family planning services. The Medi-Cal provider reimbursement rate had only seen one increase in twenty years. Because of this, Planned Parenthood has had to turn away 10,000 patients a year due to the lack of funding to hire staff to meet the needs of these patients.

AB 629 ensures state money will only be spent on medically accurate, effective sex education! Despite comprehensive sex education laws in California, some public funds were being spent on inaccurate, biased programs often in the most underserved communities that have the greatest health disparities and the least access to quality sexual health information. AB 629 promotes healthy communities by funding accurate, reliable information about preventing unintended pregnancies and sexually transmitted infections.

Thank you to all the dedicated Planned Parenthood: Shasta-Diablo volunteers and activists who wrote thousands of letters, made hundreds of phone calls and came to several key visibility events. It is supporters like you who made this bill a priority in the State Legislature and got it signed into law by the Governor! Thank you and congratulations!

Urge The Governor To Sign SB 94 - 10/11/07

If you haven't called the Governor yet, make a call today to show your support of SB 94, critical piece of legislation that would increase reimbursement rates for vital family planning services and increase access to time-sensitive care for low-income women throughout the state. The situation in California requires immediate action. Every month, Planned Parenthood clinics statewide turn away more than 10,000 patients because of insufficient reimbursement from the state. He has until Sunday, October 14 to sign the bill, so keep the calls coming!

Making a call is quick and easy. It's all automated, so you don't have to talk with anybody. Here are the directions:

Governor's office: (916) 445-2841
Press 1 for English
Press 5 for Senate Bills
Press 5 for SB 94
Press 1 to support

And here is an article from North Gate News in Berkeley highlighting the necessity to have SB 94 signed into law:

North Gate News: Reporting UC Berkeley School of Journalism
Clinic Workers Urge Governor to Increase Family Planning Funds

Anna Belle Peevey, October 3, 2007 at 4:09 pm

SAN FRANCISCO — Within the next two weeks, California Governor Arnold Schwarzenegger will make a decision that could affect thousands of women seeking family planning services.

SB-94, one of the many bills now on his desk awaiting approval, would increase Medi-Cal funds for family planning for the first time in 20 years.

“You’re having folks pay for services with 1987 money that have 2007 costs,” said Chris Lee, Vice President for Public Policy for Planned Parenthood Shasta-Diablo, at a rally held today in San Francisco urging the Governor to sign the bill. Although Medi-Cal reimbursement rates have remained the same for two decades, the cost of providing family planning services has increased as much as 300 percent.

Maya Ingram, public policy director for Planned Parenthood Golden Gate, said California family planning service providers turn away 10,000 patients each month because they don’t have the funds to staff their clinics.

“We’ve been pushing for this year after year, and there’s always some push back because the state lacks funds,” Ingram said about the bill. “We’re at a critical stage now.”

The bill, subtitled Medi-Cal Reimbursement Rates, would provide $3.2 million in state Medi-Cal funds for family planning office visits. California would receive an additional $9 million in matching federal funds.

Currently, California receives nine federal dollars for every dollar the state spends on family planning. But for every dollar a clinic bills Medi-Cal, the state reimburses at 50 percent, and clinics use other funding to cover the remaining half. With SB 94, the reimbursement rate to family planning providers would increase to 80%.

Heather Saunders Estes, CEO of Planned Parenthood Shasta-Diablo, said at the rally today that family planning programs are increasingly strained by lack of funding.

“We are scraping the bottom of the barrel,” she said. “The system has been eroding for quite a while. Now it’s breaking.”
Estes said Planned Parenthood has been unable to fund a clinic in El Cerrito because the funds aren’t there, and that existing HIV-testing programs would likely be terminated if the $3.2 million doesn’t go through.

Planned Parenthood is not the only family planning provider that would be affected by this new bill. Every clinic that receives Medi-Cal patients for family planning would see a boost in the services it is able to provide. Because these clinics must compete for nurse practitioners with hospitals that offer 20 percent more in annual salaries, clinics are having a difficult time filling positions.

“We have two positions open right now,” said Leslie Barron-Johnson, Vice President of Client Services for Shasta-Diablo Planned Parenthood. “That’s 80 hours a week of possible time for patients.”

Supporters say that Family Planning, Access, Care and Treatment (PACT), California’s Medi-Cal funded family planning program, has saved the state more than $2 billion in medical and social service costs through the prevention of unintended pregnancies and sexually transmitted infections. And an evaluation by San Francisco Family PACT says every dollar spent on family planning saves the state $5.33 on social welfare costs down the road.

Carol Hogan, spokesperson for the California Catholic Conference, called that statistic “amazingly callous and utilitarian.” Referring to a letter she wrote to the Governor urging him not to sign SB94, she said, “In other words, paying to prevent a birth is more cost-effective than helping the child’s mother give birth and care for it.” Hogan said State Senator Sheila Kuehl, the author of the bill, performed a common legislative action the day before the bill went to a vote — by “gutting and amending” at the last minute, she changed the language to include family planning services.

Lee said the language was added at the last minute because the legislators “saw this was something left out of the 2008 budget and shouldn’t have been, because it brings money back to the state.” Lee and other supporters at the rally maintain that this is about emphasizing preventative care. Said Lee, “It’s the one program that makes fiscal sense.”

STD Cases Prove Costly In Youth - 10/11/07

Yesterday's Contra Costa Times reports on a deadly problem that shows the importance of comprehensive sex education and prevention education.

STD Cases Prove Costly In Youth
Study says 1.1 million new cases are reported each year, adding up to more than $1 billion in lifetime medical costs

By Sara Steffens STAFF WRITER Contra Costa Times

Article Launched:10/10/2007 03:03:05 AM PDT

Each year, teens and young adults in California suffer more than 1.1 million new cases of sexually transmitted diseases, according to a new study from California's Public Health Institute. And those infections bring more than $1 billion in lifetime medical costs, the report shows. "Society is not aware of how common STDs are, and how much not just personal stress and burden they cause, but financial burden," said Petra Jerman, a research scientist for the Oakland-based institute and co-author of the study. Published in the California Journal of Health Promotion, the study focused on eight major STDs: chlamydia, gonorrhea, syphilis, genital herpes, HPV, hepatitis B, trichomoniasis and HIV. Researchers used mathematical models to calculate the incidence of the infections among 15- to 24-year-olds in each California county. In 2005, new STD cases totaled: 62,417 in Alameda County 28,519 in Contra Costa County 15,440 in Solano County 8,642 in San Mateo County. Existing public health reports show only a fraction of those cases, partly because many STDs are not subject to mandatory reporting -- including human papillomavirus, or HPV, which accounts for more than half of the estimated cases in the new report. HPV is common partly because it's easy to transmit, Jerman said. It's also the target of a vaccine recently licensed for young adults by the federal Food and Drug Administration. "As more young people get vaccinated, then the numbers should go down," Jerman said. "We might be able to avoid those costs of HPV and their consequence of cervical cancer." New HPV infections accounted for $460 million of the total medical costs. Though much less common, new HIV infections are more costly, at $560 million. Public health workers have long known that STD cases are under-reported, said Francie Wise, communicable disease program chief for Contra Costa Public Health. "Some physicians aren't clear as to what's reportable. Some see these things as very private and they don't want to breach the patient's privacy," she said. "And patients say 'Please don't report it.'" Teenagers and young adults are biologically more susceptible to contracting STDs, Wise said, but they may not realize the long-term effects the infections can have. "Gonorrhea or chlamydia, especially if they go untreated, can lead to infertility, which is a lifetime issue for women," she said. The new numbers underscore the importance of using protection if sexually active and promptly seeking medical care for any symptoms, Wise said. And because women can contract "silent infections" that go on for years without obvious effects, she said, "it doesn't hurt to have screening tests periodically (even) if you don't have symptoms." The prevalence of STDs among teens and young adults shows the need for accurate, comprehensive sex education in schools, said Chris Lee, vice president of public policy and advocacy for Planned Parenthood Shasta-Diablo. "Kids are obviously still having sex," he said. "Abstinence-only is not the answer." Researchers say they hope that seeing the long-term costs of STDs will help spur renewed public discussion about the need to invest in preventive measures, Jerman said. She said she hopes the county-specific data will catch the attention of high school and college-age youths. "I hope they're surprised," she said. "I hope it makes them think, 'Oh my gosh, they're around us, we need to protect ourselves.'" Reach Sara Steffens at 925-943-8048 or ssteffens@bayareanewsgroup.com.