ABL HEALTHCARE ONLINE
ABL Healthcare Member News & Industry Trendletter * June 4, 2019
WELCOME NEW MEMBERS!

>>> Thomas Leffler is President of RE Pharmacy, a specialty pharmacy and infusion service provider which specializes in comprehensive care management for patients who have complex or chronic conditions. RE is also on its way to becoming a leader for infusion services. Founded in 2008, RE is now licensed to serve patients in 19 states with $90 million in 2018 revenues. Administered by specially trained infusion nurses, its services are provided in patients' homes, standalone RE locations, and/or physicians' offices. Previously, Thomas was Founder, Chairman and CEO of iMatrix Software, a SaaS company providing the software platform for many of the world's leading direct sales companies, and CEO of The Tech Factory, a provider of workflow and process improvement enterprise software systems for the mortgage, healthcare, and retail industries. He was also Managing Partner of Platinum Venture Group, Director of Acquisition Integration at Vanguard Integrity Professionals, CEO of L7 Network, PTY LTD, and President of Westar International. Thomas has joined the Orange County Round Table.

>>> Dan Manson is President and Chairman of Elevate Addiction Services, a Joint Commission-accredited drug and alcohol rehabilitation program operating residential and outpatient campuses in Watsonville (28 acres, overlooking the Monterey Bay, with over 100 beds), and in South Lake Tahoe (a 70-bed facility, nestled in a forest). Based on Dan's 23+ years of experience in the industry, Elevate's staff utilizes a unique, copyrighted educational curriculum that addresses not only symptoms of addiction, but also the individual's relationships and even underlying personal issues. Elevate utilizes modern, evidence-based practices rooted in cognitive behavioral therapy, and supplements these with a daily routine of exercise, nutritious diet, mindfulness meditation sessions, and an array of other options to bring health, clarity and reinvigoration of one's purpose. As "Sam D," an Elevate graduate, writes: "This place is amazing and I would recommend it for anyone that is struggling. Especially if the 12-Stop Model didn't work for you. The holistic, science-based approach they take really works." Dan has joined the Silicon Valley Round Table.

>>> Robbins Schrader is Co-Founder and CEO of SafeRide Health, a healthcare logistics provider with the mission of improving access to care for the nation's underserved populations. Venture-backed SafeRide works with medically qualified transport operators and preferred partners to increase access to care. Health plans across the country use SafeRide's fully-integrated solution and services to manage every aspect of their transportation programs. The company's platform delivers around 1.5 million trips a year, simplifies health system operations, improves patient outcomes, and reduces costs. SafeRide integrates all stakeholders onto one software platform to seamlessly automate compliance, benefit management, and pre-authorization. It then leverages its proprietary technology to deliver on-demand and scheduled multi-modal transport for all members, ranging from mass transit, to rideshare, to medically qualified transport. Prior to co-founding SafeRide, in 2016, Robbins worked for The Boston Consulting Group, as a consultant and project leader; Alvarez & Marsal, where he was a member of the Private Equity Performance Improvement Team; and for Goldman Sachs and Skanska USA Building Inc. Robbins has joined the Los Angeles Round Table.

Click on Headlines Below to Read Articles

HEALTHCARE MEMBER NEWS
  How the Fed's Playing "Whack-a-Mole" with Healthcare's High Costs
by Mimi Grant

As we get closer to the 2020 elections, it's clear that the majority of the 24 Democratic candidates want something akin to "Medicare for All." Assumably, once THE Democratic candidate emerges, likely on March 3rd, when California and a dozen other "super Tuesday" states hold their primary elections, we'll get closer to knowing who will be the likely Democratic contender on the November 3rd ballot - and what "Medicare for All" will actually look like.

In the meantime, the current Administration has recently announced several proposals aimed at cutting healthcare spending, as concerns about medical costs emerge as a major issue for both sides of the aisle in the lead-up to next year's presidential election . . . CLICK TO READ REST OF BLOG

 
UPCOMING ABL HEALTHCARE
ROUND TABLES
  • 6/05 - Orange County Round Table
  • 6/11 - Silicon Valley Round Table
  • 6/12 - San Francisco Round Table
  • 6/13 - East Bay Round Table
  • 6/21 - Los Angeles Round Table
ARTICLES
HEALTHCARE MEMBER NEWS
BAY AREA ROUND TABLES
CEI Unveils Updated Downtown Oakland Center

The Center for Elders' Independence (CEI) recently celebrated the grand opening of its newly remodeled downtown Oakland center, which features a demonstration kitchen that enables participants to observe and be involved in food and snack prep, an ultramodern fitness gym staffed with physical and occupational therapists, an indoor lounge sitting area and new outdoor courtyard for socializing, and a covered walkway for people to enter the building with ease. (Linda Trowbridge)

Covered California to Provide $6.3M to Help People Enroll in Healthcare Coverage

Covered California announced plans to partner with 105 community-based organizations to educate consumers about their healthcare options, offer in-person enrollment and renewal assistance, and provide ongoing support on how to get the best value from their health plan. To date, Covered California's aggressive outreach campaign has helped it achieve one of the best take-up rates in the country, which in turn meant that enrollees in California were about 20% healthier on average than the enrollees of the 38 states that rely on the federal government to promote enrollment. The healthier population of enrollees means that premiums in California are 20% lower than they would have been if the state's enrollment looked more like much of the rest of the nation. (Kathy Keeshen)

HumanGood Facilities Honored, Opened & Updated

The American College of Health Care Administrators named Windcrest, HumanGood's skilled nursing residence at Regents Point, as a top performer for 2019, based on occupancy, three years of survey data from state and federal regulators, and the resident assessments that make up the nursing home Minimum Data Set. Meanwhile, several HumanGood affordable housing communities have recently celebrated: the grand opening of the new Rotary Terrace in South San Francisco; and (following extensive renovations) the re-openings of Park Paseo in Glendale and Mount Rubidoux Manor in Riverside. (Tara McGuinness)

Kaiser Permanente Wins Numerous Awards for Achievement & Culture

For the ninth year in a row, Kaiser Permanente (KP) has earned the Pharmacy Quality Alliance's Excellence in Quality Award for high achievement in medication safety and appropriate use. Meanwhile, KP has been named to Becker's Healthcare's "150 Top Places to Work in Healthcare - 2019" list, developed based on nominations and editorial research. Becker's notes that KP "has made innovation and leadership a top priority. For nine years, Computerworld has named the system a best place to work in IT, and National Business Group on Health has named it a best employer for healthy lifestyles. DiversityInc also named KP to its Top 50 Companies to Work For, and Forbes named the system a best employer for women, and it's a Top 100 military-friendly employer." (Walt Meyers)

King & Spalding to Hold Webinar on Internationalization of Healthcare & Conference on Med Devices; + Achieves Tier 1 Ranking

On June 20, King & Spalding (K&S) will present a webinar - Going Global: The Internationalization of the Healthcare Industry, at 10 a.m. Pacific. Topics will include: The State of the Market, Foreign Ownership Restrictions, Due Diligence, Matching Mission to the Market, New Horizons for Investment, and Lessons Learned. Also on June 20, the K&S 5th Annual West Coast Pharmaceutical & Medical Device University, featuring recent developments and trends critical to drug, biologic and medical device manufacturers, presented by their in-house counsel, regulatory professionals, managers, and executives, in San Francisco. Meanwhile, the firm's healthcare industry practice has earned a Tier 1 ranking in the nationwide category in The Legal 500 2019, based on criteria most valued by clients, including size of the team, bench strength, quality of work handled, caliber of clients, client feedback, and the reputation of the individual practitioners. (Marcia Augsburger & Travis Jackson)

Michael Stacey Named CMO of LifeLong Medical Care

Mike Stacey has announced that he will be the new Chief Medical Officer for LifeLong Medical Care based in Berkeley, effective June 24. LifeLong is an innovative, non-profit Federally Qualified Health Center serving Alameda, Contra Costa, and Marin Counties with 16 health centers, mental health services, three Dental Centers, an Adult Day Health Center in Marin, four School-Based Health Centers, a Supportive Housing Program, and Urgent Care services. Most recently, Mike was Director of Medical Services for Solano County Health & Social Services. (Michael Stacey)

Wipfli Joins Cybersecurity Tech Accord

Wipfli recently signed the Cybersecurity Tech Accord, an international and industry-led pledge to protect technology users by improving the security of cyberspace. The firm joined 15 other companies in signing the accord, bringing the total number of cybersecurity-committed companies to 106. (Jeff Johnson, Larry Blitz, Tony Taddey & Steve Rousso)

LOS ANGELES ROUND TABLE
Nelson Hardiman Advises on Sale of Verity Health Systems Hospitals

Nelson Hardiman served as lead regulatory counsel for the $235 million sale of two Verity Health System hospitals - 358-bed O'Connor Hospital, and 93-bed Saint Louise Regional Hospital - to Santa Clara County, helping ensure a timely close and smooth transition. Meanwhile, reviews of Harry Nelson's current book, The United States of Opioids: A Prescription for Liberating a Nation in Pain, can be found here. (Harry Nelson, JD)

SafeRide Health CEO Named an Industry Advisor

Robbins Schrader, CEO of SafeRide Health, was recently named to the Advisory Boards of NEMTAC, a nonprofit dedicated to championing standards and best practices for the provision of non-emergency medical transportation. Meanwhile, Robbins was recently interviewed by FundRx Venture Partner Perspectives, in a discussion about SafeRide and healthcare trends. (Robbins Schrader)

ORANGE COUNTY ROUND TABLE
Alvaka Networks Offering Software Security Patching Webinars

Alvaka Networks will host a live and interactive webinar - Software Security Patching: Why you are struggling with this essential task!, from 10-11 a.m. Pacific, on the following dates: June 6, 13, 20, 27; and July 11, 18, 25; and August 1 and 8. Unpatched vulnerabilities are a leading source of compromise, and yet many organizations struggle to stay current on their patching and leave themselves exposed to security breaches. This webinar will take a deep dive into this complex security dilemma, what the risks are, and how you can start to solve this problem. (Oli Thordarson)

Cigna Among "100 Best Corporate Citizens" for Fifth Consecutive Year

Corporate Responsibility Magazine has named Cigna to its 20th annual "100 Best Corporate Citizens" ranking, recognizing outstanding environmental, social, and governance transparency and performance among the 1,000 largest publicly traded companies in the U.S. 'Cigna Connects' is focused on: health and well-being, environment, and inclusive and responsible business. Within each area, the company applies global health services expertise, resources and innovative thinking to help solve complex challenges. (Chris De Rosa)

MYnd Analytics' Arcadian to Provide Telepsychiatry Services in Mississippi & New York

Arcadian Telepsychiatry, a wholly owned subsidiary of MYnd Analytics, Inc., has signed an agreement with Memorial Hospital, in Gulfport, MS, to provide telebehavioral health services. THE 303-bed Memorial is one of the most comprehensive healthcare systems in the state, including a state-designated level II trauma center, two outpatient surgery centers, satellite diagnostic and rehabilitation centers, and 95+ physician clinics. Also, Arcadian has partnered with Care Compass Network, in upstate New York, to offer telepsychiatry and teletherapy services - in a phased roll-out of solutions with a variety of organizations, including nursing homes, primary care, pharmacy, behavioral health agencies, and a visiting nurse service. (George Carpenter)

PreludeDx Receives New York State CLEP Approval for DCISionRT Test

The State of New York Clinical Laboratory Evaluation Program has approved the proprietary DCISionRT test from Prelude Corporation (PreludeDx) to assess breast cancer recurrence risk and to predict radiation therapy benefit in patients diagnosed with ductal carcinoma in situ (DCIS). PreludeDx's DCISionRT test is now available in all 50 U.S. states. Meanwhile, PreludeDx recently presented interim results from its large PREDICT study, which found that inclusion of DCISionRT changed 51% of radiation therapy recommendations for patients with DCIS, in a patient group of 200 people. (Dan Forche)

SAVI Group Discusses Outsourcing, EMR Management, & Data Utilization

In The Reason Why Medical Outsourcing is Booming, SAVI Group discusses reasons that include a focus on patient care, drop in operational costs, evolving medical coding compliance, and increased revenues. Other recent posts from SAVI Group include: 8 EMR Management Best Practices Examples and How to Achieve Work-Life Balance with a Medical Practice. (Sumit Mahendru)

SILICON VALLEY ROUND TABLE
El Camino Hospital Achieves Goals in Reducing Hospital-Acquired Infections

El Camino Hospital announced that its Hospital Acquired Infections (HAI) teams achieved and, in some cases, surpassed its hospital infection reduction goals, and that the processes, put into place in 2018, continue to be refined as time goes on for even further improvement. Four multi-disciplinary teams took a lean performance approach to improve hand hygiene and reduce HAIs in three key areas: catheter-associated urinary tract infections; central line-associated blood stream infections; and Clostridium difficile infections. This hospital-wide initiative involved the use of process maps, constant feedback on results and data analysis to implement a plan of action for each challenge the team encountered. It was a focused plan, communicated well and with strict implementation that produced positive results, including: a 29% reduction in the use of Foley catheters, expansion of the use of UV disinfection, adoption of best practices, development of core competencies, and improvement of critical hygienic protocols for the prevention of HAIs. (Michelle McGowen & Cecile Currier)

Elevate Addiction Services Discusses Canada's Move to Prescription Heroin

In its recent blog post, Canada Approves Prescription Heroin: A Problematic "Solution" to an Ongoing Crisis, Elevate Addiction Services examines the Canadian government's recent decision to allow prescription heroin in their country. What is the full scope of this decision? Will it alleviate the opioid crisis or only serve to worsen it? Elevate addresses what the repercussions could be. (Dan Manson)

Pathways to Hold Annual Golf Tournament in July

Pathways Home Health and Hospice will present its 7th annual Links to the Heart Golf Tournament on July 15, at the Stanford University Golf Course, which is consistently rated one of the finest in the world. The fundraising event, which supports Pathways' critical programs, will include golf, lunch, dinner, contests, awards, prizes, and more. (Barbara Burgess)

TECH MEMBERS' HEALTHCARE NEWS
Catasys Expands Services & Addresses Loneliness

Catasys, Inc. is expanding the use of OnTrak to help identify and address loneliness, as poor social relationships have been associated with a significant increase in risk of coronary heart disease and stroke, along with increased use of accident and emergency services independent of chronic illness. Meanwhile, Catasys has expanded its OnTrak-C solution with a leading health insurance provider serving Medicaid members in Texas, as well as its OnTrak-Ci solution to eligible Medicare Advantage members in Alabama, Mississippi, and Florida, and has entered into an agreement with Optima Health to provide OnTrak to eligible Commercial members in Virginia. (Rick Anderson)

PCIHIPAA to Present Free HIPAA Compliance Webinar on June 6

On June 6, PCIHIPAA will present a free webinar - Protect Your Practice from Penalties and Fines, from 10-11 a.m. Pacific. Key takeaways will include a HIPAA compliance checklist, how to navigate the complexities of compliance, how to get a complimentary HIPAA risk assessment, and best data backup and restoration practices. (Jeff Broudy)

Sidebench Develops Apps for Children's Hospital LA & for OCD

Sidebench reports that they've been working with Children's Hospital Los Angeles to develop a NICU navigation app for parents of children who have been in the intensive care unit, and also shares a case study on how they revamped an OCD treatment tool - the nOCD app - to be engaging, accessible, and HIPAA compliant. (Kevin Yamazakis)

Tanner Research CEO to Present Nutrition Science Workshop

On the evening of June 13, John Tanner, Ph.D., CEO of Tanner Research, will present a Nutrition Science workshop, where he will share his story about how he suffered a near-fatal cardiac arrest in 2009. Since then, he has studied intensely the causes of heart disease, and found that it can be completely avoided through a proper diet - and THAT cancer, stroke, diabetes, high blood pressure, and about 30 other diseases can be reduced, avoided, or reversed by this same diet. The free workshop, to be held at Tanner Research in Monrovia, includes a meal and your choice of one of the top books on nutrition science. (John Tanner, Ph.D.)

HEALTHCARE INDUSTRY NEWS & TRENDS
Silicon Valley Boomer Venture Summit: Save 30%

ABL Member Robin Raff, CEO of Boomer Business & Beyond, Inc., highly recommends attending the Silicon Valley Boomer Venture Summit, in Berkeley, on June 5-6. The event attracts leaders in the fields of aging and health, bringing together forward-thinking entrepreneurs and venture capitalists to create innovative products and services for the global longevity marketplace. Robin has provided a code for a 30% discount on the cost of the summit: Use SV19fom30 to register at the above link.

Even a Single Workout May Make Our Brain's Memory Centers, Like Our Muscles, More Fit

A single, moderate workout may immediately change how our brains function and how well we recognize common names and similar information, according to a promising new study of exercise, memory and aging. The study adds to growing evidence that exercise can have rapid effects on brain function and also that these effects could accumulate and lead to long-term improvements in how our brains operate and we remember. Multiple, newer experiments have shown that adult brains, in fact, can be quite plastic, rewiring and reshaping themselves in various ways, depending on our lifestyles. (Read Article: New York Times, 5/1/19)

Amazon Developing Wearable, App for Voice-Based Emotion Detection

Amazon is building a wrist-worn device and accompanying app that listens to the wearer's voice to identify their emotions, according to an anonymous source as well as internal documents acquired and reported on by Bloomberg. The system, codenamed Dylan, is intended to be used as a health and wellness product, and might be adapted to provide the wearer guidance on how they may more effectively socialize with others. (Read Article: MobiHealthNews, 5/23/19)

Facebook Launches Three New Disease Mapping Tools

Facebook recently launched three new maps aimed at helping public health officials tackle the problem of pinpointing where diseases are present and spreading. The new additions include high-resolution population density maps with demographic estimates, movement maps and network coverage maps. (Read Article: MobiHealthNews, 5/21/19)

FEDERAL GOVERNMENT HEALTHCARE NEWS
CMS Modernizes Care for Frail, Elderly Individuals Enrolled in PACE

CMS recently finalized a rule to update and modernize requirements for the Programs of All-Inclusive Care for the Elderly (PACE). The program provides comprehensive medical and social services to certain frail, elderly individuals who qualify for nursing home care but, at the time of enrollment, can still live safely in the community. The policies finalized in this rule reflect the latest standards in caring for PACE participants - many of whom are "dually eligible" for both Medicare and Medicaid - and will strengthen patient protections, improve care coordination, and provide administrative flexibilities and regulatory relief for PACE organizations. Read CMS Release, 5/28/19

When asked for her comments on the final rule, ABL Member Linda Trowbridge, CEO of Center for Elders Independence (CEI), said: "It will allow some flexibility for us to come up with new models and to potentially serve Medicare only. At least it gives us a fighting chance. This was developed over an additional three-year period where PACE programs nationally weighed in. While we did not get everything we wanted, it is a great improvement." Linda also shared the link to PACE Final Rule: Highlights of the Updated Requirement, published by the National PACE Association. Upon reviewing that document, Linda remarked: "A few new areas of flexibility, e.g. in types of primary care providers, assessments, periodic audits, marketing. The latter actually seems to allow PACE Organizations to contract with brokers if they are appropriately trained about PACE (if I'm reading it correctly), which is a big priority for some of our members and more flexible than what was in the proposed rule. It retains inflexible requirements to submit formal applications for service area expansions and new PACE centers; however, it does nothing to allow POs to have more than one expansion application pending at a time.

White House Plans Executive Order to Foster Greater Price Transparency

President Trump is preparing to issue an executive order to foster greater price transparency across a broad swath of the healthcare industry as consumer concerns about medical costs emerge as a major issue in the lead-up to next year's presidential election. The most far-reaching element favored by the White House aides developing the order would require insurers and hospitals to disclose for the first time the discounted rates they negotiate for services, according to healthcare lobbyists and policy experts familiar with the deliberations. (Read Article: Washington Post, 5/29/19)

Senate Bipartisan Discussion Draft Released to Lower Healthcare Costs, Address Surprise Billing

On May 23, Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and Patty Murray (D-WA) released the Lower Health Care Costs Act of 2019 - bipartisan draft legislation to reduce healthcare costs. The bill contains five titles addressing various health policies under the committee's jurisdiction: surprise billing, drug pricing, transparency in healthcare, improvements to public health, and promotion of health information technology. Chairman Alexander hopes to move the legislation through the HELP Committee by the end of June. This legislation would be combined with healthcare legislation working through the Senate Finance and Judiciary Committees and is expected to be considered by the Senate in July as part of a larger healthcare legislative package. (Read Article: King & Spalding Health Headlines, 5/28/19)

FDA Soliciting New Volunteers to Test Drive Experimental Pre-Cert Program

The FDA has put out a call for new companies to test drive the current framework of its Digital Health Software Precertification Program, the ongoing effort to streamline regulation of digital health products prone to frequent update: "Recognizing the need to test the Pre-Cert model against a diverse set of test cases, the FDA is looking for volunteer cases to represent a broad spectrum of software developers: small and large software development firms; companies that develop a range of products, including both low- and high-risk Software as a Medical Device (SaMD); and companies that are not considered to be traditional medical device manufacturers but who intend to make SaMD." (Read Article: MobiHealthNews, 5/22/19)

CALIFORNIA GOVERNMENT HEALTHCARE NEWS
California Assembly OKs Healthcare for Adult Immigrants

The California Assembly voted last week to extend the state's Medicaid program to eligible adults who are in the country illegally. Democratic Gov. Gavin Newsom wants to spend about $98 million a year to cover low-income immigrants between the ages of 19 and 25 who are living in the country illegally. The state Senate's budget proposal would also add coverage for people 65 and older living in the country illegally. The state Assembly's bill would cover all immigrants in California living in the country illegally over the age of 19. But Newsom has raised concern about the assembly's bill because it is estimated to cost more than $3 billion a year. The bill passed 44-11. The proposed law, Assembly Bill 4, goes next to the state Senate. (Read Article: Associated Press, 5/28/19)

Newsom Proposes Penalty to Fund Health Insurance Subsidies

California Governor Gavin Newsom wants to help an estimated 850,000 Californians pay their health insurance premiums and would fund his plan with a tax penalty on people who don't have coverage. If he succeeds, California would be the first state to subsidize middle-income people who make too much to qualify for federal financial aid. (Read Article: California Healthline, 6/3/19)

New DMHC Regulation Expands Knox-Keene Licensure Requirements: Effective July 1st

ABL Member Harry Nelson, Managing Director of Nelson Hardiman, recently sent this Healthcare Client Alert: Effective July 1, 2019: New DMHC Regulation Expands Knox-Keene Licensure Requirements. As you contemplate any "shared risk" arrangements with MA plans, keep in mind that DMHC is requiring Knox-Keene licensure for "risk-bearing" providers (on contracts signed after 7/1/19). Here's an excerpt from the Alert: "A new regulation is about to disrupt California healthcare risk-sharing relationships by expanding significantly the types of entities licensed by the California Department of Managed Health Care. Effective July 1, 2019, the new DMHC licensing regulation establishes a new scope of entities and individuals who, for the first time, will require a Knox-Keene health plan license. Healthcare organizations operating in California and bearing financial risk need to prioritize understanding the implications of the new licensing regulation and developing a strategy for compliance.

Dignity in Discharge Law: What You Need to Know

Since the first of the year, all hospitals in California must develop a plan for safely discharging patients without homes. Specifically, hospitals must do the following: > Attempt to secure a sheltered discharge location, resource permitting, or discharge a patient to the location of their choice. > Provide transportation to the discharge location, within 30 miles or 30 minutes of the hospital. > Offer the patient weather-appropriate clothes. > Offer the patient a meal. > Provide referrals to health and mental health resources. Note for homeless services providers: A hospital must receive your agreement to discharge a patient to your facility. If a hospital sends a patient to your facility without notice, this is a violation of the law. The law focuses on improved coordination of support resources. By July 1, 2019, each hospital must create a plan for collaborating with community resources, such as shelters, mental health providers, and supportive services. (Read Article: California ACEs Action, 1/2/19)

Former Verily Leader Named "Mental Health Czar" of California

Neuroscientist and psychiatrist Tom Insel, MD, is California's new "mental health czar" who will advise the governor on mental health issues, according to the Los Angeles Times. California Gov. Gavin Newsom named Dr. Insel to the role May 21, in connection with the formation of a task force to address the state's homelessness crisis. California has nearly 130,000 homeless people, according to the Times. Dr. Insel served as director of the National Institute of Mental Health, a division of the National Institutes of Health, from 2002 to 2015. He led the mental health team at Verily, the life sciences division of Alphabet, previously Google Life Sciences. Dr. Insel left Verily in 2017 to cofound Mindstrong Health, a startup focused on providing objective measures to diagnose and treat mental health disorders. (Read Article: Becker's Hospital Review, 5/23/19)

While Rats & Filth Plague L.A. Streets, SF's Investing in Kids' Wellness

Is it the 21st century in the largest city of a state that ranks among the world's most robust economies, or did someone turn back the calendar a few hundred years? We've got thousands of people huddled on the streets, many of them withering away with physical and mental disease. Sidewalks have disappeared, hidden by tents and the kinds of makeshift shanties you see in Third World places. Typhoid and typhus are in the news, and an army of rodents is on the move. (Read Article: Los Angeles Times, 6/2/19) MEANWHILE, San Francisco Mayor London Breed recently announced that her upcoming budget for Fiscal Years 2019-2020 and 2020-21 will direct $22.4 million in revenue from the City's Soda Tax to programs benefitting children and youth. Over $6.5 million will support grants for Community Based Organizations that provide health services, physical education programming, and healthy food and water access in school settings. An additional $2 million will support community and school-based oral health programs administered by the Department of Public Health and the San Francisco Unified School District, and $2 million will support access to healthy food and improve food security. Youth under 18 who live in shelters or public housing will be offered free on-site recreation and health and wellness programming, and will be encouraged to participate in the City's recreation and swim programs, camps, and sports leagues free of charge. (Read City of San Francisco Press Release, 5/24/19)

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