California Eliminates Student Debt for Doctors Who Will Serve Medi-Cal Patients

Facing a shortage of doctors, California has started an effort to erase $58.6 million of medical school debt from physicians who will commit to a caseload made up of at least 30% Medi-Cal patients for five years. Medi-Cal covers one in three residents in the state, but as the program has expanded, the number of physicians who accept those patients has not kept pace. The debt relief program is now designed to help low-income residents with public insurance find physicians and dentists more easily. “[They’ve] committed [their lives] to this kind of service, and that’s what our loan repayment program is about,” said Gov. Gavin Newsom at a news conference celebrating the first debt relief payments. “If you support providing quality care to Medi-Cal patients, we are going to support your journey by providing a little bit of relief on these loans,” he said. This month, the state provided 40 dentists with $10.5 million and 247 physicians with $58.6 million in debt relief. This year, the state will spend $340 million paying off debts by tapping tobacco tax revenue. The impact of such a program will be “huge,” according to Sandra R. Hernández, a physician and president of the California Health Care Foundation. “You have a lot of young physicians who graduate from medical school with tremendous debt. We think this is a good long-term win for getting physicians to serve in under-served areas,” said Hernández. One concern with the program, however, is that even with loan repayment, physicians can still make much more only treating patients with private insurance. But Janet Coffman, a professor at the University of California, San Francisco, said that the program will also allow people from low-income communities to return there without the burden of debt. “I wouldn’t say that with a loan repayment you’re necessarily earning as much as you would if you’re working for Kaiser or Sutter, but it can be the difference that enables folks to say, ‘OK, if I get this loan repayment in addition to salary, I can see my way to work in an urban or rural underserved community,” Coffman said. [Sacramento Bee; WPSD; Los Angeles Times]

ERIC GARNER | The U.S. Department of Justice announced on Tuesday that they will not bring federal charges against NYPD officer Daniel Pantaleo, whose actions in July 2014 resulted in the death of Eric Garner. Garner’s death after he was put in a chokehold made national news and spurred protests with the chant ‘I can’t breathe,’ his last words captured on video before he died. When evaluating Pantaleo’s actions, U.S. attorney for the Eastern District of New York Richard P. Donoghue said that “we determined that there was insufficient evidence to prove beyond a reasonable doubt that Pantaleo acted in willful violation of federal law.” Donoghue also said that he did not believe that Pantaleo’s use of a chokehold, which is prohibited by NYPD policy, ”directly caused" Garner's death, which he said could have resulted from “a number of causes, in addition to the chokehold.” A medical examiner testified that the pressure on Garner’s neck and chest caused a fatal asthma attack. The DOJ’s decision was met with anger by New York City officials. "Today’s inaction reflects a DOJ that has turned its back on its fundamental mission — to seek and serve justice. In memory of Eric Garner and all others who have lost their lives unjustly, we will continue to fight for reforms to a criminal justice system that remains broken,” said New York Attorney General Letitia James. Mayor Bill de Blasio similarly expressed disappointment in the DOJ. "Years ago, we put our faith in the federal government to act. We won't make that mistake again,” he said. Garner’s mother, Gwen Carr, said her fight for justice will continue, despite the DOJ’s decision. "Five years ago, my son said 'I can't breathe' 11 times. Today we can't breathe because they have let us down,” Carr said. A state grand jury in 2014 declined to bring charges against Pantaleo, who has denied he did anything wrong. A disciplinary trial was held last month, but there has yet to be a ruling from the police commissioner on whether he should be fired or receive some other  punishment. [Buzzfeed News; The New York Times; USA TODAY]

GUN LOCK UP | The San Diego City Council approved a measure that would require gun owners to lock their guns in containers or disable them with a trigger lock when not in use. The measure is intended to limit accidental shootings, children’s access to guns, and suicides. According to City Attorney Mara Elliot, who proposed the measure, 46% of gun owners with children in the U.S. do not secure their guns, and 73% of children know where the guns in their homes are kept. Wendy Wheatcroft, founder of San Diegans for Gun Violence Prevention, said that the ordinance will be crucial to promoting public safety, but needs to be paired with health services for veterans, police officers, and other groups with high suicide rates. "We need to attack this from all angles, not just locking up firearms but also making sure they have adequate mental health support. But we also need to be reducing the means and the access to a firearm because in a moment of crisis, even having that gun locked up can be the difference between life and death,” Wheatcroft said. Opponents said breaking the proposed law should be an infraction, not a crime. Wendy Hauffen, of the San Diego County Gun Owners political action committee, said "Criminalizing normal activity has the potential to ruin a lot of innocent lives and this is especially a concern in a city like San Diego, where we have so many residents, such as active-duty military [personnel], who come from so many other states where this kind of law doesn't and would never exist.” [KPBS; NBC San Diego] 

INDIANA DISASTER | After the wettest 12 months on record, Indiana Gov. Eric Holcomb has requested a disaster designation from the USDA due to crop losses caused by flooding and excessive rain during the planting season. A disaster designation can be requested when at least 30% of one crop in a county is damaged or lost. This kind of  declaration allows farmers to apply for emergency low-interest loans. Indiana Farm Service Agency Executive Director Steve Brown said that all counties in the state submitted a report to the state emergency board, and 88 out of 92 met the disaster threshold. “When I outlined the process and how it works, I know the [USDA] secretary likes to have data and hard proof when these requests are made. I think the governor chose the accurate way to do this and we have done our due diligence,” Brown said. One Daviess County farmer said this was the worst year he has ever seen. “Even with the great technology we have with hybrid corn I expect this to be the shortest crop we have seen in 20 years. I would say we are in a disaster...It is going to be a tough, tough year, and it isn’t just Daviess County or Indiana — the whole country is fighting with this,” said the farmer. “As I continue to monitor this situation, Hoosier farmers can rest assured that we will keep a close eye on the long-term effects of these relentless rains,” Holcolmb said. [Washington Times-Herald; Hoosier Ag Today]

AMUSEMENT RIDES | After a teenager died due to an amusement park ride malfunction at the 2017 Ohio State Fair, the state is looking at measures to enhance rider safety. In June of this year, the state House approved Tyler’s Law, named for Tyler Jarrell, the eighteen-year-old who died. The proposal would require the state Department of Agriculture to establish new rules around the number of inspections needed for each ride based on its complexity. The measure also would require both public fairs and private amusement parks to document with photographic evidence before and after any major repairs are made. The bill was sponsored by Rep. John Patterson, a Democrat who said that purpose has come out of this tragedy. “There have been feelings of hope and a spirit of determination that somehow, some way we can ensure to the best of our ability that events like this will never happen again. The focus [of the bill] is three-fold. To revise current safety inspection standards, define qualifications better for ride inspectors and clearly outline the responsibilities of amusement ride owners,” Patterson said. The bill is now awaiting consideration in the Ohio Senate. This week, Republican Gov. Mike DeWine said he supports Agriculture Director Dorothy Pelanda's request for more funding for her department's ride safety division, which would increase the number of inspections. DeWine said that safety "is the essential function of government." [Cleveland Plain Dealer; Associated Press; FOX 28]