Los Angeles Times on opening safe injection facilities:
About 72,000 Americans died from drug overdoses in 2017. That’s nearly 200 people per day - more than the number of people killed in car accidents. Fatal overdoses have been on the rise in recent years, due in large part to the proliferation of tremendously dangerous synthetic opioids such as fentanyl, and it’s a safe bet that the daily death rate will be higher again by the end of this year.
This escalating crisis has forced state and local governments to think about new approaches to the problem, including harm-reduction strategies that will help keep people alive and expand treatment options. That has included equipping police officers and emergency medical staff with naloxone, a medication that can reverse opioid overdoses. And thank heaven for that, or the overdose rate would have likely been higher.
Another promising way to reduce fatal drug overdoses is by opening so-called safe injection facilities, where addicts can self-administer illicitly obtained drugs, including heroin and fentanyl, under medical supervision. Dozens of safe injection sites, also known as drug consumption sites, have been operating successfully for years in Europe and Canada, and authorities in a handful of U.S. cities - San Francisco, Seattle and New York, among them - are either considering or planning to open facilities.
Last month, the Legislature gave its blessing to a proposal under which San Francisco would be allowed to open one safe injection facility on a three-year trial basis. It was a scaled-back version of a controversial bill that gave the same permission to seven other counties, including Los Angeles. That bill stalled a year earlier after a contentious legislative battle.
The narrower bill is now on the desk of Gov. Jerry Brown. He should sign it, despite the threat leveled by Deputy U.S. Atty. Gen. Rod Rosenstein in an op-ed in the New York Times in August, the day after the Legislature approved the bill.
“Because federal law clearly prohibits injection sites, cities and counties should expect the Department of Justice to meet the opening of any injection site with swift and aggressive action,” Rosenstein wrote.
What a waste of taxpayer money that would be. Sure, it’s a bit strange for government to be in the business of helping people consume drugs. Some people think that it’s immoral to “normalize” drug use that way; others fear that government-sanctioned drug use will merely encourage the problem.
But surely, given the breadth of the problem, it’s worth a try to see if it reduces deaths.
Despite Rosenstein’s assertions to the contrary (which he bases on one person’s observations and the treatment rate at a year-old safe injection site), there are data showing that the facilities reduce overdoses and direct addicts into treatment. These aren’t dirty drug dens but sterile health facilities staffed with medical professionals who can recognize and reverse deadly overdoses, provide clean needles to reduce infection and help addicts connect with treatment providers. One study of Canada’s first safe injection facility, which has been open since 2003 in Vancouver, found that drug overdoses decreased by 35% in the surrounding community, prompting the Canadian government to develop more such facilities across the country.
Why wouldn’t we at least try out a program with such promise?
Of course, the ideal way to lower fatal drug overdoses is for people to stop using dangerous drugs. But helping people kick opioid addictions requires public investment in treatment options, and often time for treatment to work. Meanwhile, we should be doing everything possible to help addicts stay alive. That’s where harm-reduction strategies such as naloxone, needle exchanges and safe injection facilities can help.
We hope that Rosenstein’s threat was an empty one, not an indication that the Department of Justice is planning to waste its crime-fighting resources prosecuting social workers and nurses trying to help addicts. Instead, the federal government should be supporting desperate cities and counties as they work to develop strategies to cope with the effects of the overdose crisis.
Happily, Gov. Brown isn’t one to be cowed by federal government bullies when it comes to doing what’s best for Californians.
The Press Democrat on abuse of the initiative system:
Proposition 8 is nothing short of an abuse of California’s initiative process, which allows anyone with enough money to put a proposed law on the ballot.
This initiative is designed to punish dialysis clinic operators who have resisted union efforts to organize their employees. Voters shouldn’t play along.
We don’t have a position on whether clinic employees should unionize. However, we’re absolutely certain that voters shouldn’t be asked to judge a regulatory scheme for a specialty medical procedure that literally is a matter of life and death for tens of thousands of California residents suffering from serious kidney disease. That’s a job for the Legislature and the state Department of Public Health Services.
Proposition 8, sponsored by the Service Employees International Union-United Healthcare Workers West, supposedly is about improving conditions at the 588 licensed dialysis clinics around the state. Yet there is nothing in this initiative about standards of patient care.
Instead it targets clinic owners by imposing a 15 percent cap on profits and mandating rebates of any excess revenue to private health insurance companies (but, for unexplained reasons, not to Medicare or other public programs that cover expenses for many dialysis patients).
The list of authorized expenses is arbitrary. Employee salaries, benefits and training, drugs and medical supplies are allowed, but administrative overhead is not. That presumably includes a medical director and nursing (both positions are required by Medicare) and, perhaps, a payroll manager. The initiative doesn’t specify.
This slanted approach may violate U.S. and state constitutional prohibitions on government takings of private property without due process or fair compensation, according to the state’s nonpartisan legislative analyst. SEIU appears to have anticipated as much, as the initiative includes a provision allows courts to reduce the mandatory rebates to, as the analyst puts it, “just enough” that they would meet constitutional muster. That’s likely to produce a flood of litigation.
Meanwhile, the potential impact of Proposition 8 on dialysis patients is too unpredictable for the legislative analyst to do much more than venture a guess. Clinics might raise wages, the analyst said, or they could cut costs, or maybe even close.
The number of people undergoing dialysis increased 26 percent to 139,000 between 2011 and 2016, according to state figures, meaning closures would be a hardship for seriously ill patients, who would be left to travel farther, wait longer or seek treatment in hospitals.
This is likely to be one of the costlier fights on the November ballot. SEIU-UHW has raised more than $17 million to support Proposition 8, according to a report in the Sacramento Bee, and clinic owners have chipped in about $27 million to fight it.
This isn’t the first time these unions have used ballot initiatives to try to gain leverage at the bargaining table. But this fight doesn’t belong on the ballot, as voters are in no position to write accounting rules for dialysis clinics. The Press Democrat recommends a no vote on Proposition 8.
Ventura County Star on anniversary of fatal train collision:
The nation Tuesday remembered and honored the nearly 3,000 victims of the Sept. 11 terrorist attacks 17 years earlier, and rightfully so. We must never forget that horrific day of violence, and we need to continually reflect on how it changed America, for better or worse.
There’s another important anniversary this week to remember, especially in Ventura County and Southern California. At 4:22 p.m. Sept. 12, 2008, a Metrolink commuter train hit a Union Pacific freight train head-on in Chatsworth, killing 25 people and injuring 135 others.
Twenty-one of the 25 victims were from Ventura County, including 10 from Simi Valley. Wednesday is a time to again mourn that unmeasurable loss. But it’s also a time to honor the countless first responders who saved lives that day, and to applaud the improvements to rail safety that the crash - one of the worst in U.S. history - has spurred over the past decade.
“It’s such a bittersweet feeling, but if there was anything positive to come out of Chatsworth, it was the safety measures that transformed rail safety throughout the United States,” Keith Millhouse, a former Metrolink board chairman and Moorpark councilman, told The Star for its in-depth anniversary story Sunday.
Metrolink Train 111, operated by a subsidiary of French conglomerate Veolia, was traveling from Chatsworth to Simi Valley when it collided with the oncoming Union Pacific train near Topanga Canyon Boulevard. National Transportation Safety Board investigators later concluded the commuter train’s distracted engineer was sending text messages and ran a red light, causing the crash.
First responders from a host of Southern California agencies, including Los Angeles and Ventura County firefighters and paramedics, worked for nearly 24 hours to treat the wounded and recover the dead. Their tireless efforts that day should not fade away.
Metrolink officials said “positive train control” - a system that uses GPS, radio and computers to monitor trains - would have prevented the crash. To their credit, and with the help of many elected and other officials, such a system is now in place on Metrolink trains. In fact, Congress passed a law only a month after the crash to require positive train control nationwide.
Metrolink also has made other safety improvements since the crash, including new cameras on all trains and cars better able to absorb the force of collisions. The total tab has been about $500 million. And just Tuesday, we learned Metrolink will receive an additional $9.9 million grant from the U.S. Department of Transportation to upgrade the hardware on its positive train control system.
Yet a decade later, some U.S. rail systems still do not have positive train control. Millhouse called that “unconscionable,” and we agree. The deadline is the end of this year, and we urge federal regulators to turn up the heat on those out of compliance.
The nation owes that to those who died on Sept. 12, 2008: Christopher Aiken and Ernest “Pete” Kish, both of Thousand Oaks; Dennis Arnold, Aida Magdaleno and Doyle Souser, all of Camarillo; Dean Brower, of Ventura; Alan Buckley, Yi Chao, Spree DeSha, Walter A. Fuller, Ronald G. Grace, Michael Hammersley, Gregory Lintner, Donna Lynn Remata, Roger Spacey and Atul Vyas, all of Simi Valley; Jacob Hefter, of Palmdale; Chen-Wyuan Kari Hsieh, of Newhall; Paul Long, Beverly Mosley, Howard Pompel and Maria Elena Villalobos, all of Moorpark; Manuel Acosta Macias Jr., of Santa Paula; Charles Peck, of Salt Lake City; and Robert Martin Sanchez, of La Crescenta, the train’s engineer.
The Monterey County Herald on propositions 11, 12:
Proposition 12 on the November California ballot would provide bigger cages for farm animals.
In addition to placing specific size requirements on coops and cages for animals, it would also require all egg-laying hens be raised in “cage-free” conditions by 2022. Moreover, businesses in California would be prohibited from selling any food products from animals not raised in compliance with this new law, even if they come from out of state.
We recommend its approval.
In 2008, 64 percent of voters passed Proposition 2, sponsored by the U.S. Humane Society, which required that caged farm animals be allowed to stand up and turn around. The law has brought significant marketplace changes, with many major food companies now only buying and selling cage-free eggs.
But there’s more that can be done to provide a more humane environment in California. Some animal welfare advocates are unhappy this measure wouldn’t require egg-laying hens to be raised in cage-free conditions until 2022. But, Prop. 12, also backed by the Humane Society, requires that egg-laying hens be housed in an environment that allows them a minimum of 144 square inches, equal to a square foot, of space per hen. The specific cage size requirements are actually smaller than what was required under Prop. 2. The proposition also doesn’t stop at simply protecting hens. It also requires that breeding pigs and calves used for veal be cage-free by 2020 and allowed to roam inside barns. California does not have sizable pork and veal industries, but, just as it would with eggs, Prop. 12 would ban the sales from other states not meeting California’s standards.
The measure most likely would have little cost other than decreased tax revenue from farms and egg producers who might decide to get out of the egg or meat products business - which is the argument by farm industry opponents to Prop. 12 who say it may drive them out. As for the cost to consumers, McDonald’s, a major purchaser of eggs, has said the fast-food chain wouldn’t be raising prices as a result of producers having to go with cage-free hens.
While we would prefer, as we do with most ballot measures, the Legislature deal with these issues, improving the lives of hens, pigs and calves was the right thing to do in 2008. It still is. Vote yes on Proposition 12.
Proposition 11 would continue to allow private ambulance services to require their emergency medical service employees to remain on call during meal and rest breaks. The measure also guarantees technicians receive additional training and some paid medical health services.
Two years ago, the state Supreme Court ruled security guards can’t be required to remain on call during meal and other break times. Following that decision, a number of private ambulance companies - including American Medical Response, the Colorado-based company backing Prop. 11 - were hit with class-action lawsuits over alleged break-time violations.
Although, again, we would prefer this was handled by the Legislature, voters should approve this measure. The U.S. Department of Health requires that ambulance services reach 75 percent of life-threatening calls within eight minutes. This means providers need to adequately staff ambulances to meet those regulations. But if paramedics and EMT workers aren’t available during work breaks, the independent state Legislative Analyst’s Office estimates 25 percent more ambulance crews would be needed to meet state standards. Ambulance providers would be forced to either absorb the additional losses or pass the estimated total cost of more than $100 million a year on to local governments and their taxpayers.
Labor unions are opposed to this measure, which they argue is a special carve out for one industry. But Prop. 11 also protects workers, by requiring that meal breaks not be during the first or last hour of a shift and that breaks be spaced at least two hours apart. If workers are needed to respond to a call during a break, that break would not be counted as a required break.
Voters should approve Proposition 11.
The San Diego Union-Tribune on not yet trusting California Public Utilities Commission:
The California Public Utilities Commission has long had a reputation for being far too chummy with the giant investor-owned electrical utilities it regulates - as well as being hostile to lawmakers, activists and journalists trying to understand its decision-making process. But that’s not how the CPUC sees it. In response to a critical Aug. 10 piece on the CPUC by The San Diego Union-Tribune Editorial Board, a communications aide to commission President Michael Picker sent an email saying the CPUC was different now than it had been under President Michael Peevey, who left office under a cloud in 2014.
Refreshingly, an email exchange led Picker to agree to meet with the editorial board on Aug. 29. While we appreciated the visit - and the candor that Picker showed in describing the structural reasons why his agency seems so slow-moving and mysterious to outsiders - he wasn’t able to shake our concern that his agency can’t be trusted. That’s not because of a Peevey hangover. It’s because of what’s happened since Picker took over in 2015.
This is exemplified by the agency’s response to the San Onofre nuclear plant scandal under Picker. In 2014, the CPUC approved a plan to assign $3.3 billion of the $4.7 billion cost of shuttering the broken plant to the ratepayers of Southern California Edison and San Diego Gas & Electric, which jointly own it. A year later, the Union-Tribune revealed that Peevey secretly crafted the deal in an unreported meeting with an Edison executive in Poland in 2013. This led to Edison being fined $16.7 million, the deal being revised, and criminal investigations of Peevey.
It also led the CPUC to request and receive $6 million from the Legislature in 2016 so the agency “can cooperate” with the criminal probes by hiring private attorneys. Documents unsealed by a Los Angeles Superior Court judge in 2017 showed the CPUC instead sought to obstruct the probe, fighting the execution of search warrants. A judge blasted the agency’s “inequitable conduct” and said it had not honored a promise to work with investigators from the state Attorney General’s Office.
That was, simply put, an outrageous display of bad faith by a government agency - one that compounded the mistakes of Peevey and Edison. But Picker doesn’t agree. When asked repeatedly about this bad faith, he offered several versions of this statement: “I have to listen to what my attorneys tell me is proper for the courts and particularly when it’s an investigation of the agency. I don’t get to make those kinds of decisions. That’s a legal matter.”
This is the leader of the CPUC saying there’s nothing he can do about his agency’s deceit toward both the Legislature and the attorney general because those responsible were agency lawyers.
Picker also questioned the accuracy of news coverage that faulted the CPUC’s failure to follow up on wildfire safety rules and the dubiousness of its 2015 sanctions against Pacific Gas & Electric over the 2009 San Bruno disaster, saying, “the news industry is in decline and it’s sad that reporters have to work hard and they don’t always have time to truly understand these massive documents that we prepare.”
The fact Picker met with us shows he is an improvement on Peevey. This quote alone was a revelation: “We are an antiquated body that uses a forum of rulemaking and decision making that is not something people are used to, and I think that is a problem. People will probably always have doubts.”
And he doesn’t plan on defending the CPUC forever. When asked if he’d seek another six-year term, he colorfully said, “No (expletive) way.”
His whole interview is worth reading at sdut.us/picker. It offers insights into him - and how he still circles the wagons to protect an agency that deserves its bad reputation. Trust the CPUC? Not yet.
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