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Kaiser facing accusations that patients are losing mental healthcare

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Months after Kaiser Permanente reached a sweeping agreement with state regulators to improve its mental health services, the healthcare giant is facing allegations that patients could be improperly losing such care.

The National Union of Healthcare Workers, which represents thousands of Kaiser mental health professionals, complained earlier this year to state regulators that Kaiser appeared to be inappropriately handing off decisions about whether therapy is still medically necessary.

The union alleged that Rula Health, a contracted network of therapists that Kaiser uses to provide virtual care to its members, had been directed by Kaiser to use “illegal criteria” to make those decisions during regular reviews.

California requires such decisions about mental health care to be based on criteria developed by professional groups, but the union said there was no evidence that was happening. Instead, the union complained that documents indicated Rula was relying on questions answered by Kaiser patients about their own symptoms.

The risk is that patients “have a psychological disorder that requires additional treatment and Kaiser is unfairly and improperly terminating their access to care,” said Fred Seavey, a researcher for the union.

The union also alleged that regularly requiring such “clinical care reviews” violated laws barring insurers from putting up barriers to mental healthcare that don’t exist for other health conditions. Kaiser does not subject other outpatient care to such reviews, “let alone at such frequencies,” the union said in its complaint.

The union called on the California Department of Managed Health Care to order Kaiser to immediately halt that review process and notify any Kaiser patients whose treatment was “illegally terminated” by Rula.

Kaiser said in a statement that it does not set limits on the number of therapy sessions, and that “the level of therapy needed and the frequency and number of sessions for any patient is a decision made by our mental health care providers in consultation with patients and as appropriate based on the patient’s clinical needs.”

It added that “the self-assessment tools do not determine whether treatment remains medically necessary. … Patient self-assessment tools may be used as one aspect of gathering information from the patient but are never the only factor.”

A Department of Managed Health Care spokesperson said its enforcement office was looking into the issues raised by the union under its recent settlement with Kaiser. That agreement, reached last fall, required Kaiser to pay a $50-million penalty and invest $150 million over five years into improving its mental healthcare.

The state agency said it had found shortcomings at Kaiser related to failures to provide timely appointments, insufficient oversight of medical groups in determining “appropriate care,” and inadequate handling of patient grievances, among other issues.

Among the problems that DMHC noted: Medical records for patients did not show the use of legally required guidelines for making decisions about mental health treatment. Patient records instead showed “self-assessment scores” from questionnaires, according to the settlement agrement.

Kaiser Permanente chief executive Greg A. Adams said last year that the organization had seen demand for mental healthcare surge amid the pandemic, which collided with an “ongoing shortage of qualified mental health professionals, clinician burnout and turnover,” as well as a 10-day strike by mental health clinicians.

In a recent statement, Kaiser said it was “in the process of implementing transformational changes contemplated by the settlement agreement,” including a “dramatic increase in the number of providers available to see our members — both newly-hired therapists and contracted therapists.”

A Rula spokesperson said in a statement that its therapists, “in collaboration with their patients, make all clinical decisions around the course of care.”

In Chino, Jaklynn Fuentes-Soto said she was told by her therapist earlier this year that her sessions with the Rula provider would soon stop, even though “my therapist thought that I should continue treatment.” The 25-year-old said that if she wanted to keep seeing the therapist, she would have to pay out of pocket.

As a student working part time, “I don’t think that financially I’m able to.”

Fuentes-Soto said she has been diagnosed with major depressive disorder and other mental health conditions. She said she had been regularly seeing her therapist after one episode led her mother to take her to the emergency room.

“If I’m not having the help that I need for my mental health,” she said, “it has me regress to a very dark place.”



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Unconfirmed sighting of mountain lion in Griffith Park recalls L.A.’s favorite big cat, P-22

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The mountain lion was caught in the Tesla’s headlights. Vladimir Polumiskov moved both quickly and slowly, not wanting to draw unwanted attention.

He put his 2-year-old son back in the car seat and got behind the wheel and quietly closed the door. His wife, Anastasiia Prokopenko, was in the passenger seat; she couldn’t believe what they were seeing.

“No way. No way,” she said. “Get in the car. Get in the car.”

The family, just back from a sushi dinner on Tuesday night, had pulled into a parking space at their apartment complex off Barham Boulevard in the Hollywood Hills. Living on the western edge of Griffith Park, they were accustomed to seeing wildlife — coyotes, bobcats, deer, foxes — wandering into their backyard. But a mountain lion was extreme.

“We’re not getting out,” Prokopenko said.

Less than 13 feet away, the cat was sitting on the low-angled trunk of an oak tree, partly hidden by weeds, his blond coat set off by the bright lights. Polumiskov, 30, reached for his phone and started shooting video.

“This guy was huge,” he said.

Though the sighting has not been confirmed by the National Park Service, which oversees the Santa Monica Mountains National Recreation Area and has also studied wildlife in the 4,000 acres of Griffith Park, the possibility of a mountain lion making its home in this island wilderness may give many Angelenos a sense of déjà vu all over again.

The mountain-lion king of Griffith Park — a cat known as P-22 — roamed these hills for 10 years. Captured in December 2022, he was euthanized after a team of doctors determined that because of internal injuries and infection, he was too sick to return to the wild.

A few months before, Polumiskov said he had seen P-22 skulking through the same parking lot before running off. “I had the same reaction then,” he said. “That doesn’t change. It was shocking.”

“Los Angeles misses P-22,” said Beth Pratt of the National Wildlife Federation, perhaps his most ardent champion.

In February 2023, Pratt helped organize at the Greek Theatre a sold-out celebration of his improbable life in Griffith Park, drawing more than 6,000 people wanting to pay their respects to the charismatic cat who, surrounded by development, freeways and cemeteries, lived peaceably in the center of Los Angeles.

Seven months later, the eighth annual official P-22 Day festival drew 15,000 attendees.

When Pratt first heard of this new sighting, she felt slightly overcome.

“It does my heart good,” she said . “It felt like P-22 had sent someone back to us — just to keep the hope alive that we hadn’t entirely banished the wildness in our lives.”

The National Park Service, which has reviewed Polumiskov’s video, is taking the claim seriously, according to spokesperson Ana Beatriz Cholo.

The park service has been studying the mountain lion population in the Santa Monica Mountains since 2002, when it collared its first cougar, which was given the name P-1 (P is for puma). Since then, it has tracked and collared 121 of the animals throughout the park.

If collared, the big cat in last week’s video would be P-122.

Video of a mountain lion spotted on Tuesday near Barnham Boulevard in Toluca Hills, new Hollywood. (Vladmir Polumisko)

“I’m a scientist at heart, but there is something almost mystical about this,” said Pratt, referring to the coincidental possibility that the two cats in Griffith Park would share so similar a number.

Park Service researchers are conducting interviews and combing through footage from wildlife cameras positioned throughout Griffith Park.

“We obviously want to make sure we confirm this is the real thing,” Cholo said. “Hopefully we’ll get that in the near future.”

But hope aside, she added, there is no guarantee that the mountain lion will stick around. Pumas need up to 200 square miles of habitat, and Griffith Park offers a little more than eight.

After shooting the video, Polumiskov put the Tesla in reverse and found another parking space far away from the mountain lion. Two hours later, he returned with a friend, and the cat was still there.

“He was still sitting in that tree, looking at us,” he said. “He is a beautiful, beautiful animal, young and healthy, perhaps the biggest mountain lion I’ve seen in my life.”

Four months earlier, Polumiskov had seen — while driving — what he believed was also a mountain lion. But without evidence, his family and friends doubted him. Now he had something more tangible.

The next day, he got a call from Jeff Sikich, a wildlife biologist and mountain lion specialist with the park service, who asked him a few simple questions — where and when — and reminded him to play it safe.

“He definitely educated me,” Polumiskov said.

“While it is exciting to see a wild animal,” said Cholo, “if you see a mountain lion, give it space. Don’t follow it. As tempting as it might be, this is a big cat and its behavior can be unpredictable.”

The total number of mountain lions in California is estimated to be between 3,200 and 4,500. About a dozen of the cats are said to live in the Santa Monica Mountains, and they are at risk for extinction because of low genetic diversity.

The current construction of a wildlife corridor over a 10-lane stretch of the 101 Freeway at Liberty Canyon in Agoura Hills promises to be a critical lifeline for the endangered species. When completed in 2026, it will be the largest — 200 feet long and 165 feet wide — and most expensive bridge of its kind in the world.

“The Wallis Annenberg Wildlife Crossing is critical” for the survival of the species, Pratt said . “But Griffith Park also needs safe routes for its wildlife trying to navigate the city.”



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Former CIA director reacts to Stefanik’s remarks about ‘wiping’ Hamas ‘off the face of the Earth’

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House GOP Conference Chair Elise Stefanik delivered remarks at the Israeli Knesset Sunday, saying victory for Israel in the war against Hamas starts with “wiping” those responsible for the October 7 terrorist attacks “off the face of the Earth” and calling for a return to former President Donald Trump’s policies. Former CIA director Leon Panetta reacts.



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Texas crime victims liaison pleads guilty to human smuggling with county vehicle

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A Texas crime victims coordinator who was employed by the Starr County District Attorney’s Office has pleaded guilty to using a county vehicle to smuggle immigrants into the United States.

Bernice Garza pleaded guilty Friday to conspiracy to transport undocumented people within the United States, according to a report from KRGV.

Two others, Magali Rosa and Juan Antonio Charles, were also arrested in connection with the investigation and have pleaded guilty to human smuggling charges, according to the report.

TEXAS CRIME VICTIMS LIAISON ARRESTED AFTER ALLEGEDLY USING COUNTY-ISSUED CAR IN HUMAN SMUGGLING SCHEME

Texas human smuggling arrest

A 2015 Chevrolet Traverse with the emblem of the Starr County District Attorney’s Office in Texas. An employee of the office was fired after the car was used in a human smuggling scheme, authorities said. (Victoria County Sheriffs Office)

Garza was arrested in December 2022 after a traffic stop in Victoria County noted that the vehicle registered with the county was making “numerous unauthorized trips to the Houston area,” the criminal complaint said.

Magali Rosa was the driver of the vehicle, according to police, while Garza and Charles were among the passengers in the vehicle.

Police say Rosa tried to argue that Garza was the Starr County district attorney during the stop, though she later confessed to making over 40 smuggling trips from Rio Grande City to Houston in the government vehicle.

Texas

Houston skyline (Reuters/Richard Carson)

FOX NEWS CREW WITNESSES DRAMATIC HUMAN SMUGGLING BUSTS BY TEXAS AUTHORITIES

“This investigation is an example of no one being above the law, and our office taking swift action in eliminating public corruption,” the DA’s office said in a statement after the arrests.

Garza was soon terminated from the DA’s office, while the four migrants who were in the vehicle at the time of the stop were turned over to the U.S. Border Patrol.

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Sentencing for Garza and Charles was set for Sept. 28, the reporting notes, while sentencing for Magali Rosa is set for June 27.



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