Bay Area News Group: California's Vaccine Law: Opponents Moving, Home Schooling To Avoid Controversial Mandate
Senate Bill 277, which last year triggered one of the most contentious debates in the state Capitol in years, takes effect Friday. But tens of thousands of Californians still remain vehemently opposed to a mandate they consider a violation of their parental rights. The law, however, is being hailed by its proponents as a victory for public health. They say state records show it is already achieving measurable results in raising the number of vaccinated children. (Seipel, 6/30)

Bay Area News Group: New California Vaccine Law: Some Questions And Answers
Senate Bill 277 requires almost all California children who attend private or public schools to be fully vaccinated regardless of their parents' personal or religious beliefs. Unvaccinated children can attend schools only if they obtain a medical exemption from a doctor. Q. When will the law take effect? A. Friday. Schools will be required to verify students' immunization records before the start of kindergarten and seventh grade. (Seipel, 7/1)

In other news out of Sacramento —

Sacramento Business Journal: What $2B In State Grants To House The Homeless Means For Sacramento
The state Legislature passed a bipartisan bill Thursday that provides $2 billion in grants for housing projects that would give permanent shelter to homeless people with mental disabilities. Gov. Jerry Brown has endorsed the bill and is expected to sign it. The “No Place Like Home” initiative was drafted with help from Mayor-elect Darrell Steinberg and is supported by the city of Sacramento. (Young, 7/1)

San Francisco Chronicle: November Ballot Crowded With Weighty Measures
California voters will face a long and weighty list of statewide ballot measures this November — 17 measures in all made Thursday’s fall election deadline and they include big decisions on the death penalty, marijuana use and taxes on the wealthy. “It’s incredible the amount of substance and complexity on the November ballot,” said Mark Baldassare, president of the Public Policy Institute of California. “It’s going to be overwhelming for voters to deal with.” (Gutierrez, 7/1)

The San Diego Union-Tribune: Sharpening The Focus On Medical Errors
Focus on deepening the hospital’s safety culture tightened in 2012 when a surgical team mistakenly removed patient Paul Kibbett’s healthy left kidney though a cancerous tumor had been discovered on the right. Ultimately both organs were removed, and the patient was forced to rely on dialysis for the rest of his life. In addition to a lawsuit, Sharp [Memorial Hospital in San Diego] received a $100,000 fine and bad publicity .... The incident highlighted a simple truth: Rules and procedures only work if all of the people involved actually follow them every single time. (Sisson, 6/30)

The San Diego Union Tribune: Do Penalties Reduce Medical Errors?
California has issued $17 million in fines for severe yet preventable medical errors since 2007, publicly shaming 192 hospitals for everything from leaving surgical sponges inside patients to giving fatal doses of medication...But the state’s penalty system, the only one of its kind in the United States, has failed to bring about a significant reduction in such incidents, according to an analysis of state data by The San Diego Union-Tribune. In fact, even after marked improvement between 2014 and last year, the number of errors is still higher than when California’s program began nine years ago. (Sisson, 6/30)

The New York Times: Zenefits Compensates Investors Over Past Misconduct
Zenefits investors are getting a larger piece of the troubled human resources start-up because they overpaid for their stakes, unaware that the company’s sales teams flouted regulations to enhance growth, Zenefits announced on Thursday. The move will cut the company’s valuation in half, to about $2 billion. The unusual agreement comes after months of turmoil at Zenefits, once a high-flying company that helps small businesses buy insurance. (Benner and Isaac, 6/30)

San Francisco Business Times: Zenefits CEO Cuts Deal With Investors To Avoid Litigation, Slash Valuation
In the latest surprise from struggling startup Zenefits, CEO David Sacks has given Series C investors a bigger stake in the company to compensate them for its shrinking valuation of $2 billion — less than half what it was just over a year ago. Investors put $500 million into the then-high-flying health care insurance and benefits startup last May, which at the time gave them an 11 percent stake in a venture valued at $4.5 billion. (Rauber, 6/30)

The Wall Street Journal: Zenefits Investors Cut Valuation By Half
Embattled health-benefits broker Zenefits on Thursday said it struck a deal with some investors to cut its valuation by more than half to $2 billion, giving them additional shares in exchange for releasing the company of potential legal claims. Zenefits, a once highflying startup that in just two years after its founding was valued at $4.5 billion, has been reeling from regulatory investigations, stalled sales, layoffs and management missteps. On Thursday, Zenefits’s recently installed chief executive, David Sacks, said the company has been trying to work out a deal with investors to move past the problems. (Winkler, 6/30)

Reuters: Scandal-Hit Zenefits Slashes Own Valuation As It Cuts Deal With Investors
Software startup Zenefits has cut a highly unusual deal with investors to increase their ownership while slashing the once-hot firm's valuation as it seeks to avoid litigation and mend damage in the wake of revelations of cheating. The deal, a concession to investors in the firm's latest funding round, will boost the investors' combined stake to about 25 percent from about 11 percent but cuts the Zenefits' valuation by more than half to $2 billion from $4.5 billion. (Somerville and Todd, 7/1)

KPCC: An Inside Look At The World Of Drug Presentations
Psychiatrist Dr. Jason Kellogg is proud that drug makers ask him to make presentations to his peers about their products. ... According to data from the Centers for Medicare and Medicaid Services, drug makers paid Kellogg $355,000 in 2014. He is part of an elite club of providers -- less than 1 percent of those at California hospitals with 50 or more doctors -- who earn six figures or more from drug and/or device companies for speaking and consulting. Some make handsome sums in royalties. (Agullera, 7/1)

KQED: Northern California Has Highest Costs In The U.S. To Deliver A Baby
Sacramento and the San Francisco Bay Area ranked as the most expensive places to have a baby of 30 major metropolitan regions in the U.S. according to an analysis released Thursday. Sacramento came in first (congrats to you) where a vaginal birth cost $15,420 on average. The San Francisco Bay Area was a close second at $15,204. Minneapolis trailed in third place by almost $4,000, coming in at $11,527, and the least expensive of the 30 largest metropolitan areas surveyed was Kansas City, Missouri, where a vaginal delivery costs an avery $6,075. (Aliferis, 6/30)

Los Angeles Times: Planned Parenthood Targets Eight States' Abortion Restrictions
Emboldened by this week’s Supreme Court ruling, Planned Parenthood has launched a campaign to repeal laws in eight states it says restrict women’s ability to get an abortion. The group plans to target abortion laws in Arizona, Florida, Michigan, Missouri, Pennsylvania, Tennessee, Virginia and Texas. Though portions of Texas’ abortion law were found unconstitutional by the Supreme Court, Planned Parenthood said the state has additional restrictions it intends to fight. “We have spent years building the infrastructure to fight these laws.… Getting ready for the day when we could put that plan into action,” said Dawn Laguens, executive vice president of the Planned Parenthood Action Fund. “That day is now.” (Hennessy-Fiske, 6/30)

KQED: Here’s Where Zika Mosquitoes Are Likely Found In California
The first thing to know about the mosquito that can carry Zika is that it is not widespread in California. Most of California’s 58 counties do not have — and have never had — any infestation of the Aedes aegypti mosquito, the most worrisome carrier when it comes to Zika. The Centers for Disease Control and Prevention has crunched data from across the country and created a national map showing where the Aedes aegypti mosquito has been found any time over the past two decades. We asked CDC for the county-specific data in California. Click on the map above to see how your county fares. (Aliferis, 6/30)

Orange County Register: O.C. Nonprofit: After 117 Lives Saved, We're Running Out Of Drug That Blocks Heroin Overdoses
On Saturday, an Orange County nonprofit will run out of a heroin-blocking medication that it distributes weekly, eliminating the county’s only free supply of a drug the group says has revived at least 117 people from overdoses over the past four months. Since late February, the Solace Foundation, working with the Orange County Needle Exchange Program, has distributed 610 kits of naloxone at the Santa Ana Civic Center. The drug has provided heroin users with an easy-to-administer medication that blocks the effects of opiates, reversing potentially fatal overdoses in seconds. (Graham, 6/30)

Los Angeles Times: Hundreds Of Companies In The U.S. Are Selling Unproven Stem Cell Treatments, Study Says
From coast to coast, at least 351 businesses at 570 locations are marketing stem cell therapies that have not been fully vetted by medical researchers or blessed by the U.S. Food and Drug Administration, according to a study published Thursday in the journal Cell Stem Cell. Paul Knoepfler, a bona fide stem cell researcher at UC Davis with a doctorate in molecular pathology, and Leigh Turner, a bioethicist at the University of Minnesota who studies the ramifications of medical tourism, scoured the Internet to find companies advertising all sorts of stem cell treatments directly to patients and their families. They used nearly 100 search terms to identify as many websites as they possibly could — and turned up a lot more than they thought they would. (Kaplan, 6/30)

Oakland Tribune: Sutter Health: State-Of-The-Art Medical Helicopters, Ground Ambulances To Provide Quicker, More Efficient Service
Sutter Health's critical care patients can now expect quicker and more efficient transfers from one facility to another thanks to its new fleet of medical helicopters and ground ambulances. The nonprofit announced on Thursday it would be partnering with California Shock Trauma Air Rescue (CALSTAR) and American Medical Response (AMR) to operate its own fleet of helicopters and ambulances, respectively. While Sutter has teamed up with the emergency medical transport providers in the past, the new partnerships enable the health provider to more effectively coordinate its efforts, said Ted Matson, vice president of strategy for Sutter Health. (Baldassari, 6/30)

In other news from across the state —

KPCC: Meningitis Outbreak Prompts LA Clinics To Offer Free Vaccine
Two area organizations that serve the gay community and those with HIV/AIDS are now offering the meningitis vaccine, following last week's announcement of an outbreak in Southern California. As of Thursday, the AIDS Healthcare Foundation is offering the vaccine for free at its after-hours clinics, which are held at its regular treatment centers. AIDS Project Los Angeles is offering the vaccine for free at its health centers in Long Beach and Baldwin Hills. (Plevin, 6/30)

Capital Public Radio: Rural Health Focus Of Grant Program
Mark Twain Medical Center in San Andreas is awarding grants to organizations that want to improve the health of people living in Calaveras County. Project proposals must address unmet health needs in the rural county, which include childhood obesity, congestive heart failure and diabetes prevention. Nicki Stevens, manager of marketing and business development for the center, says access to health care has been a problem for the county located in the foothills. (Johnson, 6/30)

Los Angeles Times: Medical Marijuana Dispensaries Should Be Up To Voters, City Says
Laguna Beach City Council members agreed Tuesday that they still wanted voters to decide whether medical marijuana dispensaries should be allowed in the city. The issue came to the fore in April, when the council learned authors of a petition that would repeal the city's current ban on dispensaries gathered enough signatures to place the matter on the November ballot. Since then, the city has wrestled with how to respond. (Alderton, 6/30)

The Associated Press: About 1.6M Drop-Outs From Health Law Coverage This Year
About 1.6 million people who signed up for coverage this year under President Barack Obama's health care law dropped out by the end of March, according to administration figures released late Thursday. The report from the Health and Human Services department said some 11.1 million people were still signed up. But that's a drop of nearly 13 percent from the 12.7 million who initially enrolled for subsidized private coverage this year. Those dropouts failed to seal the deal by paying their premiums. (6/30)

In other national health care news —

Politico: Anti-Opioid Bill Touted By Vulnerable Republicans Hits Snag
Republicans looking to pass legislation addressing the nation’s opioid crisis and Zika epidemic before skipping town to campaign for the summer are running into a nettlesome problem: Senate Democrats. The Senate minority blocked a $1.1 billion Zika funding proposal due to what they called “poison pill” riders earlier this week. And now, as Republicans try to wrap up House and Senate conference negotiations on fighting the spread of heroin and prescription pill addiction, Democrats are demanding that Republicans plow new funding into combating opioids. ... Democrats’ renewed demands for appropriating new spending, rather than authorizing spending but not actually providing new funds, could have serious political implications for Republicans. (Everett and Haberkorn, 6/30)

The Washington Post: Americans Were More Worried About Ebola Than They Are About Zika
The global spread of the Zika virus and its links to severe birth defects have yet to worry most Americans, and few are taking measures to limit their exposure to the mosquito-borne disease, according to a new Washington Post-ABC News poll. Two-thirds of Americans say they are “not too” or “not at all” worried about Zika infecting them or a family member, while one-third are at least “somewhat worried.” Fewer Americans are concerned about Zika infections today than were worried about the deadly Ebola epidemic at its height. (Dennis, Sun and Clement, 6/30)

Bloomberg: Anthem-Cigna Meltdown Might Spark Deals for Smaller Health Plans
A breakup of Anthem Inc.’s $48 billion bid for Cigna Corp., under scrutiny by U.S. antitrust regulators, could spark new deals for smaller health plans in a continued wave of industry consolidation. Smaller insurers could become targets for Cigna, including WellCare Health Plans Inc., Centene Corp. and Molina Healthcare Inc. Anthem, meanwhile, may chase after assets that might be sold by industry rivals Aetna Inc. and Humana Inc. as they seek approval for their $35 billion tie-up. (Tracer and McLaughlin, 6/30)

Bloomberg: Drug, Device Makers Gave U.S. Doctors, Hospitals $6.49 Billion
U.S. doctors and teaching hospitals got $6.49 billion in research and speaking fees, food and other goods or services from drug, biotechnology and medical-device companies in 2015, according to an annual report by the government. The data released Thursday represent the second full year of disclosures from the industry, describing financial links with clinicians who prescribe and use their products. The amount paid by manufacturers is on par with 2014, when they made $6.43 billion in payments. (Chen and Tracer, 6/30)

Sacramento Bee: Gridlock In Congress Gets Dangerous As Anti-Zika Funding Delayed
Given how dysfunctional Congress is, we expect partisan battles to sometimes block important legislation. Still, the current standoff over $1.1 billion to fight the Zika virus is absurd – and dangerous. Lawmakers ought to be ashamed – if they have any shame left – that they’re holding hostage essential funding for what is a real public health emergency. (6/29)

Orange County Register: Congress' 'Outrageous' Obamacare Exchange Fraud
In defiance of the ACA, the Office of Personnel Management implemented a rule allowing congressmen and their staff to enroll in the D.C. Small Business Exchange, a health insurance marketplace Vitter says is “explicitly reserved” under ACA “for employers of … 50 persons or fewer.” In order to be eligible to purchase health insurance on the D.C. Exchange, Congress, which employs about 20,000 people, needed to enroll as a qualifying “small business.” In October 2013, unnamed staff in both the Republican-led House and Democrat-led Senate applied separately to the D.C. Exchange as employers with only 45 employees each, a designation they have kept – quite dishonestly – ever since. (Justin Haskins, 7/1).

Los Angeles Times: The Supreme Court Ruling Is An Abortion-Rights Victory. But It Doesn't Guarantee Access To Services
Over seventy percent of American women who live in rural areas already have to travel more than 50 miles to get an abortion. Making it ever more onerous, a 2011 Texas sonogram law requires each woman to either view an image of her fetus or hear it exhaustively described, and then wait at least 24 hours before the procedure (often, the wait time is longer due to the demand for services providers face). This means that there is no single-day abortion procedure available in Texas. Even simpler medical abortions, ie. pill-based procedures, require an overnight visit, or a series of visits.The court’s ruling does not affect that law, and offers no guarantee of universal access. (Melissa Batchelor Warnke, 6/28)

Los Angeles Times: After A SCOTUS Setback, Pro-Lifers Should Focus On Preventing Unwanted Pregnancies
Hopefully antiabortion activists will take this opportunity to focus more on preventing unwanted pregnancies. Colorado offers a good example of how prevention programs result in less unwanted pregnancies. Since 2009, the state has offered intrauterine devices and implants to teenagers and poor women. The birth rate among these populations declined by 40% between 2009 and 2013. (Berta Graciano-Buchman, 6/29)

Modesto Bee: States Can’t Block Right To Abortion
A woman has the right to determine when and whether she will bear a child. That right – first established by the U.S. Supreme Court in Roe v. Wade in 1973 – was reaffirmed on Monday when the court struck down a law that placed obstacles in front of Texas women who wanted to get an abortion. The 5-3 decision in Whole Woman’s Health v. Hellerstedt stems from a 2013 law that set specific “safety” requirements on abortion providers. (6/28)

LA Daily News: Abortion? Immigration? No, Court’s Biggest Rulings Are Yet To Come: Susan Shelley
The Supreme Court’s ruling in Whole Woman’s Health v. Hellerstedt, striking down two provisions of a Texas law as an unconstitutional burden on women seeking an abortion, was a reassuring victory for supporters of abortion rights. But Hillary Clinton sounded the alarm. “This fight isn’t over,” she tweeted after the decision was announced. (Susan Shelley, 6/30)

LA Daily News: Should Pharmacists Have Religious Freedom?
The U.S. Supreme Court has refused to hear a case involving religious freedom and the pharmacy profession. This lets stand a Washington state law requiring pharmacies to dispense all federally approved drugs — including so-called morning-after birth control pills that some pharmacists object to for religious reasons. Was this the right decision? (Ben Boychuk and Joel Mathis, 6/30)

Orange County Register: California Law Should Be Strengthened To Allow Rape Victims To Seek Civil Justice
The U.S. Department of Justice has five open Title IX sexual assault investigations ongoing against Stanford. According to Michele Landis Dauber, a Stanford law professor, only one student in its history has been expelled for sexual assault. That statistic illustrates that Stanford has, at best, an institutional indifference and, at worst, an acceptance of a rape culture. (John Manly, 7/1)

Orange County Register: The High Price Of "Cheap" Drugs
Fifty percent more people overdose today than in 2006. Fortunately, the Food and Drug Administration just approved the anti-addiction treatment Probuphine. It’s an implant placed in a person’s upper arm, where it releases a steady stream of an anti-addiction drug called buprenorphine to help addicts stay sober. (Sally C. Pipes, 6/27)

Bakersfield Californian: Everyone Deserves Health Care
Orange County is simply not the same without Disneyland. Silicon Valley would suffer without Google and Apple. Kern County would fail without agriculture, and Kern County’s agricultural economy would collapse without farm workers...Undocumented Californians constitute a vast majority of farm workers in our state. Thousands of these adult residents plant our crops, pick our produce, pack our trucks and keep the agricultural industry humming, yet the only access they have to health care in Kern County is in the emergency room, and the county spends billions of dollars each year on emergency room costs because that’s where families go when they don’t have health care. (Pilar Medrano, 6/29)

Oakland Tribune: Health Care Needs 'High-Risk Pools
Obamacare guarantees all Americans health insurance. But it doesn't guarantee that coverage will be affordable. That's becoming a bit of a problem. This year, premiums were up an average of 8 percent. In many states, double-digit premium hikes were the norm. Next year, they're likely to be even bigger, according to Marilyn Tavenner, the former chief of the Centers for Medicare and Medicaid Services under President Barack Obama and current head of the insurers' main trade group -- America's Health Insurance Plans. (Sally Pipes, 6/28)

Los Angeles Times: Take It From A Trauma Center Physician — Gun Violence In America Is As Routine As The Sunrise
As an emergency physician working at a trauma center, I recently got a call for a gunshot wound victim headed to us just as I walked in the door. We received another call for a second victim while still trying to revive the first. Neither one survived. Being unable to save these lives was tough. The difficult conversations with the families of these victims were devastating. But somehow, the worst part of my day was when I walked out of the hospital and realized that nothing out of the ordinary happened at work that day. Seeing patients die from gun violence is just normal for me. (Erick Eiting, 6/26)

Orange County Register: State Officials Addicted To Nicotine Taxes
The tobacco-tax initiative’s backers say “an increase in the tobacco tax is an appropriate way to decrease tobacco use and mitigate the costs of health care treatment.” It’s true that a higher tax discourages smoking. So a higher e-cigarette tax would also discourage vaping, which happens to be a great way to stop smoking. The logic seems inescapable that hiking taxes on vaping products is more about revenue than public health. (Steven Greenhut, 6/25)

Los Angeles Times: Stop Worrying About GMOs; It's That Organic Granola Bar That Could Make You Sick
Karma can be so cruel. Just think how many times anti-GMO activists have protested against the imaginary risks of food that has been genetically modified. Now a favorite snack of those same protesters, the sacred granola bar, has been found to pose an actual health risk. ... Recalls of organic foods amounted to 7% of all food units recalled in 2015, even though organic farms account for only about 1% of agricultural acreage. In early June, several types of Clif Bars were recalled from stores because they contained organic sunflower kernels potentially contaminated with a bacterium called listeria. (Henry I. Miller, 6/30)