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California Editorial Rdp

By The Associated PressMay 22, 2019

May 22

Mercury News & East Bay Times on the need for California to invest more in state parks:

California needs a vision for its state parks that provides the next generation of families with the quality outdoor recreation opportunities they deserve.

The failure to open a new state park since 2009 marks the longest period of time California has gone without expanding its system since the state parks department was established in 1927. That includes the Great Depression.

Gov. Gavin Newsom needs to step forward with a plan for increasing the size of the park system while properly maintaining the lands the state currently controls. And he needs a new parks director who can help him provide that vision.

The current director, Lisa Mangat, is not that person. The state owes Mangat a debt of gratitude for restoring confidence in the parks system’s finances after an embarrassing 2012 scandal. Then-Gov. Jerry Brown was threatening to close 70 state parks in the midst of a budget battle when it was discovered that department officials had hidden $54 million in funds in an off-the-books accounting system.

Mangat’s expertise in fiscal policy made her the right choice then to lead the parks department. But California has not opened a new state park under her leadership. Nor has she convinced state leaders, despite strong economic growth, to provide a dedicated funding source adequate for expansion and maintenance.

Consequently, Bay Area News Group’s Paul Rogers reported last week, California’s 280 state parks, beaches and historic sites are becoming more crowded. As the state’s population continues to grow, parking and camping sites are harder to find. It’s shameful that California spends less than 1% of its budget on state parks when a small investment could make a significant impact.

Two Bay Area opportunities illustrate how California has failed to take advantage of golden opportunities to expand its parks system.

The Sempervirens Fund raised $8 million to buy 33 acres on the Santa Clara-Santa Cruz County line to build a parking lot, restrooms, signs and trails for a new entrance at Castle Rock State Park. Parking is so limited for the popular park that for years cars have lined Skyline Boulevard, creating a hazard for drivers and pedestrians. But state park officials said they wouldn’t buy the property unless it came with an endowment to provide maintenance and rangers.

In the East Bay, adjacent to Mount Diablo State Park, an environmental group came up with $7.2 million to buy Curry Canyon Ranch, a 1,000-acre property with breathtaking views. The group offered to sell the property to the state at a reduced price, but state parks officials again said they didn’t have the money.

Imagine if past California leaders had decided that they couldn’t afford to purchase the land that now makes up Big Basin, Mount Diablo, Mount Tamalpais, Big Sur and Jedediah Smith Redwoods state parks.

The governor, legislators and the state parks department must build on that legacy to ensure meaningful recreational opportunities for future generations.

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May 21

The Press Democrat on emergency room overcrowding:

There’s nothing fun about a visit to the emergency room — whatever brings you there. But it’s even less pleasant when the emergency room is overcrowded and you end up waiting hours for the urgent care you need, and hours longer if you need to be admitted to the hospital.

In California, emergency room patients are more likely than not encounter that situation. In 2017, the median wait time for patients before admission to hospitals was 336 minutes, or more than 5½ hours. For patients discharged without admission, the wait time was more than 2½ hours.

The state has been wrestling with emergency room overcrowding for years. The situation was bad 15 years ago, and it has not improved. According to a 2018 study by the California Healthcare Foundation, emergency room visits increased by 44% between 2006 and 2016 — even as hospitals worked to reduce their use.

Many factors contribute to the overcrowding. Too many people go to the emergency room for ailments that aren’t actual emergencies — sometimes because they don’t know better; sometimes because they don’t have access to a primary care physician. Though Medi-Cal was expanded under Obamacare, many California doctors don’t accept it. Sometimes it is a lack of inpatient rooms available for people waiting for admission.

Whatever the causes, those lengthy wait times and overcrowded conditions are leading to an increase in emergency room patients who essentially give up and leave against medical advice, according to a report by Kaiser Health News. And when patients leave, whatever problem brought them in originally festers, often becoming an even greater public health risk and expense.

Statewide, about 2.4% of emergency room visits ended with patients leaving against medical advice, but some hospitals had far higher rates. At Fresno’s Community Regional Medical Center, nearly 10% of emergency room patients left prematurely in 2017.

That abominably high rate prompted some necessary changes. The hospital instituted a program to place caregivers in the emergency room lobby to ensure that patients get at least some immediate attention.

“When patients bring themselves into the ED, they are seen in about five minutes by a qualified registered nurse and, on average, are seen by a provider within 30 minutes of arrival,” Dr. Jeffrey Thomas, the hospital’s chief medical and quality officer, told Kaiser Health News.

Internal hospital data shows that effort reduced premature departures to fewer than 2%.

Other California hospitals should take note of this approach.

If capacity can’t be increased to meet the demand or if demand can’t be lowered, then hospitals need to find ways to better manage the situation to ensure patients who need care don’t leave before they receive it.

Ideally, an emergency room should be for emergencies, not otherwise preventable health problems. As long as too many people don’t have access to primary care or choose not to fully engage with it, the problem will persist. That’s a bigger issue that won’t be fixed in the short term. Implementing strategies to make sure patients are seen in a reasonable time and not allowed to leave without treatment is much more attainable.

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May 21

Los Angeles Times on the College Board adding an adversity score to the SAT:

When the University of California threatened to drop the SAT as a college entrance requirement more than 15 years ago, the College Board eliminated the analogy questions and introduced a new essay portion. The changes helped keep the test in business but didn’t necessarily make it a stronger predictor of whether students would succeed in college. The new writing portion, in particular, was poorly designed and easily gamed by composing longer essays and using what Mark Twain would call five-dollar words.

In more recent years, new concerns have arisen about the SAT, and especially about the advantage it gives to affluent students who have attended academically robust schools and benefited from the help of SAT tutors. Making matters worse, this year’s college admissions scandal showed that the SAT is far from impervious to cheating.

These days, more than 1,000 colleges and universities do not require the SAT or its competitor, the ACT; the University of Chicago is among the most recent to have dropped the requirement. The University of California is studying how useful the tests really are in finding great applicants. The College Board has revamped the test yet again and added access to a free online tutoring program, but the objections have continued.

Against that backdrop, the College Board has now announced its latest gambit: It is adding a new score to students’ SAT reports designed to show the level of adversity they have faced. On a scale of 1 to 100, the “Environmental Context Dashboard” is supposed to give admissions officers a sense of what students have had to overcome in life, which can then be used by colleges in deciding whom to admit. The student’s “overall disadvantage level” will be calculated based on 15 factors, including whether he or she lives in a neighborhood that struggles with poverty, crime and family instability, or has attended schools where relatively few students take challenging courses. The income, education and marital status of families in the student’s neighborhood are also among the factors considered.

The College Board is right about this much, at least: Admissions officers should take into account the obstacles that students have faced and overcome. Performance on the SAT is highly correlated with family income and education.

But the new adversity score is all wrong when it comes to accomplishing the task at hand. It is a blunt instrument that won’t give colleges accurate information about each student. The index doesn’t provide information about the actual student; it’s a theoretical number based on neighborhood census data, FBI crime data, school data and other sources. It ignores the fact that students face all kinds of difficulties, many of them immeasurable.

After all, unstable families, ill health and domestic violence occur in affluent areas, too. In addition, a fair number of poor families live in middle-class and affluent enclaves. In the Beverly Hills Unified School District, 17.5% of students are classified as socioeconomically disadvantaged, meaning that they qualify for free or reduced-price school lunches, and/or have parents who never made it through high school. Other low-income families put in huge efforts to enroll their children in high-performing charter schools or magnet schools. Such students could end up being penalized because their parents worked hard to get them a better education.

In addition, students won’t be allowed to see their own scores of privilege or disadvantage, which means they won’t be able to challenge ratings that are off base. And it’s not impossible to imagine families working the system by setting up phony addresses in low-income areas. That may sound a little crazy — but it’s no more so than Photoshopping applicants’ faces onto the bodies of athletes, which was allegedly done for some of the students caught up in the recent college admissions scandal.

The disadvantage score seems ill-thought out. But it also leads to bigger questions about the SAT generally: Is it an effective measure of future college success for all students or only those who have not faced tremendous adversity? Or does it work only when students are compared with those of similar backgrounds? If so, what’s the point? It’s reasonable to think that a proctored, standardized exam can at least provide a check on inflated grades and subjective college recommendations, but a state’s own standards tests could do the same without costing families any additional money. All eyes are on the UC study of the tests. Maybe it will point the way to a fairer and more rational way forward.

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