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Telemedicine Is Transforming Patient Care in California – With Some New Challenges

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When Dr. Andrea Goings launched her mobile medical service, offering athome doctor visits and virtual consultation sessions via video in 2016 in the Los Angeles areashe did not know that just four years later her business model would be more the norm than not. 

Dr. Andrea Goings mobile medical service Los Angeles area.

Goings, an African American pediatrician, launched her service in West Lake Village, a city about 40 miles northwest of Los Angeles near the Ventura County line. She made house calls to patient homes across the metropolitan area. 

“Technology has changed the way we approach and experience so many aspects of our lives, so I thought at the time, why not apply it to the work I do,” said Goings, who has been able to provide care to patients in various parts of the country while she is temporarily in Ohio caring for her mom as she recovers from surgery
“Being able to save busy parents from long waits in the emergency room or long drives to doctor appointments or giving them around-the-clock access to medical advice from the comfort of their home are all reasons clients have appreciated BabyDocHouseCalls.com over the years. Now, there is an added safety component that makes the service convenient, even necessary, for so many.”
Goings said because her businesses gave her a head start. Therefore, pivoting to respond to the constraints COVID-19 safety measures have imposed on clinical care, has been easy for her.  
“Telehealth is a really good option for young adults who have returned to college campuses and dorms,” she says. 
The California Department of Health Care Services (DHCS) says remote consultations like the kind Goings’s provides should not be technically regarded as a distinct service, but an “allowable mechanism” through which medical practitioners can provide clinical services. 
The standard of care is the same whether the patient is seen in-person, by telephone, or through telehealth. As a result, DHCS has strongly encouraged all counties to work with providers to maximize the number of services that can be provided by telephone and telehealth, to minimize community spread of COVID-19,” said Ivan Bhardwaj, Section Chief, Community Services Division at the DHCS. 
The DHCS has requested that all medical care providers adhere to all federal, state, and local guidelines. 
The U.S. Department of Health and Human Services Office of Civil Rights says it will use “enforcement discretion” and it will not impose penalties for non-compliance with all aspects of the HIPAA rules when healthcare providers use telehealth in “good faith” during the COVID-19 public health emergency. The DCHS has also relaxed some of its rules to accommodate telehealth, expanding platforms allowed to include popular video services such as Apple’s FaceTime, Facebook’s Messenger video chat, Google’s Hangouts and Skype.
“So far it’s been great. No problems. We’ve been able to keep all of our doctor appointments and do it safely” said Joe Bowers, Ladera Heights resident in Los Angeles County who is retired and writes a column on education for California Black Media. Bowers says, “My wife, Margaret and I appreciate the convenience of visiting with our doctors — from the comfort of our home.” 
 
For some critical mental health services that are vital to some of the most vulnerable Californians during the pandemic, like Medication Assisted Treatment (MAT) for those struggling with opioid use disorder (OUD)DHCS has increased its support. 
The Department of Health Care Services, in partnership with The Center at Sierra Health Foundation (The Center)is funding 21 sites to provide telehealth substance use disorder and mental health services for individuals in counties that have been impacted by COVID-19, or in the case of providers, who have experienced trauma as a result of treating individuals with the coronavirus,” said Bhardwaj. 
DHCS and The Center additionally launched the Behavioral Health Telehealth funding opportunity in 2020 for non-profit behavioral health providers to receive up to $50,000 each for telehealth infrastructure beginning September 1, 2020 through June 30, 2021,” he added. “Providers applied for telehealth equipment, including laptops, desktops, monitors, electronic health record software licenses, internet subscriptions, cell phones for providers, and telehealth training. Providers that were awarded through this opportunity will receive funding in Fall 2020.” 
 
DHCS is also providing Personal Protective Equipment so that facilities that provide in-person mental health services and MAT sessions can continue to do so without interruption.
California’s public awareness campaign titled “Choose Change California” provides information on opioid use disorder and a list of centers across the state where people misusing opioids or other substances can go for treatment and community-based wraparound services. The campaign is a collaboration operated by Sacramento- and Fresno-based The Center at Sierra Health Foundation and funded through the California Department of Public Health MAT Expansion Project. 
DHCS efforts have resulted ihelping some medical institutions to survive the pandemic and move closer to their pre-COVID levels of clinical care by transitioning to telehealth services, but they have come with some challenges. For example, the DHCS says some providers do not have enough funding to fully invest in telehealth infrastructure. On the flip side, some patients cannot afford or do not have sufficient broadband services and the required equipment to receive services through telehealth. Other patients, depending on their living situations, do not have adequate privacy to engage in telehealth sessions.
Goings pointed out that there are some obvious limitations to telehealth, too. With some conditions involving trauma or physical injury or pain, there is no way around seeing the patient in-person, she said.  
Now, that school has started, its difficult because you don’t know if someone has the flu or COVID,” she says.  I can’t give a clearance note, until you’vbeen seen, tested and quarantined, if necessary,” she says.  

Michelle Snider

Associate Editor for The Post News Group. Writer, Photographer, Videographer, Copy Editor, and website editor documenting local events in the Oakland-Bay Area California area.

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COMMENTARY: The National Protest Must Be Accompanied with Our Votes

Just as Trump is gathering election data like having the FBI take all the election data in Georgia from the 2020 election, so must we organize in preparation for the coming primary season to have the right people on ballots in each Republican district, so that we can regain control of the House of Representatives and by doing so, restore the separation of powers and balance that our democracy is being deprived of.

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Dr. John E. Warren Publisher, San Diego Voice & Viewpoint
Dr. John E. Warren, Publisher San Diego Voice & Viewpoint Newspaper. File photo..

By  Dr. John E. Warren, Publisher San Diego Voice & Viewpoint Newspaper

As thousands of Americans march every week in cities across this great nation, it must be remembered that the protest without the vote is of no concern to Donald Trump and his administration.

In every city, there is a personal connection to the U.S. Congress. In too many cases, the member of Congress representing the people of that city and the congressional district in which it sits, is a Republican. It is the Republicans who are giving silent support to the destructive actions of those persons like the U.S. Attorney General, the Director of Homeland Security, and the National Intelligence Director, who are carrying out the revenge campaign of the President rather than upholding the oath of office each of them took “to Defend The Constitution of the United States.”

Just as Trump is gathering election data like having the FBI take all the election data in Georgia from the 2020 election, so must we organize in preparation for the coming primary season to have the right people on ballots in each Republican district, so that we can regain control of the House of Representatives and by doing so, restore the separation of powers and balance that our democracy is being deprived of.

In California, the primary comes in June 2026. The congressional races must be a priority just as much as the local election of people has been so important in keeping ICE from acquiring facilities to build more prisons around the country.

“We the People” are winning this battle, even though it might not look like it. Each of us must get involved now, right where we are.

In this Black History month, it is important to remember that all we have accomplished in this nation has been “in spite of” and not “because of.” Frederick Douglas said, “Power concedes nothing without a struggle.”

Today, the struggle is to maintain our very institutions and history. Our strength in this struggle rests in our “collectiveness.” Our newspapers and journalists are at the greatest risk. We must not personally add to the attack by ignoring those who have been our very foundation, our Black press.

Are you spending your dollars this Black History Month with those who salute and honor contributions by supporting those who tell our stories? Remember that silence is the same as consent and support for the opposition. Where do you stand and where will your dollars go?

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Why Black Parents Should Consider Montessori

BLACKPRESSUSA NEWSWIRE — I have found that there are some educational approaches that consistently provide a safer, more enriching, and more affirmative environment for Black children. The Montessori method, developed by Italian physician Maria Montessori and introduced to the U.S. in the early 20th century, is one such approach.

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By Laura Turner-Essel, PhD

As a mother of four children, I’ve done A LOT of school shopping. I don’t mean the autumn ritual of purchasing school supplies. I mean shopping for schools – pouring over promotional materials, combing through websites, asking friends and community members for referrals to their favorite schools, attending open houses and orientations, comparing curriculums and educational philosophies, meeting teachers and principals, and students who all claim that their school is the best.

But keep in mind – I’m not just a mom of four children. I’m a mom of four Black children, and I’m also a psychologist who is very interested in protecting my little ones from the traumatic experience that school can too often become.

For Black children in the United States, school can sometimes feel more like a prison than an educational institution. Research shows that Black students experience school as more hostile and demoralizing than other students do, that they are disciplined more frequently and more harshly for typical childhood offenses (such as running in the halls or chewing gum in class), that they are often labeled as deviant or viewed as deficient more quickly than other children, that teachers have lower academic expectations of Black students (which, in turn, lowers those students’ expectations of themselves), and that Black parents feel less respected and less engaged by their children’s teachers and school administrators. Perhaps these are some of the underlying reasons that Black students tend to underperform in most schools across the country.

The truth is that schools are more than academic institutions. They are places where children go to gain a sense of who they are, how they relate to others, and where they fit into the world. The best schools are places that answer these questions positively – ‘you are a valuable human being, you are a person who will grow up to contribute great things to your community, and you belong here, with us, exploring the world and learning how to use your gifts.’ Unfortunately, Black children looking for answers to these universal questions of childhood will often hit a brick wall once they walk into the classroom. If the curriculum does not reflect their cultural experiences, the teachers don’t appear to value them, and they spend most of their time being shamed into compliance rather than guided towards their highest potential, well…what can we really expect? How are they supposed to master basic academic skills if their spirits have been crushed?

Here’s the good news. In my years of school shopping, and in the research of Black education specialists such as Jawanza Kunjufu and Amos Wilson, I have found that there are some educational approaches that consistently provide a safer, more enriching, and more affirmative environment for Black children. The Montessori method, developed by Italian physician Maria Montessori and introduced to the U.S. in the early 20th century, is one such approach.

The key feature of Montessori schooling is that children decide (for the most part) what they want to do each day. Led by their own interests and skill levels, children in a Montessori classroom move around freely and work independently or with others on tasks of their own

choosing. The classroom is intentionally stocked with materials tailored to the developmental needs of children, including the need to learn through different senses (sight, touch/texture, movement, etc.). The teacher in a Montessori classroom is less like a boss and more like a caring guide who works with each child individually, demonstrating various activities and then giving them space to try it on their own. The idea is that over time, students learn to master even the toughest tasks and concepts, and they feel an intense sense of pride and accomplishment because they did it by themselves, without pressure or pushing.

I think that this aspect of the Montessori method is good for all kids. Do you remember the feeling of having your creativity or motivation crushed by being told exactly what to do, when to do it, how to do it, and why? The truth is that when presented with a new challenge and then given space, children actually accomplish a lot! They are born with a natural desire to learn. It is that spirit of curiosity, sense of wonder, and excitement to explore that Montessori helps to keep alive in a child. But that’s not the only reason that I think Black parents need to consider Montessori.

Fostering a love of learning is great. But more importantly, I think that Montessori students excel at learning to love. It begins with Montessori’s acknowledgement that all children are precious because childhood is a precious time. In many school systems, Black children are treated like miniature adults (at best) or miniature criminals (at worst), and are subjected to stressful situations that no kids are equipped to handle – expectations to be still and silent for long periods, competitive and high-stakes testing, and punitive classroom discipline. It’s easy to get the sense that rather than being prepared for college or careers, our children are being prepared to fail. Couple this with the aforementioned bias against Black children that seems to run rampant within the U.S. school system, and you end up with children who feel burned out and bitter about school by the time they hit 3rd grade.

In my experience, Montessori does a better job of protecting the space that is childhood – and all the joy of discovery and learning that should come along with that. Without the requirement that students “sit down and shut up,” behavioral issues in Montessori classrooms tend to be non-existent (or at least, the Montessori method doesn’t harp on them; children are gently redirected rather than shamed in front of the class). Montessori students don’t learn for the sake of tests; they demonstrate what they’ve learned by sharing with their teacher or classmates how they solve real-world problems using the skills they’ve gained through reading, math, or science activities. And by allowing children a choice of what to focus on throughout the day, Montessori teachers demonstrate that they honor and trust children’s natural intelligence. The individualized, careful attention they provide indicates to children that they are each seen, heard, and valued for who they are, and who they might become. Now that’s love (and good education).

As a parent, I’ve come to realize that many schools offer high-quality academics. Montessori is no different. Students in Montessori schools gain exposure to advanced concepts and the materials to work with these concepts hands-on. Across the nation, Montessori schools emphasize early literacy development, an especially important indicator of life success for young Black boys and men. Montessori students are provided with the opportunity to be

successful every day, and the chance to develop a sense of competence and self-worth based on completing tasks at their own pace.

But I have also learned that the important questions to ask when school shopping are often not about academics at all. I now ask, ‘Will my children be treated kindly? Will they be listened to? Protected from bias and bullying? Will they feel safe? Will this precious time in their lives be honored as a space for growth, development, awe, and excitement? Will they get to see people like them included in the curriculum? Will they be seen as valuable even if they don’t always ‘measure up’ to other kids on a task? Will they get extra support if they need it? Will the school include me in major decisions? Will the school leaders help to make sure that my children reach their fullest potential? Will the teacher care about my children almost as much as I do?’

Consistently, it’s been the Montessori schools that have answered with a loud, resounding ‘Yes!’ That is why my children ended up in Montessori schools, and I couldn’t be happier with that decision. If you’re a parent like me, shopping for schools with the same questions in mind, I’d urge you to consider Montessori education as a viable option for your precious little ones. Today more than ever, getting it right for our children is priceless.

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LIVE from the NMA Convention Raheem DeVaughn Says The Time Is Now: Let’s End HIV in Our Communities #2

Set against the backdrop of the NMA conference, Executive Officers from the National Medical Association, Grammy Award Winning Artist and Advocate Raheem DeVaughn, and Gilead Sciences experts, are holding today an important conversation on HIV prevention and health equity. Black women continue to be disproportionately impacted by HIV despite advances in prevention options. Today’s event […]

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Set against the backdrop of the NMA conference, Executive Officers from the National Medical Association, Grammy Award Winning Artist and Advocate Raheem DeVaughn, and Gilead Sciences experts, are holding today an important conversation on HIV prevention and health equity.

Black women continue to be disproportionately impacted by HIV despite advances in prevention options. Today’s event is designed to uplift voices, explore barriers to access, and increase awareness and key updates about PrEP, a proven prevention method that remains underutilized among Black women. This timely gathering will feature voices from across health, media, and advocacy as we break stigma and center equity in HIV prevention.

Additional stats and information to know:

Black women continue to be disproportionately affected by HIV, with Black women representing more than 50% of new HIV diagnoses among women in the U.S. in 2022, despite comprising just 13% of women in the U.S.

Women made up only 8% of PrEP users despite representing 19% of all new HIV diagnoses in 2022.

● Gilead Sciences is increasing awareness and addressing stigma by encouraging regular HIV testing and having judgment-free conversations with your healthcare provider about prevention options, including oral PrEP and long-acting injectable PrEP options.

● PrEP is an HIV prevention medication that has been available since 2012.

● Only 1 in 3 people in the U.S. who could benefit from PrEP were prescribed a form of PrEP in 2022.

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