Kaiser Health News

Heat Rules for California Workers Would Also Help Keep Schoolchildren Cool

Published

2 months ago

June 10, 2024

Samantha Young
Mon, 10 Jun 2024 09:00:00 +0000

SACRAMENTO, Calif. — Proposed rules to protect California workers from extreme heat would extend to schoolchildren, requiring school districts to find ways to keep classrooms cool.

If the standards are approved this month, employers in the nation's most populous state will have to provide relief to indoor workers in sweltering warehouses, steamy kitchens, and other dangerously hot job sites. The rules will extend to schools, where teachers, custodians, cafeteria workers, and other employees may work without air conditioning — like their students.

“Our working conditions are students' learning conditions,” said Jeffery Freitas, president of the California Federation of Teachers, which represents more than 120,000 teachers and other educational employees. “We're seeing an unprecedented change in the environment, and we know for a fact that when it's too hot, kids can't learn.”

A state worker safety board is scheduled to vote on the rules June 20, and they would likely take effect this summer. The move, which marks Democratic Gov. Gavin Newsom's latest effort to respond to the growing impacts of climate change and extreme heat, would put California ahead of the federal government and much of the nation in setting heat standards.

The standards would require indoor workplaces to be cooled below 87 degrees Fahrenheit when employees are present and below 82 degrees in places where workers wear protective clothing or are exposed to radiant heat, such as furnaces. Schools and other worksites that don't have air conditioning could use fans, misters, and other methods to bring the room temperature down.

The rules allow workarounds for businesses, including the roughly 1,000 school districts in the state, if they can't cool their workplaces sufficiently. In those cases, employers must provide workers with water, breaks, areas where they can cool down, cooling vests, or other means to keep employees from overheating.

“Heat is a deadly hazard no matter what kind of work you do,” said Laura Stock, a member of the Occupational Safety and Health Standards Board. “If you have an indoor space that is both populated by workers and the public, or in this case by children, you would have the same risks to their health as to workers.”

Heat waves have historically struck outside of the school year, but climate change is making them longer, more frequent, and more intense. Last year was the hottest on record and schools across the U.S. closed sporadically during spring and summer, unable to keep students cool.

Scientists say this year could be even hotter. School officials in Vicksburg, Mississippi, last month ended the school year early when air conditioners had issues. And California's first heat wave of the season is hitting while some schools are still in session, with temperatures reaching 105 in the Central Valley.

Several states, including Arizona and New Mexico, require schools to have working air conditioners, but they aren't required to run them. Mississippi requires schools to be air-conditioned but doesn't say to what temperature. Hawaii schools must have classrooms at a “temperature acceptable for student learning,” without specifying the temperature. And Oregon schools must try to cool classrooms, such as with fans, and provide teachers and other employees ways to cool down, including water and rest breaks, when the heat index indoors reaches 80 degrees.

When the sun bakes the library at Bridges Academy at Melrose, a public school in East Oakland with little shade and tree cover, Christine Schooley closes the curtains and turns off the computers to cool her room. She stopped using a fan after a girl's long hair got caught in it.

“My library is the hottest place on campus because I have 120 kids through here a day,” Schooley said. “It stays warm in here. So yeah, it makes me grouchy and irritable as well.”

A 2021 analysis by the Center for Climate Integrity suggests nearly 14,000 public schools across the U.S. that did not need air conditioning in 1970 now do, because they annually experience 32 days of temperatures more than 80 degrees — upgrades that would cost more than $40 billion. Researchers found that same comparison produces a cost of $2.4 billion to install air conditioning in 678 California schools.

It's not clear how many California schools might need to install air conditioners or other cooling equipment to comply with the new standards because the state doesn't track which ones already have them, said V. Kelly Turner, associate director of the Luskin Center for Innovation at the University of California-Los Angeles.

And a school district in the northern reaches of the state would not face the same challenges as a district in the desert cities of Needles or Palm Springs, said Naj Alikhan, a spokesperson for the Association of California School Administrators, which has not taken a position on the proposed rules.

An economic analysis commissioned for the board provided cost estimates for a host of industries — such as warehousing, manufacturing, and construction — but lacked an estimate for school districts, which make up one of the largest public infrastructure systems in the state and already face a steep backlog of needed upgrades. The state Department of Education hasn't taken a position on the proposal and a spokesperson, Scott Roark, declined to comment on the potential cost to schools.

Projections of a multibillion-dollar cost to state prisons were the reason the Newsom administration refused to sign off on the indoor heat rules this year. Since then, tens of thousands of prison and jail employees — and prisoners — have been exempted.

It's also unclear whether the regulation will apply to school buses, many of which don't have air conditioning. The Department of Industrial Relations, which oversees the worker safety board, has not responded to queries from school officials or KFF Health News.

Libia Garcia worries about her 15-year-old son, who spends at least an hour each school day traveling on a hot, stuffy school bus from their home in the rural Central Valley community of Huron to his high school and back. “Once my kid arrives home, he is exhausted; he is dehydrated,” Garcia said in Spanish. “He has no energy to do homework or anything else.”

The California Federation of Teachers is pushing state lawmakers to pass a climate-resilient schools bill that would require the state to develop a master plan to upgrade school heating and air conditioning systems. Newsom last year vetoed similar legislation, citing the cost.

Campaigns to cool schools in other states have yielded mixed results. Legislation in Colorado and New Hampshire failed this year, while a bill in New York passed on June 7 and was headed to the governor for approval. A New Jersey proposal was pending as of last week. Last month, a teachers union in New York brought a portable sauna to the state Capitol to demonstrate how hot it can get inside classrooms, only a quarter of which have air conditioning, said Melinda Person, president of New York State United Teachers.

“We have these temperature limits for animal shelters. How is it that we don't have it for classrooms?” said Democratic New York Assembly member Chris Eachus, whose bill would require schools to take relief measures when classrooms and buildings reach 82 degrees. “We do have to protect the health and safety of the kids.”

Extreme heat is the No. 1 weather-related killer in the U.S. — deadlier than hurricanes, floods, and tornadoes. Heat stress can cause heatstroke, cardiac arrest, and kidney failure. The Centers for Disease Control and Prevention reported 1,600 heat-related deaths occurred in 2021, which is likely an undercount because health care providers are not required to report them. It's not clear how many of these deaths are related to work, either indoors or outdoors.

California has had heat standards on the books for outdoor workers since 2005, and rules for indoor workplaces have been in development since 2016 — delayed, in part, because of the covid pandemic.

At the federal level, the Biden administration has been slow to release a long-awaited regulation to protect indoor and outdoor workers from heat exposure. Although an official said a draft is expected this year, its outlook could hinge on the November presidential election. If former President Donald Trump wins, it is unlikely that rules targeting businesses will move forward.

The Biden White House held a summit on school sustainability and climate change in April, at which top officials encouraged districts to apply an infusion of new federal dollars to upgrade their aging infrastructure. The administration also unveiled an 18-page guide for school districts to tap federal funds.

“How we invest in our school buildings and our school grounds, it makes a difference for our students' lives,” Roberto Rodriguez, an assistant secretary at the U.S. Department of Education, said at the summit. “They are on the front line in terms of feeling those impacts.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

——————————
By: Samantha Young
Title: Heat Rules for California Workers Would Also Help Keep Schoolchildren Cool
Sourced From: kffhealthnews.org/news/article/california-indoor-heat-rules-schools-children-cooling/
Published Date: Mon, 10 Jun 2024 09:00:00 +0000

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Union With Labor Dispute of Its Own Threatens to Cut Off Workers’ Health Benefits

Published

9 hours ago

July 26, 2024

Staff Editor

Phil Galewitz, KFF Health News
Fri, 26 Jul 2024 09:00:00 +0000

The National Education Association, the nation's largest union, is threatening to cut off health insurance to about 300 Washington, D.C.-based workers on Aug. 1 in an effort to end a bitter contract dispute.

It's a tactic some private employers have used as leverage against unionized workers that has drawn scrutiny from congressional Democrats and is prohibited for state employers in California. Experts on labor law say they've never seen a union make the move against its own workers.

“This is like a man-bites-dog situation where the union is now in a position as the employer,” said Paul Clark, a professor of labor and employment relations at Penn State University. “It's not a good look for a union.”

NEA workers with pressing health needs are worried but say they won't fold. Joye Mercer Barksdale, a writer on the NEA's government relations team, said she needs coverage for a medical procedure to address atrial fibrillation, a cardiac disorder. “This is insane for the NEA to use our health benefits as a bargaining chip,” she said.

But Barksdale said the threat isn't enough to force her to agree to an unacceptable contract. “I am not ready to give in,” she said.

The NEA Staff Organization, the union representing workers at the NEA's headquarters, launched a strike on July 5 in Philadelphia, during the union's annual delegate assembly. It was its second walkout this summer as the two parties negotiate a new contract, navigating sticking points such as wages and remote work.

In response, the NEA ended the conference early. President Joe Biden was supposed to speak at the event but withdrew, refusing to cross the picket line. The NEA on July 24 endorsed Kamala Harris for president.

On July 8, the day after the conference had been scheduled to end, the NEA locked out workers. In a letter the day before, the NEA informed its unionized workers that they would not be paid, effective immediately, and their health benefits would expire at the end of July unless a new deal were reached.

“NEA cannot allow NEASO to act again in a way that will bring such lasting harm to our members and our organization,” Kim Anderson, the NEA's executive director, wrote in the letter, obtained by KFF Health News. “We are, and have always been, committed both to our union values and to the importance of conducting ourselves as a model employer.”

Democrats in Congress, including Sens. Sherrod Brown of Ohio and Bob Casey of Pennsylvania, introduced legislation last year to protect striking workers from losing their health benefits, after several large companies, including General Motors, John Deere, RTX (formerly Raytheon Technologies), and the maker of Kellogg's cereals, threatened to or did cut off coverage during labor disputes.

“Workers shouldn't have to choose between their family's health and a fair contract,” Brown said in a statement to KFF Health News.

The legislation was endorsed by large labor unions including the Service Employees International Union and United Steelworkers, according to a press release from Brown's office. The NEA wasn't among them.

“This tactic is immoral, and it should be illegal,” United Steelworkers' president at the time, Thomas Conway, said in the release.

Officials at the NEA, which represents teachers and other administrators, declined an interview request. In a statement, the organization's president, Becky Pringle, said “we are making every effort to reach an agreement as quickly as possible” with its staff union.

“As union leaders who have been on strike, we recognize the significance and impact of these important decisions on a personal and family level. We truly value our employees and look forward to continued collaboration with NEASO to develop a new contract that benefits us all,” she said.

Kate Hilts, a digital strategist who works for the NEA, said she fears losing her coverage will leave her unable to afford treatment for a rare autoimmune disease that attacks her kidneys. Her next treatment was slated for August.

“I wake up every day and can't believe this is happening,” she said. “You would expect this from an employer that is antiworker or has a terrible labor record, but I am totally flabbergasted that a labor union would do this that bills itself as pro-worker, pro-family, pro-education, and pro-children.”

The NEA staff union has filed multiple charges with the National Labor Relations Board this year, including allegations that the NEA withheld holiday overtime pay and failed to provide information on the outsourcing of millions of dollars in bargaining unit work.

California is one of the only states that protect striking workers from losing health coverage. The state legislature passed a law in 2021 that blocks the tactic from being used against public employees and another law in 2022 that allows any striking workers who lose their insurance to immediately get heavily discounted coverage through the state's Affordable Care Act marketplace.

If they remain locked out, the NEA workers would be eligible for coverage under COBRA, a federal program that allows people who are fired or laid off to maintain their employer-sponsored insurance for 18 months.

But the coverage can be a financial hardship, as individuals often must pay the entire cost of their insurance premiums, plus a 2% administrative fee.

Another option for workers would be coverage through the Affordable Care Act marketplace, though that also could be costly. And it may be unclear how soon that coverage would begin or whether insurers would cover their existing doctors.

“I'm hoping the NEA will be so ashamed of what they are doing that, at the very least, they will not take away our health benefits,” Barksdale said.

——————————
By: Phil Galewitz, KFF Health News
Title: Union With Labor Dispute of Its Own Threatens to Cut Off Workers' Health Benefits
Sourced From: kffhealthnews.org/news/article/nea-national-education-association-union-threatens-health-insurance-benefit-lockout/
Published Date: Fri, 26 Jul 2024 09:00:00 +0000

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Kaiser Health News

The CDC’s Test for Bird Flu Works, but It Has Issues

Published

11 hours ago

July 26, 2024

Staff Editor

Arthur Allen and Amy Maxmen
Fri, 26 Jul 2024 09:00:00 +0000

The Centers for Disease Control and Prevention says a glitch in its bird flu test hasn't harmed the agency's outbreak response. But it has ignited scrutiny of its go-it-alone approach in testing for emerging pathogens.

The agency has quietly worked since April to resolve a nagging issue with the test it developed, even as the virus swept through dairy farms and chicken houses across the country and infected at least 13 farmworkers this year.

At a congressional hearing July 23, Rep. Brett Guthrie (R-Ky.) asked about the issue. “Boy, that rings of 2020,” he said, referring to when the nation was caught off guard by the covid-19 pandemic, in part because of dysfunctional tests made by the CDC. Demetre Daskalakis, director of the CDC's National Center for Immunization and Respiratory Diseases, responded that the agency rapidly developed a workaround that makes its bird flu test reliable.

“The tests are 100% usable,” he later told KFF Health News, adding that the FDA studied the tests and came to the same conclusion. The imperfect tests, which have a faulty element that sometimes requires testing a sample again, will be replaced soon. He added, “We have made sure that we're offering a high-quality product.”

Still, some researchers were unnerved by the news coming four months after the government declared a worrisome bird flu outbreak among cattle. The CDC's test is the only one available for clinical use. Some researchers say its flaws, though manageable, underscore the risk of relying on a single entity for testing.

The problem came to light in April as the agency prepared to distribute its test to about 100 public health labs around the country. CDC officials detected the issue through a quality control system put in place after the covid test catastrophe of 2020.

Daskalakis said the CDC's original test design was fine, but a flaw emerged when a company contracted by the agency manufactured the tests in bulk. In these tests, one of two components that recognize proteins called H5 in the H5N1 bird flu virus was unreliable, eliminating an important safeguard. By targeting the same protein twice, tests have a built-in backup in case one part fails.

The agency developed a fix to ensure a reliable result: If only one of the two parts detected H5, the test was considered inconclusive and would be run again. With the FDA's blessing, the CDC distributed the tests — with workaround instructions — to public health labs.

Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories, said the results of the tests have not been ambiguous, and there is no need to discard the tests.

Still, the agency has asked a different manufacturer to remake the faulty component so that 1.2 million improved tests will be available soon, Daskalakis said. Some of the updated tests are already in stock at the CDC, but the FDA hasn't yet signed off on their use. Daskalakis declined to name the manufacturers.

Meanwhile, the outbreak has grown. Farmworkers continue to lack information about the virus and gear to protect them from it. Rural clinics may miss cases if they don't catch a person's connection to a farm and notify health officials rather than their usual diagnostic testing laboratories.

Those clinical labs remain unauthorized to test for the bird flu. Several of those labs have spent months working through analyses and red tape so that they can run the CDC's tests. As part of the licensing process, the CDC alerted them to the workaround with the current test, too.

But outside select circles, the news was largely overlooked. “I'm totally surprised by this,” Alex Greninger, assistant director of the University of Washington Clinical Virology Laboratory, told KFF Health News this week. Greninger's lab is developing its own test and has been trying to obtain CDC test kits to evaluate.

“It's not a red alarm,” he said, but he's worried that as the CDC and the FDA spend months developing and evaluating an updated test, the only one available relies on a single component. If the genetic code underlying that fragment of the H5 protein mutates, the test could give false results.

It's not uncommon for academic and commercial diagnostic labs to make mistakes and catch them during quality control checks, as the CDC did. Still, this isn't the agency's first mishap. In 2016, well before the covid debacle, CDC officials for months directed public health labs to use a Zika test that failed about a third of the time.

The CDC caught and worked to remediate the situation far more quickly and effectively in this case. Nonetheless, the mishap raises concern. Michael Mina, chief science officer of the telemedicine company eMed.com, said diagnostic companies may be better suited to the task.

“It's a reminder that CDC is not a robust manufacturer of tests” and lacks the resources that industry can marshal for their production, Mina said. “We do not ask CDC to make vaccines and pharmaceuticals, and we do not ask the Pentagon to manufacture missiles.”

The CDC has licensed its updated test design to at least seven clinical diagnostic labs. Such labs are the foundation of testing in the U.S. But none have FDA clearance to use them.

Diagnostic labs are developing their own tests, too. But that has been slow-going. One reason is the lack of guaranteed sales. Another is regulatory uncertainty. Recent FDA guidance could make it harder for nongovernmental laboratories to issue new tests in the early phase of pandemics, said Susan Van Meter, president of the American Clinical Laboratory Association, in a July 1 letter to the FDA.

Transparency is also critical, scientists said. Benjamin Pinsky, medical director of the clinical virology laboratory at Stanford University, said as a public agency the CDC should make its protocol — its recipe for making the test — easily accessible online.

The World Health Organization does so for its bird flu tests, and with that information in hand, Pinsky's lab has developed an H5 bird flu test suited to the strain circulating this year in the U.S. The lab published its approach this month but doesn't have FDA authorization for its broad use.

The CDC's test recipe is available in a published patent, Daskalakis said.

“We have made sure that tests are out there, and that they work,” he added.

As the CDC came under fire at the July 23 congressional hearing, Daniel Jernigan, director of the CDC's National Center for Emerging and Zoonotic Infectious Diseases, noted that testing is just one tool. The agency needs money for another promising area — looking for the virus in wastewater. Its current program uses supplemental funds, he said: “It is not in the current budget and will go away without additional funding.”

——————————
By: Arthur Allen and Amy Maxmen
Title: The CDC's Test for Bird Flu Works, but It Has Issues
Sourced From: kffhealthnews.org/news/article/bird-flu-test-cdc-flaws/
Published Date: Fri, 26 Jul 2024 09:00:00 +0000

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Kaiser Health News

KFF Health News’ ‘What the Health?’: Harris in the Spotlight

Published

1 day ago

July 25, 2024

Staff Editor

Thu, 25 Jul 2024 18:45:00 +0000

The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

As Vice President Kamala Harris appears poised to become the Democratic Party's presidential nominee, health policy in general and reproductive health issues in particular are likely to have a higher profile. Harris has long been the Biden administration's point person on abortion rights and reproductive health and was active on other health issues while serving as California's attorney general.

Meanwhile, Congress is back for a brief session between presidential conventions, but efforts in the GOP-led House to pass the annual spending bills, due by Oct. 1, have run into the usual roadblocks over abortion-related issues.

This week's panelists are Julie Rovner of KFF Health News, Stephanie Armour of KFF Health News, Rachel Cohrs Zhang of Stat, and Alice Miranda Ollstein of Politico.

Panelists

Stephanie Armour
KFF Health News

@StephArmour1

Read Stephanie's stories.

Rachel Cohrs Zhang
Stat News

@rachelcohrs

Read Rachel's stories.

Alice Miranda Ollstein
Politico

@AliceOllstein

Read Alice's stories.

Among the takeaways from this week's episode:

President Joe Biden's decision to drop out of the presidential race has turned attention to his likely successor on the Democratic ticket, Vice President Kamala Harris. At this late hour in the campaign, she is expected to adopt Biden's health policies, though many anticipate she'll take a firmer stance on restoring Roe v. Wade. And while abortion rights supporters are enthusiastic about Harris' candidacy, opponents are eager to frame her views as extreme.
As he transitions from incumbent candidate to outgoing president, Biden is working to frame his legacy, including on health policy. The president has expressed pride that his signature domestic achievement, the Inflation Reduction Act, took on the pharmaceutical industry, including by forcing the makers of the most expensive drugs into negotiations with Medicare. Yet, as with the Affordable Care Act's delayed implementation and results, most Americans have yet to see the IRA's potential effect on drug prices.
Lawmakers continue to be hung up on federal government spending, leaving appropriations work undone as they prepare to leave for summer recess. Fights over abortion are, once again, gumming up the works.
In abortion news, Iowa's six-week limit is scheduled to take effect next week, causing rippling problems of abortion access throughout the region. In Louisiana, which added the two drugs used in medication abortions to its list of controlled substances, doctors are having difficulty using the pills for other indications. And doctors who oppose abortion are pushing higher-risk procedures, like cesarean sections, in lieu of pregnancy termination when the mother's life is in danger — as states with strict bans, like Texas and Louisiana, are reporting a rise in the use of surgeries, including hysterectomies, to end pregnancies.
The Government Accountability Office reports that many states incorrectly removed hundreds of thousands of eligible people from the Medicaid rolls during the “unwinding” of the covid-19 public health emergency's coverage protections. The Biden administration has been reluctant to call out those states publicly in an attempt to keep the process as apolitical as possible.

Also this week, Rovner interviews Anthony Wright, the new executive director of the consumer health advocacy group Families USA. Wright spent the past two decades in California, working with, among others, now-Vice President Kamala Harris on various health issues.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: NPR's “A Study Finds That Dogs Can Smell Your Stress — And Make Decisions Accordingly,” by Rachel Treisman.

Alice Miranda Ollstein: Stat's “A Pricey Gilead HIV Drug Could Be Made for Dramatically Less Than the Company Charges,” by Ed Silverman, and Politico's “Federal HIV Program Set To Wind Down,” by Alice Miranda Ollstein and David Lim.

Stephanie Armour: Vox's “Free Medical School Won't Solve the Doctor Shortage,” by Dylan Scott.

Rachel Cohrs Zhang: Stat's “How UnitedHealth Harnesses Its Physician Empire To Squeeze Profits out of Patients,” by Bob Herman, Tara Bannow, Casey Ross, and Lizzy Lawrence.

Also mentioned on this week's podcast:

States Newsroom's “Anti-Abortion Researchers Back Riskier Procedures When Pregnancy Termination Is Needed, Experts Say,” by Sofia Resnick.
KFF Health News' “Louisiana Reclassifies Drugs Used in Abortions as Controlled Dangerous Substances,” by Rosemary Westwood, WWNO.
The New York Times' “Biden and Georgia Are Waging a Fight Over Medicaid and the Future of Obamacare,” by Noah Weiland.

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Audio producer

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Editor

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And subscribe to KFF Health News' “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Title: KFF Health News' ‘What the Health?': Harris in the Spotlight
Sourced From: kffhealthnews.org/news/podcast/what-the-health-357-kamala-harris-campaign-health-policy-july-25-2024/
Published Date: Thu, 25 Jul 2024 18:45:00 +0000

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