After record turnout, Academy expands voting pool in Doc and Shorts categories






LOS ANGELES (TheWrap.com) – The Academy has dramatically expanded the potential pool of voters in three categories, looking to increase voter participation just as its first-ever adoption of online voting has apparently led to unexpectedly high turnout.


On Saturday, AMPAS president Hawk Koch sent an email to voters announcing that all 5,856 voting members would be sent screeners of all the nominees in the Best Documentary Feature, Best Live-Action Short Film and Best Animated Short Film categories.






The change had actually been adopted by the Board of Governors more than a year ago, at a December 2011 meeting.


Academy rules still require voters in the three categories to see all five nominees before voting, but the rules no longer insist that members to view the films theatrically at special AMPAS screenings.


The third short-film category, Best Documentary Short Subject, is not affected by the new policy, even though the push to expand the pool of voters via screeners began in the Documentary Branch when it changed the doc-feature rules a year ago.


Branch governor Michael Moore told TheWrap he plans to push for changes in the doc-shorts category this year.


The new procedures have the potential to increase the number of voters in those categories from the low hundreds into the thousands. The Academy does not release the numbers of members who vote, but those who’ve participated in the process have long surmised that categories requiring members to attend special voting screenings may only attract a couple hundred voters.


This year’s nomination vote was beset by snags in the transition to online voting, with the Academy first pushing back the deadline for members to request paper ballots, then opting to automatically send ballots to every member who didn’t sign up for the online option regardless of whether they’d requested paper.


The week that ballots were due, AMPAS also pushed back the final deadline for nomination voting by one day, amid rampant speculation and anecdotal evidence that voters were confused by the new procedures.


Many people insisted that the earlier deadline and the different voting procedures would cause members to give up, and thus substantially depress the number of voters who cast ballots.


But according to three Academy sources, voter turnout was in fact the highest number in years in every category.


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Well: That Loving Feeling Takes a Lot of Work

When people fall in love and decide to marry, the expectation is nearly always that love and marriage and the happiness they bring will last; as the vows say, till death do us part. Only the most cynical among us would think, walking down the aisle, that if things don’t work out, “We can always split.”

But the divorce rate in the United States is exactly half the marriage rate, and that does not bode well for this cherished institution.

While some divorces are clearly justified by physical or emotional abuse, intolerable infidelity, addictive behavior or irreconcilable incompatibility, experts say many severed marriages seem to have just withered and died from a lack of effort to keep the embers of love alive.

I say “embers” because the flame of love — the feelings that prompt people to forget all their troubles and fly down the street with wings on their feet — does not last very long, and cannot if lovers are ever to get anything done. The passion ignited by a new love inevitably cools and must mature into the caring, compassion and companionship that can sustain a long-lasting relationship.

Studies by Richard E. Lucas and colleagues at Michigan State University have shown that the happiness boost that occurs with marriage lasts only about two years, after which people revert to their former levels of happiness — or unhappiness.

Infatuation and passion have even shorter life spans, and must evolve into “companionate love, composed more of deep affection, connection and liking,” according to Sonya Lyubomirsky, a professor of psychology at the University of California, Riverside.

In her new book, “The Myths of Happiness,” Dr. Lyubomirsky describes a slew of research-tested actions and words that can do wonders to keep love alive.

She points out that the natural human tendency to become “habituated” to positive circumstances — to get so used to things that make us feel good that they no longer do — can be the death knell of marital happiness. Psychologists call it “hedonic adaptation”: things that thrill us tend to be short-lived.

So Dr. Lyubomirsky’s first suggestion is to adopt measures to avert, or at least slow down, the habituation that can lead to boredom and marital dissatisfaction. While her methods may seem obvious, many married couples forget to put them into practice.

Building Companionship

Steps to slow, prevent or counteract hedonic adaptation and rescue a so-so marriage should be taken long before the union is in trouble, Dr. Lyubomirsky urges. Her recommended strategies include making time to be together and talk, truly listening to each other, and expressing admiration and affection.

Dr. Lyubomirsky emphasizes “the importance of appreciation”: count your blessings and resist taking a spouse for granted. Routinely remind yourself and your partner of what you appreciate about the person and the marriage.

Also important is variety, which is innately stimulating and rewarding and “critical if we want to stave off adaptation,” the psychologist writes. Mix things up, be spontaneous, change how you do things with your partner to keep your relationship “fresh, meaningful and positive.”

Novelty is a powerful aphrodisiac that can also enhance the pleasures of marital sex. But Dr. Lyubomirsky admits that “science has uncovered precious little about how to sustain passionate love.” She likens its decline to growing up or growing old, “simply part of being human.”

Variety goes hand in hand with another tip: surprise. With time, partners tend to get to know each other all too well, and they can fall into routines that become stultifying. Shake it up. Try new activities, new places, new friends. Learn new skills together.

Although I’ve been a “water bug” my whole life, my husband could swim only as far as he could hold his breath. We were able to enjoy the water together when we both learned to kayak.

“A pat on the back, a squeeze of the hand, a hug, an arm around the shoulder — the science of touch suggests that it can save a so-so marriage,” Dr. Lyubomirsky writes. “Introducing more (nonsexual) touching and affection on a daily basis will go a long way in rekindling the warmth and tenderness.”

She suggests “increasing the amount of physical contact in your relationship by a set amount each week” within the comfort level of the spouses’ personalities, backgrounds and openness to nonsexual touch.

Positive Energy

A long-married friend recently told me that her husband said he missed being touched and hugged. And she wondered what the two of them would talk about when they became empty-nesters. Now is the time, dear friend, to work on a more mutually rewarding relationship if you want your marriage to last.

Support your partner’s values, goals and dreams, and greet his or her good news with interest and delight. My husband’s passion lay in writing for the musical theater. When his day job moved to a different city, I suggested that rather than looking for a new one, he pursue his dream. It never became monetarily rewarding, but his vocation fulfilled him and thrilled me. He left a legacy of marvelous lyrics for more than a dozen shows.

Even a marriage that has been marred by negative, angry or hurtful remarks can often be rescued by filling the home with words and actions that elicit positive emotions, psychology research has shown.

According to studies by Barbara L. Fredrickson, a social psychologist and professor at the University of North Carolina at Chapel Hill, a flourishing relationship needs three times as many positive emotions as negative ones. In her forthcoming book, “Love 2.0,” Dr. Fredrickson says that cultivating positive energy everyday “motivates us to reach out for a hug more often or share and inspiring or silly idea or image.”

Dr. Lyubomirsky reports that happily married couples average five positive verbal and emotional expressions toward one another for every negative expression, but “very unhappy couples display ratios of less than one to one.”

To help get your relationship on a happier track, the psychologist suggests keeping a diary of positive and negative events that occur between you and your partner, and striving to increase the ratio of positive to negative.

She suggests asking yourself each morning, “What can I do for five minutes today to make my partner’s life better?” The simplest acts, like sharing an amusing event, smiling, or being playful, can enhance marital happiness.

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Grounded 787 Dreamliner leaks fuel in tests by Japanese airline

The FAA stepped in Friday to assure the public that Boeing's new 787 "Dreamliner" is safe to fly. The AP spoke with Kevin Hiatt, Flight Safety Foundation CEO & President, who says mechanical issues with new aircrafts are not uncommon. (Jan. 11)









Tokyo—





Japan Airlines Co (JAL) said on Sunday that a Boeing Co 787 Dreamliner jet undergoing checks in Tokyo following a fuel leak at Boston airport last week had leaked fuel during tests earlier in the day.

An open valve on the aircraft caused fuel to leak from a nozzle on the left wing used to remove fuel, a company spokeswoman said. The jet is out of service after spilling about 40 gallons of fuel onto the airport taxiway in Boston due to a separate valve-related problem.






In Boston, a different valve on the plane opened, causing fuel to flow from the center tank to the left main tank. When that tank filled up, it overflowed into a surge tank and out through a vent. The spill happened as the plane was taxiing for takeoff on a flight to Tokyo on January 8. It made the flight about four hours later.

The causes of both incidents are unknown, the JAL spokeswoman added. There is no timetable for the plane to return to service.

On Friday, the U.S. government ordered a wide-ranging review of Boeing's 787 Dreamliner, citing concern over a battery that caught fire on January 7, also on a JAL plane in Boston, and other problems. The government and Boeing insisted the passenger jet remained safe to fly.

The 787 represents the boldest bet Boeing has made on a new plane in more than a decade, and because the aircraft required billions to develop, much of the company's financial performance is riding on its success. Boeing is trying to double production to 10 jets a month this year to cash in on nearly 800 orders.

The eight airlines that operate the 50 jets delivered so far have expressed support for it, saying the mishaps are teething problems common with most new airplanes, and the 787's fuel savings make it an important addition to their fleets. JAL and local rival All Nippon Airways Co fly 24 Dreamliners.

The review follows a slew of incidents that have focused intense scrutiny on the new plane. While many of the issues that have dogged the 787 are typically considered routine, their occurrence in quick succession on an aircraft that incorporates major new technology and has not seen wide use yet has sparked concerns about safety.

In December, a 787 operated by United Airlines and bound from Houston to Newark, New Jersey, was forced to land in New Orleans after a warning light in the cockpit indicated a generator had failed.

Boeing later said a faulty circuit board produced in Mexico and supplied by UTC Aerospace Systems, a unit of United Technologies , had produced a false reading in the cockpit. A UTC Aerospace spokesman declined to comment.

Also in December, two other 787s suffered problems with electrical panels. The fire on January 7 started when a lithium-ion battery used in an auxiliary power system ignited while the plane was parked at the gate. It burned for about 40 minutes before firefighters put the flames out, and smoke entered the cabin. Passengers and crew had already left the aircraft.

On December 5, U.S. regulators said there was a manufacturing fault in 787 fuel lines and advised operators to make extra inspections to guard against engine failures.

Last week, the plane had seven reported incidents, ranging from the fire to a cracked cockpit window.

(Reporting by James Topham in Tokyo and Alwyn Scott in Seattle; Editing by Jeremy Laurence, Catherine Evans and Dale Hudson)

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Singer Randy Travis charged with drunken driving in crash






DALLAS (Reuters) – Grammy-winning country music singer Randy Travis had a blood alcohol level nearly twice the state’s legal limit when he was arrested last summer after a Texas state trooper found him lying naked on a road after crashing his car, authorities said.


Travis, 53, was charged on Wednesday with driving while intoxicated for the August 7 incident near his hometown of Tioga, about 60 miles north of Dallas, in which he also threatened to shoot and kill state troopers while he was being transported to jail, Grayson County prosecutors said.






Travis had a blood alcohol level of more than 0.15 percent, or nearly twice the legal limit of 0.08 in Texas, authorities said in the statement issued on Thursday.


The misdemeanor charge carries up to two years in jail and a $ 4,000 fine if he is convicted.


Travis has not been charged for the threats to troopers, which remain under investigation and could be considered retaliation, a third-degree felony, the statement said.


Prosecutors and lawyers representing Travis have been actively negotiating a resolution, Grayson County District Attorney Joe Brown said in the statement, apparently hinting at a possible plea deal.


“The filing of this charge allows us to get the case into court, in order to finalize the case as soon as we can,” Brown said, noting that it took some time to complete blood alcohol tests needed by the state and defense attorneys.


In addition to winning multiple Grammy awards, Travis also has appeared in movies and television shows.


The August crash and drunken driving charge is the latest in a series of law enforcement incidents involving Travis, who is known for “Forever and Ever, Amen” and other songs.


Travis pleaded not guilty in December to assaulting a man in a church parking lot in the Dallas suburb of Plano last August. Police said Travis intervened in a dispute between a woman he was with and her estranged husband. The misdemeanor charge carries a maximum $ 500 fine. Trial is set for March 11.


He was also arrested last February on suspicion of drunken driving while sitting in his car in the parking lot of another North Texas church.


(Editing by David Bailey and Will Dunham)


Celebrity News Headlines – Yahoo! News





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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

A version of this article appeared in print on 01/13/2013, on page A21 of the NewYork edition with the headline: New York Declares Health Emergency.
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Illinois' 'fracking' future fractured









Thousands of landowners downstate have sold their rights to drill for oil and natural gas for upfront fees ranging from $50 to $350 per acre, plus a cut of the profits.

Others are fighting to prevent the drilling out of fear that they could be exposed to drinking water contamination, earthquakes, toxic gases and industrialization.

In the middle of this battle are Illinois legislators who have yet to pass laws to deal with horizontal hydraulic fracturing, better known as fracking. The issue is expected to be taken up again this year.





Horizontal hydraulic fracturing has opened up vast reserves of natural gas deposits in the U.S. that until now were impossible to tap. The drilling technique uses pressurized sand, water and chemicals to crack open layers of rock that trap such fuels hundreds or thousands of feet below ground.

The stampede to unleash such fuels has been compared to the Gold Rush of the 1840s. And in addition to the money being made by landowners in selling drilling rights, the fracking rush has brought jobs to other parts of the country.

"Other states have found the way to find the sweet spot to protect the environment and bring jobs; we should not miss that boat," said Tom Wolf, executive director of the Energy Council at the Illinois Chamber of Commerce.

For people desperate for jobs, a shale gas boom downstate can't come soon enough. Many counties are dealing with unemployment rates that top 10 percent.

Proponents of fracking hope to inject new life into areas of the state where a once-vibrant coal industry has declined precipitously. At the same time, there's a fear drilling will never begin unless the companies that want to extract the gas know what regulatory risks they face.

"If legislation doesn't pass at some point this year, from the state's perspective the risk is that the industry might invest elsewhere in other states that have more favorable conditions to invest in and develop these sorts of wells," said Leonard Kurfirst, a partner at Edwards Wildman Palmer LLP in Chicago who practices environmental law, chemical product liability litigation and regulatory compliance.

The state has laws to deal with gas and oil wells, but those regulations date to 1983 — before modern horizontal drilling techniques were used.

Without meaningful regulation, some landowners are learning that their property rights don't necessarily extend to what's buried beneath the surface. Some have found that their mineral rights were sold years before or that if enough neighbors give permission to drill, they can be forced to join them. Others, who want to test their drinking water for the presence of fracking chemicals, are learning they could be denied access to such information if companies claim it's proprietary.

Commonly referred to as the New Albany shale play, the gas lies in the Illinois basin, a 60,000-square-mile area that encompasses parts of Illinois, Indiana and Kentucky. The U.S. Energy Information Administration estimates New Albany holds 11 trillion cubic feet of shale gas, approximately enough to meet the needs of about 5 million households for 30 years, according to the American Gas Association.

Hydraulic fracturing has been around for more than 60 years, but the modern methods that have led to the shale gas boom were not used until the turn of this century. Unlike vertical wells of the past, modern horizontal wells vastly multiply the exploitable area of a well and involve more chemicals and water.

According to the Colorado Oil and Gas Conservation Commission, about 250,000 gallons might be used to frack a vertical well compared with as much as 5 million gallons to frack a horizontal well.

Southern Illinoisans Against Fracturing Our Environment (SAFE) is one of several organizations and environmental groups that want a moratorium on fracking in Illinois until a task force looks into the risks associated with hydraulic fracturing and recommends what kinds of regulations need to be in place.

The Illinois Chamber of Commerce is among those opposed to SAFE's proposal, which is similar to what New York state adopted with a four-year-old moratorium that has stalled natural gas development efforts.

"There is no energy source that is perfect for the environment or the economy. If there was, we would be using it," Wolf said.

Without regulations in place, a tacit moratorium already exists, Wolf said, explaining that drillers won't go forward with wells only to learn later that they face environmental regulations, new taxes or other unexpected hurdles.

The chamber released a study last month from David Loomis, a professor of economics at Illinois State University and director of the Center for Renewable Energy, estimating that downstate fracking could create 1,000 to 47,000 direct and indirect jobs depending on how many wells were drilled and what level of local resources were used.

Opponents countered that such jobs studies tend to be overly optimistic and don't take into account harmful environmental and quality-of-life issues that could come with fracking.





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Aaron Swartz, Internet activist and programmer, dead at 26













Aaron Swartz in Boston


Internet activist Aaron Swartz, pictured at a Wiki Meetup in Boston in 2009, has reportedly committed suicide.
(Flickr/Wikimedia Commons / January 12, 2013)



























































Internet activist and programmer Aaron Swartz, who helped create an early version of RSS and later played a key role in stopping a controversial online piracy bill in Congress, has died at age 26, in an apparent suicide, New York authorities said Saturday.


Police found Swartz's body hanging in his Brooklyn apartment on Friday, according to the New York City Office of Chief Medical Examiner.


Swartz, a Highland Park native, founded the group Demand Progress and led a successful campaign to stop a bill introduced in 2011 in the U.S. House of Representatives called the Stop Online Piracy Act, which generated fierce opposition in the technological community.





He also played a role in building the news sharing website Reddit.


(Reporting by Alex Dobuzinskis in Los Angeles and P.J. Huffstutter in Chicago; Editing by Colleen Jenkins and Gunna Dickson)






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“Storage Wars” porn lawsuit: alleged Brandi Passante video distributor found in contempt

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“The Middle” will gladly take longevity over awards






LOS ANGELES (TheWrap.com) – ABC’s “The Middle” doesn’t get the recognition, ratings or Emmy Awards that “Modern Family” does, but the cast and creators are fine with cruising under the radar if they can continue producing more episodes.


“I say slow and steady wins the race,” series star Neil Flynn rationalized at the Television Critics Association’s winter press tour.






Despite averaging a middling 2.8 rating in the 18-49 demographic this season – a feeble number compared to the 5.4 for “Modern Family” and the 6.4 for CBS’s top-rated “Big Bang Theory” – “The Middle” has lasted 83 episodes over the course of four seasons. (The rating counts live viewing plus seven days of DVR viewing.)


“Before you know it, we’ll have done 120 episodes,” Flyn continued. “I’d much rather be underrated than overrated.”


And although the show has only been nominated for one Emmy – in the Outstanding Makeup for a Single-Camera Series (Non-Prosthetic) category – executive producers Eileen Heisler and DeAnn Heline joke that they consider it an award every time critics label the show “underrated.”


In fact, they revel in “kindly being called under-appreciated” so much that star Patricia Heaton jokes that they have developed a drinking game for every time the show receives the compliment.


“We’re on fourth season with a show that people love and we’re incredibly, incredibly grateful for that,” Heaton concluded, in all seriousness. “Would it be nice to have more? Yeah, but it’s fantastic and I certainly can’t complain.”


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‘Bodega Clinicas’ Draw Interest of Health Officials





HUNTINGTON PARK, Calif. — The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.




County health officials describe the clinics as a parallel health care system, serving a vast number of uninsured Latino residents. Yet they say they have little understanding of who owns and operates them, how they are regulated and what quality of medical care they provide. Few of these low-rent corner clinics accept private insurance or participate in Medicaid managed care plans.


“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, the chairman of the family medicine department at the David Geffen School of Medicine at the University of California, Los Angeles.


Not that researchers have not tried. Dr. Dowling, for one, has canvassed the clinics for years to document physician shortages as part of his research for the state. What he and others found was that the owners were reluctant to answer questions. Indeed, multiple attempts in recent weeks to interview owners and employees at a half-dozen of the clinics in Southern California proved fruitless.


What is certain, however, is that despite their name, many of these clinics are actually private doctor’s offices, not licensed clinics, which are required to report regularly to federal and state oversight bodies.


It is a distinction that deeply concerns Kimberly Wyard, the chief executive of the Northeast Valley Health Corporation, a nonprofit group that runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Ms. Wyard of the bodega clinicas, “and it’s unclear what they’re doing.”


But with deadlines set by the federal Affordable Care Act quickly approaching, health officials in Los Angeles are vexed over whether to embrace the clinics and bring them — selectively and gingerly — into the network of tightly regulated public and nonprofit health centers that are driven more by mission than by profit to serve the uninsured.


Health officials see in the clinics an opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to two million uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care.


And the clinics, public health officials point out, are already well established in the county’s poorest neighborhoods, where they are meeting the needs of Spanish-speaking residents. The clinics also could continue to serve a market that the Affordable Care Act does not touch: illegal immigrants who are prohibited from getting health insurance under the law.


Dr. Mark Ghaly, the deputy director of community health for the Los Angeles County Department of Health Services, said bodega clinicas — a term he seems to have coined — that agree to some scrutiny could be a good way of addressing the physician shortage in those neighborhoods.


“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”


Los Angeles is not the only city with a sizable Latino population where the clinics have become a part of the streetscape. Health care providers in Phoenix and Miami say there are clinics in many Latino neighborhoods.


But their presence in parts of the Los Angeles area can be striking, with dozens in certain areas. Visits to more than two dozen clinics in South Los Angeles and the San Fernando Valley found Latino women in brightly colored scrubs handing out cards and coupons that promised a range of services like pregnancy tests and endoscopies. Others advertised evening and weekend hours, and some were open around the clock.


Such all-hours access and upfront pricing are critical, Latino health experts say, to a population that often works around the clock for low wages.


Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to corner clinics, which are common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, intravenous vitamins and liberally dispensed antibiotics — that are frowned upon in traditional American medicine.


The waiting rooms at the clinics reflected the everyday maladies of peoples’ lives: a glassy-eyed child resting listlessly on his mother’s lap, a fit-looking young woman waiting with a bag of ice on her wrist, a pensive middle-aged man in work boots staring straight ahead.


For many ordinary complaints, the medical care at these clinics may be suitable, county health officials and medical experts say. But they say problems arise when an illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.


Dr. Raul Joaquin Bendana, who has been practicing general medicine in South Los Angeles for more than 20 years, said the clinics would refer patients to him when, for example, they had uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said.


The clinic physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified or have admitting privileges at area hospitals. That can mean that some clinics try to treat patients who face serious illness.


Olivia Cardenas, 40, a restaurant worker who lives in Woodland Hills, Calif., got a free Pap smear at a clinic that advertises “especialistas,” including in gynecology. The test came back abnormal, and the doctor told Ms. Cardenas that she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Ms. Cardenas said the doctor told her. “Otherwise you could die.”


She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid, and she went to a hospital. The diagnosis, it turned out, was correct.


Health care experts say the clinics’ medical practices would come under greater scrutiny if they were brought closer into the fold.


But being connected would mean the clinics’ cash-only business model would need to change. Dr. Dowling said the lure of newly insured patients in 2014 might draw them in. “To the extent there are payments available,” he said, “the legitimate ones might step up to the plate.”


This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.



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