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Michelle Flynn has been a nurse in Providence St. Joseph Hospital’s emergency department for almost a decade. The environment inside, amid the often desperate patients and hustling staff, can be described as “so much chaos,” she said in an interview earlier today.

In recent months, though, Flynn has been able to spend a lot more time with each patient, answering their questions, explaining their labs, even helping them make appointments or arrange family visits.

Ironically, perhaps, this increased level of personal engagement has been facilitated through cutting-edge technology that takes her out of the hospital entirely — physically, anyway. Working from home, Flynn appears in patient rooms virtually, her face popping up on a wall-mounted TV screen while she interacts with patients via secure, two-way audio and visual, enabled through a remote-controlled high-resolution camera.

Here’s what that looks like:

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Back in July, St. Joseph Hospital became the first Providence-owned medical facility to launch a virtual nursing model and hybrid approach in its Emergency Department. This pilot program combines telehealth with traditional bedside care, an approach that’s part of a broader tech-forward strategy that includes adoption of A.I.-empowered documentation and a “Physician in Triage” model that is streamlining workflows while enabling more patient-centered care, according to staff.

Hansen

Kristen Hansen, director of nursing for St. Joseph’s emergency department, told a group of reporters this morning that the virtual nursing program has been a hit with both patients and staff. Participating nurses do their rounds virtually, beaming into patient rooms to handle documentation, assess their pain levels, answer questions, facilitate language interpreter services when necessary — in short, handling tasks that help to free up in-person medical staffers for direct care.

“They can help with isolation patients, so the [other] nurses don’t have to go into the rooms as often, or violent patients with behavioral health [issues],” Hansen said.

The program is also helping Providence to retain some of its most experienced nurses in Humboldt County. Working in the Emergency Department can be very physically and emotionally demanding, Hansen said. “So this [virtual nursing program] gives an opportunity for us to keep those really high-performing nurses who are highly experienced involved in emergency care even when it’s difficult for them, physically or emotionally, to keep doing that work.”

Technology is allowing these nurses to reconnect with the most meaningful aspects of their work, Hansen said.

“Everyone gets into nursing because they want to take care of patients, and then you find that so much of your time is a checklist of things. You have to document; you have to complete [administrative] tasks; you don’t get to spend that time connecting with patients as much,” she explained. “The virtual nurses all express how much they love the opportunity to connect with their patients and actually spend the time doing the work that they got into nursing to do.”

Patients have been much happier, too.

“Our patient experience metrics have gone through the roof — some of the highest they’ve been in years,” Hansen said. 

Nurses in the program work from home on special Providence-issued computers built to comply with all HIPAA privacy regulations. The in-room cameras are all turned off and aimed away from patients until a virtual nurse beams in and “knocks,” then asks permission to “enter,” meaning turn the camera around and engage. 

“Usually, for the most part, they say, ‘I guess so,’” Flynn told reporters from her position on one of the wall-mounted TVs. Referring back to her description of the pandemonium that often overtakes the Emergency Department, Flynn said, “Being a virtual nurse? We’re like the calm in the chaos. … I’m able to go in and, like, talk with them for as long as they’d like.”

Predictably, some patients are a bit taken aback during their initial interactions with a virtual nurse. 

“They’re very, like, ‘Oh, this is weird,’” Flynn said. “But then, by the end of it, they’re like, ‘This is amazing.’”

Flynn was likewise a bit hesitant about the new approach at first. She wasn’t sure she’d like appearing remotely, but she said serving in this new role allows her to spend 20 or 30 minutes talking to individual patients.

“By doing this, I’m able to go on their chart and reassure them,” she said. “I’ve made appointments for patients that needed [them]; I have called family members. It’s very personal and it’s very, I don’t know, it’s meaningful. I actually really do enjoy doing this, and I feel like patients do as well.”

Meanwhile, St. Joseph Hospital has started using A.I. assistants to help with documentation, which saves medical staff even more time. 

Below is a press release from Providence with more information:

Providence St. Joseph Hospital Eureka enhances care delivery and reduces wait times with new innovations in the Emergency Department

Eureka, Calif. — Patients arriving at the Emergency Department at Providence St. Joseph Hospital Eureka, a Level III Trauma Center, are now being seen on average in less than ten minutes of their arrival, thanks to a series of groundbreaking innovations designed to enhance the care experience, improve efficiency, and support bedside teams.

On July 17, St. Joseph Hospital Eureka became Providence’s first Emergency Department to launch a virtual nursing model and hybrid approach that blends telehealth support with traditional bedside care. This pilot program is part of a broader strategy that also includes adoption of AI technology by physicians and utilization of the Physician in Triage model to streamline workflows and enable more patient-centered care. “

These innovations are transforming how we deliver emergency care,” said Kristen Hansen, director of nursing, Emergency. “Patients are being seen faster, receiving more personalized attention, and our caregivers are feeling more supported than ever.”

Virtual nurses support ED teams

Each Emergency Department room is equipped with a mounted TV and camera, allowing virtual nurses to assist patients remotely via secure two-way audio and video. With a patient’s consent, family members or advocates can also join calls from outside the hospital. 

Virtual nurses do not replace bedside nurses, they provide supplemental support handling key tasks such as admissions, discharge preparation, medication reconciliation, and patient education, freeing up bedside teams to focus on direct care. 

One virtual nurse, Matthew Stevens, shared how the model is reshaping the patient experience:

“Virtual nursing allows us to return to the fundamentals of nursing, like being present, listening, educating, and advocating. In our fast-paced environment, virtual nurses can help patients feel seen and supported, while also relieving bedside caregivers of tasks like coordinating with outside facilities or facilitating interpreter-supported video calls. It’s a collaborative approach that truly enhances care.”

Patients are already noticing the difference. Vanessa Anderson, who recently visited the ED, shared her experience:

“The virtual nurse made sure I had everything I needed because they were busy; the emergency room was packed! The bedside nurse isn’t having to run around from room to room, making life easier. I was happy with my overall experience.”

Artificial Intelligence and Physician in Triage streamlines workflows 

St. Joseph Hospital Eureka also utilizes an AI assistant that securely captures patient-physician conversations and automatically converts them into notes for delivery within Providence’s electronic health record in real-time. Since implementation, the ambient tool has significantly reduced administrative burdens, allowing providers to spend more of their time focused on their patients at the bedside.

In addition, the hospital now utilizes a Physician in Triage model, placing a physician at the front of the emergency department workflow, allowing patients to be assessed and treated more quickly upon arrival. 

Together, these innovations are helping St. Joseph Hospital Eureka deliver faster, smarter, and more compassionate emergency care.

“We’re building this together,” Hansen said. “The response from our caregivers and patients has been overwhelmingly positive. This is a rare and exciting opportunity to shape the future of health care delivery.”

St. Joseph Hospital Eureka is proud to help lead these efforts for the broader Providence health system and welcomes feedback from the community as the pilot continues to evolve. 

Big night at Arcata’s city council meeting yesterday, so no ado.

State hands down new RHNA numbers

Every so often, the state of California sends every jurisdiction in the state a number of housing units by income level that must be planned for.  Called the Regional Housing Needs Allocation (RHNA), the process repeats every eight years. If they’re not planned for, the state can pull funding, developers can ignore zoning laws, huge fines are leveled — it’s a burden. California released the requirements for the 2027-2035 cycle in July, and Humboldt County and the city governments have now started planning how best to distribute and construct all 5,692 of the new units by 2035. Arcata’s deputy director of the community development department, Jennifer Dart, updated the council last night on how they’re trying to accomplish the task. 

Dart said Arcata was willing to take 1,042 of them. It’s a big increase from the last cycle; Arcata only had to build 610 units then. Much of the increase is coming from new housing for those making 80% or less of Humboldt’s median income. California added two new categories for this cycle: “Acutely low” (0-15% of Humboldt’s median income) and “extremely low” (15-30%), totalling 225 more units. Above moderate housing for residents who make over 120% of the median income also increased 151 units. 

It’ll be a tough challenge to meet, Dart said. It’ll be hard to come up with a way to fund so much housing for people who might not be able to pay for it — especially when state and federal funding for affordable housing is being reduced, and homeless shelters don’t count for RHNA.  

Additionally, although Cal Poly Humboldt’s new Hinarr Hu Moulik dorms house almost 1,000 people, they can’t count them towards any income level — plus, it filled up a large site that could have made a great infill project, which is Arcata’s main strategy to keep up with the state’s mandate along with accessory dwelling units and deconstruction and remodeling. There’s not a lot of vacant land left in Arcata, Dart said, and the city has no desire to start sprawling out. 

“What can we do?” Dart asked. “We’re going to get creative, because we are creative. I think Arcata continues to be a forward-thinking community.”

But long-term, Dart and a few of the city council members agreed that Humboldt needs to push for reform to the RHNA system, which doesn’t consider that many rural populations are declining in number and may not need to build more housing. 

“We’re very pro-housing, and we want to provide more housing,” councilmember Stacy Atkins-Salazar said. “But it also needs to be done in a way that is achievable…it’ll be a long journey and we’re just starting to make noise about it.”

Water bills

Long story short: they’re going up. When that happens will be up to the city council next month. They’re either going to jack them up immediately and keep the price the same for a few years before doing it again, or it’ll happen a little more evenly. 

Why? Well, Arcata’s water fund is drying up, and needs more revenue. Arcata is going to sink about $36 million into various improvement projects in the next five years. Much of that money will be borrowed, but the finance department would like to minimize that as much as possible. 

Either the rates will go up 44% in February, followed by a few years of 10% increases for a total balance of $8.5 million in 2030, or they will be increased by 23% and followed by several increases between 10-18%, winding up around $6.9 million in 2030. 

Customers’ fixed charges will either rise from $12.23 monthly to $23.58 or $24.65, depending on which way the council decides to swing. The price per hundred cubic feet will go up to either $13.50 or $14.12 from the current $7.15. 

In 2028, single-family residences will be charged a flat rate for their sewer bill and on average will save about $2 a month. Commercial accounts will still be charged for their total usage. 

Right now the average single-family household in Arcata pays $136.93 monthly for all of their water usage. By 2030, they’ll pay either $155.94 if the city council decides they want more money upfront, or $145.81 if they decide to be a little more patient. 

There will be a public hearing on the subject Jan. 7.

Roger’s Garage project

The city council unanimously decided to award a $155,000 contract to environmental reviewer Helix to do an environmental impact report on the Roger’s Garage site, where a proposed low-income apartment complex could be built. Quite a few Bayside residents came to complain about the review, which they didn’t think was general enough for a contaminated site near an elementary school. Director of Community Development David Loya disagreed. 

“We make decisions we think is necessary for levels of public disclosure,” Loya said. “We asked for a focused EIR because that’s where we’re going to land. The community does not determine that…I have some experience in this field, and based on that experience, I think we’ll be fine with a focused EIR.”

Other stuff

Humboldt Made got $5,000 for an ad campaign and City Manager Merritt Perry, in a brief aside, said there a Cal Poly Humboldt student was interested in drafting guidelines for a sister city project with a city around the same size as Arcata and Camoapa, Arcata’s sister city in Nicaragua. 

Here’s what we originally thought would be a fun map to make — median household income in various Humboldt County neighborhoods, compared with one another, and as estimated by the Census Bureau’s most recent five-year averages from the American Community Survey.

Check it out below. Go ahead and scroll around and zoom in and such. Hover over or click a census track to get the numbers for that region.  

… and then, probably, you can go ahead and forget you ever saw it, because the data is kind of crap.

Why? Well, when you were hovering and clicking a second ago, did you see the figures for the margin of error in these estimates? Some are better than others, but overall they are not great.

Take the Hoopa square, for example — estimated median household income of $54,306, but with a 36.6% margin of error, meaning that the actual median household income in that area could be anywhere between $34,430 and $74,182. Pretty wide target!

And that’s not even taking into account the American Community Survey’s usual 90 percent confidence interval — meaning the Census Bureau is only 90 percent certain that Hoopa’s median household income is in that range.

These wide margins of error are always a problem the more you break up a dataset into smaller and smaller subsets, and it appears that census tract-level data is small enough to make it all but useless, here in Humboldt County.

Oh well. Maybe some community planner type out there, or someone generally more versed in statistical analysis than I am, can tell me why all this fun tract-level data in the ACS isn’t a total bust for local purposes. Until then, I am declaring it so.

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The California State University system will seek a state loan of $144 million that it’ll have a year to repay at no interest, even though current projections show the system will have to add to its deficit to repay the debt.

Cal State’s chief financial officer says the loan will be used to offer one-year bonuses to faculty and staff. While salaries vary widely across the system, the extra $144 million is roughly a 3% increase in the total pay for Cal State’s workers, including executives. State law says the loan needs to be repaid by next July.

Despite months of hesitation, the system today took the first step to request the loan and will likely get the money in 60 days or less, said Cal State’s interim chief financial officer, Patrick Lenz, in an interview. The process involves approval from state lawmakers, who are likely to support the move.

State lawmakers made the loan available to Cal State after they cut state funding to the system by $144 million this year. Cal State has 22 campuses and enrolls 460,000 students.

The system’s largest union, the California Faculty Association of 30,000 workers, is cheering this decision but says more work is needed to bring back lecturers whose contracts were cancelled as many campuses contend with shrinking budgets. The union’s contract is expiring but negotiators from the union and Cal State leadership haven’t met since April.

“We will take this as a win, but we have so much work to do, and I do hope that this provides an opening for the management to come to the table with us and negotiate fairly,” said Elaine Bernal, a lecturer at the Department of Chemistry and Biochemistry at Cal State Long Beach and senior member of the faculty association.

“The one-time investment, great, but we really got to focus on long-term investment,” she said.

The Legislature intends to increase state spending for Cal State in 2026-27 by just $101 million — far lower than previous promises from Gov. Gavin Newsom of about $250 million — so the system will effectively be $43 million short once it repays the loan, Lenz said.

The decision to take the loan came “after careful deliberation, conversations with the chancellor, conversations with our Board of Trustees,” Lenz said.

Money is chronically tight at CSU. Since 2023 the system has battled ongoing deficits that have led to hundreds of degree and course cuts, fewer lecturers and hiring freezes. Back then, the system said it was spending $1.5 billion less than it should to adequately educate its students.

Over the past two years that figure has grown by several hundred million dollars as costs rise for campus utilities, insurance, health benefits and more. The deficits exist even as the system in 2024 began increasing tuition annually; the added costs outweigh the new revenue from charging students more. However, most students don’t pay tuition because of state and system financial aid.

Despite those fiscal pressures and likely new expenses to replace the Trump administration’s cuts to federal education grants, Lenz said system leaders want to spend the money on workers.

Unions wanted loan

The zero-interest loan has been the source of intrigue and scrutiny since July as unions representing Cal State workers have been pressuring the system to agree to borrow the money so campuses can offer pay increases for workers. Unions and some lawmakers argued that the the system was fully funded because the state budget gave CSU the option to borrow the loan, which should trigger collective bargaining contract language that stipulated that ongoing raises would kick in if the system received an increase in state funding.

But Cal State officials say that even if they take the loan, it’s not new or ongoing funding — it’s money they’d have to repay after a year — so the system isn’t obligated to increase wages like those contracts dictate.

Lenz reiterated that point during an interview, even after indicating the system will take out the loan.

“Clearly, anything that is one time is not ongoing,” he said of the loan. So any raise “would be only for the 12 months of the budget year.” But maybe the state will send more cash to the system than what lawmakers and Newsom signaled in the annual budget deal they solidified in June, Lenz said. He also suggested that CSU could negotiate more time to repay the loan.

“There’s a long way to go in this process, and there’s a lot of unknowns,” he said.

How CSU got here

That the loan even exists is itself an example of curious budgeting tactics by lawmakers and Newsom. Last year they passed a state budget that gave Cal State a moderate increase in state funding with a warning of huge cuts of $375 million this July — equal to about 8% of what the state spends supporting the CSU.

After a half-year of fierce advocacy from Cal State officials, students and workers, the final 2025-26 budget approved in June applied just a 3% cut to CSU, with a promise that the cut — $144 million — would be restored in the 2026-27 budget year that begins next July. To help Cal State manage its finances this fiscal year, the state said the system could borrow $144 million this year and repay it by the end of June 2026.

The loan option was extended to multiple state agencies, including the University of California.

System budget leaders, including Lenz, in July expressed wariness over taking out the loan because if the state’s budget picture remains shaky — it’s already projecting billions of dollars in deficits — then lawmakers may decide to apply further cuts to the CSU. That means the system would be in a deeper deficit and be on the hook for a loan they couldn’t repay.

The fiscal malaise could have been worse. In 2022, Newsom promised the CSU and University of California five years of increasing budget support totaling more than $1 billion for each system in new, ongoing funding. But because of state budget constraints, that so-called “compact” has only been partially funded. And new funding pain points are likely on the horizon. Congressional Republicans and President Donald Trump approved spending plans that Newsom says will kick millions of low-income Californians off public health insurance. If the state plans to pay for that care, budgets for other agencies, especially those that can raise tuition, may need to decrease.

UPDATE, 3:30 p.m.: DHHS says that funding for WIC has been extended through the month of November. SNAP funding is still at risk.

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ORIGINAL POST:

Press release from the Humboldt County Department of Health and Human Services:

As the federal government shutdown enters its third week, the Humboldt County Department of Health & Human Services (DHHS) is bracing for impacts to benefits starting Nov. 1, including to the approximately 22% of county residents who receive Supplemental Nutrition Assistance Program (SNAP) benefits. 

In Humboldt County, more than 30,000 individuals receive SNAP — CalFresh — which equates to between $5.8 and $6 million a month. These benefits not only supplement the food budgets of elderly community residents, families with children and other individuals, there are many businesses in the county that accept EBT cards (which is how these benefits are delivered) and rely on this income as well. Statewide, approximately 5.5 million residents are expected to lose benefits effective Nov. 1, 2025.

Officials from the U.S. Department of Agriculture estimate approximately 42 million individuals will be impacted by the loss of SNAP benefits nationwide, if the shutdown continues. 

Currently, the approximately 2,880 participants who receive benefits through the WIC (Women, Infants & Children) program, can expect to continue receiving them through the first week in November. 

DHHS Director Connie Beck said she is already seeing the impacts on staff who are anticipating this loss of benefits in the coming weeks. “It is daunting knowing we soon may not be able to provide services to the folks who depend on us.” 

Beck said staff is working on messaging about other resources that may be available, including local food banks, to provide to current customers if benefits are halted.

At this time, funding to programs including Foster Care Title IV-E and In-Home Supportive Services is expected to be covered through the end of the year, despite the ongoing shutdown. 

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California’s elected and appointed officials will now have to tell the public when they’ve accepted a job offer from a new employer that might seek favors from them while they’re still in a position of power.

Gov. Gavin Newsom earlier this month signed Assembly Bill 1286 by Democratic Assemblymember Tasha Boerner of Solana Beach. The measure requires California’s elected officials and state appointees to note on mandatory conflict of interest forms whether they’ve gotten a new job before their term in office ends.

Boerner introduced the measure in response to a CalMatters story last year that highlighted how lawmakers were not required to tell the public if they were negotiating or had accepted a job with an organization trying to get something from the Legislature.

“People’s distrust of the government is growing,” Boerner said in a statement after the bill was presented to Newsom. “As public servants, one of the most important parts of our job is transparency. It is the one-way ticket to building confidence between government officials and their communities.”

Shery Yang, a spokesperson for the California Fair Political Practices Commission, which enforces California’s ethics laws, said Chairperson Adam Silver proposed the bill idea to Boerner’s office after reading CalMatters’ story.

Under the new law, officials must now provide the commission with the date they accept a job offer, the position they’re going to take and a description of what their employer does, as well as their employer’s name and address. Boerner’s bill passed the Legislature without any lawmaker voting against it.

The CalMatters report came as around a quarter of the Legislature was leaving office. Some lawmakers were searching for their next job while still casting votes, potentially on matters that could benefit their future employers.

Of the 180 lawmakers who left office since 2012, the story noted, around 40 registered as lobbyists, worked as political consultants or took executive-level jobs with companies or organizations actively lobbying at the Capitol.

It’s illegal and considered bribery for a government official to cast votes or do other official favors in exchange for a promise of future employment. It’s also illegal for officials to use state resources to search for or secure a new job.

Lawmakers also are supposed to recuse themselves from any official actions that have “direct and significant” financial impact on an entity with whom they are negotiating employment or who has made them an employment offer,” according to a legislative ethics committee handout.

But state ethics guidelines still allow lawmakers to vote on bills that could benefit a prospective employer, allowing them to discuss and vote on bills that would benefit a “significant segment” of an industry rather than their specific would-be employer.

In practice, that means a lawmaker with a job pending at a major tech company can continue to vote on legislation that impacts all tech companies.

Government ethics experts told CalMatters last year that adding disclosure requirements for job-hunting lawmakers would add needed transparency and help keep lawmakers and lobbyists honest.

FPPC Chairperson Silver called the measure “an important step forward for transparency and accountability in the political process.”

“This reform is about something bigger than disclosure forms — it is about trust,” he said in a statement. “It guarantees that Californians know their government is working for them, not for private interests. And more practically, it ensures that the FPPC has the information necessary to timely and effectively identify and prosecute violations of the state’s ban on influencing prospective employment.”

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Starting next year, Californians with diabetes will be able to purchase state-branded insulin at steeply reduced prices, Gov. Gavin Newsom announced today.

Long-acting insulin pens will be available at pharmacies for $11 per pen — or $55 for a five-pack — beginning Jan. 1. The pens are interchangeable with glargine, the generic alternative for Lantus, a once-a-day injection that regulates blood sugar. An equivalent amount of Lantus sells to pharmacies for more than $92, according to data compiled by the governor’s office, but consumers may pay a different price based on their insurance.

“California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands,” Newsom said in a statement released at 3 a.m. Pacific time. “No Californian should ever have to ration insulin or go into debt to stay alive.”

Roughly 3.5 million Californians have diabetes, according to the American Diabetes Association.

Lawmakers at the state and federal level have focused in recent years on the high cost of insulin, a life-saving drug used by diabetics. Price caps set by the Biden administration in 2023 as well as public pressure have driven down the cost nationally, according to health economists.

The sale of insulin is part of the state’s CalRx initiative aimed at lowering prescription drug prices for Californians. Today’s announcement comes three years after Newsom announced the state would tackle the cost of insulin. The first vials of insulin will be for sale two years after the governor’s promised delivery date of 2024.

Newsom originally pledged that the state would spend $50 million to contract with Civica Rx, a nonprofit drug manufacturer headquartered in Utah. The state earmarked another $50 million to build a manufacturing plant in California, but has given no updates on that project.

In a statement, Elizabeth Landsberg, director of the state health care access department that oversees CalRx, said the program was “committed to transparent pricing, eliminating hidden costs, and ensuring equitable medication access for uninsured, underinsured, and vulnerable residents.”

Less than a week ago, Newsom signed legislation capping out-of-pocket insurance costs for insulin at $35.

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Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.