A selection of health policy stories from California, Pennsylvania, Arizona, D.C., Texas and Missouri.Kaiser Health News: California Prop. 46, Inspired By Tragedy, Pits Doctors Against LawyersProp. 46 would make it mandatory for doctors to consult the database. California would become one of nine states requiring doctors to check before prescribing painkillers to first-time patients. After passing similar laws, Tennessee and New York saw a significant reduction in the number of narcotics prescriptions written. Studies have verified the correlation, but acknowledge that drug abusers may be turning to street drugs, like heroin. Many doctors in California like the database. Some have called it ‘indispensable.’ But they don’t like being told how to practice medicine (Dembosky, 10/14).The New York Times: Philadelphia Teachers Hit By Latest CutsMoney is so short at Feltonville School of Arts and Sciences, a public middle school here, that a nurse works only three afternoons a week, leaving the principal to oversee the daily medication of 10 children, including a diabetic who needs insulin shots. On the third floor filled with 200 seventh and eighth graders, one of two restrooms remains locked because there are not enough hall monitors. And in a sixth-grade math class of 33 students with only 11 textbooks to go around, the teacher rations paper used to print out homework equations. … The latest fund-raising effort came last week when the School Reform Commission, the state-appointed board that oversees the Philadelphia schools, unilaterally and abruptly canceled the union contract for teachers and required them to pay minimum health care premiums from $25 to $67 a month for a single person. Until now, teachers have not paid for health insurance (Rich, 10/14).Arizona Central-Republic: Will Next Governor Keep Arizona’s Expanded Safety Net?Gov. Jan Brewer took steps in recent years to restore Arizona’s safety net by expanding health care for low-income Arizonans and beefing up funding for child welfare. Whether those key pieces of Brewer’s legacy remain intact next year hinges in large part on the next governor, who will face an immediate budget deficit of more than a half-billion dollars when he takes office (Pitzl, 10/14).Los Angeles Times: UCLA Study Offers Hope On Emergency Room CrowdingA new UCLA study has found that while people enrolled in low-cost, government-run health plans visit emergency rooms at high rates soon after becoming insured, the number falls dramatically within a year. That’s good news, said study author and UCLA professor Dr. Gerald Kominski, because patients’ long-neglected health problems are being “addressed during the first year, and because of that there’s a drop-off.” Some worry that the expansion of health coverage under the Affordable Care Act will not ease emergency room crowding as President Obama and others have predicted, but will instead encourage more people to go to the hospital (Karlamangla, 10/14).The Washington Post: America’s Fastest-Growing Profession Is Joining A Very Public Fight For Higher WagesKnowing what a difference higher pay can make, Reece has joined a new movement launching this week to raise wages and improve workplace protections for home health-care aides nationwide. Backed by the Service Employees International Union, the effort seeks to replicate the “Fight for 15,” a push earlier this year to raise the income of fast-food workers through high-profile strikes. On Wednesday, Reece will rally on D.C.’s Freedom Plaza to demand the same for home health-care aides. It’s part of actions in nine states aimed at putting the concerns of the nation’s fastest-growing workforce — one that’s 91 percent female, 56 percent non-white and highly dependent on public aid — on the political agenda. About 600,000 of the country’s 2.1 million home health-care aides are members of the SEIU (DePillis, 10/14).Arizona Central-Republic: DOC Agrees To Major Improvements In Health CareAt first, the Arizona Department of Corrections refused to admit there was a dire problem with regards to the administering of health care to state prisoners. Today, a settlement agreement has been reached in a class-action lawsuit (Halloran, 10/14).The Wall Street Journal: Arizona Agrees To Improve Prison Conditions In Settlement With ACLUThe state Department of Corrections will take more than 100 measures to change its practices on providing prisoners with medical and mental-health care, according to terms of the deal, filed Tuesday in the U.S. District Court of Arizona. The settlement covers Arizona’s state prison system, which holds more than 33,000 inmates. The new measures, according to the agreement, will allow mentally ill prisoners who are held in isolation to have better access to treatment and 19 hours a week outside their cells; will provide more medical and dental care for the overall prison population; and will restrict the use of pepper spray to situations that jeopardize the safety of prisoners or guards or compromise prison security (Lazo, 10/14).Arizona Central-Republic: Prison Health-Care Settlement May Add To Ariz. DeficitArizona must significantly improve health-care and mental-health-care treatment for about 33,000 prison inmates under a proposed settlement of a class-action lawsuit brought in 2012 by prison-rights groups. That suit charged that the state unconstitutionally denies adequate care to inmates in state prisons and routinely keeps mentally ill prisoners in solitary confinement under brutal conditions. Under the settlement announced Tuesday, the state does not admit any wrongdoing. The settlement would reduce the amount of time mentally ill inmates spend in solitary confinement and would restrict guards’ use of pepper spray to control those inmates. Spray could be used only to prevent serious injury or escape (Ortega, 10/14).Dallas Morning News: CMS Approves Baylor’s Plan To Remove ‘Immediate Jeopardy’ DeterminationThe Centers for Medicare & Medicaid Services has approved Baylor University Medical Center’s plan to correct deficiencies that threaten its federal funding. CMS sent the hospital an “immediate jeopardy” warning last week after inspectors found several instances of psychiatric patients walking away from the emergency department before treatment concluded. After such warnings, hospitals have 23 days to fix the problems that jeopardize patient safety or else risk termination of Medicare eligibility. Medicare accounts for about $300 million of the medical center’s $1 billion in annual revenue (Jacobson, 10/14).Kansas City Star: Carondelet Health To Sell Two Kansas City-Area Hospitals To Prime Healthcare ServicesCarondelet Health, a part of the Ascension hospital chain, said Tuesday that it had signed a definitive agreement to sell its two Kansas City area hospitals to Prime Healthcare Services. St. Joseph Medical Center in Kansas City and St. Mary’s Medical Center in Blue Springs will become part of the for-profit Prime hospital chain, subject to regulatory approval. The two Carondelet hospitals are approved for 450 beds and have 900 physicians on their combined staffs. Ascension is a not-for-profit Catholic health care organization based in St. Louis. The Prime chain employs more than 30,000 and operates 27 hospitals in seven states — California, Michigan, Nevada, Pennsylvania, Rhode Island, Texas and Kansas. It previously acquired Providence Medical Center in Kansas City, Kan., and St. John Hospital in Leavenworth (Stafford, 10/14). State Highlights: Ariz. Agrees To Settlement On Health Care For Prisoners This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.