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Apple Forging New Base, But iPhone Chip Plays Struggle: S&P 500 Futures

Futures for the SP 500 turned slightly lower early Wednesday morning after Democrat Doug Jones won Alabama’s special election Tuesday, reducing the GOP’s already-narrow Senate majority. Still, the overnight impact was muted.

X Alabama is normally a deep-red state, but accusations of sexual misconduct involving teens hurt Republican Roy Moore.

Tuesday’s vote will complicate President Trump’s agenda by cutting the GOP Senate majority to just 51-49. However, Jones likely won’t take office for a few weeks, giving Republicans some time to pass tax cuts with another vote to spare.

Details of the evolving GOP tax-cut plan appeared after Tuesday’s close. Meanwhile, investors expect a Federal Reserve interest-rate hike Wednesday.

SP 500 index futures fell 0.1% vs. fair value. Dow futures were essentially flat. Nasdaq 100 futures sank 0.1%.

Meanwhile, Apple (AAPL) is close to carving out a flat base. But Apple chip plays are not faring as well, with Broadcom (AVGO) undercutting its buy point Tuesday, joining Skyworks Solutions (SWKS), Applied Materials (AMAT), Analog Devices (ADI) and Qorvo (QRVO) below the 50-day line as chipmakers continue to slump.

The GOP tax plan being hashed out between the House and Senate now has a 21% corporate tax cut, down from the current 35%, but up from prior  plans for 20%. There would be a 37% personal income rate and the mortgage interest deduction would  be capped at $750,000, down from the current $1 million but above the House’s $500,000.

Apple

Apple shares fell 0.6% to 171.70 in Tuesday’s stock market trading, but they’re still holding support slightly above the 50-day moving average.

Apple appears to be headed toward a flat base, which needs a minimum of five weeks. That would occur at the end of this week. This hypothetical bullish consolidation, with a potential buy point of 176.34, would be a base-on-base formation above a prior cup-with-handle pattern.

The tech titan, a member of the Nasdaq, SP 500 and Dow industrials, has shaken off iPhone X supply concerns.

But such worries may be affecting key iPhone-related chip plays, which are also struggling due to general weakness in semiconductors.

Broadcom

Broadcom had been one of the stronger Apple chipmakers, holding above its 259.46 buy point for the most part since the late-October breakout, becoming somewhat extended in late November.

Broadcom, which is mounting a now-hostile bid for fellow wireless-chip giant Qualcomm (QCOM), reported strong earnings and guidance as well as a big dividend hike last week.

Shares popped intraday Dec. 7 on the report, but closed flat. In the last three sessions, shares tested their buy point and 50-day moving average, finally closing below both levels with Tuesday’s 0.4% loss to 258.81.

Because Broadcom wiped out a 10% gain from its buy point, that entry is now invalid. A strong, high-volume retaking of the 50-day line could present a new buying opportunity.

Applied Materials

The chip-equipment giant is not a direct Apple supplier, though it’s been deemed an iPhone X play for its work with OLED screens.

Applied Materials fell 2.2% to 50.47 on Tuesday, continuing to hold below its 50-day moving average.

In fact, just one of the 22 largest chip-gear stocks by market cap is current above that key support line, Kulicke Soffa (KLIC). That’s despite the record chip-gear sales in 2017 and 2018 seen by industry group SEMI.

Among top chipmakers, Intel (INTC) and Texas Instruments (TXN) are slightly above their 50-day lines, but not many others are, outside of MA-related plays.

Analog Devices

Analog Devices successfully broke out in late September/early October, unlike many other Apple suppliers. Shares rose more than 9% above an 85.81 buy point by Nov. 20. But shares then reversed lower on the company’s latest earnings report and soon undercut their 50-day line.

In recent sessions, Analog Devices has been holding just above or below the 85.81 entry, which is technically still valid. Shares fell 0.4% to 85.48 on Tuesday.

Skyworks Solutions, Qorvo

Skyworks broke out in late October and Qorvo in early November, with both rising for a few sessions but then quickly tumbling through their buy points and 50-day lines.

Skyworks fell 0.5% to 96.47 on Tuesday, about 18% off its high. Qorvo lost 1.3% to 67.70, hitting a four-month low intraday.

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Apple Forging New Base, But iPhone Chip Plays Struggle: S&P 500 Futures

Futures for the SP 500 turned slightly lower early Wednesday morning after Democrat Doug Jones won Alabama’s special election Tuesday, reducing the GOP’s already-narrow Senate majority. Still, the overnight impact was muted.

X Alabama is normally a deep-red state, but accusations of sexual misconduct involving teens hurt Republican Roy Moore.

Tuesday’s vote will complicate President Trump’s agenda by cutting the GOP Senate majority to just 51-49. However, Jones likely won’t take office for a few weeks, giving Republicans some time to pass tax cuts with another vote to spare.

Details of the evolving GOP tax-cut plan appeared after Tuesday’s close. Meanwhile, investors expect a Federal Reserve interest-rate hike Wednesday.

SP 500 index futures fell 0.1% vs. fair value. Dow futures were essentially flat. Nasdaq 100 futures sank 0.1%.

Meanwhile, Apple (AAPL) is close to carving out a flat base. But Apple chip plays are not faring as well, with Broadcom (AVGO) undercutting its buy point Tuesday, joining Skyworks Solutions (SWKS), Applied Materials (AMAT), Analog Devices (ADI) and Qorvo (QRVO) below the 50-day line as chipmakers continue to slump.

The GOP tax plan being hashed out between the House and Senate now has a 21% corporate tax cut, down from the current 35%, but up from prior  plans for 20%. There would be a 37% personal income rate and the mortgage interest deduction would  be capped at $750,000, down from the current $1 million but above the House’s $500,000.

Apple

Apple shares fell 0.6% to 171.70 in Tuesday’s stock market trading, but they’re still holding support slightly above the 50-day moving average.

Apple appears to be headed toward a flat base, which needs a minimum of five weeks. That would occur at the end of this week. This hypothetical bullish consolidation, with a potential buy point of 176.34, would be a base-on-base formation above a prior cup-with-handle pattern.

The tech titan, a member of the Nasdaq, SP 500 and Dow industrials, has shaken off iPhone X supply concerns.

But such worries may be affecting key iPhone-related chip plays, which are also struggling due to general weakness in semiconductors.

Broadcom

Broadcom had been one of the stronger Apple chipmakers, holding above its 259.46 buy point for the most part since the late-October breakout, becoming somewhat extended in late November.

Broadcom, which is mounting a now-hostile bid for fellow wireless-chip giant Qualcomm (QCOM), reported strong earnings and guidance as well as a big dividend hike last week.

Shares popped intraday Dec. 7 on the report, but closed flat. In the last three sessions, shares tested their buy point and 50-day moving average, finally closing below both levels with Tuesday’s 0.4% loss to 258.81.

Because Broadcom wiped out a 10% gain from its buy point, that entry is now invalid. A strong, high-volume retaking of the 50-day line could present a new buying opportunity.

Applied Materials

The chip-equipment giant is not a direct Apple supplier, though it’s been deemed an iPhone X play for its work with OLED screens.

Applied Materials fell 2.2% to 50.47 on Tuesday, continuing to hold below its 50-day moving average.

In fact, just one of the 22 largest chip-gear stocks by market cap is current above that key support line, Kulicke Soffa (KLIC). That’s despite the record chip-gear sales in 2017 and 2018 seen by industry group SEMI.

Among top chipmakers, Intel (INTC) and Texas Instruments (TXN) are slightly above their 50-day lines, but not many others are, outside of MA-related plays.

Analog Devices

Analog Devices successfully broke out in late September/early October, unlike many other Apple suppliers. Shares rose more than 9% above an 85.81 buy point by Nov. 20. But shares then reversed lower on the company’s latest earnings report and soon undercut their 50-day line.

In recent sessions, Analog Devices has been holding just above or below the 85.81 entry, which is technically still valid. Shares fell 0.4% to 85.48 on Tuesday.

Skyworks Solutions, Qorvo

Skyworks broke out in late October and Qorvo in early November, with both rising for a few sessions but then quickly tumbling through their buy points and 50-day lines.

Skyworks fell 0.5% to 96.47 on Tuesday, about 18% off its high. Qorvo lost 1.3% to 67.70, hitting a four-month low intraday.

RELATED:

The Big Picture: This Key Tech Sector Shows Unusual Weakness

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Bullish Chart Patterns: Do You Know The Basics Of A Cup With Handle?

Bullish Chart Patterns II: How To Find The Exact Buy Point

Apple Forging New Base, But iPhone Chip Plays Struggle: S&P 500 Futures

Futures for the SP 500 turned slightly lower early Wednesday morning after Democrat Doug Jones won Alabama’s special election Tuesday, reducing the GOP’s already-narrow Senate majority. Still, the overnight impact was muted.

X Alabama is normally a deep-red state, but accusations of sexual misconduct involving teens hurt Republican Roy Moore.

Tuesday’s vote will complicate President Trump’s agenda by cutting the GOP Senate majority to just 51-49. However, Jones likely won’t take office for a few weeks, giving Republicans some time to pass tax cuts with another vote to spare.

Details of the evolving GOP tax-cut plan appeared after Tuesday’s close. Meanwhile, investors expect a Federal Reserve interest-rate hike Wednesday.

SP 500 index futures fell 0.1% vs. fair value. Dow futures were essentially flat. Nasdaq 100 futures sank 0.1%.

Meanwhile, Apple (AAPL) is close to carving out a flat base. But Apple chip plays are not faring as well, with Broadcom (AVGO) undercutting its buy point Tuesday, joining Skyworks Solutions (SWKS), Applied Materials (AMAT), Analog Devices (ADI) and Qorvo (QRVO) below the 50-day line as chipmakers continue to slump.

The GOP tax plan being hashed out between the House and Senate now has a 21% corporate tax cut, down from the current 35%, but up from prior  plans for 20%. There would be a 37% personal income rate and the mortgage interest deduction would  be capped at $750,000, down from the current $1 million but above the House’s $500,000.

Apple

Apple shares fell 0.6% to 171.70 in Tuesday’s stock market trading, but they’re still holding support slightly above the 50-day moving average.

Apple appears to be headed toward a flat base, which needs a minimum of five weeks. That would occur at the end of this week. This hypothetical bullish consolidation, with a potential buy point of 176.34, would be a base-on-base formation above a prior cup-with-handle pattern.

The tech titan, a member of the Nasdaq, SP 500 and Dow industrials, has shaken off iPhone X supply concerns.

But such worries may be affecting key iPhone-related chip plays, which are also struggling due to general weakness in semiconductors.

Broadcom

Broadcom had been one of the stronger Apple chipmakers, holding above its 259.46 buy point for the most part since the late-October breakout, becoming somewhat extended in late November.

Broadcom, which is mounting a now-hostile bid for fellow wireless-chip giant Qualcomm (QCOM), reported strong earnings and guidance as well as a big dividend hike last week.

Shares popped intraday Dec. 7 on the report, but closed flat. In the last three sessions, shares tested their buy point and 50-day moving average, finally closing below both levels with Tuesday’s 0.4% loss to 258.81.

Because Broadcom wiped out a 10% gain from its buy point, that entry is now invalid. A strong, high-volume retaking of the 50-day line could present a new buying opportunity.

Applied Materials

The chip-equipment giant is not a direct Apple supplier, though it’s been deemed an iPhone X play for its work with OLED screens.

Applied Materials fell 2.2% to 50.47 on Tuesday, continuing to hold below its 50-day moving average.

In fact, just one of the 22 largest chip-gear stocks by market cap is current above that key support line, Kulicke Soffa (KLIC). That’s despite the record chip-gear sales in 2017 and 2018 seen by industry group SEMI.

Among top chipmakers, Intel (INTC) and Texas Instruments (TXN) are slightly above their 50-day lines, but not many others are, outside of MA-related plays.

Analog Devices

Analog Devices successfully broke out in late September/early October, unlike many other Apple suppliers. Shares rose more than 9% above an 85.81 buy point by Nov. 20. But shares then reversed lower on the company’s latest earnings report and soon undercut their 50-day line.

In recent sessions, Analog Devices has been holding just above or below the 85.81 entry, which is technically still valid. Shares fell 0.4% to 85.48 on Tuesday.

Skyworks Solutions, Qorvo

Skyworks broke out in late October and Qorvo in early November, with both rising for a few sessions but then quickly tumbling through their buy points and 50-day lines.

Skyworks fell 0.5% to 96.47 on Tuesday, about 18% off its high. Qorvo lost 1.3% to 67.70, hitting a four-month low intraday.

RELATED:

The Big Picture: This Key Tech Sector Shows Unusual Weakness

5 Truck Stocks Set Up Buy Points Despite Tesla Semi: Investing Action Plan

Bullish Chart Patterns: Do You Know The Basics Of A Cup With Handle?

Bullish Chart Patterns II: How To Find The Exact Buy Point

Millennials’ struggle with health bills could push hospitals to change

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a1384_104884108-image1.530x298 Millennials' struggle with health bills could push hospitals to change

Jonathan and Nikia Reynolds are still deciding on a new health plan for 2018, weighing the pros and cons of a high-deductible insurance plan to try to keep their monthly premium lower.

“How it’s supposed to work, I kind of get all that stuff. … In practice, it’s usually less clear,” said Jonathan, a 34-year old Atlanta-based freelance video photographer.

At least, that’s how he felt after a late-night trip to the emergency room a couple of years ago resulted in months of confusing bills in the mail.

“I would get bills way after the fact, and it was never clear exactly what the bills were from, and how they related to what the insurance covered,” he said.

As the first generation to come of age under Obamacare, millennials are finding the new rules of consumer-driven health care tough to navigate.

More than half of millennials, 57 percent, say they have little to no understanding of how out-of pocket health costs such as co-pays, deductibles and co-insurance work, according to a new report from consumer credit firm TransUnion. By contrast, about 40 percent of baby boomers admit to limited knowledge about their benefits.

“Millennials came into the health-care market at a really volatile time, when cost-shifting was really happening … [and] deductibles have quadrupled,” said Jonathan Wiik, principal at TransUnion’s health-care unit.

For hospitals and other health providers, millennial patients — born from 1980 to 1994 — are proving to be a challenge when it comes to collecting payment for bills.

Nearly 3 in 4 millennials, 74 percent, failed to pay their medical expenses in full when first billed in 2016; that’s up from 64 percent in 2014, TransUnion’s survey said.

The vast majority cited limited savings for not paying, but nearly half of those surveyed say they’d be more apt to pay if they could get a cost estimate up front.

“They don’t pay their bills on time because they don’t understand them. That’s pretty typical of that generation — they’re not going to pay until somebody explains it to them,” said Wiik, who consults with hospitals on bill collection.

He says hospitals are starting to change the way they have traditionally billed, by trying to prepare patients for what their out of pocket costs will be ahead of treatment, and working out flexible payment plans to allow patients to pay over time.

But the hospitals have a long way to go.

“I don’t think any millennial pays their bills on paper,” Wiik said. “That’s how hospitals are billing right now. … It’s a big gap that the industry’s going to have to help fill.”

Jonathan Reynolds is hoping not to see any hospital bills in the mail any time soon.

“I know health care is complicated,” he said, but it’s high time for real “simplification of how deductibles and co-pays are explained, and just the process of billing itself.”

a1384_104884108-image1.530x298 Millennials' struggle with health bills could push hospitals to change



Rocket Internet start-ups struggle to swing into profit – Financial Times

Keep abreast of significant corporate, financial and political developments around the world. Stay informed and spot emerging risks and opportunities with independent global reporting, expert commentary and analysis you can trust.

Rocket Internet start-ups struggle to swing into profit

Rocket Internet start-ups struggle to swing into profit

Internet’s Top Cop Under Trump May Struggle to Run at Web Speeds

Federal Communications Commission Chairman Ajit Pai’s plan to gut Obama-era net neutrality rules calls for handing off the job of policing broadband service to an agency with different powers and a different mandate.

Giving the Federal Trade Commission oversight for the web can make sense from Pai’s perspective: It’s a consumer-protection agency that already has taken action against high-speed internet providers.

0ddaf_60x-1 Internet's Top Cop Under Trump May Struggle to Run at Web Speeds

Ajit Pai

But, there’s a key difference: The FCC sets rules designed to prevent bad behavior, while the FTC acts after wrongdoing has occurred. That distinction has become a flash point in the debate over Pai’s proposal, which would change the way the government regulates the internet with far-reaching implications for a host of industries.

Opponents say that reactive nature means the trade commission is too slow to oversee the rapidly evolving digital economy.

“It’s not adequate,” said Gigi Sohn, who helped write the current net neutrality rules as an FCC aide in 2015. “If you wait for a case to be through, you can be out of business.” 

Others say Pai is bringing a powerful watchdog into the fray.

“There’s no doubt they can bring cases,” said Roslyn Layton, a visiting scholar with the American Enterprise Institute policy group in Washington. “The FTC has the right people” including economists “used to looking at all kinds of new arrangements” to enforce fair competition, Layton said.

Why Trump Wants to Toss Obama’s Net Neutrality Rules: QuickTake

Pai on Nov. 21 proposed killing the FCC’s 2015 net neutrality rules and allowing broadband providers such as ATT Inc. and Comcast Corp. to block websites or charge more for faster speeds on their networks, as long as the companies disclose their practices. His proposal faces a Dec. 14 vote at the agency, and is likely to pass because Pai leads a three-member Republican majority.

The 188-page proposed order lays out disclosure requirements for broadband providers. The FTC could act to make sure the companies adhere to their promises, for instance by saying that failing to follow through as promised amounts to an unfair trade practice. 

“Transparency amplifies the power of antitrust law and the FTC Act to deter and where needed remedy behavior that harms consumers,” according to the FCC’s proposed order.

“The FTC has great expertise in this issue” and has acted against companies that throttle data flows, Pai told Bloomberg Radio on Nov. 21. “They’ll be able to perform their consumer protection and pro-competition function.”

Open-Internet Rules Fight Seen Raging Beyond FCC Rollback

Both the FCC and FTC are run by bipartisan commissions made up of five commissioners, although the FTC is currently short three members. The president names one of the commissioners on each panel to serve as chairman while no more than three can be from the same political party. The FCC has a staff of 1,500 compared to the FTC’s 1,100 employees; both have budgets of about $300 million a year.

But the commissions have very different mandates and areas of expertise. The FCC, founded in 1934, has traditionally regulated industries such as cable television, telephone and broadcast companies. The FTC was created in 1914 and says it works “to protect consumers by preventing anti-competitive, deceptive, and unfair business practices” across a wide range of industries. Its recent actions have ranged from investigating multibillion dollar deals like Amazon.com Inc.’s takeover of Whole Foods Market to false advertising of dietary supplements.

Data Security

Internet baffled by Auburn’s early struggle against Louisiana-Monroe

The first half of Auburn’s game against Louisiana-Monroe raised a few eyebrows among Twitter users.

On Saturday, most expected the Tigers to roll past the Warhawks on their way to a giant matchup against Alabama next week at Jordan-Hare Stadium to decide the SEC West. However, it was no rout for Auburn (8-2) against Louisiana-Monroe (4-5) after two quarters. The Tigers entered the locker room with just a 14-7 lead.

As you can imagine, some had opinions about the development. We’ve collected a sampling of the reactions below.

Internet baffled by Auburn’s early struggle against Louisiana-Monroe

The first half of Auburn’s game against Louisiana-Monroe raised a few eyebrows among Twitter users.

On Saturday, most expected the Tigers to roll past the Warhawks on their way to a giant matchup against Alabama next week at Jordan-Hare Stadium to decide the SEC West. However, it was no rout for Auburn (8-2) against Louisiana-Monroe (4-5) after two quarters. The Tigers entered the locker room with just a 14-7 lead.

As you can imagine, some had opinions about the development. We’ve collected a sampling of the reactions below.

Stretched thin, LA County’s mental health teams struggle to get patients out of jails and into hospitals

AN EDITOR’S NOTE TO OUR READERS:  Because she is a minor, the name of the 13-year-old in this story has been omitted to protect the privacy of the girl and her family.

The 13-year-old held a knife against her throat one spring morning, looked her mom in the eyes and said she’d do it.

It was a threat built on depression, anger and despair. The teen had tried to run away from home. She twisted and pinched her skin until her arms and neck turned blue. She stole a cell phone from a student at school and used it to post photos of herself on an adult dating site. When her mother confronted her, the teen became upset.

She grabbed the blade.

In desperation, her mom called 911. It was the second time her daughter’s behavior forced her to dial the trio of digits, to reach out to strangers for help.

But unlike the last time, the two Los Angeles County sheriff’s deputies who responded weren’t alone. They came with social workers who are part of the Mental Evaluation Teams, a growing program that the public and many in law enforcement across the nation want to see expanded. One of the goals of the Los Angeles County Department of Mental Health program is to divert people with psychiatric needs away from overcrowded jails and juvenile halls and even from scarce emergency room beds, and into consistent services.

Activists say these teams can be key to de-escalate situations between law enforcement and people who are mentally ill that can turn deadly.

But in L.A. County, where law enforcement officers serve a vast area stretching from Long Beach to the Antelope Valley and from the San Fernando Valley to the Inland Empire, there aren’t enough beds or teams to help people like the 13-year-old.

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
A suicidal teen sits in the back of a Los Angeles County Sheriff’s Mental Evaluation Team vehicle outside Anderson Elementary School in Compton as Nurse Randy Blake, a mental health counselor with MET, works on her report to find a mental health facility that can take her for a 72-hour psychiatric hold. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

Not enough beds

The last time the teen fell into depression, she was taken to Martin Luther King Medical Center, Jr. Medical Center in Willowbrook. There, she waited for three days in the hallway until a psychiatric bed opened up at the Del Amo Behavioral Center in Torrance. But there was no follow up.

This time, the members of MET determined she needed long-term, consistent care. After about an hour on the telephone searching through the maze of Los Angeles County’s mental health system, a case worker found a psychiatric bed for her, but in Orange County.

Such distance has not gone unnoticed.

“We could put 1,000 mental health experts on the street, but if you don’t have the beds that need to be in hospitals, then it’s very frustrating for law enforcement and mental health workers,” Los Angeles County Supervisor Kathryn Barger said.

In Los Angeles County, Barger noted, the 2,305 beds designated to help patients with psychiatric emergencies is not enough. And the system currently in place to treat these patients leads to a costly cycle, public safety officials said. Medi-Cal recipients placed on psychiatric hold may be admitted for 72 hours then released unless their needs are especially dire.

Barger said she is working with Los Angeles County Mental Health director Dr. Jonathan Sherin, to add 100 more beds.

“I believe in this program,” Barger said of the MET units. But she also noted that even if teams increase, without more urgent mental health care centers or emergency psychiatric beds, the MET program won’t be as effective.

That’s because even getting admitted is an issue.

Average wait times at public emergency department hospitals is almost 3 hours.

“This equated to $18,000 in lost productivity in November of 2016,” according to a report by the Sheriff’s Department.

At private hospitals, the wait is about 42 minutes.

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
LASD Deputy Joe Miranda, of a MET team, stands back and watches a mirror to see Deputy Brett Radloff calm down an inmate during a psychotic episode at the West Hollywood Jail. The inmate threatened Miranda with racial slurs during a mental health evaluation. But Miranda was unoffended and said it’s part of the job. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

The psychiatric bed shortage means that Los Angeles County’s jails have become the largest de facto mental institution in the nation.

In 2010, inmates with mental illness in the county jails in 2010 totaled 2,475. As of 2016 that number more than doubled and exceeded 4,000, according to the Sheriff’s Department.

To help, Barger and other board members hope to expand mental health Urgent Care Centers which can alleviate emergency care. There are four such centers across the county so far, and a telecare service.

“The goal of mental health UCCs is to reduce the incidence of unnecessary and lengthy involuntary inpatient treatment while promoting care in voluntary, recovery-oriented treatment settings.”

From July to September, there were 10,418 clients served. Almost 10 percent of them were brought in by law enforcement or probation officials.

Expand

Lt. John Gannon, who oversees the MET program, said he has been encouraged by county leaders who are looking at the issue comprehensively. By expanding the urgent care system, for example,  both deputies and patients will be helped.

“This will free up deputies to help more people, so they don’t have to wait in the emergency departments,” Gannon added.

More teams needed

“It’s all about the cell phone,” a worried mother said as she stood in front of Anderson Elementary School in Compton, where her daughter had later run to after she threatened to commit suicide.

Inside the school, a deputy, social workers and the school principal talked to the teen, to ask her why she pulled the knife on herself.

Outside, her mother explained to another deputy that she had taken the cell phone away as punishment, and that’s when the teen acted out.

“She started talking to herself, injuring herself,” her mother said.

Such interactions are becoming an increasing part of police work for agencies whose officers and deputies aren’t trained to be psychologists. From 2010 to 2015, calls for service to the Sheriff’s Department involving mental health needs rose 54 percent, from 11,660 to 18,061.

Besides growing awareness, mental health needs have increased because of the closure of mental health hospitals, some say. In 1967,  then California Gov. Ronald Reagan signed the Lanterman-Petris-Short Act, which stopped the involuntary commitment of people with mental health disorders and chronic alcoholism. As president in the early 1980s, Reagan cut federal funding for mental health services. Mental institutions let people out then shut the doors for good. Promised social services never came to fruition.

In the meantime, the Los Angeles County Sheriff’s Department rolled out the first MET team in 1991, which became the first of its kind in the nation.

A preliminary report by the newly formed Los Angeles County Sheriff’s Civilian oversight Commission praised the potential of such teams and efforts made, but also expressed concern with the county’s jail population.

“Although the current expansion plan’s proposed 23 teams may be a start, significantly more, 40 to 80 may be ideal and even necessary in the future to ensure effective coverage of Los Angeles County and to be adequate for use as a de-escalation tactic and diversion to resources accompanying first responders,” according to the report. A final report is expected in December.

More teams, more training

Clinical psychologist Ronda Hampton, who advocates on behalf of families, agreed with the report’s summary, but said more teams won’t matter if deputies aren’t trained properly.

Officers with the LAPD and deputies with the LASD receive 15 hours of training to learn if someone is experiencing signs of mental illness. In Chicago, police officers receive 30 hours. In Philadelphia, it’s 40 hours, according to a recent LAPD “Use of Force” report.

“If we are going to allow officers to be first responders and give them the power to decide when behavior warrants a mental health evaluation, then these officers must be trained, not once, but frequently on how to recognize the signs and symptoms of mental illness or a mental health crisis and they must be trained on how to interact appropriately in those situations.”

— Ronda Hampton, clinical psychologist

Hampton has been a vocal critic of the Los Angeles Sheriff’s department and the way deputies handled the case of Mitrice Richardson, a 24-year-old woman who went missing from the Malibu/Lost Hills sheriff’s station in September 2009. Richardson was found dead 11 months later. Hampton has said the Sheriff’s Department failed to take Richardson’s mental health issues and disappearance seriously. Hampton knew Richardson and helped organize the search for her.

“It is often untrained deputies who are the first-responders that make the decision to call for the MET,” Hampton said. “Officers do not always know when it is appropriate to make the decision to call for MET back up, or their impatience in waiting for the team to arrive leads them to take deadly action.”

She also said an increase of teams, while helpful, will provide only a band-aide solution unless officers are trained better.

“If we are going to allow officers to be first responders and give them the power to decide when behavior warrants a mental health evaluation, then these officers must be trained, not once, but frequently on how to recognize the signs and symptoms of mental illness or a mental health crisis and they must be trained on how to interact appropriately in those situations,” Hampton noted.“Anything short of regular, ongoing training and education to all deputies is a death sentence to those who suffer mental illness and who may encounter an untrained officer, and costly to the county due to settlements and lawsuits for wrongful death.”

Hope is stoked

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
A suicidal teen sits in the back of a Los Angeles County Sheriff’s Mental Evaluation Team vehicle outside Anderson Elementary School in Compton as MET finds a mental health facility that can take her for a 72-hour psychiatric hold. The school gave her a lunch and book. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)br /.

Meanwhile, in front of Anderson Elementary school, members of the MET unit told a distraught mother to let her daughter go. Don’t talk to her, they said. Don’t look her way.  

“I just want to help my child,” she said, before agreeing.

Tears fell from her eyes as she crossed the street, without looking back.

In a few minutes, the 13-year-old walked out of Anderson Elementary and was led to a patrol car. She was given the school lunch she hadn’t eaten that day and a book to read, but she sat frozen with both on her lap and looked straight ahead.  

A thousand-mile stare came over her eyes as the deputy started up the engine and drove away.

‘She’s trying’

Months later, on a recent summer day, a tall, young teenager stood on the porch of the Compton home she shared with her mother, sisters and brother.

She was glad to be home, the teen said with a smile, but she was grateful for the help she received in Orange County a few months before.

“They said I was really depressed,” the teen told visitors. “It wasn’t a good time for me. I was going through a lot of things. I was really really stressed out with my mom. Things weren’t going so well.”

But since she returned home, social workers from the Department of Mental Health have been helping her. She liked that they visited.

“For me, I just thought dying was the answer, that taking my life away would have made it easier,” she said. “Now I see it wouldn’t have been easier, because now I see there are a lot of people who care for me, to make things easier.”

She’s getting along better with her mom, too, the teen added.

“I’ve been listening more,” she said.

Her mother said she was glad she asked for help. She said more people need to reach out, to not be afraid. So far, it has been worth it.

“She’s been trying,” her mom said. “She really has.”

— Staff photographer Sarah Reingewirtz contributed to this story

Stretched thin, LA County’s mental health teams struggle to get patients out of jails and into hospitals

AN EDITOR’S NOTE TO OUR READERS:  Because she is a minor, the name of the 13-year-old in this story has been omitted to protect the privacy of the girl and her family.

The 13-year-old held a knife against her throat one spring morning, looked her mom in the eyes and said she’d do it.

It was a threat built on depression, anger and despair. The teen had tried to run away from home. She twisted and pinched her skin until her arms and neck turned blue. She stole a cell phone from a student at school and used it to post photos of herself on an adult dating site. When her mother confronted her, the teen became upset.

She grabbed the blade.

In desperation, her mom called 911. It was the second time her daughter’s behavior forced her to dial the trio of digits, to reach out to strangers for help.

But unlike the last time, the two Los Angeles County sheriff’s deputies who responded weren’t alone. They came with social workers who are part of the Mental Evaluation Teams, a growing program that the public and many in law enforcement across the nation want to see expanded. One of the goals of the Los Angeles County Department of Mental Health program is to divert people with psychiatric needs away from overcrowded jails and juvenile halls and even from scarce emergency room beds, and into consistent services.

Activists say these teams can be key to de-escalate situations between law enforcement and people who are mentally ill that can turn deadly.

But in L.A. County, where law enforcement officers serve a vast area stretching from Long Beach to the Antelope Valley and from the San Fernando Valley to the Inland Empire, there aren’t enough beds or teams to help people like the 13-year-old.

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
A suicidal teen sits in the back of a Los Angeles County Sheriff’s Mental Evaluation Team vehicle outside Anderson Elementary School in Compton as Nurse Randy Blake, a mental health counselor with MET, works on her report to find a mental health facility that can take her for a 72-hour psychiatric hold. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

Not enough beds

The last time the teen fell into depression, she was taken to Martin Luther King Medical Center, Jr. Medical Center in Willowbrook. There, she waited for three days in the hallway until a psychiatric bed opened up at the Del Amo Behavioral Center in Torrance. But there was no follow up.

This time, the members of MET determined she needed long-term, consistent care. After about an hour on the telephone searching through the maze of Los Angeles County’s mental health system, a case worker found a psychiatric bed for her, but in Orange County.

Such distance has not gone unnoticed.

“We could put 1,000 mental health experts on the street, but if you don’t have the beds that need to be in hospitals, then it’s very frustrating for law enforcement and mental health workers,” Los Angeles County Supervisor Kathryn Barger said.

In Los Angeles County, Barger noted, the 2,305 beds designated to help patients with psychiatric emergencies is not enough. And the system currently in place to treat these patients leads to a costly cycle, public safety officials said. Medi-Cal recipients placed on psychiatric hold may be admitted for 72 hours then released unless their needs are especially dire.

Barger said she is working with Los Angeles County Mental Health director Dr. Jonathan Sherin, to add 100 more beds.

“I believe in this program,” Barger said of the MET units. But she also noted that even if teams increase, without more urgent mental health care centers or emergency psychiatric beds, the MET program won’t be as effective.

That’s because even getting admitted is an issue.

Average wait times at public emergency department hospitals is almost 3 hours.

“This equated to $18,000 in lost productivity in November of 2016,” according to a report by the Sheriff’s Department.

At private hospitals, the wait is about 42 minutes.

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
LASD Deputy Joe Miranda, of a MET team, stands back and watches a mirror to see Deputy Brett Radloff calm down an inmate during a psychotic episode at the West Hollywood Jail. The inmate threatened Miranda with racial slurs during a mental health evaluation. But Miranda was unoffended and said it’s part of the job. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

The psychiatric bed shortage means that Los Angeles County’s jails have become the largest de facto mental institution in the nation.

In 2010, inmates with mental illness in the county jails in 2010 totaled 2,475. As of 2016 that number more than doubled and exceeded 4,000, according to the Sheriff’s Department.

To help, Barger and other board members hope to expand mental health Urgent Care Centers which can alleviate emergency care. There are four such centers across the county so far, and a telecare service.

“The goal of mental health UCCs is to reduce the incidence of unnecessary and lengthy involuntary inpatient treatment while promoting care in voluntary, recovery-oriented treatment settings.”

From July to September, there were 10,418 clients served. Almost 10 percent of them were brought in by law enforcement or probation officials.

Expand

Lt. John Gannon, who oversees the MET program, said he has been encouraged by county leaders who are looking at the issue comprehensively. By expanding the urgent care system, for example,  both deputies and patients will be helped.

“This will free up deputies to help more people, so they don’t have to wait in the emergency departments,” Gannon added.

More teams needed

“It’s all about the cell phone,” a worried mother said as she stood in front of Anderson Elementary School in Compton, where her daughter had later run to after she threatened to commit suicide.

Inside the school, a deputy, social workers and the school principal talked to the teen, to ask her why she pulled the knife on herself.

Outside, her mother explained to another deputy that she had taken the cell phone away as punishment, and that’s when the teen acted out.

“She started talking to herself, injuring herself,” her mother said.

Such interactions are becoming an increasing part of police work for agencies whose officers and deputies aren’t trained to be psychologists. From 2010 to 2015, calls for service to the Sheriff’s Department involving mental health needs rose 54 percent, from 11,660 to 18,061.

Besides growing awareness, mental health needs have increased because of the closure of mental health hospitals, some say. In 1967,  then California Gov. Ronald Reagan signed the Lanterman-Petris-Short Act, which stopped the involuntary commitment of people with mental health disorders and chronic alcoholism. As president in the early 1980s, Reagan cut federal funding for mental health services. Mental institutions let people out then shut the doors for good. Promised social services never came to fruition.

In the meantime, the Los Angeles County Sheriff’s Department rolled out the first MET team in 1991, which became the first of its kind in the nation.

A preliminary report by the newly formed Los Angeles County Sheriff’s Civilian oversight Commission praised the potential of such teams and efforts made, but also expressed concern with the county’s jail population.

“Although the current expansion plan’s proposed 23 teams may be a start, significantly more, 40 to 80 may be ideal and even necessary in the future to ensure effective coverage of Los Angeles County and to be adequate for use as a de-escalation tactic and diversion to resources accompanying first responders,” according to the report. A final report is expected in December.

More teams, more training

Clinical psychologist Ronda Hampton, who advocates on behalf of families, agreed with the report’s summary, but said more teams won’t matter if deputies aren’t trained properly.

Officers with the LAPD and deputies with the LASD receive 15 hours of training to learn if someone is experiencing signs of mental illness. In Chicago, police officers receive 30 hours. In Philadelphia, it’s 40 hours, according to a recent LAPD “Use of Force” report.

“If we are going to allow officers to be first responders and give them the power to decide when behavior warrants a mental health evaluation, then these officers must be trained, not once, but frequently on how to recognize the signs and symptoms of mental illness or a mental health crisis and they must be trained on how to interact appropriately in those situations.”

— Ronda Hampton, clinical psychologist

Hampton has been a vocal critic of the Los Angeles Sheriff’s department and the way deputies handled the case of Mitrice Richardson, a 24-year-old woman who went missing from the Malibu/Lost Hills sheriff’s station in September 2009. Richardson was found dead 11 months later. Hampton has said the Sheriff’s Department failed to take Richardson’s mental health issues and disappearance seriously. Hampton knew Richardson and helped organize the search for her.

“It is often untrained deputies who are the first-responders that make the decision to call for the MET,” Hampton said. “Officers do not always know when it is appropriate to make the decision to call for MET back up, or their impatience in waiting for the team to arrive leads them to take deadly action.”

She also said an increase of teams, while helpful, will provide only a band-aide solution unless officers are trained better.

“If we are going to allow officers to be first responders and give them the power to decide when behavior warrants a mental health evaluation, then these officers must be trained, not once, but frequently on how to recognize the signs and symptoms of mental illness or a mental health crisis and they must be trained on how to interact appropriately in those situations,” Hampton noted.“Anything short of regular, ongoing training and education to all deputies is a death sentence to those who suffer mental illness and who may encounter an untrained officer, and costly to the county due to settlements and lawsuits for wrongful death.”

Hope is stoked

d0490_met-13-year-old031 Stretched thin, LA County's mental health teams struggle to get patients out of jails and into hospitals
A suicidal teen sits in the back of a Los Angeles County Sheriff’s Mental Evaluation Team vehicle outside Anderson Elementary School in Compton as MET finds a mental health facility that can take her for a 72-hour psychiatric hold. The school gave her a lunch and book. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)br /.

Meanwhile, in front of Anderson Elementary school, members of the MET unit told a distraught mother to let her daughter go. Don’t talk to her, they said. Don’t look her way.  

“I just want to help my child,” she said, before agreeing.

Tears fell from her eyes as she crossed the street, without looking back.

In a few minutes, the 13-year-old walked out of Anderson Elementary and was led to a patrol car. She was given the school lunch she hadn’t eaten that day and a book to read, but she sat frozen with both on her lap and looked straight ahead.  

A thousand-mile stare came over her eyes as the deputy started up the engine and drove away.

‘She’s trying’

Months later, on a recent summer day, a tall, young teenager stood on the porch of the Compton home she shared with her mother, sisters and brother.

She was glad to be home, the teen said with a smile, but she was grateful for the help she received in Orange County a few months before.

“They said I was really depressed,” the teen told visitors. “It wasn’t a good time for me. I was going through a lot of things. I was really really stressed out with my mom. Things weren’t going so well.”

But since she returned home, social workers from the Department of Mental Health have been helping her. She liked that they visited.

“For me, I just thought dying was the answer, that taking my life away would have made it easier,” she said. “Now I see it wouldn’t have been easier, because now I see there are a lot of people who care for me, to make things easier.”

She’s getting along better with her mom, too, the teen added.

“I’ve been listening more,” she said.

Her mother said she was glad she asked for help. She said more people need to reach out, to not be afraid. So far, it has been worth it.

“She’s been trying,” her mom said. “She really has.”

— Staff photographer Sarah Reingewirtz contributed to this story

Children’s Health Bill Clears House as States Struggle to Keep …

In addition, the bill would end insurance coverage for several hundred thousand people who fail to pay their share of premiums for insurance purchased in marketplaces under the 2010 health care law.

Most people who buy insurance through the Affordable Care Act marketplace receive subsidies to help pay their monthly premiums. Under the law, if they do not pay their share of premiums, insurers must give them a three-month grace period before terminating their coverage. The House bill would reduce the grace period to one month unless a state specified a different period.

The Congressional Budget Office estimates that the government would save nearly $5 billion over a decade because fewer people would have government-subsidized coverage.

Republicans said some people were abusing the longer grace period to skip out of their financial obligations. But Representative Diana DeGette, Democrat of Colorado, said, “Nobody should have to lose coverage in order for others to keep it.”

“Colorado is likely to run out of CHIP funding in January, with termination notices going out to worried families in the next few weeks,” Ms. DeGette said. “Yet here we are with a partisan bill that asks us to pay for low-income children’s insurance on the backs of seniors and the most vulnerable.”

Republicans defended their path to pay for the children’s health program, especially the higher Medicare premiums. It was reasonable to require wealthy people to help defray the cost of care for children from families of modest means, they said.

“When you are making a half-million dollars a year, you can pay a little bit more,” said Representative Tom Cole, Republican of Oklahoma. “Warren Buffett and Donald Trump don’t need the same Medicare program that Ma and Pa Kettle living on Social Security do.”

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Continue reading the main story

Democrats, who often seek higher taxes on high-income people, denounced the proposal.

“I’m not worried about whether wealthy families can afford to pay increased Medicare premiums,” said Representative Debbie Dingell, Democrat of Michigan. “But I’m worried that these changes will result in wealthy people abandoning the program in large numbers, which would worsen the risk pool and ultimately increase the cost for middle- and lower-income seniors. It would fracture the universal nature of Medicare and put the entire program at risk.”

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AARP, the lobby for older Americans, strongly supports the children’s insurance program, but tried to block the increase in Medicare premiums.

“Higher-income Medicare beneficiaries already pay more in monthly premiums,” Nancy LeaMond, an executive vice president of AARP, said in a letter to House members. In addition, she said, “higher-income seniors have been paying more into the Medicare program throughout their working lives.”

But Representative Greg Walden, Republican of Oregon and the chief author of the bill, said, “We are just asking the wealthiest seniors in America, those making $40,000 a month — not a year, a month — to pay about $135 a month more for their Medicare, so we can fund children’s health insurance for five years.”

Five states — Arizona, California, Minnesota, Oregon and Washington — have received emergency infusions of federal cash to prevent an interruption in coverage of children. But the amount of unused funds available for that purpose is far less than the expected need, and an independent commission that advises Congress warned this week that 29 states “will exhaust all available federal funds” by March unless Congress passed legislation to provide more money.

In the Senate, work on CHIP legislation has been bipartisan from the start. The Senate Finance Committee has voted to provide five years of funds for the program, but it has not specified a way to cover the cost.

The committee chairman, Senator Orrin G. Hatch of Utah, and Senator Ron Wyden of Oregon, the senior Democrat on the panel, have been discussing ways to pay for the bill. They have not reported much progress toward an agreement, but their talks hold more promise than negotiations between Republicans and Democrats in the House.

The Senate is unlikely to take up a free-standing CHIP bill. Funds could be included in a larger piece of legislation, perhaps a sprawling spending bill in December to keep the government open, senators say.

The House bill would send $1 billion in additional Medicaid funds to Puerto Rico as it tries to cope with damage from Hurricane Maria, and the island’s delegate in Congress, Jenniffer González-Colón, a Republican, endorsed the legislation.

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Continue reading the main story

Representative Frank Pallone Jr., Democrat of New Jersey, said Republicans had missed the deadline for renewing the children’s insurance program because they “chose to spend the first nine months of this year trying to repeal the Affordable Care Act.”

But Mr. Walden said Democrats were partly responsible because they had requested delays in hopes of finding other ways to pay for the legislation.

“We cannot wait any longer,” Mr. Walden said Friday. “Patients cannot wait any longer. Patients need care. These critical programs need funding. And we must move forward.”


Continue reading the main story

Children’s Health Bill Clears House as States Struggle to Keep Programs Afloat

In addition, the bill would end insurance coverage for several hundred thousand people who fail to pay their share of premiums for insurance purchased in marketplaces under the 2010 health care law.

Most people who buy insurance through the Affordable Care Act marketplace receive subsidies to help pay their monthly premiums. Under the law, if they do not pay their share of premiums, insurers must give them a three-month grace period before terminating their coverage. The House bill would reduce the grace period to one month unless a state specified a different period.

The Congressional Budget Office estimates that the government would save nearly $5 billion over a decade because fewer people would have government-subsidized coverage.

Republicans said some people were abusing the longer grace period to skip out of their financial obligations. But Representative Diana DeGette, Democrat of Colorado, said, “Nobody should have to lose coverage in order for others to keep it.”

“Colorado is likely to run out of CHIP funding in January, with termination notices going out to worried families in the next few weeks,” Ms. DeGette said. “Yet here we are with a partisan bill that asks us to pay for low-income children’s insurance on the backs of seniors and the most vulnerable.”

Republicans defended their path to pay for the children’s health program, especially the higher Medicare premiums. It was reasonable to require wealthy people to help defray the cost of care for children from families of modest means, they said.

“When you are making a half-million dollars a year, you can pay a little bit more,” said Representative Tom Cole, Republican of Oklahoma. “Warren Buffett and Donald Trump don’t need the same Medicare program that Ma and Pa Kettle living on Social Security do.”

Advertisement

Continue reading the main story

Democrats, who often seek higher taxes on high-income people, denounced the proposal.

“I’m not worried about whether wealthy families can afford to pay increased Medicare premiums,” said Representative Debbie Dingell, Democrat of Michigan. “But I’m worried that these changes will result in wealthy people abandoning the program in large numbers, which would worsen the risk pool and ultimately increase the cost for middle- and lower-income seniors. It would fracture the universal nature of Medicare and put the entire program at risk.”

Newsletter Sign Up

Continue reading the main story

AARP, the lobby for older Americans, strongly supports the children’s insurance program, but tried to block the increase in Medicare premiums.

“Higher-income Medicare beneficiaries already pay more in monthly premiums,” Nancy LeaMond, an executive vice president of AARP, said in a letter to House members. In addition, she said, “higher-income seniors have been paying more into the Medicare program throughout their working lives.”

But Representative Greg Walden, Republican of Oregon and the chief author of the bill, said, “We are just asking the wealthiest seniors in America, those making $40,000 a month — not a year, a month — to pay about $135 a month more for their Medicare, so we can fund children’s health insurance for five years.”

Five states — Arizona, California, Minnesota, Oregon and Washington — have received emergency infusions of federal cash to prevent an interruption in coverage of children. But the amount of unused funds available for that purpose is far less than the expected need, and an independent commission that advises Congress warned this week that 29 states “will exhaust all available federal funds” by March unless Congress passed legislation to provide more money.

In the Senate, work on CHIP legislation has been bipartisan from the start. The Senate Finance Committee has voted to provide five years of funds for the program, but it has not specified a way to cover the cost.

The committee chairman, Senator Orrin G. Hatch of Utah, and Senator Ron Wyden of Oregon, the senior Democrat on the panel, have been discussing ways to pay for the bill. They have not reported much progress toward an agreement, but their talks hold more promise than negotiations between Republicans and Democrats in the House.

The Senate is unlikely to take up a free-standing CHIP bill. Funds could be included in a larger piece of legislation, perhaps a sprawling spending bill in December to keep the government open, senators say.

The House bill would send $1 billion in additional Medicaid funds to Puerto Rico as it tries to cope with damage from Hurricane Maria, and the island’s delegate in Congress, Jenniffer González-Colón, a Republican, endorsed the legislation.

Advertisement

Continue reading the main story

Representative Frank Pallone Jr., Democrat of New Jersey, said Republicans had missed the deadline for renewing the children’s insurance program because they “chose to spend the first nine months of this year trying to repeal the Affordable Care Act.”

But Mr. Walden said Democrats were partly responsible because they had requested delays in hopes of finding other ways to pay for the legislation.

“We cannot wait any longer,” Mr. Walden said Friday. “Patients cannot wait any longer. Patients need care. These critical programs need funding. And we must move forward.”

Continue reading the main story

I’ve had an iPhone X all week. Here’s what’s easier and what’s still a struggle

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How well does Face ID work? We let USA TODAY newsroom staffers test Apple’s new facial recognition system.
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Where did the battery percentage go? How do I reset it? Remind me how to turn the darn thing off!

I’ve been living now with the iPhone X (officially pronounced “ten” not “ex”) since Monday, when Apple supplied me with a review unit of its stratospherically-priced new smartphone. The 256GB phone I’ve been using, the same model I woke up at 3 a.m. ET last Friday to preorder on faith, will set you back $1,150. (The 64GB X commands $999.)

Since publishing my first impressions of the X on Tuesday morning, I’ve been able to spend more time using it. 

Notably, that meant shooting a bunch of pictures, and as with other premium-priced smartphones, the iPhone X excels in this regard. You’ll certainly appreciate the Portrait mode feature that lets you keep a subject in focus while the background is blurred, including when that subject is you in a selfie. Portrait mode debuted on the iPhone 7 Plus and is also on the 8 Plus, but it is not available for the front cameras on those devices.

The Portrait Lighting effects feature is still in beta but already one of my favorite features. You can get artsy and shoot a portrait with a completely dark background.

I predicted that everyone who buys the X will quickly fool around with the animated emojis or Animojis you can send to a friend in a message, from a unicorn to a pile of poo. Animojis speak in your voice when you do and mirror your facial movements. I’m sticking with that prediction, judging by the people I unleashed Animojis on or who created their own. 

Mostly, though, I’ve been trying to best navigate the transition from a phone with a home button and the Touch ID fingerprint sensor to one that relies instead on new gestures and facial recognition.

Some things have gotten easier, I’m still struggling with others, and there have been a few quirks, as well.

While I’m reluctant to declare that any handset that exceeds $1,000 is worth the ransom, I can say without much hesitation that the iPhone X is the finest smartphone you can buy.

More: Don’t want an iPhone 8 or iPhone X? There are plenty of alternatives

More: iPhone 8 review: An excellent phone forced to the shadows by iPhone X

More: Follow USA TODAY Money and Tech on Facebook

Changing your behavior

The absence of a home button requires a new way to get to your home screen, and I got the hang of swiping up from the bottom of the 5.8-inch OLED display almost from the start. If anything, when I now use an iPhone with a home button, my initial inclination is to swipe up rather than press. Muscle memory is a funny thing.

Some of the other navigational stunts you must absorb into your regular routine don’t come as naturally. It’s simple to get to the app switcher or multitasking screens by swiping up and pausing for a second. But my inclination is to swipe up on a card representing a running app to remove it, when instead you must press down for a moment until a circled red dash appears before you swipe up. Apple should make this process easier. 

On iPhone Plus devices, Apple introduced a “reachability” feature that let users of these large display models access the upper portion of the screen while using the phone with one hand. On those models, you would double-tap the home button. Reachability on the iPhone X requires you to swipe down from the bottom edge of the screen, which is a little trickier.

Tasks you summon less often require a bigger learning curve. To “force restart” a frozen phone or one that is misbehaving requires a new drill: You press and quickly release the volume up button, followed by a quick press of the volume down button, followed by having to press and hold the side button until you see the Apple logo. Got all that?

You might even have to look up how to turn off the phone. The answer: Press and hold either volume key and the side button key, then swipe to turn off the phone. 

Holding down the side button, located on the right side of the what some might consider to be the “power button,” brings up Siri. A double tap initiates Apple Pay. 

More: The iPhone’s still got it, judging by the lines

More: Want the iPhone X? It doesn’t have to cost you $1,000

The hidden ‘home button’

Buried inside the accessibility settings of your phone is a feature known as AssistiveTouch, with tools for people who have difficulty touching the screen or who need an adaptive accessory. If you turn AssistiveTouch on, you can summon a virtual button that gives you shortcuts to the home screen, Siri, notifications and other settings. The feature has been in iOS for awhile. 

Speaking of buttons, Apple has added helpful onscreen buttons for the flashlight and camera to the lock screen, or when displaying notifications.

Training Face ID 

I was able to set up Face ID in less than 15 seconds and was even able to set it up on the fly and then complete an Apple Pay purchase in a store in under a half-minute. But not everyone gets the hang of the Face ID set up right away.

You’re supposed to position your face in the camera frame and move your head in a circular fashion, until the outer rim of the frame turns green. You have to do this twice. But I’ve watched some people try moving the phone in a circular fashion, rather than their face.

Where’s the battery percentage?

On other iPhones, you can flip on a setting to show off the battery percentage indicator on the upper right corner of the display. It’s more useful to me than the battery gauge that appears by default.

But it’s gone AWOL on the X, possibly because the notch covering the TrueDepth camera that Apple uses for Face ID, Animojis and augmented reality claims too much real estate.

Fortunately, all isn’t completely lost.

The battery percentage indicator is visible inside Control Center, which you can view by swiping down from the upper right portion of the screen. I’d rather it come out of hiding on most iPhone X screens.

Apple is promising all-day battery life on the iPhone X, two hours longer, the company claims, than on the iPhone 7. And the X (like the new 8 and 8 Plus models) supports wireless charging through an industry standard known as Qi, meaning you can plunk down an X on a compatible pad, cradle or base to juice it up.

The charger itself must be plugged in, of course, so wireless charging isn’t completely wireless. Unfortunately, wireless charging on the X was extremely slow, at least on the Belkin accessory I used for my tests.

Apple says fast wireless charging will arrive via a software update in the future. If you are looking to purchase a wireless charger today, you may want to wait for this update to arrive to make sure it supports the faster speeds. 

What’s more, the phone was only about halfway charged one morning after I left the X on the Belkin pad overnight. On some chargers you may have to make sure the phone is properly aligned on the sweet spot– as with wired charging, a battery icon on the phone lets you know when the phone is charging.

That was the case, or so I thought, on the Belkin. All this bears watching. 

Face or fingerprint?

Apple explains that third-party apps that support Touch ID automatically support Face ID — and that’s a good thing. Via Face ID, I could get past password-protected screens on my banking and credit card apps, even when the design of such apps hadn’t yet been updated to reflect the capability. Be prepared, however, to encounter some confusing messages about Touch ID and Face ID, even when everything otherwise functions as it should.

Speaking of minor issues, given the odd design of the iPhone X, early users are bound to encounter some odd glitches. One such bug I noticed was while watching Guardians of the Galaxy Vol. 2 vertically — normally you’d view it horizontally — the iPhone X’s notch blocked the ability to easily jump ahead or behind in the movie. 

If you pre-ordered the X you’ll likely be very pleased with what your money bought you. But you’ll have some learning to do. 

Follow USA TODAY personal tech columnist @edbaig on Twitter

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We take a look at the iPhone X and break down the new features.
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Living with iPhone X: What’s easier, what’s still a struggle, what is a surprise?

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How well does Face ID work? We let USA TODAY newsroom staffers test Apple’s new facial recognition system.
USA TODAY

Where did the battery percentage go? How do I reset it? Remind me how to turn the darn thing off!

I’ve been living now with the iPhone X (officially pronounced “ten” not “ex”) since Monday, when Apple supplied me with a review unit of its stratospherically-priced new smartphone. The 256GB phone I’ve been using, the same model I woke up at 3 a.m. ET last Friday to preorder on faith, will set you back $1150. (The 64GB X commands $999.)

Since publishing my first impressions of the X on Tuesday morning, I’ve been able to spend more time using it. 

Notably, that meant shooting a bunch of pictures, and as with other premium-priced smartphones, the iPhone X excels in this regard. You’ll certainly appreciate the Portrait mode feature that lets you keep a subject in focus while the background is blurred, including when that subject is you in a selfie. Portrait mode debuted on the iPhone 7 Plus and is also on the 8 Plus—but it is not available for the front cameras on those devices.

The Portrait Lighting effects feature is still in beta but already one of my favorite features. You can get all artsy and shoot a portrait with a completely dark background.

I predicted the other day that every one of you who buys the X will quickly fool around with the animated emojis or Animojis you can send to a friend in a message, from a unicorn to a pile of poo. Animojis speak in your voice when you do, and mirror your facial movements. I’m sticking with that prediction, judging by the people I unleashed Animojis on or whom I let create their own. 

Mostly, though, I’ve been trying to best navigate the transition from a phone with a home button and the Touch ID fingerprint sensor, to one that relies instead on new gestures and facial recognition.

Some things have gotten easier, I’m still struggling with others, and there have been a few quirks as well.

While I’m reluctant to declare that any handset that exceeds $1000 is worth the ransom, I can say without much hesitation that the iPhone X, is the finest smartphone you can buy.

More: Don’t want an iPhone 8 or iPhone X? There are plenty of alternatives

More: iPhone 8 review: An excellent phone forced to the shadows by iPhone X

My observations.

Changing your behavior

The absence of a home button requires a new way to get to your home screen, and I got the hang of swiping up from the bottom of the 5.8-inch OLED display almost from the start. If anything, when I now use an iPhone with a home button, my initial inclination is to swipe up rather than press. Muscle memory is a funny thing.

Some of the other navigational stunts you must absorb into your regular routine don’t come as naturally. It’s simple to get to the app switcher or multitasking screens by swiping up and pausing for a second. But then my inclination is to swipe up on a card representing a running app to remove it, when instead you must press down for a moment until a circled red dash appears before you swipe up. Apple should make this process easier. 

On iPhone Plus devices, Apple introduced a “reachability” feature that let users of these large display models access the upper portion of the screen while using the phone with one hand. On those models, you would double-tap the home button. Reachability on the iPhone X requires you to swipe down from the bottom edge of the screen, a little trickier.

Tasks you summon less often require a bigger learning curve. To “force restart” a frozen phone or one that is misbehaving requires a new drill: You press and quickly release the volume up button, followed by a quick press of the volume down button, followed by having to press and hold the side button until you see the Apple logo. Got all that?

You may even have to look up how to turn off the phone. The answer:  Press and hold either volume key and the side button key, then swipe to turn off the phone. 

Holding down the side button, located on the right side of the what some might consider to be the “power button,” brings up Siri. A double tap initiates Apple Pay. 

The hidden ‘home button’

Buried inside the accessibility settings of your phone is a feature known as AssistiveTouch, with tools for people who have difficulty touching the screen or who need an adaptive accessory. If you turn AssistiveTouch on, you can summon a virtual button that gives you shortcuts to the home screen, Siri, notifications and other settings. The feature has been in iOS for awhile. 

Speaking of buttons, Apple has added helpful onscreen buttons for the flashlight and camera to the lock screen, or when displaying notifications.

Training Face ID 

I was able to set up Face ID in less than 15 seconds, and was even able to set it up on the fly and then complete an Apple Pay purchase in a store in under a half-minute. But not everyone gets the hang of the Face ID set up right away. You’re supposed to position your face in the camera frame and move your head in a circular fashion, until the outer rim of the frame turns green. You have to do this twice. Only some people I observed tried moving the phone in a circular fashion rather than their face.

Where’s the battery percentage?

On other iPhones, you can flip on a setting to show off the battery percentage indicator on the upper right corner of the display. It is more useful to me than the battery gauge that appears by default. It’s gone AWOL on the X, possibly because the notch covering the TrueDepth camera that Apple uses for Face ID, animojis and augmented reality, claims too much real estate. Fortunately, all isn’t completely lost.

The battery percentage indicator is visible inside Control Center, which you can view by swiping down from the upper right portion of the screen. I’d rather it come out of hiding on most iPhone X screens.

Face or fingerprint?

Apple explains that third party apps that support Touch ID automatically support Face ID and that’s a good thing. Via Face ID, I could get past password-protected screens on my banking and credit card apps, even when the design of such apps hadn’t yet been updated to reflect the capability. Be prepared, however, to encounter some confusing messages about Touch ID and Face ID, even when everything otherwise functions as it should.

Speaking of minor issues, given the odd design of the iPhone X, early users are bound to encounter some odd glitches. One such bug I noticed was while watching Guardians of the Galaxy Vol. 2 vertically–and normally you’d do view it horizontally–the iPhone X’s notch blocked the ability to easily jump ahead or behind in the movie. 

If you pre-ordered the X you’ll likely be very pleased with what your money bought you. But you’ll have some learning to do. 

Email: ebaig@usatoday.com; Follow USA TODAY Personal Tech Columnist @edbaig on Twitter

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We take a look at the iPhone X and break down the new features.
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Coal towns struggle for good mental health care

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Millions of adults in the U.S. suffer from mental health conditions. Many of those conditions start during teenage years. Treatment is attainable and vital.
Wochit

PINEVILLE, W.Va. — Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions.

But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day.

Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end.

“I’ll call and tell them I’m ready (after my appointment ends), but they tell me they’re waiting for someone else,” Nelson said as she described a typical trip.

Getting mental health services here is fraught with challenges. But the need is great.

There are no psychiatrists in Wyoming County. A handful of small, general medical practices and a few behavioral health specialists handle services for the 21,763 residents. Patients’ issues — ranging from depression, anxiety, addiction and other mental health concerns — are aggravated by the local economic downturn.

Dr. Joanna Bailey, who practices family medicine here and treats patients covered by Medicaid, said the lack of mental health care access puts her patients at a disadvantage.

“As a family doctor, I’m doing way more psychiatry than I am comfortable with,” Bailey said. She sends patients such as Nelson who need more specialized help to the closest psychiatrist in Beckley, W.Va. In addition to the transportation hurdle, it can take a month or more to get an appointment.

Bailey practices in both Wyoming and McDowell counties — Appalachian areas once fueled by a booming coal industry. Today, much of the local economy relies on tourists coming to use the area’s ATV trails. Infrastructure has been neglected. Shops have been boarded up and abandoned. Medicaid enrollment is roughly 35% in Wyoming County and 48% in McDowell County, according to the advocacy group West Virginians for Affordable Health Care.

She said about 30% of her caseload is treatment for mental health issues. As someone who was born and raised in Wyoming County and has witnessed the economic slide, Bailey understands many of her patients’ issues.

The coal industry, which was once king in this region, has been declining for years. “So, we’ve lost a lot of people, and that’s depressing,” Bailey said. “We haven’t had growth and a lot of people are unemployed right now. That’s traumatic to families on every level.”

When parents with mental health disorders go untreated, a “vicious cycle” is set in motion, she said. “Those children grow up with the same mental health issues because they’ve watched the same unhealthy relationships their whole life,” Bailey said. “It’s just a cycle of abuse and trauma.”

Joy Butcher-Winfree works alongside Bailey as the sole clinical psychologist within their practice. She usually handles about nine behavioral health cases each day.

“I only have so much time and only so much energy,” Butcher-Winfree said. “If someone is in a crisis, they need more than that 15-, 30- or 45-minute slot.”

One resource for patients is the Southern Highlands Community Mental Health Center, which also accepts Medicaid patients. The Wyoming county location serves about 400 people, clinic administrator Rebecca Marsh said. It offers therapy sessions and counseling among other services, such as group support meetings and community engagement programs. Yet Marsh said she has trouble hiring employees.

“It’s difficult for folks from surrounding areas to drive to this area to provide the services that are needed,” Marsh said.

Studies show health markers in Appalachia lagging. A recent analysis in the journal Health Affairs found a widening gap comparing health indicators such as infant mortality and life expectancy in Appalachia with the rest of the country.

And research released in August by the Appalachian Regional Commission highlighted the area’s high mortality rates for seven of the nation’s leading causes of death — including suicide.

It also showed the region has fewer health care professionals compared with the rest of the country, specifically mental health care providers.

The lack of sufficient mental health care access contributes to a number of other health issues, such as chronic pain, substance abuse, nicotine-related diseases and more, Bailey said.

She said some cases make her nervous about whether she has the background to provide sufficient care. One of those is depression in adolescents. She said she prescribed one patient the antidepressant Prozac but fears that a bad reaction to the drug led the teen to attempt suicide.

Since that episode, “it makes me more nervous,” Bailey said. “But you know at this point, I’m a month out of being able to get people in (to see a psychiatrist), unless I’m sending somebody to the hospital.”

Kaiser Health News, a non-profit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

 

 

Trump Closes a Health Dispute, but Leaves Open a Power Struggle

In a less charged political climate, the executive branch might fight that issue out to protect its own power even if it wanted the health care law dismantled, as the Trump administration does. Opening the door to lawsuits initiated by Congress over the specifics of how the executive branch spends tax dollars would be a marked change and a potential threat to the White House.

“The idea that Congress would have standing to go into court, as opposed to using their legislative remedies to dictate how the executive branch spends appropriated funds, would really shift the balance of power between the two branches,” said Kathryn Ruemmler, a White House counsel in the Obama administration.

W. Neil Eggleston, who succeeded Ms. Ruemmler as President Barack Obama’s legal adviser, said the Trump administration might come to regret not pursuing the separation-of-powers issue if it finds itself facing an aggressive Democratic Congress.

“It is a mistake to think of this as a partisan fight over health care,” said Mr. Eggleston, who called the litigation critical to separation-of-powers issues. “The White House has Leader McConnell and Speaker Ryan now, but could easily be dealing before the end of the administration with Leader Schumer and Speaker Pelosi.”

He was referring, of course, to Senator Mitch McConnell of Kentucky, the majority leader, and Speaker Paul D. Ryan of Wisconsin — two Republicans unlikely to initiate a lawsuit against a Republican president — and Senator Chuck Schumer of New York and Representative Nancy Pelosi of California, two Democrats now leading the minority, with hopes of claiming the majority in 2018.

The 2016 decision by Judge Rosemary M. Collyer that the health care spending was unconstitutional and that the House could pursue the lawsuit was at only the district court level, and its reach was viewed as limited. The judge also said the unique circumstances of a case testing the authority of the congressional power of the purse — its most fundamental constitutional role — had led her to grant standing, suggesting she did not mean to bestow expansive new legal rights on Congress.

Still, the decision alarmed the White House sufficiently that it rapidly pushed forward with an appeal both to preserve its independence and to protect the health care law.

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The decision by the Justice Department to drop its defense of the Obama program and cut off the subsidies was not unexpected. Since President Trump took office, his administration has shown little interest in taking up the Obama administration cause. Quite the contrary. Given their strong opposition to the Obama health care program, the Trump administration and House Republicans asked the appeals court to hold off on any action in the lawsuit until Congress decided what to do about the health care law. Unable to force through a repeal, the administration has now turned to other actions it can take, with the decision to cut off the subsidies just the latest one.

How the court case will ultimately be disposed of remains unclear. Nicholas Bagley, a University of Michigan law professor who has followed it closely, expects that the Justice Department will move to have it declared moot, since the main point of contention — the legality of the subsidies — has been settled by the new finding by Mr. Sessions.

“There is nothing left to fight about,” Mr. Bagley said.

It might not be so simple. A coalition of states successfully intervened in the lawsuit this year in an effort to protect consumers when it became clear that the Trump administration was not inclined to contest the House claim. Mr. Bagley said the states could ask the appeals court to block the Trump administration from cutting off the funding. In addition, insurance companies could go to court to recover the subsidies they had been promised under the law. There are also bipartisan efforts in Congress to formally appropriate the money.

One thing is clear: With the House and the executive branch now on the same legal side, there is no longer any separation between the two main powers in the case.


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Entrepreneurs Struggle To Hire As Health Care’s Future Remains …

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Entrepreneur Stinson Dean (left) and his wife Stephanie play with their three children in their yard in Independence, Mo. He says the Affordable Care Act made it possible for him to start his own business.

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Entrepreneur Stinson Dean (left) and his wife Stephanie play with their three children in their yard in Independence, Mo. He says the Affordable Care Act made it possible for him to start his own business.

Alex Smith/KCUR

Stinson Dean, an entrepreneur from Independence, Mo., is used to taking risks. He buys Canadian softwood framing lumber to sell to lumberyards in the U.S. and says coping with the ups and downs of the market is an inevitable part of doing business.

But when he started the company about a year and a half ago, he laid down a firm rule.

“One of the things I wasn’t willing to risk was the health of my family,” Dean says.

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Dean is the proud father of three young children — two girls and a boy. Playing with them in the front yard before dinner, he and his wife, Stephanie, talk about the possibility of another.

Like many Americans, Stinson Dean has nervously watched this year’s national health care debate. He says the Affordable Care Act made it possible for him to start his business. Now, uncertainty about the ACA’s future is affecting his business’s ability to grow.

In May of 2016, Stephanie was pregnant with their daughter Julie, and Stinson was working as a commodities risk consultant.

A few months before a baby’s due date is typically not the time for a big career move, but it also happened to be when the lumber market seemed to offer a once-in-a-lifetime opportunity to buy low and sell high.

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Encouraged by the availability of affordable insurance, the family took the plunge. Dean left his job and started his company.

The move paid off, as new construction boosted Dean’s business far beyond what he imagined.

He’s now ready to expand and bring on three or four new people, but there’s a problem.

“There’s a huge unknown with the ACA and what that’s going to look like,” Dean says.

President Trump and many members of Congress campaigned with promises to repeal and replace the Affordable Care Act, and they’ve spent much of this year attempting to do so.

That’s meant hardship for Dean. He’s having trouble convincing people with steady jobs and great benefits to take a chance and come work for him.

Repeal and replace efforts are again alive in the Senate, and the president has threatened to cut subsidies to insurers for to help pay for sicker, more expensive patients. That strain, on top of already unstable insurance markets, has led Dean to worry about whether decent insurance coverage will be available in the long run for him, his family, and potential new employees.

“What that’s doing for me is preventing me to convince folks who are in a similar situation to where I was — a nice corporate job, making good money, with great benefits, with kids — convincing them to leave that to come work for me with no benefits,” he says. “They’re going to have to go on the individual marketplace, on HealthCare.gov just like I did and pick a plan.”

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Exactly how the ACA has affected entrepreneurs and job growth is still unclear, according to Dean Baker, co-director of the left-leaning Center for Economic and Policy Research, based in Washington D.C. But there’s been a sharp increase in entrepreneurial activity since 2013, when the insurance marketplaces started.

Baker says the ACA has helped entrepreneurs by leveling the playing field in the competition for hiring new talent.

Prior to the health law, entrepreneurs had been at a disadvantage compared with larger businesses who were more likely to be able to afford to offer insurance.

“Once [an entrepreneur’s] workers are able to get insurance through the exchange, much of that disadvantage goes away,” Baker says.

Baker says uncertainty is poison for any business, but all the questions about the ACA’s future have made 2017 especially toxic for entrepreneurs.

“For a lot of small businesses, they are sitting there with some trepidation, saying, ‘OK, how does this work out? Where are we a year from now? Where are we two years from now?’ And presumably, at least some of them are going to be putting their plans on hold,” Baker says.

Stinson Dean says that the lumber world once again is opening up some big opportunities, but he may not be able to take advantage of them. Dean worries he may be missing out on his chance to go big, even if the ACA survives this year.

“What about 2019, 2020?” Dean says. “These are the questions I’m being asked by these folks I’m trying to recruit, and I don’t have an answer for them.”

This story is part of a reporting partnership with NPR, KCUR and Kaiser Health News.




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