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Felix Adamo / The Californian

California Calls canvassers Alex Villanueva, left, Amando Gayosso, Juan Fuentes, and Peter Villa, right, meet on Rosewood Avenue in northeast Bakersfield before going door-to-door to talk with people about insurance and the Affordable Care Act.

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Casey Christie / The Californian

San Joaquin Community Hospital's new AIS Cancer Center on Chester Avenue.

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Henry A. Barrios / The Californian

Shane Hoover is begins his treatment for valley fever at Kern Medical Center. Starting at 8 a.m., it will be until noon or longer before he is finished. He goes in for treatment three times a week.

Kern County residents, and the rest of the country, learned how to swallow a new prescription for health care in 2013.

The Affordable Care Act, aka Obamacare, topped health news this year as businesses and individuals tried to understand the law's implications for their particular situation.

On top of those changes, Bakersfield hospitals saw leadership shakeups this year, with two CEOs leaving their posts in troubled times and another taking the lead at the county's distressed public hospital.

Bakersfield made national news this year for several health-related stories, first when a disturbing 911 recording called the actions of a local assisted-living center employee into question, and again when national public health leaders and politicians came to town to talk valley fever.

-- The Affordable Care Act kept Kern's community groups, insurance agents and health care advocates busy preparing for the Oct. 1 open enrollment launch, while businesses breathed a sigh of relief when penalties for the so-called "employer mandate" were postponed.

Complete numbers aren't available yet, but in the first two months of open enrollment, nearly a quarter of a million Californians finished applications for insurance through Covered California, the state's health insurance marketplace.

In Kern County, 1,026 people signed up for plans through the exchange from Oct. 1 through Nov. 30, and almost 90 percent of them were eligible for federal subsidies to make their plans cheaper. And as of Dec. 14, the Kern County Department of Human Services had received 1,474 applications for expanded Medi-Cal, meaning those folks who previously would not have qualified will be able to get Medi-Cal starting Jan. 1.

Officials praised the state's exchange for performing better than the disastrous launch of the federal exchange. But the local enrollment effort had a rocky October start with local groups saying glitches and delays on the state's side were holding them up. Things seemed to smooth out as the end of the year -- and the deadline to get coverage by Jan. 1 -- approached.

* GLENWOOD GARDENS 911 CALL -- It was the 911 call heard 'round the country: A frantic dispatcher begging an employee, who identified herself as a nurse at Glenwood Gardens' independent living facility, to provide CPR to an 87-year-old woman in distress. The employee refused and the resident, Lorraine Bayless, died later that day.

The February incident sparked national outrage but Bayless' family stood by the facility, saying Bayless wanted to "die naturally and without any kind of life-prolonging intervention." In a statement, the family said Bayless picked that Glenwood Gardens community knowing it "did not offer trained medical staff" and that it would not sue the facility.

The incident prompted a reaction from one local lawmaker. In October, the governor signed a bill into law penned by Assemblyman Rudy Salas, D-Bakersfield, prohibiting employers from forbidding workers from voluntarily performing emergency medical aid, including CPR. However, the law also stated that an employer can forbid a worker from doing CPRif a person has "do not resuscitate," or DNR, or other legal order.

* CANCER CENTER DELAYS -- The opening of San Joaquin Community Hospital's $36.2 million cancer center was delayed until April by a federal investigation.

Officials had said the cancer center would start seeing patients early in 2013 and a hospital spokesman also blamed construction delays for the holdup.

But the Centers for Medicare & Medicaid Services threatened to yank the hospital's Medicare provider agreement unless administrators cleared up investigators' safety concerns that built up over repeated inspections of the hospital. For example, on a December 2012 visit, called a "survey," inspectors faulted the hospital after they saw a nurse draw medications into a syringe and leave it without a label.

The hospital could not get state approval for its new cancer center while it was out of line with federal regulations.

Amid the ongoing inspections, then-CEO Robert J. Beehler left the hospital for a corporate position with Adventist Health in February. He was replaced by the nonprofit's corporate chief operating officer and the hospital took myriad measures to appease inspectors, including hiring a director of infection prevention and starting a monthly newsletter from the hospital's infection control department.

News of the investigations broke in March but the hospital was cleared shortly thereafter. The AIS Cancer Center at San Joaquin Community Hospital began to see patients in late April and Adventist hospital executive Doug Duffield was tapped to replace Beehler in June.

* VALLEY FEVER -- Valley fever is often labeled an "orphan disease," but in 2013 the illness found new attention.

The woeful state of the disease, also known as coccidioidomycosis, was laid out in the "Just One Breath" series by the Reporting on Health Collaborative, a partnership between Southern and Central California media outlets, including The Californian.

U.S. House Majority Whip Kevin McCarthy, R-Bakersfield, made fighting the fungal illness a priority following the collaborative's reports on increasing cases of valley fever and inadequate funding to develop better treatments or a vaccine. And in June, a judge ordered the state to move inmates at high risk of developing serious cases of the disease out of two Central Valley prisons.

To top it off, McCarthy brought some of the country's most prominent public health officials -- including the leaders of the Centers for Disease Control and Prevention, and the National Institutes of Health -- to Bakersfield for a two-day valley fever symposium to learn about the disease and brainstorm better ways to help fight it. They unveiled plans for a clinical trial aimed at gaining a better understanding of how to treat valley fever.


* The saga of Obamacare is sure to continue next year. In 2014, most people who remain uninsured will have to pay a penalty of $95 or 1 percent of their annual household income, whichever is more. The first open enrollment period ends March 31.

* Two big cancer fundraisers will vie for Kern County's attention next spring -- one new and the other long running. The Kern County Cancer Fund's first Campout Against Cancer will set up tents in April to raise money to help local cancer patients cover treatment expenses, while the American Cancer Society's Bakersfield Relay for Life will be held in May to raise money for research, education and other programs.

* Watch for possible advances in the fight against valley fever in 2014. Researchers at Kern Medical Center have received funding for a pilot project to explore why the disease affects people differently. Time will tell whether the promises and dreams of September's valley fever symposium lead to breakthroughs in the battle against the disease.