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Exam Code: PCNSA Practice exam 2022 by Killexams.com team
PCNSA Palo Alto Networks Certified Network Security Administrator

Exam Name : Network Security Administrator
Exam Number : PCNSA PAN OS 9
Exam Duration : 80 minutes
Questions in exam : 50
Passing Score : 70%
Exam Registration : PEARSON VUE
Real Questions : Palo Alto PCNSA Real Questions
VCE practice exam : Palo Alto Networks Certified Network Security Administrator Practice Test

OBJECTIVE: Demonstrate your ability to configure the central features of Palo Alto Networks Next Generation Firewall and capability to effectively deploy the firewalls to enable network traffic

Section Objectives Palo Alto Networks Security Operating Platform Core Requirements
- Identify the components of the Palo Alto Networks Security Operating Platform.
- dentify the components and operation of single‐pass parallel processing architecture.
- Given a network design scenario, apply the Zero Trust security model and describe how it relates to traffic moving through your network.
- Identify stages in the Cyber‐Attack Lifecycle and firewall mitigations that can prevent attacks. Simply Passing Traffic - Identify and configure firewall management interfaces.
- Identify how to manage firewall configurations.
- Identify and schedule dynamic updates.
- Configure internal and external services for account administration.
- Given a network diagram, create the appropriate security zones.
- Identify and configure firewall interfaces.
- Given a scenario, identify steps to create and configure a virtualrouter.
- Identify the purpose of specific security rule types.
- Identify and configure security policy match conditions, actions, and logging options.
- Given a scenario, identify and implement the proper NAT solution. Traffic Visibility - Given a scenario, select the appropriate application‐based security policy rules.
- Given a scenario, configure application filters or application groups.
- Identify the purpose of application characteristics as defined in the App‐ID database.
- Identify the potential impact of App‐ID updates to existing security policy rules.
- Identify the tools to optimize security policies. Securing Traffic - Given a risk scenario, identify and apply the appropriate security profile.
- Identify the difference between security policy actions and security profile actions.
- Given a network scenario, identify how to customize security profiles.
- Identify the firewalls protection against packet‐ and protocol‐ based attacks.
- Identify how the firewall can use the cloud DNS database to control traffic based on domains.
- Identify how the firewall can use the PAN‐DB database to control traffic based on websites.
- Discuss how to control access to specific URLs using custom URL filtering categories. Identifying Users - Given a scenario, identify an appropriate method to map IP addresses to usernames.
- Given a scenario, identify the appropriate User‐ID agent to deploy.
- Identify how the firewall maps usernames to user groups.
- Given a graphic, identify User‐ID configuration options. Deployment Optimization - Identify the benefits and differences between the Heatmap and the BPA reports.
- Heatmap Component
- Zone Mapping Feature Section

Palo Alto Networks Certified Network Security Administrator
Palo-Alto Administrator action
Killexams : Palo-Alto Administrator action - BingNews https://killexams.com/pass4sure/exam-detail/PCNSA Search results Killexams : Palo-Alto Administrator action - BingNews https://killexams.com/pass4sure/exam-detail/PCNSA https://killexams.com/exam_list/Palo-Alto Killexams : Looking At Palo Alto Networks's exact Whale Trades No result found, try new keyword!A whale with a lot of money to spend has taken a noticeably bearish stance on Palo Alto Networks. Looking at options history for Palo Alto Networks (NASDAQ:PANW) we detected 27 strange trades. Thu, 04 Aug 2022 02:51:05 -0500 en-us text/html https://www.msn.com/en-us/money/news/looking-at-palo-alto-networkss-recent-whale-trades/ar-AA10jaYL Killexams : Alamo Colleges adjunct instructors will get a nice pay bump — and so will top administrators

Weeks before the start of the fall semester, the Alamo Colleges District joined the list of area education institutions and school systems approving pay raises for faculty and staff.

Like many of them, the district’s board of trustees steered the highest raises to some of its frontline instructors, with a 9.5 percent increase for adjunct professors.

And it approved a 4 percent raise for faculty and a 4.5 percent increase for all staff and administrators — including those making well over $100,000 per year.

Effective Sept. 1, that formula will add more than $10,000 to the salaries of a handful of the highest-paid administrators, while faculty will average between $2,000 and $3,000 in additional pay, which raised some eyebrows.

The 4.5 percent increase does benefit the lowest paid employees, such as student workers, and the unanimous board action included additional increases to ensure all employees get at least $2,000 more per year.

It will be the first year after the COVID-19 pandemic arrived that the district has distinguished between faculty and staff raises in a comparison with other community colleges, rather than the flat across-the-board increases for all employees approved in the past two years, Chancellor Mike Flores said. Last year, it was 3 percent for everybody.

The latest increases were a return to the district’s “3ness” approach, adjusted to make the Alamo Colleges the third best paid among the eight largest community colleges Texas - Tarrant, Austin, Dallas, Lone Star, Houston, San Jacinto, El Paso and the Alamo Colleges.

“In (fiscal year) 2017 and 2018, actually, faculty received higher increases than staff and administration,” Flores said. “But because of COVID - we didn’t know what COVID was going to pertain - so we decided then that we would not compare to market.”

Flores, who makes $400,000 annually, is the only administrator who won’t qualify for the 4.5 percent increase this year, officials confirmed on Monday, as his contract won’t be up for renewal until 2024.

Presidents of the district’s five colleges and district vice chancellors now make $235,653, and they will see a $10,604 pay bump.

In total, the board approved about $12.6 million to raise salaries for current faculty and staff. Out of that sum, about $5.2 million will go to 1,732 staff and administrators, with increases averaging $2,757 per employee - including the additional adjustments to reach a $2,000 minimum raise.

About $2.4 million was allocated to cover 779 full-time faculty, whose annual salaries currently average about $56,600, meaning their average increase will total $2,264.

The raises for adjunct faculty - those working part-time at the colleges - and continuing education faculty will average $845 among 3,112 employees. And those teaching career and technical courses in high demand fields such as nursing and cyber engineering will receive an additional $5,000 to $10,000 stipend.

The district evaluates its pay against other community colleges in the region using public faculty salary survey data from the Texas Community College Teachers Association, said Linda Boyer-Owens, the associate vice chancellor of human resources.

“It puts us in a very defined position in our market for community colleges in Texas,” Boyer-Owens said. “I think it’s a very solid process, it’s good practice and something that the faculty understand and that they trust.”

For some faculty, “trust” may be too strong a word to describe their view of the process.

“I think it’s very unfair,” said Professor Daniel Rodriguez, who teaches counseling and student development at Palo Alto College. “And it’s almost a punch in the stomach whenever you look at the pay that administrators are getting versus the pay that faculty are getting, especially in relationship to morale building.”

Rodriguez has tenure and has taught at Palo Alto for more than 35 years. About 10 years ago, he said. he did feel a sense of trust in a process that resulted in cost-of-living pay increases to full-time faculty, on top of regular opportunities to earn more money by teaching summers, signing up for additional hours and other incentives for moving up the academic ladder.

Even without much involvement on his part on any committees that discussed pay, Rodriguez said, there was a sense that the district wanted to see its faculty remain and grow.

Today, faculty members have little opportunity to get involved in pay conversations ahead of board recommendations, he said, and he no longer feels like anyone is fully representing and backing them.

“Faculty has kind of been kept out of the loop when it comes to pay,” Rodriguez said. “(Since 2008) we’ve just kind of been at the mercy of administrators, or maybe accountants, at the district level to determine our pay.”

“We’ve never had really a seat at the table related to faculty pay here more recently,” he said. “I’ve never been at that table.”

Trustee Clint Kingsbery questioned the optics of giving administrators a larger percentage increase than faculty, but ended up voting to approve the proposal.

The Alamo College District’s new headquarters opened in 2019. Administrators and staff will get 4.5 percent pay raises in the coming academic year, and full-time faculty will get 4 percent. Rebecca Slezak/Staff photographer

The Alamo College District’s new headquarters opened in 2019. Administrators and staff will get 4.5 percent pay raises in the coming academic year, and full-time faculty will get 4 percent. Rebecca Slezak/Staff photographer

Rebecca Slezak, Staff / Staff photographer

“I just worry that it may not send the right kind of message,” Kingsbery said before the vote.

In future years, the college district can always decide between continuing to compare its salaries to other community colleges or simply approving across-the-board increases, but the point of the market-driven adjustments is to retain and attract good employees, Chancellor Flores said in an interview.

“We need to be able to offer a competitive wage that’s going to ensure that we can retain the staff that we have and that we can also recruit the individuals to the organization to support the students,” he said.

Some faculty have long accused the district of becoming top-heavy with administrators or prioritizing non-its teaching staff.

During the pandemic, between the academic years 2020-21 and 2021-22, the district’s faculty count decreased by 20 positions, to 830, but its 989 professional positions grew to about 1,120, and its 82 administrative positions nudged up to 84.

In the same period, the budget to cover faculty pay decreased by about $1.5 million, while the budget for professional employees and administrators grew by about $2.9 million and $431,578, respectively.

Flores attributes this growth to the district’s focus on providing more wrap-around services to students to help students graduate, such as additional advising, counseling, advocacy, and tutoring.

“It is important to partner with students, and it is critical to always have the partnership between the faculty member and the student, because that’s why they are here,” Flores said. “What we have done over the past six years is we (have) also been able to provide a partner in the form of an academic adviser… to be able to ensure that they’re on path to graduation.”

About 175 individuals make up this team of advisers and related professionals, he said, and now it’s taking students about three and a half years to graduate, even with about 68 percent of them attending college part time.

Alamo Colleges District Chancellor Mike Flores in a 2019 file photo.

Alamo Colleges District Chancellor Mike Flores in a 2019 file photo.

Jerry Lara, Staff / Staff photographer

“What’s key is also providing targeted support for students outside of the classroom,” Flores said.

Rodriguez shares the same passion and commitment to providing a path to graduation for every student. For years he has volunteered to help lead the Catch the Next program at Palo Alto College, which seeks to increase retention and completion rates for at risk or underserved students.

He teaches five courses every semester and to supplement his pay, he adds overload hours when possible, he said, and two classes in the summer.

When engaged in the “numbers game” of the budget process, Rodriguez said, administrators should focus more on the impact that these changes bring to faculty and students.

“You would kind of hope that the same passion that you have is the same passion that could see from our administrators,” he said. “I’m going to continue doing what I’m doing, and it almost seems like they know that.”

danya.perez@express-news.net | @DanyaPH

Mon, 08 Aug 2022 02:01:00 -0500 en-US text/html https://www.expressnews.com/news/local/article/Alamo-Colleges-pay-raise-17357523.php
Killexams : Former Baylor Administrator Resigns From California Private School After Sexual Allegations From Baylor Alum And Former Dallas Student

A former Baylor School administrator has resigned at a private school in California after a former Baylor student along with a student at another school in Dallas, Tex., where she also taught came forward with allegations of sexual misconduct.

The teacher resigned recently from Castilleja School in Palo Alto, though she currently faces no criminal charges. She was academic dean, head of the upper school, and assistant head of the school.

Barbara Kennedy, spokesperson for Baylor School, said, "Baylor School has been made aware that an English teacher at Castilleja School in Palo Alto, Calif. resigned in December.  Her resignation occurred after school officials there were contacted by two individuals, one of whom is a Baylor alum, who made an allegation of sexual misconduct by this teacher while she was employed at Baylor as an administrator in the 1980s.  

"Though this allegation reaches back more than two decades and we have no record of any misconduct, we are taking it very seriously, and appropriate authorities have been advised of the matter. 

"The care and safety of our students has always been, and continues to be, our foremost priority."

The other student is from a school in Texas. Both alleged incidents happened in the 1980s, according to the San Jose Mercury News.

The newspaper said the teacher was placed on administrative leave and an investigation was started regarding the alleged inappropriate relationships.

The teacher resigned from the 6-12 grade school, though she denied the allegations.

The teacher was at Hockaday School in Dallas, Tex.,from 1973 to 1983 and at Baylor from 1985 to 1990. She also taught at Harpeth Hall in Nashville at one time.

The California school did not release the name of the teacher since no charges were brought.

Thu, 28 Jul 2022 12:00:00 -0500 en text/html https://www.chattanoogan.com/2014/1/29/268481/Former-Baylor-Administrator-Resigns.aspx
Killexams : Saturday Morning News Roundup

A South San Francisco police officer received non-life-threatening injuries Friday afternoon after being dragged and forced to the ground following a traffic stop in which the stopped driver restarted his vehicle and sped off.

A spokesperson for the South San Francisco Police Department said officers made a traffic stop at 5:18 p.m. in the 1000 block of San Mateo Avenue after observing a vehicle code violation.

During the traffic stop and as the officers were speaking with the male driver, he suddenly restarted his vehicle and rapidly accelerated. One of the officers standing outside the vehicle was dragged and forced to the ground.

A vehicle pursuit began, which eventually ended in San Bruno when the man collided with two parked vehicles after tossing a loaded firearm out of his car window.

The suspect, Vincent Lewis Harris, 31, of East Palo Alto, was arrested and apprehended. He was also found to be in possession of burglary tools. Harris was transported to San Mateo County Jail. He faces charges of assault on a police officer and illegal firearms possession.

The injured officer was treated at a local hospital and released.

Anyone with information about the incident is asked to contact the South San Francisco Police Department at (650) 877-8900.

A 13-year-old girl was taken to a local hospital late Friday morning after being struck by a bullet fragment in San Leandro.

A spokesperson for the San Leandro Police Department said officers responded to the 2200 block of East 14th Street at about 11:30 a.m. for a report on a shooting that may have occurred at a business.

As of Friday evening, it is unknown if this was a robbery attempt or a direct and targeted shooting.

During the gunfire, two or three shots were believed to have been fired, according to police.

Detectives said the girl was injured by a bullet fragment striking her foot.

The suspects fled the scene following the incident.

This is an ongoing police investigation and detectives from the department's Criminal Investigation Division have taken over the case.

Anyone with information about the shooting is urged to contact the San Leandro Police Department at (510) 577-2740.

Occupation of Oakland's Parker Elementary School overheated Thursday afternoon with conflict between community members and school district security staff, organizers said Friday.

Oakland Unified School District officials said staff went early in the day Thursday to the school, located at 7929 Ney Ave., and found no one inside. But, occupation organizers dispute that.

Parents, students and other community members have occupied the school since the end of the 2021-22 school year following the district's decision to close it as part of a district-wide closure, merger and consolidation plan.

Organizers argue the district's plan is racist. School district data show that in the case of Parker Elementary School, 90 percent of school children were either Black or Hispanic students during the most exact school year.

Nate Landry, a parent of a district fourth grader, said community members were inside the building after 4 p.m. Thursday. A little after 4:30 p.m., they heard of someone being physically assaulted, said Landry, who, with his wife, has joined the opposition to the school district's plans.

He said that security told people they would be subject to arrest if they did not leave. Security officers pushed everybody out and did a poor job of securing the building, Landry said.

By 6 p.m., community members including at least one school board candidate and an elected official were outside. By about 6:30 p.m., when Oakland City Councilmember Carroll Fife arrived, a door had been breached and a lot of pushing and shoving was occurring from both sides, Fife said.

People were trying to get in and security officers were trying to keep people out, Fife said.

Someone called police at 6:09 p.m. regarding an assault at the school. Officers arrived and located one victim, police said.

In the confrontation, one person suffered a concussion. In all, three people went to the hospital, Landry said. Police detained one person and took a statement from them, police said.

Since May 25, parents, teachers, students and community members have occupied the school 24 hours a day, seven days a week, organizers said. They renamed it Parker Community School.

Through Thursday, school-age children have participated in a summer program there, food has been given away, voter registration drives held, and among other activities, town halls held.

Security officers also detained a parent and held him against his will for over an hour, Landry said.

By about 7:45 p.m., police and security had left the building and community members re-established control of it.

A portion of state Highway 17 at the interchange with state Highway 1 will be temporarily closed during overnight hours next week to allow for work crews to replace overhead directional signs.

A Caltrans spokesperson said the southbound lanes of Highway 17 will be closed just north of the Highway 1 interchange -- also known as "the Fishhook" -- on Monday and Tuesday evenings, Aug. 8 and 9, beginning at 9 p.m. The freeway will be closed until 5 a.m. the following day.

Motorists traveling south on Highway 17 may detour onto the southbound Highway 1 offramp to avoid the work zone. Detour signs will be in place to assist drivers.

Additionally, the left lane of northbound Highway 1 near Highway 17 will be closed during the same period of time.

Motorists can expect delays of up to 15 minutes.

The Contra Costa Board of Supervisors on Tuesday will discuss oversight of the county sheriff's office and a recommendation from the county's public protection committee to create a regular reporting structure to the board from the sheriff's office.

Assembly Bill 1185, which became law Jan. 1, 2021, authorizes the county to establish a sheriff oversight board and/or an inspector general to assist in its oversight duty. Doing either requires action on the board's part or a public vote.

The law also authorizes an oversight board and/or an inspector general to issue a subpoena when deemed necessary to investigate a matter within that jurisdiction. It also says exercising that power can't obstruct the sheriff's office's ability to conduct investigations.

The staff report for Tuesday's meeting says four out of nine Bay Area counties have established an inspector general or a sheriff oversight board, with two other counties in the process of doing so.

The county administrator's office and the sheriff's office have developed the framework for a quarterly oversight report to present to the board, updating it on sheriff's office activities and allowing the board to ask questions about operational issues. The report would cover custody services, field operations, support services, and administration.

Custody services include total number of bookings, number of participants in custody alternatives, in-custody deaths, and medical data overseen by the county health department.

Bay Area activists plan to gather Saturday in Richmond for a march and actions commemorating the 10-year anniversary of an explosion and fire that tore through the Chevron Richmond refinery.

Activists will be led by Richmond Our Power Coalition, made up of local community organizations that fight for climate justice. Organizers will recall smoke from the fire that sent thousands to local hospitals and clinics on Aug. 6, 2012.

Investigators with the U.S. Chemical Safety Board reported that Chevron had ignored warnings about corrosion in the pipe that eventually caused the fire. The goal of Saturday's march is to advocate for the eventual phaseout of oil refineries statewide.

Events will begin at 9:30 a.m. with protesters gathering at the Richmond BART station and marching to the Chevron refinery. At 11 a.m., the Bay Area Climate Kayaktivists, a group who protests from kayaks, will make their inaugural launch at Keller Beach, the location of a February 2021 oil spill related to the Chevron refinery, among other planned actions.

Organizers expect hundreds to be in attendance Saturday, but this is not the first time that Richmond residents have protested the refinery. There was a large demonstration at Chevron in 2013, one year after the explosion.

A 28-year-old Petaluma man was arrested early Friday morning after what police say was the negligent discharge of a firearm inside his residence.

No one was injured, and no one else was inside the man's residence, located in the 2100 block of Willow Drive.

Just before 6 a.m., police officers were dispatched to Willow Drive to investigate suspicious circumstances following a 911 call from a person at a separate location received a call from the arrested suspect, Tyler Elliott, who told them he had shot someone inside his residence.

Officers arrived on scene, but did not notice any signs of a disturbance. including any suspicious individuals in the neighborhood.

Moments later, police dispatchers received a call from Elliott, who was then ordered to come outside.

Officers located an assault rifle inside the residence and discovered a shattered glass door. The door appeared to have been shot at from inside the residence, causing it to shatter.

After speaking with Elliott, officers determined there was not any evidence that suggested an intruder was inside or attempting to break in. Elliott was arrested for the negligent discharge of a firearm, among other associated charges. He was booked into Sonoma County Jail.

Officers believe only one shot was fired. The surrounding area was checked for the location and direction of the bullet. It is believed the bullet entered Elliott's backyard, fragmenting when it struck a concrete patio.

Anyone with information about this incident is asked to contact Ofc. McGovern at (707) 778-4372.

The National Weather Service forecast for Saturday for the San Francisco Bay Area calls for less humid conditions with daytime highs in the 70s to low 80s around the Bay and the upper 80s inland. Temperatures along the coast will be in the 60s. Overnight lows Saturday morning will reach the low to mid 50s.

Copyright © 2022 Bay City News, Inc. All rights reserved. Republication, rebroadcast or redistribution without the express written consent of Bay City News, Inc. is prohibited. Bay City News is a 24/7 news service covering the greater Bay Area.

Copyright © 2022 by Bay City News, Inc. Republication, Rebroadcast or any other Reuse without the express written consent of Bay City News, Inc. is prohibited.

Sat, 06 Aug 2022 02:00:00 -0500 en-US text/html https://www.sfgate.com/news/bayarea/article/Saturday-Morning-News-Roundup-17356177.php
Killexams : TSA Updated Security Directives Push Protected Access and Secure Digital Conduits for Critical ...

PALO ALTO, Calif., July 22, 2022 (GLOBE NEWSWIRE) -- Increased cyber threats have spurred continued action from the government, including multiple security directives from the Transportation Security Administration (TSA) for pipeline operators. The agency this week released the  latest version  of its Pipeline Security directive; another step towards a more secure energy infrastructure.

Despite speculation that the TSA is easing up on requirements, Duncan Greatwood, CEO of Xage, explains that their updates dig in on core zero trust principles:

  • “The TSA is doubling down on some areas, such as access control and credential management for critical infrastructure systems, while relaxing some rules in other areas, such as lead times for incident reporting.”
  • “What comes through most strongly is the TSA approval of performance-based, rather than prescriptive, measures for cyber-hardening. They’re providing greater choice in the methods operators can use to enhance cybersecurity, which could significantly accelerate implementation timelines.”
  • “While this idea was already present in last year’s draft regulations, under the name of ‘alternative methods,’ this idea—now called ‘compensating controls’—has become central to access management requirements. The TSA is saying that any critical infrastructure element that lacks strong built-in security (as is the case with many operational assets) won’t need to be uprooted. Instead, these critical assets will need ‘compensating controls’ to protect them—in other words, a way to protect vulnerable assets that makes up for their lack of built-in security capabilities.”

These insights come from first hand experience implementing technologies and tactics to reach compliance without impacting existing operational technology assets. Xage works with some of the largest pipelines in the US, and Greatwood explained that “pipeline operators see this update as an accelerator of cyber-hardening, not an indication that they can sit back and relax. They wouldn’t want to anyway—the growing threat landscape is giving them even more of a wake up call than the TSA directives did in the first place.”

Xage is delivering comprehensive zero trust security and already deploying TSA-approved solutions for regulated energy companies across the country, including:

  • Access and Credential Management: TSA continues to stress access control and credential management. Xage provides granular identity-based access and credential management for all assets, including legacy assets, powered by its patented Xage Fabric. The Xage Fabric seamlessly overlays an operation to impose granular control over all interactions, without any asset or network changes.
  • Compensating Controls and Multi-layer MFA: For the many critical systems that lack their own strong security controls and/or security integrations, Xage’s Fabric provides zero trust-based access control, including multi-layer MFA, delivering the “compensating controls” required in the latest TSA regulations. In particular,  Xage’s multi-layer MFA capability  combines zero trust with a defense in-depth authentication strategy.
  • Granular Zones, Conduits and Beyond: TSA also requires operational environments to be segmented into zones, interconnected with secure, controlled conduits, preventing contagion from zone-to-zone in the event of an initial breach. Xage’s Fabric acts as a mesh, providing session and protocol termination at each Xage node, guaranteeing the security of cross-zone conduits between the nodes, and ensuring that there is no unauthorized access to assets from outside or even from within each zone.

To learn more about how Xage is enabling critical infrastructure organizations to adopt zero trust without disruption, visit  Xage.com/solutions.

About Xage

Xage is the first and only zero trust real-world security company. The Xage Fabric accelerates and simplifies the way enterprises secure, manage and transform digital operations across OT, IT, and cloud. Xage solutions include Identity & Access Management (IAM), remote access and dynamic data security, all powered by the Xage Fabric.

Media Contact

LaunchSquad for Xage

xage@launchsquad.com

Copyright 2022 GlobeNewswire, Inc.

Fri, 22 Jul 2022 08:16:00 -0500 en text/html https://www.bakersfield.com/ap/news/tsa-updated-security-directives-push-protected-access-and-secure-digital-conduits-for-critical/article_f335514f-f7e2-5db9-b210-57a2eed6d5bc.html
Killexams : The Service of Burnzie's Battalion in Action
Sharks defenseman Brent Burns embodied the mission of his foundation, Burnzie's Battalion, on Monday afternoon, honoring servicemen and women at the Veterans Administration Hospital in Palo Alto with a surprise visit.

Since being traded to San Jose in June, Burns has made an indelible mark on the Bay Area community, frequently taking time out of his busy schedule to serve those around him. San Jose Mercury News writer Mark Emmons joined Burns on his trip to the VA Hospital on Monday and his story appeared in Tuesday's print edition as well as online.
[ MercuryNews.com ]

Sat, 15 Oct 2016 01:55:00 -0500 en-US text/html https://www.nhl.com/sharks/news/the-service-of-burnzies-battalion-in-action/c-4954
Killexams : The Peninsula mobilizes for war
by Don Kazak

If you stand at the corner of Santa Cruz Avenue and El Camino Real in Menlo Park and look south, you can see where the road goes uphill to cross San Francisquito Creek. Standing at the same spot and looking west, it's hard to see where Santa Cruz makes its half-left turn on its way up to the Alameda.

Now, with those two distant reference points in mind, imagine everything between them, where you are standing and the creek, which is a lot of real estate, 25,000 acres or so. That was Camp Fremont in 1917-18, home of the 8th Division of the U.S. Army, which was being trained to go to France and fight in trenches against the Kaiser's army.

Camp Fremont had 27,000 men at its peak, and a curious history. Construction began in July 1917; was halted for three weeks by the War Department at one point; saw its troops transferred to the East Coast; finally received the 8th Division, which was trained for France but ended up in Siberia; had a chance to become a permanent Army camp but was closed after the war; and saw its buildings all dismantled or moved, leaving Menlo Park much as it had found it--a sleepy little hamlet of 2,300 souls.

In between, a lot happened.

Menlo Park and San Francisco merchants rented every available store space, a post office, church, library and theater were built along with nine YMCA huts, the Bank of Palo Alto opened a branch in Menlo Park (and promptly closed it when the camp closed, to the dismay of Menlo Park residents), Beltramo's Winery and every other similar store and tavern within five miles of the camp in San Mateo County went "dry" by decree of the Army and county, Sequoia High School opened a branch on the base (teaching arithmetic, English, typing, shorthand and accounting) and then closed it because of poor attendance, and lots of guns, machine guns, hand grenades, cannon and whatnot were shot off in the interests of training the soldiers to fight.

The camp had infantry, cavalry and 10,000 animals--horses and mules-- which were based farther east on Ravenswood Avenue at a "remount station" near the camp hospital (which would become the Veteran's Administration hospital on Willow Road.)

The irony of Camp Fremont, of course, is that the 8th Division never made it to the fighting in France, with the armistice reached before they arrived. Part of the 8th did get to see some action, however--in Siberia.

But the area was not left empty-handed when the camp was dismantled 18 months after it was assembled. Besides the addition of new businesses in both Menlo Park and Palo Alto, Menlo Park had its first streets and its first water and gas services, left behind by the 8th Division engineers.

Camp Fremont also left behind some of its 1,000 buildings. Two popular restaurants of today, MacArthur Park--which once housed Palo Alto's first community center--and the Oasis Beer Garden are both located in former Camp Fremont buildings.



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Fri, 21 Apr 2017 04:05:00 -0500 text/html https://www.paloaltoonline.com/news_features/centennial/1906B.php
Killexams : Health care costs keep rising. A new California agency aims to fix that

by Kristen Hwang and Ana B. Ibarra / CalMatters

In 2017, a rare viral infection hospitalized Bernadette Moordigian for three weeks and paralyzed her for nearly nine months. Although she had health insurance, the hospital sent her an $80,000 bill. She appealed and got financial aid but was still on the hook for $10,000.

In 2018, Shelly Tsai, a lawyer with Neighborhood Legal Services Los Angeles, took on a client who opted to give birth at home with a midwife. Insurance wouldn't foot the $8,000 bill despite it costing three times less than a hospital birth.

Last year, Laila Dellapasqua reduced her family's health insurance coverage yet again as premiums increased. Collectively their yearly deductibles are more than $31,000.

Stories like these three are increasingly common. California and the country are in the midst of a health care affordability crisis. The Golden State has taken a multi-pronged approach in its effort to get a grip on skyrocketing costs — its latest effort being a new Office of Health Care Affordability whose job will be to investigate the causes behind price increases and hold health industry players accountable.

In California and nationally, the most cited reason for people being uninsured or underinsured is cost. Even those with robust insurance sometimes struggle to afford hospital bills and their medication. Some take extreme measures, such as rationing their dosages or traveling south of the border for more affordable care. Half of Californians skipped or postponed medical care in 2021 because of costs, according to a California Health Care Foundation report.

"For all the talk of inflation in the last year, if gas prices went up the same rate as health care prices over the last couple of decades, we wouldn't be seeing $5 to $6 a gallon, we'd be seeing $30 to $40 a gallon," said Anthony Wright, executive director of Health Access California, a consumer rights group. "What is raising people's concerns about inflation these days has been the case for health care for decades."

The recently approved state budget includes $30 million to create the office, whose key responsibility will be to set and enforce limits on cost growth for the industry, including hospitals, health insurers and physician groups.

The office has been years in the making, with industry representatives, legislators and Gov. Gavin Newsom haggling over specifics. In its final form, it will be seated in the Department of Health Care Access and Information and led by department director Elizabeth Landsberg.

"We absolutely will be shining a light specifically on how much of the health care dollar that's coming out of people's pocket — that's putting a strain on their family budget — how much of that is going to administrative costs and profits," Landsberg said.

However, the office's work won't translate into instant savings for people nor immediately eliminate stories like Moordigian's or Dellapasqua's. Expectations should be tempered, Landsberg said.

The office isn't necessarily aiming to reduce costs, but rather to slow the rate of growth of those costs. "Which may not feel that great to consumers who already feel like they're paying too much, but we have got to get the costs under control, and we think this will absolutely have a meaningful impact," Landsberg said.

Household health spending has grown twice as fast as wages, and medical inflation is 1.5 times greater than general inflation, according to the Kaiser Family Foundation. State spending on Health and Human Services, which encompasses Medi-Cal, the health program for low-income people, makes up nearly one-third of the state budget. And health insurance premiums and deductibles have steadily increased for Californians in the past decade, equaling 10.5% of the median household income in 2020, according to the Commonwealth Fund, a health care think tank.

"Bottom line, health care is too expensive, its growth rate is unsustainable and we have to do something," said Assemblymember Jim Wood, a Santa Rosa Democrat, who was involved in negotiations to establish the office.

The Office of Health Care Affordability is attempting to tackle the root of the issue: Providers can charge patients virtually any amount they want with no incentive to lower prices.

"Whenever we've tried to make health care more affordable, we've done it by increasing subsidies, but that's not doing anything about the underlying cause," said Gary Cohen, a former Obama Administration advisor and principal with Health Management Associates, a health care consulting group. Cohen previously led Blue Shield of California's negotiations on the formation of the office as vice president of government affairs.

In California, the Office of Health Care Affordability will be responsible for examining the health care market as a whole. Currently, three departments and the Office of the Attorney General oversee parts of the system separately. The fragmentation often results in industry players blaming each other for rising costs. The new office plans to identify the primary drivers of cost increases, including individual facilities with above-average prices.

It will collect data on expenditures, including doctor's visits, hospital care, medication, and medical supplies. The data is expected to help identify how much is going toward an entity's administrative costs and profits.

An eight-member appointed advisory board will set limits on cost growth for different sectors and regions. Any entity that exceeds limits and shows no improvement may face financial penalties.

States have limited power when it comes to regulating the pharmaceutical industry, so drug companies will not be subject to the office's cost targets. However, the office will analyze the role drug manufacturers are having on overall health care spending, Landsberg said. In one effort to cut drug costs, the Newsom administration is also working on producing its own line of generic drugs, starting with insulin.

Eight other states have created similar health care affordability offices with moderate success. Between 2017 and 2020, Massachusetts, which created the first office, saw health care costs exceed its growth limits in two of the four years. California's office will have the toughest enforcement mechanisms, Landsberg said.

"The (enforcement) teeth are important just to convey what a critical initiative this is, and that if parties aren't able to comply, then the state will have the ability to take action," Landsberg said.

Landsberg will be responsible for enforcing the limits on cost growth with a variety of tools at her disposal, ranging from requiring violators to submit performance improvement plans to levying fines. Advocates and researchers are counting on the office's ability to create price transparency and bring more competition to the health marketplace.

"If you look at other parts of our economy that are market-driven but where there is competition, consumers are the ones that determine what the prices are. They make tradeoffs for service, quality, access," said Glenn Melnick, health economics expert from the University of Southern California's Sol Price School of Public Policy. "The problem is, our health care system is far from that model."

The office will also conduct reviews of mergers and acquisitions that have remained unregulated in California.

Getting to this point was a hard-won battle, albeit a savvy political move by several players in the health care industry.

In 2014, a California ballot initiative aimed at regulating health insurance rates narrowly failed. Three years later, a state bill to establish a single-payer health system was shelved without a hearing. Earlier this year, another single-payer bill died without a vote after contentious and impassioned hearings. Although those efforts failed, the powerful California Nurses Association, which sponsored the bills, said it remains committed to pushing single-payer forward.

For health care power brokers, the message was clear: Make health care more affordable or the government would do it for them.

"If in fact this commission can get the private system to perform in a way that is consumer friendly and provides access, over the long run it may very well obviate the need for single payer," said Blue Shield President and CEO Paul Markovich.

Newsom, who had campaigned on implementing a single-payer system, was an early supporter of the office's more moderate mechanisms. Deputy communications director Alex Stack said making health care more affordable and accessible was a "top priority" for the administration.

Newsom first introduced the Office of Health Care Affordability in his January 2020 budget proposal but it was sidelined by the pandemic. In 2021, Assemblymember Wood drafted legislation to detail the office's role, but after legislators and industry officials failed to reach a deal, he announced that discussions would continue into this year.

"In order for this policy to be meaningful, it must include every stakeholder in health care, and they have all had an opinion about this office," Wood said when he pulled his bill last September. "One amendment after another has been requested in an attempt to minimize the impact on them and shift the focus to other players in the health care system."

Initial iterations of the proposal took a hardline stance on controlling the cost of medical goods and services by capping prices even lower than current prices. Instead, in its current form, industry officials and legislators compromised by having the office only target future cost growth.

"We proposed rate regulation and got pushback from industry," Wright, with Health Access California, said. "(The office) was an attempt to try to do this in a different way with the same goal."

Consumer advocates and health care economists say the office has the authority to make health care more affordable, but some of its power was undercut during negotiations. Earlier versions of the proposal mandated financial penalties. The version that passed says violations "may" result in penalties.

The California Medical Association, which lobbies for doctors, successfully pushed to get doctor groups consisting of less than 25 physicians exempted from the bill.

Association spokesperson Shannan Velayas said the group "worked to ensure the Office of Health Care Affordability proposal focuses primarily on those entities with enough market power to influence health care costs."

Another lobby, the California Hospital Association, successfully asked that the office create a public commission of industry experts to advise the office. The lobby also insisted all industry players be subject to the office's rules, with no exemptions.

"Our point of view has always been, this is an all-in proposition," California Hospital Association spokesperson Jan Emerson-Shea said. "This can't just be on the backs of hospitals."

On the insurance side, Blue Shield of California was one of the first industry players at the table. Markovich said it was "very, very difficult" to get other insurers, hospitals and doctors to come to an agreement, and that difficulty underscores the need for this office's work.

"There's far too much inertia, resistance and parochialism in health care today. This office has the opportunity to inject a much-needed sense of urgency and accountability," Markovich said.

Moordigian — the Fresno resident with the $80,000 hospital bill — has a doctorate in clinical psychology and teaches part time at Fresno City College. But she doesn't get health benefits as a part-timer.

Instead, Moordigian is enrolled in a plan through Covered California, the state's health insurance marketplace. She only pays $1 a month after federal aid. The tradeoff is her deductible and annual out-of-pocket maximum are high, at $6,300 and $8,200, respectively. It's the lowest coverage option available, but with rent and student loans eating away most of her take-home pay, it's the only one she can afford.

Moordigian said she frequently skips doctors' appointments or laboratory tests because of the cost. "Every time I go to the doctor I'm asking ‘Is this free? Is this included?' and that's a horrible way to receive care," she said.

Dellapasqua, another community college adjunct professor, said one of her employers offers insurance through Kaiser Permanente, but the premium is more than $2,200 per paycheck.

"I would be working for free in order to have health insurance for my family of four," Dellapasqua said. She chose a Covered California plan instead.

"I get anxiety every time it comes to open registration. What's the cost? You know, is this going to work?" Dellapasqua said.

But even those with employer-sponsored insurance feel the burden of rising costs.

Tsai, the attorney with Neighborhood Legal Services, said a exact client was hospitalized twice for heart problems and had a $4,000 deductible. At the same time, his wife received a $10,000 medical bill. Even though he worked full time in a factory and had employer-based insurance, his family didn't have the cash to pay for what wasn't covered.

"What are you going to do, squeeze water out of a stone?" Tsai said.

Last year, the national average annual premium for workers was $7,739 for an individual and $22,221 for family coverage, according to the Kaiser Family Foundation. Much of the cost for increasing premiums has been swallowed by employers, but it gets passed down to employees anyway. When health costs increase, wages stagnate, said Laurel Lucia, director of health care at the UC Berkeley Labor Center.

"Many workers probably don't realize that family premiums have exceeded $20,000 a year. To put that in perspective, that's equivalent to the employer and the worker getting together each year and buying a new car every year," Lucia said.

Labor union officials signed on as staunch supporters of the Office of Health Care Affordability early in negotiations, largely to tackle wage growth.

"When we get to the bargaining table, health care costs are the number one issue," said Steve Smith, communications director for the California Labor Federation. "It's awfully difficult to get wage gains when health care is eating up so much of overall compensation."

The office has the potential to benefit both employers paying high premiums and workers struggling to make ends meet, said Bill Kramer, executive director for health policy at the Purchaser Business Group on Health, which represents employers. "This is not just a health care costs bill. This is really a jobs and wages bill."

CALmatters.org is a nonprofit, nonpartisan media venture explaining California's policies and politics.

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