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Health care or housing? More states are using Medicaid funds to help the homeless

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In some states, the line between housing and health care is becoming increasingly blurred.

The Medicaid program is intended to offer government assistance with medical expenses for those with low incomes. Yet in at least 20 states, some of those funds are being allocated to social services — including housing support for the homeless.

While some tout the move as a means of alleviating the health conditions that can arise from poor living conditions, others say the funding will not solve the underlying problems.

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The federal government oversees the Medicaid program, yet each state can set its own benefits and eligibility requirements.

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“States have broad flexibility in their Medicaid programs to create a program that is unique,” said Dr. Marc Samuels, founder and CEO of ADVI Health, a health care and life sciences advisory and consulting services firm headquartered in Washington, D.C. 

In some states, Medicaid funds are being directed toward housing support for the homeless. (iStock)

“In general, states look to aid in housing on a temporary basis in an effort to focus on social determinants of health/population-based issues around serious mental illness or substance abuse disorders, and those with disabilities or receiving long-term care, high-risk pregnancy, or with a history of chronic homelessness,” he told Fox News Digital.

Which states offer Medicaid-funded housing?

At least 20 states today cover housing support services under their Medicaid program, according to the National Academy of State Health Policy (NASHP).

“There are five states — Arizona, California, New York, Oregon and Washington — that have received the approval from the federal government to cover short-term housing assistance through their Medicaid program using a specific type of waiver from the federal government (section 1115 demonstration waiver),” NASHP said in a statement provided to Fox News Digital.

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“States have broad flexibility in their Medicaid programs to create a program that is unique.”

States can also offer this type of coverage through a program called Money Follows the Person.

This program “facilitates rebalancing states’ long-term care services and supports from institutional to community-based care,” the agency said.

A homeless woman begs for money along a city sidewalk. Her sign reads, “Homeless & Hungry – Please help. Thank you.” (Getty Images)

California has unveiled the most ambitious plan so far for state-funded housing support

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In 2022, Gov. Gavin Newsom announced a $12 billion, five-year plan to revamp its Medicaid program — called Medi-Cal — to include a range of social services outside the scope of medical care.

Those non-traditional services, officially called “in lieu of services,” include housing deposits, moving costs and rent, according to the state’s Health and Human Services Agency website.

California’s non-traditional medical services are officially called “in lieu of services.”

Nearly all the state’s public and private managed care health insurers participating in Medi-Cal will cover housing-related expenses.

In Sept. 2023, the Oregon Health Authority submitted a proposal for expanded Medicaid benefits that would include six months of rent assistance. If approved, the housing support would be available starting in Nov. 2024.

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Arizona’s Medicaid program — the Arizona Health Care Cost Containment System (AHCCCS) — also offers funds for a “limited number of housing units” for members, according to the state’s health services website.

Non-traditional services — officially called “in lieu of services” in California — include housing deposits, moving costs and rent. (iStock)

Arkansas, Massachusetts, Hawaii, New Jersey and Washington are among the other states that have launched Medicaid initiatives targeting homelessness, according to the National Academy of State Health Policy (NASHP).

Last month, New York was approved for a Medicaid expansion that will include housing support — and additional states are expected to follow suit.

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Link between housing and health

Proponents of this funding believe there is a direct connection between housing and health.

The Medicaid and CHIP Payment and Access Commission (MACPAC), a non-partisan federal agency that makes recommendations to Congress about Medicaid programs, stated in a 2018 brief that “poor housing conditions can worsen health outcomes related to infectious and chronic disease, injury and mental health, and may also affect childhood development through exposure to harmful toxins such as lead.”

The agency added that people experiencing homelessness or housing instability may struggle to get health care for routine visits as well as necessary medical treatments.

“Data suggest that among those who are chronically homeless, the provision of supportive housing … led to a decrease in emergency department use,” MACPAC wrote in the brief.

While some tout the move to use Medicaid funds for housing as a way to alleviate the health conditions that can arise from poor living conditions, others say the funding will not solve the underlying problems. (iStock)

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Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said he does not think that providing housing is the answer to homelessness.

“It is a huge money drain on the state and it doesn’t solve the underlying problems of chronic mental health issues, excess drug use and the spread of infectious disease — not to mention the unemployment that drives all of it,” he told Fox News Digital.

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Siegel pointed out that housing in California is not currently affordable — an issue that affects everyone, not just the homeless.

“Using Medicaid to finance housing for the homeless bypasses the blue-collar workers who can’t really afford housing either,” he said.

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The doctor does believe that shelter is a health issue, however.

“The vast majority of health variations are driven by factors completely unrelated to health care.”

“Without shelter, you are prone to many more medical issues, including dehydration, exposure to the elements, contagious diseases, malnutrition, drug use and the impact of mental illness,” he said.

“I like the New York City shelter system, which has worked well over the last three decades,” Siegel added. “It is starting to struggle now because of the influx of migrants with nowhere to go — which also represents part of the public health crisis.”

“Using Medicaid to finance housing for the homeless bypasses the blue-collar workers who can’t really afford housing either,” said Dr. Marc Siegel. (iStock)

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Other doctors, however, said they are supportive of Medicaid funding going to housing costs. 

“Many people think of health care as what happens in a doctor’s office, hospital or pharmacy — but what I can do for my patients as a doctor can quickly be undone if they don’t have food to eat or a roof over their heads,” said Colin Banas, M.D., chief medical officer for DrFirst, a health care technology company in Maryland.

“It’s refreshing to see that states such as California, Arizona, Oregon and Arkansas are allocating Medicaid funding in innovative and practical ways, especially as people experiencing homelessness are nearly twice as likely to have diabetes or experience heart attacks, according to the CDC,” he told Fox News Digital. 

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Rather than using “scarce resources” for housing instead of traditional health care, Banas said he believes that an “additive approach” is ideal. 

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“Programs addressing homelessness should help us learn where interventions can have the greatest impact,” he said.

Homeless people stand with their belongings in front of an outpatient mental health clinic in Los Angeles, California, on Dec. 6, 2022. (FREDERIC J. BROWN/AFP via Getty Images)

Scott Shipman, M.D., executive director of the Institute for Population Health at Creighton University in Omaha, Nebraska, said the association of secure housing with better health is “widely understood.”

In an email to Fox News Digital, Shipman referred to Medicaid-funded housing as “a means of achieving better, and more stable, health while curtailing a vicious, often multigenerational cycle of costly recurring physical and mental health services that are exacerbated by prolonged housing insecurity.”

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When state governments pursue housing coverage through Medicaid waivers, they get a match of federal funding, Shipman noted. 

“These programs do not shift funding away from medical services in favor of housing, but rather attract additional resources to meet housing needs, typically for those whose health is most directly at risk due to inadequate housing,” he said.

Shipman called for investments in addressing community-level social needs rather than simply pouring more money into “shiny new medical care technology,” which he said will lead to “overspending and disappointing results.”

“It doesn’t solve the underlying problems of chronic mental health issues, excess drug use and the spread of infectious disease.”

“The vast majority of health variations are driven by factors completely unrelated to health care,” he added.

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To qualify for housing assistance, people must meet certain needs-based health criteria, including serious mental illness, disability, pregnancy or homelessness, according to NASHP.

Fox News Digital reached out to the Centers for Medicare & Medicaid Services as well as several state health agencies for additional comment.

For more Health articles, visit www.foxnews.com/health.

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Melissa Joan Hart, 49, Opens up About Weight Loss in Perimenopause

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Melissa Joan Hart, 49, Opens up About Weight Loss in Perimenopause


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Alzheimer’s prevention breakthrough found in decades-old seizure drug

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Alzheimer’s prevention breakthrough found in decades-old seizure drug

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A drug that has long been used to treat seizures has shown promise as a potential means of Alzheimer’s prevention, a new study suggests.

The anti-seizure medication, levetiracetam, was first approved by the FDA in November 1999 under the brand name Keppra as a therapy for partial-onset seizures in adults. The approval has since expanded to include children and other types of seizures.

Northwestern University researchers recently found that levetiracetam prevented the formation of toxic amyloid beta peptides, which are small protein fragments in the brain that are commonly seen in Alzheimer’s patients.

The medication was found to prevent the formation of amyloid-beta 42 in both animal models and cultured human neurons, according to the study findings, which were published in Science Translational Medicine.

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The effect was also seen in post-mortem human brain tissue obtained from individuals with Down syndrome, who are at high risk for Alzheimer’s disease.

The medication was found to prevent the formation of amyloid-beta 42 in both animal models and cultured human neurons. (iStock)

“While many of the Alzheimer’s drugs currently on the market, such as lecanemab and donanemab, are approved to clear existing amyloid plaques, we’ve identified this mechanism that prevents the production of the amyloid‑beta 42 peptides and amyloid plaques,” said corresponding author Jeffrey Savas, associate professor of behavioral neurology at Northwestern University Feinberg School of Medicine, in a press release. 

“Our new results uncovered new biology while also opening doors for new drug targets.”

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The brain is better able to avoid the pathway that produces toxic amyloid‑beta 42 proteins in younger years, but the aging process gradually weakens that ability, Savas noted. 

“This is not a statement of disease; this is just a part of aging. But in brains developing Alzheimer’s, too many neurons go astray, and that’s when you get amyloid-beta 42 production,” he said. 

The effect was also seen in post-mortem human brain tissue obtained from individuals with Down syndrome, who are at high risk for Alzheimer’s disease. (iStock)

That then leads to tau (“tangles”) — abnormal clumps of protein inside brain neurons — which can kill brain cells, trigger neuroinflammation and lead to dementia.

In order for levetiracetam to function as an Alzheimer’s blocker, high-risk patients would have to start taking it “very, very early,” Savas said — up to 20 years before elevated amyloid-beta 42 levels would be detected.

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“You couldn’t take this when you already have dementia, because the brain has already undergone a number of irreversible changes and a lot of cell death,” the researcher noted.

The researchers also did a deep dive into previous human clinical data to determine whether Alzheimer’s patients who were taking the anti-seizure drug had slower cognitive decline. They reported that the patients in that category had a “significant delay” in the span from cognitive decline to death compared to those not taking the drug.

“This analysis supports the positive effect of levetiracetam to slow the progression of Alzheimer’s pathology,” the researcher said. (iStock)

“Although the magnitude of change was small (on the scale of a few years), this analysis supports the positive effect of levetiracetam to slow the progression of Alzheimer’s pathology,” Savas said.

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Looking ahead, the research team aims to find people who have genetic forms of Alzheimer’s to participate in testing, Savas said.

Limitations and caveats

The study had several limitations, including that it relied on animal models and cultured cells, with no human trials conducted.

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Because the study was observational in nature, it can’t prove that the medication caused the prevention of the toxic brain proteins, the researchers acknowledged.

Savas noted that levetiracetam “is not perfect,” cautioning that it breaks down in the body very quickly.

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The team is currently working to create a “better version” that would last longer in the body and “better target the mechanism that prevents the production of the plaques.”

“You couldn’t take this when you already have dementia, because the brain has already undergone a number of irreversible changes and a lot of cell death.”

The medication’s common documented side effects include drowsiness, weakness, dizziness, irritability, headache, loss of appetite and nasal congestion.

It has also been linked to potential mood and behavior changes, including anxiety, depression, agitation and aggression, according to the prescribing information. In rare cases, it could lead to severe allergic reactions, skin reactions, blood disorders and suicidal ideation.

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Funding for the study was provided by the National Institutes of Health and the Cure Alzheimer’s Fund.

Fox News Digital reached out to the drug manufacturer and the researchers for comment.

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Seniors over 80 who eat specific diet may be less likely to reach 100 years old

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Seniors over 80 who eat specific diet may be less likely to reach 100 years old

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Older adults who avoid meat in their golden years may be less likely to reach age 100 than their meat-eating counterparts, new research suggests.

Researchers tracked more than 5,000 adults aged 80 or older who were enrolled in the Chinese Longitudinal Healthy Longevity Survey.

Between 1998 and 2018, data showed that those who did not eat meat were less likely to reach their 100th birthday than those who consumed animal products regularly.

The findings seem to contradict previous studies that have linked vegetarianism and plant-based diets to lower risks of heart disease, stroke, diabetes and obesity.

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Most evidence supporting the benefits of plant-based diets comes from studies tracking younger populations, the researchers noted. 

The findings contrast with previous research praising plant-based diets for their positive influence on heart health. (iStock)

The study, published in The American Journal of Clinical Nutrition, points to losses in muscle mass and bone density with age, shifts that can increase the risk of malnutrition and frailty in the “oldest old.”

As people enter their 80s and 90s, the nutritional priority often shifts from preventing long-term chronic diseases to maintaining day-to-day physical function, experts say.

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“The headline ‘vegetarians over 80 less likely to reach 100’ sounds surprising, because it contrasts with decades of data linking plant‑forward diets to lower chronic disease risk earlier in life,” Erin Palinski-Wade, a New Jersey-based registered dietitian, told Fox News Digital. 

“However, once you see that this research is limited to adults over the age of 80 who are also underweight — and that this link disappears with the consumption of eggs, dairy and fish — the results are less surprising.”

While diets earlier in life tend to emphasize avoiding long-term disease, older age necessitates nutrients and weight maintenance, experts say. (iStock)

In those over 80, restricting animal proteins may be less likely to promote longevity, according to Palinski-Wade, who was not involved in the study.

Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies, the nutritionist said.

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In addition to a higher tendency to be underweight, older populations also face a greater risk of bone fractures due to lower calcium and protein intake.

Potential limitations

The lower rate of vegetarians reaching 100 was only observed in participants identified as underweight, the researchers noted. No such association was found in people who maintained a healthy weight.

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Because being underweight is already linked to greater frailty and mortality risk, the researchers noted that body weight may partly explain the findings, making it difficult to determine whether diet itself played a direct role.

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Those incorporating animal-sourced products other than meat were just as likely to live to 100. (iStock)

Additionally, the shortened lifespans were not found in people who continued to eat non-meat animal products, such as fish, dairy and eggs. 

Older adults with these more flexible diets were just as likely to live to 100 as those eating meat, as these foods may provide the nutrients necessary for maintaining muscle and bone health, the researchers noted.

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“This is an observational study, so it can only show associations, and does not prove that avoiding meat directly reduces the odds of reaching 100,” Palinski-Wade added.

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The researchers suggested that including small amounts of animal-sourced foods could help older seniors maintain essential nutrients and avoid the muscle loss often seen in those who stick strictly to plants.

Eliminating all animal protein — particularly in a population that may already experience diminished hunger cues — can make it more difficult to meet adequate protein needs, potentially increasing the risk of nutrient deficiencies. (iStock)

Palinski-Wade offered some guidance for those looking to optimize nutrition later in life.

“For adults in their 80s and beyond, especially anyone losing weight or muscle, the priority should be maintaining a healthy weight and meeting protein and micronutrient needs — even if that means adding or increasing fish, eggs, dairy or well‑planned, fortified plant proteins and supplements.”

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Strict vegan or very low‑protein patterns at that age should be carefully monitored by a dietitian or clinician, with attention to B12, vitamin D, calcium and total protein, according to Palinski-Wade.

“Younger and healthier adults can still confidently use plant‑forward or vegetarian patterns to lower long‑term chronic disease risk,” she added.

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