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Leaving prison for many means homelessness and overdose. California hopes to change that

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Leaving prison for many means homelessness and overdose. California hopes to change that

Lee Reed hoped that upon leaving jail he might return to the guide labor jobs he’d labored as a youthful man.

However the 62-year-old suffered a debilitating again harm in jail, and regardless of requests for surgical procedure, approval got here solely shortly earlier than he was launched, he mentioned. It was too late. He must discover a option to have the operation after getting out.

After 25 years behind bars for assault, Reed in July returned to a remodeled San Francisco. A lot of his family members had been useless. He had no cash or residence. Despair settled in.

“I’m combating myself, combating the system, and I’m combating to do paperwork, as a result of it’s exhausting to stand up to get round. I can barely transfer,” mentioned Reed, who resides in a shelter.

Californians who depart prisons and jails quickly can have a greater likelihood of success past bars.

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In January, California turned the primary state permitted to offer some advantages beneath Medicaid (recognized right here as Medi-Cal) to incarcerated people. The brand new advantages would begin 90 days earlier than discharge in an effort to create a easy transition to the neighborhood.

The U.S. Division of Well being and Human Companies accredited the state’s request for a waiver of long-standing federal guidelines that prevented protection of individuals behind bars.

Eligible enrollees embrace those that are pregnant or have psychological diseases, substance use issues or persistent bodily circumstances and disabilities, in addition to anybody in a juvenile facility.

“That is the primary time in historical past Medicaid can be offering protection to justice-involved people earlier than they’re launched,” Well being Secretary Xavier Becerra mentioned in an announcement. “It’s a step ahead in closing gaps in providers this under-served neighborhood experiences, and I encourage different states to comply with California’s lead.”

Becerra mentioned the Biden administration is concentrated “on increasing entry to healthcare throughout the nation and doing so with fairness in thoughts” — a pledge that dovetails with the approval of California’s request.

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Regardless of being a big enlargement of Medi-Cal and a break with previous restrictions, the transfer has drawn assist from corrections officers and conservative teams that extra usually oppose state spending applications. Some again the brand new coverage as a result of it means Washington will choose up a part of the price of inmate healthcare that’s presently borne by state and native governments.

Medi-Cal is collectively paid for by the state and federal governments, with Washington masking about 65% of California’s Medicaid spending within the 2021 fiscal yr.

“It’s all the time useful to the state price range when California can draw down federal {dollars},” mentioned Susan Shelley, vice chairman of communications for the Howard Jarvis Taxpayers Assn., a nonprofit lobbying group against elevating taxes.

Arizona, Montana, Utah, Kentucky and Vermont are amongst a couple of dozen states with pending proposals to equally change their insurance policies, and plenty of consider California is blazing a path.

“Our purpose is absolutely to enhance individuals’s well being outcomes and behavioral well being outcomes, in addition to do it in a cheap method. And, if potential, change the trajectory of somebody’s life,” mentioned Jacey Cooper, California’s Medicaid director and chief deputy director of healthcare applications on the Division of Well being Care Companies.

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Lee Reed, affected by again ache, walks to his Uber journey, supplied by the Transitions Clinic Community.

(Paul Kuroda / For The Occasions)

Almost $235 million is earmarked for the brand new initiative within the state’s proposed price range for 2023-2024 — which equates to lower than 0.2% of the roughly $139 billion whole annual Medi-Cal spending.

The accredited waiver additionally provides $410 million that correctional services, county behavioral well being businesses and community-based suppliers can have out there for planning efforts and creating infrastructure to implement the applications, mentioned state well being care officers.

Even those that assist the experiment stress that its success will rely on how it’s carried out.

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Incarcerated individuals returning to the neighborhood face a slew of challenges, together with life-threatening well being dangers. Stress surges as they search to safe housing, discover a job, entry healthcare and reconnect to household and the material of social life. Many are concurrently battling psychological sickness and drug habit which can be troublesome to handle when there’s a spot in therapy.

The potential for peril is especially acute within the interval instantly after launch. The chance of demise within the first two weeks could be greater than 12 occasions larger than in the overall inhabitants, a 2007 research discovered — a grim statistic pushed by drug overdoses, suicide, murder and heart problems.

Beneath California’s new coverage, Medi-Cal will cowl substance use therapy for eligible incarcerated individuals whereas they’re inside and join them to a community-based supplier earlier than they’re launched to allow them to proceed getting care, in line with federal officers. It additionally permits for sure psychological well being interventions, together with entry to long-acting, injectable anti-psychotic medicines.

As a situation of the approval, California is required to extend the quantity it pays Medi-Cal suppliers for obstetrics and first care. The state’s proposed price range allots roughly $22 million for the speed will increase.

Previous to the approval, California rolled out reforms that didn’t require permission from the federal authorities.

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For the reason that begin of this yr, anybody who enters a California jail, jail or juvenile facility should be screened and enrolled in Medi-Cal, if eligible; state officers estimate that encompasses 80% of the incarcerated inhabitants. The insurance coverage is suspended whereas they’re behind bars however could be reinstated after launch — or earlier than, in the event that they meet eligibility necessities.

A portrait of Lee Reed.

Reed, 62, who ostensibly would have been helped by this system, stays skeptical about its possibilities.

(Paul Kuroda / For The Occasions)

Though this system has drawn reward, some specialists and advocates fear that jail and jail officers will maintain an excessive amount of sway over the brand new advantages, pointing to what they are saying is commonly poor high quality of healthcare in jails and prisons. Others concern it gained’t be paired with ample funding in different elements of the fractured well being system — or will turn into a bureaucratic boondoggle.

“Simply by having Medicaid current inside these services doesn’t imply that, rapidly, jails and prisons are going to turn into this therapeutic area, nevertheless it does current the chance to enhance the standard of care that’s being positioned there — as a result of there’s oversight,” mentioned Shannon Scully, senior supervisor of prison justice coverage on the Nationwide Alliance on Psychological Sickness, which helps totally eliminating the inmate exclusion coverage.

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Dr. Shira Shavit, government director of Transitions Clinic Community, which is devoted to decreasing well being disparities for people coming back from incarceration, referred to as the coverage shift “an actual second for prevention.”

“If we intervene,” she mentioned, “we are able to hold individuals out of the hospital, hold individuals from dying, but in addition hold them from going again to jail and jail.”

Kory Honea, president of the California State Sheriffs’ Assn., mentioned success for the coverage would rely on whether or not individuals make the most of the brand new providers.

“It is a difficult inhabitants to take care of,” he mentioned. “If individuals have substance abuse points or psychological well being points, oftentimes, once they’re out of custody, they don’t avail themselves of the providers or applications that you just arrange.”

Reed — who ostensibly would have been helped by the coverage — stays skeptical that it’ll make a distinction.

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Earlier than he left jail, Reed mentioned, Social Safety Administration workers in Kings County took his data to attach him with providers. Nonetheless, he mentioned, they refused to switch any of it to San Francisco, the place he lives. (A spokesperson for the Social Safety Administration mentioned claims which can be began throughout incarceration sometimes could be transferred to a different workplace, however privateness legal guidelines prohibit dialogue of Reed’s case.)

Lee Reed pauses outside a vehicle.

“I’m combating myself, combating the system, and I’m combating to do paperwork, as a result of it’s exhausting to stand up to get round,” says Reed, who resides in a shelter.

(Paul Kuroda / For The Occasions)

And with many workers in social providers and corrections nonetheless working from residence, Reed mentioned he has felt alone as he tries to maneuver inside labyrinthine care programs.

“I actually wish to break down and cry, however I ain’t obtained the time,” Reed mentioned. “I simply need to hold pushing.”

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The California Division of Corrections and Rehabilitation, which operates state prisons, mentioned in an announcement that the plan “would offer releasing incarcerated people with entry to essential healthcare sources in the neighborhood to make sure there’s continuity of care upon launch.”

Shavit mentioned the “secret sauce” to efficiently bringing incarcerated individuals again into the neighborhood is hiring those that have completed time themselves for care groups. This strategy supplies a path to employment for the previously incarcerated and gives hope within the neighborhoods the place the groups work — usually low-income communities of colour with few sources, mentioned Joe Calderon, who spent almost twenty years behind bars and now trains previously incarcerated neighborhood healthcare staff on the Transitions Clinic Community.

“How can we lower your expenses, however extra importantly, save lives and add high quality of life to a neighborhood that’s traditionally been forgotten about?” Calderon mentioned, including that he sees California’s broader healthcare reforms as a step in the precise route.

Change gained’t occur in a single day. It’s anticipated to take about three years to roll out the providers throughout the state, beginning with some county jails and juvenile services in April 2024, mentioned Cooper, with the state Division of Well being Care Companies. This system isn’t anticipated to achieve full maturity earlier than the federal waiver ends in late 2026.

The state will want time to develop steerage and dole out cash to construct wanted infrastructure, then await services to develop applications and assess whether or not they’re as much as par. Not all the applications will look the identical, and they’re going to launch in phases, Cooper mentioned.

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“It is a transformation,” Cooper mentioned. “Transformation is a course of; it’s not an occasion.”

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L.A. County reports first West Nile virus death this year

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L.A. County reports first West Nile virus death this year

A San Fernando Valley resident is the first person in L.A. County to die this year from West Nile virus, a mosquito-transmitted illness that can cause lethal inflammation in the brain.

The L.A. County Department of Public Health reported on Thursday that the patient died from neurological illness caused by severe West Nile. So far in 2024, there have been 14 confirmed cases of the virus in the county and 63 in the state, according to state and county public health departments.

“To the family and friends grieving the loss of a loved one due to West Nile virus, we extend our heartfelt condolences,” said Muntu Davis, L.A. County health officer. “This tragic loss highlights the serious health risks posed by mosquito-borne diseases, such as West Nile virus, dengue, and others.”

West Nile virus is the most common mosquito-borne disease that harms residents in L.A. County. The disease lives in infected birds and is transmitted to humans via mosquito bites.

Davis recommended Angelenos take simple steps to protect themselves from mosquito bites. This includes using insect repellent, getting rid of items that hold standing water around the home — such as flowerpots and bird baths — and using screens on doors and windows to keep mosquitoes out.

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Most people who are infected will not experience any symptoms, but 1 in 5 will suffer a fever with symptoms including:

  • headache
  • body ache
  • joint pain
  • vomiting
  • diarrhea
  • rash

About 1 in 150 people will experience more severe symptoms such as high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis, according to the World Health Organization. The Department of Public Health recommends anyone with severe symptoms call their doctor immediately.

In serious cases, the virus can cause inflammation of the brain or spinal cord, leading to permanent neurological damage or death. People older than 50 and those with health problems are at greater risk of complications, according to the Public Health Department.

The disease was first found in Africa before being discovered in the U.S. in 1999 and California in 2003. Since then the state has reported more than 300 deaths and 7,500 cases.

This year, there have also been deaths reported in Santa Clara County, Contra Costa County and Fresno County. Orange County reported its first case of West Nile in August, but so far there have been no deaths.

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

A respiratory virus that in rare cases can cause polio-like paralysis in children is on the rise in California and across the nation, according to wastewater analyses.

Enterovirus D68 was detected in 207 out of 268 samples taken from wastewater sites across the nation in the last 10 days, says the nonprofit WastewaterSCAN.

In the same time period, EV-D68 was detected at a medium level at 17 wastewater sites in California, including facilities in Los Angeles, San Diego, San Francisco, Sacramento and San Jose. Because humans shed viruses in waste, wastewater sampling is used to measure the prevalence of infection in a community.

Most people who contract EV-D68 will experience slight respiratory symptoms or none at all, according to the Centers for Disease Control and Prevention. Nevertheless, its spread is troubling because the virus can lead to a rare and debilitating neurological condition called acute flaccid myelitis, or AFM.

AFM attacks motor neurons in the spinal cord’s gray matter, which controls movement. This causes muscles and reflexes to weaken and, in severe cases, can lead to paralysis and death, according to the CDC.

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Around 90% of cases occur in children, and there is no known treatment.

Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert with the UCLA Fielding School of Public Health, told The Times that the best way to avoid contracting EV-D68 is to practice common respiratory hygiene.

“This is covering your coughs and sneezes, it’s washing hands,” he said, “If you’ve been around someone who’s coughing and sneezing … make sure that you haven’t touched contaminated surfaces that they’ve been touching or shared cups or utensils.”

This year, the CDC has confirmed 13 cases of AFM, including one in California, as of Sept. 3.

The largest known outbreak of the illness took place in 2018, when 238 cases were confirmed across the country. Cases also spiked in 2014 and 2016.

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Most cases of EV-D68 will be mild and feel like a common cold. However, children with asthma are at higher risk of experiencing more severe symptoms, according to the CDC.

Here are some common symptoms of EV-D68:

  • Runny nose
  • Sneezing
  • Cough
  • Body aches
  • Wheezing and difficulty breathing

If the virus progresses to cause AFM, symptoms include:

  • Arm or leg weakness
  • Difficulty swallowing or slurred speech
  • Difficulty moving the eyes and drooping in the eyelids and face

Kim-Farley recommends people seek medical care if they develop any evidence of paralysis or weakness in the limbs or muscles after having had a respiratory or fever-inducing illness one to two weeks prior.

The paralysis caused by AFM is very similar to that caused by polio — which, like EV-D68, is also an enterovirus.

Polio was eradicated in the Unites States in 1979, thanks to a widespread vaccination campaign, according to the CDC. Unfortunately, there is no vaccine for EV-D68.

“Even though [EV-D68] is not vaccine-preventable, it’s always a good opportunity to realize there are other diseases that cause paralysis, like polio, that are vaccine-preventable” and against which children can be inoculated, Kim-Farley said.

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He also recommended getting the latest COVID-19 vaccine.

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

Testifying Tuesday before the House Ways and Means Committee, Hall of Fame quarterback Brett Favre said in a prepared statement that he was recently diagnosed with Parkinson’s disease.

Favre, 54, was testifying about welfare abuses in Mississippi and allegations that he and others used Temporary Assistance for Needy Families state funds for personal and corporate gains. Favre, who earned about $140 million during a 20-year NFL career that ended in 2010, said in his statement that he was unaware he was receiving welfare funds and was misled by public officials.

A Mississippi state audit found that $5 million in TANF funds paid for the construction of a volleyball arena at the University of Southern Mississippi — Favre’s alma mater — and that $1.7 million was paid to Prevacus, a company developing concussion medication. Favre’s daughter was a volleyball player at Southern Mississippi at the time and Favre is an investor in Prevacus, whose founder, Jacob VanLandingham, pleaded guilty to wire fraud in July.

Favre, who has not been charged criminally, repaid $1.1 million in TANF money for speeches he never gave. The Mississippi Department of Human Services filed a civil lawsuit against him and other defendants, citing text messages between Favre and officials as evidence of his involvement in embezzling funds.

Favre, a Green Bay Packers legend, played in more than 300 NFL games and has long advocated research into concussions and resulting brain trauma. Asked on the “Today” show in 2018 how many concussions he suffered, Favre replied that he was diagnosed with “three or four” but believed the true number was far higher.

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“When you have ringing of the ears, seeing stars, that’s a concussion,” Favre said on the show. “And if that is a concussion, I’ve had hundreds, maybe thousands, throughout my career, which is frightening.”

A 2020 study published in the journal Family Medicine and Community Health determined that “regardless of age, sex, socioeconomic status and residence, having suffered a single concussion in one’s lifetime increased the likelihood of later being diagnosed with Parkinson’s disease by 57%.”

“Sadly, I also lost an investment in a company that I believed was developing a breakthrough concussion drug I thought would help others, and I’m sure you’ll understand why it’s too late for me because I’ve recently been diagnosed with Parkinson’s,” Favre told the House committee Tuesday.

Favre was portrayed in court filings in the embezzlement case as a willing participant in the scheme that allegedly diverted millions of dollars meant for the poorest people in the nation’s poorest state.

Court documents and text messages outlined his alleged involvement in diverting TANF money. Favre and then-Mississippi Gov. Phil Bryant discussed via text using $5 million to help build the volleyball arena at Southern Mississippi.

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Favre also exchanged text messages with Nancy New, executive director of the education center responsible for allocating millions in government funds.

“If you were to pay me, is there any way the media can find out where it came from and how much?” Favre reportedly asked her in 2017.

New, who later pleaded guilty to 13 felony counts of fraud, bribery and racketeering for her role in the theft of TANF funds, replied: “We never have that information publicized.”

Journalist Anna Wolfe of Mississippi Today revealed the payouts in a Pulitzer Prize-winning series of articles starting in April 2022.

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