$12 Billion Plan Proposed For Housing California’s Homeless

California Gov. Gavin Newsom’s suggested plan includes building 46,000 housing units. Separately, reports say San Francisco is losing care facilities for the mentally ill; the EPA says the water in Jackson, Mississippi, is safe; and Louisiana moves toward legal marijuana.

AP:
California Governor Proposes $12B To House State’s Homeless

Buoyed by a large budget surplus and swimming in federal pandemic recovery money, California Gov. Gavin Newsom on Tuesday proposed $12 billion to get more people experiencing homelessness off the streets and into homes of their own. Newsom’s proposal includes $8.75 billion over two years to create an estimated 46,000 housing units, expanding on a program he launched last year to convert motels and other properties into housing. Nearly half the money would go toward housing in places where people with mental health and other behavioral issues can get services onsite. (Watson and Har, 5/12)

San Francisco Chronicle:
S.F. Is Rapidly Losing Care Facilities For The Mentally Ill And Elderly. But A Plan To Save Them Is Promising

In San Francisco, the number of assisted living facilities for seniors and adults with disabilities dropped 38% since 2012, with beds dropping 17%, according to city reports. Hardest hit were the smallest facilities serving low-income residents. At least 100 people were waiting to get a spot in a facility, according to the most recent count. Advocates say the shortage means more people are sent out of county, which is hard for families, or end up on the streets. “If we are serious about ending homelessness for seniors and people with disabilities, we need residential care facilities,” Supervisor Rafael Mandelman said. (Moench, 5/11)

Axios:
Tennessee Governor Orders End To Federal COVID Unemployment Benefits 

Tennessee Gov. Bill Lee (R) announced Tuesday that his state will withdraw from federally funded pandemic unemployment benefits on July 3. Tennessee joins a growing list of states with Republican governors that are turning down the federal benefits citing worker shortages. Some experts say, however, it’s the job climate and not unemployment benefits that is determining when and how people return to work. (Saric, 5/11)

The Baltimore Sun:
Audit Finds Maryland Health Benefit Exchange Has Continued Problems In Verifying Some Applicants’ Medicaid Eligibility 

For the second time in three years a state audit of Maryland’s health insurance exchange system found continued problems in the program’s verification of some applicants’ income to determine their eligibility for Medicaid over a three-year period. A 2018 audit of the quasi-governmental agency that oversees the Maryland health exchange found similar problems with Medicaid eligibility screenings over fiscal years 2015 to 2017. (Miller, 5/11)

The Washington Post:
Prosecutor To Seek Hate-Crime Charges Against White Man Accused In Atlanta-Area Spa Killings

Prosecutors say they will seek the death penalty and hate-crime charges against the White man accused of fatally shooting eight people — mostly Asian women — in a March rampage across Atlanta-area spas that authorities are calling domestic terrorism. Robert Aaron Long, 22, was indicted on murder charges Tuesday by grand juries in Fulton County and Cherokee County, where authorities say Long fired on employees and customers at three Asian-run businesses. (Knowles and Willis, 5/11)

North Carolina Health News:
After Tragedy, Families Want Stronger Good Samaritan Law 

Members of five families, united in grief from a common experience, made a heartbreaking trek to Raleigh on Tuesday to talk to their legislators. Their common experience is one that no family should have to endure – the loss of a beloved child. What’s worse for these families is knowing that someone had been with their son or daughter as they neared death. In each case, their friends ran away, fearful of getting into trouble because their friend had overdosed on an opioid or because they all were drinking alcohol under the legal age. (Hoban, 5/12)

AP:
UPS Drivers Plan Action Against Company In Auburn

United Parcel Service drivers represented by the Teamsters union are planning to picket at a distribution hub in Maine. The 80 to 100 drivers based in Auburn are protesting about being overworked during the pandemic, said Brett Miller, president of Local 340. The goal is to get the attention of management, he said. “They are working Christmas hours and they’ve been doing this for 14 months straight. They’re wearing down,” he said. (5/12)

Mississippi Clarion-Ledger:
EPA To Jackson, Mississippi: Water Safe To Drink Despite Problems

Officials with the Environmental Protection Agency on Tuesday spelled out significant concerns with the city’s water system, including necessary fixes to maintain safe drinking water, following the worst water crisis Jackson has seen in recent history. EPA administrators in their first public appearance with city officials said it will take both short-term and long-term fixes to remedy the system, a prospect that will require millions of dollars of funding. The visit follows an inspection by the federal agency, along with the state Department of Health, in February of last year that found several severe violations at the city’s two water treatment plants, the O.B. Curtis Water Treatment Facility and the J.H. Fewell Water Treatment Facility. (Vicory, 5/11)

The Advocate:
Bill To Decriminalize Small-Time Marijuana Possession OK’d By Louisiana House; Next Up: Senate

The Louisiana House has approved a bill to decriminalize the possession of small amounts of marijuana, taking away the possibility of jail time and reducing the maximum penalty to a $100 fine for possession offenses. The move, on a 67-to-25 vote Tuesday, would represent a significant step in the effort to loosen Louisiana’s prohibition on marijuana. If approved by the Louisiana Senate, where the legislation heads next, and Gov. John Bel Edwards, Louisiana would become the latest in a string of states to eliminate the possibility of jail time for people caught with small amounts of marijuana. (Karlin, 5/11)

The Advocate:
Proposal To Limit, Ban Doctor Non-Competes Moves Forward; Here’s What’s Next In The Process

The state House on Tuesday approved legislation to roll back the use of noncompete agreements for doctors, amid a fierce battle between Ochsner Health System, which is fighting the bill, and doctors groups and other hospital systems pushing for it. The House voted 56-38 to approve House Bill 483, by Rep. Mark Wright, to restrict the use of noncompete provisions for doctors. Members voted 68-23 for another bill by Rep. Larry Bagley, R-Stonewall, to ban their use entirely for public employees – a bill that arose out of LSU Health Shreveport’s use of the provisions at that public institution, which is run in conjunction with Ochsner. House Speaker Clay Schexnayder voted in favor of both bills. (Karlin, 5/11)

KHN:
Don’t Eat The Yellowstone Snow: Elite Ski Resort Aims To Turn Sewage Into Powder

An exclusive Montana resort wants to turn sewage into snow so that its rich and famous members can ski its slopes in a winter season that’s shrinking because of climate change. The Yellowstone Club — a ski and golf resort just north of Yellowstone National Park that counts Bill Gates, Justin Timberlake and Jessica Biel among its members — has asked the Montana Department of Environmental Quality for a permit to allow it to use wastewater for snowmaking operations on its ski slopes. (Franz, 5/12)

And in updates on the opioid trial in West Virginia —

Charleston Gazette-Mail:
Data Analyst Says Potency Of Opiates Shipped Increased Over Time, Defense Questions His Credibility

Drug wholesalers accused of fueling the opioid epidemic by shipping millions of opiates to Cabell County over a nine-year period continued to blame federal regulators in court Tuesday and attempted to discredit years of work completed by a data analyst. The city of Huntington and Cabell County argued that the defendants — AmerisourceBergen Drug Co., Cardinal Health Inc. and McKesson Corp. — became culpable when 127.9 million opiate doses were sent to the county from 2006-14. When the number of shipped doses decreased around 2012, users turned to illicit opiate drugs, such as heroin, the plaintiffs said. (Hessler, 5/11)

Originally Appeared Here

By Rose Hoban

Members of five families, united in grief from a common experience, made a heartbreaking trek to Raleigh on Tuesday to talk to their legislators.

Their common experience is one that no family should have to endure – the loss of a beloved child. What’s worse for these families is knowing that someone had been with their son or daughter as they neared death. In each case, their friends ran away, fearful of getting into trouble because their friend had overdosed on an opioid or because they all were drinking alcohol under the legal age and Boone had passed out.

“The kids knew, but they really just didn’t want to get him into trouble,” said Julie Cummins, mother of Boone Cummins who died in July 2017.

Boone, 18 at the time, was with friends at Sugar Lake, an old quarry near Pittsboro when he passed out after taking Xanax and drinking. His friends left him behind.

“They were texting and they were Snapchatting,” Boone’s mom said, her eyes filling up with tears as she spoke. “And there’s a big record of how many people knew where he was, how messed up he was, and they just kept saying, ‘just pass out, go to sleep, just pass out and go to sleep, you know.’ And he ended up, he ended up passing out and, and drowning.”

Boone’s body was found at the bottom of the lake several days later. He’d drowned after likely stumbling into the water and being too impaired to save himself.

Stronger Good Samaritan

Cummins and the other family members standing in front of the legislative building on Jones St. in Raleigh want lawmakers to reduce the potential penalties for someone who might call emergency services to assist someone who has overdosed.

Currently, the law reads that a person who’s with someone who has overdosed cannot be prosecuted for calling for help. But the “Good Samaritan” could still potentially be arrested or charged for possession of illegal drugs or alcohol in the process of rendering help.

A new bill would reduce the fear people have of getting in trouble for doing the right thing by calling 911.

“There can’t be any question when people are together and someone overdoses of whether or not they should dial 911,” said Randy Abbott, whose daughter Vanessa was 24 years old in 2015 when she overdosed while at a party. Her friends panicked.

“We know they panicked, and we know the things that happened when they panicked, like getting stuff out of the house, putting it in her car, lots of different things that the detectives were able to figure out,” Abbott said. “But they didn’t dial 911.”

Confusing messaging

North Carolina passed its first harm reduction Good Samaritan law in 2013, when lawmakers approved a law to permit people who are “acting in good faith” to seek medical help for someone who is overdosing without fear of being prosecuted for possessing small amounts of drugs. That Good Samaritan law also made it possible to distribute naloxone, a drug that can be used to reverse an opioid overdose.

But police can still collect evidence at the scene to help with the prosecution of “other crimes” possibly committed by the caller. Those crimes could include possession of more than a gram of illegal drugs on the assumption that possession means there was an intent to sell. And police could also still arrest and charge someone who is with an overdosing friend if they found enough evidence.

“If people fear that they’re still going to be arrested, the idea that they’re protected from prosecution doesn’t necessarily feel all that helpful,” said Lee Storrow, head of the North Carolina AIDS Action Network.

Other states, including Southern states, have streamlined their Good Samaritan laws, protecting everyone at the scene from arrest, charges and prosecution in an effort to simplify the messaging and save lives.

This bill would still allow for prosecution of people who intend to distribute illegal drugs, Storrow said, and the language was crafted so that the state district attorneys’ association has no objection to the bill in its current form.

Storrow says that nonetheless, the current bill is too confusing, the risk of arrest and prosecution is too great and people are still too afraid to make the call.

That’s why Bridget O’Donnell, younger sister of Sean O’Donnell who drank too much and drowned in the same quarry as Boone Cummins only weeks before, has started speaking at local high schools to let kids know to do the right thing.

“We’ll have the sheriff tell us that kids said they heard our speech,” she said. “That’s how they knew about the law.”

“Public health leaders and criminal justice leaders have wanted to be able to educate about the law and they just feel like our current law is too complicated,” Storrow said. “They want to be able to say ‘Right, if you are with someone who overdoses call 911, and you’ll be protected from arrest, charging and prosecuting.’”

Overdose numbers remain high

Since the passage of that 2013 bill, the North Carolina Harm Reduction Coalition has tracked thousands of “saves,” where someone called for help in time to save the life of someone who had taken too much.

But even with the Good Samaritan bill and increased naloxone distribution, North Carolina has seen a steady increase in the number of overdose deaths over the past decade. The arrival of the potent opioid fentanyl, which is often laced into heroin and other drugs, has made it easier to overdose.

“Fentanyl wasn’t even on the radar when the law was written,” Storrow said.

Overdose rates had started to level off in 2019, but during the pandemic those numbers ticked up again. Preliminary state data from 2020 shows a 23 percent increase in overdose-related emergency room visits over the previous year.

In 2020, the harm reduction coalition distributed 25,062 naloxone kits across the state. And according to coalition executive director Jesse Bennett, there were 3,241 successful overdose reversals and 30 unsuccessful attempts reported to the coalition over the course of the year.

Time is short for the bill, though. It took weeks of negotiating and work to get it into shape for introduction and now needs to get passed through the House floor before a parliamentary deadline of midnight Thursday.

On Tuesday evening, Several Republican lawmakers expressed pessimism there was time to get it into shape to be agreeable to leadership.

“We knew this bill had a tight time frame with being introduced so close to the crossover deadline,” Storrow said. “Even if it doesn’t make crossover, we’ll explore other options to pass it this session.”

Originally Appeared Here

TUESDAY, May 11, 2021 (HealthDay News) — Maintaining adequate social distance from strangers — a key COVID-19 preventive measure — can be tough when you’re drinking alcohol, researchers say.

In a new study, the researchers put more than 200 young social drinkers in different social situations in laboratory settings. They drank either alcoholic or nonalcoholic beverages.

In half of the cases, participants drank with a friend, said research leader Catharine Fairbairn, professor of psychology at the University of Illinois Urbana-Champaign. The other half drank with a stranger.

Those who had alcoholic beverages were given enough to make them intoxicated.

Friends tended to draw close to one another whether or not they consumed alcohol, but “participants interacting with a stranger only moved closer to that individual if they were intoxicated. The physical distance between these pairs decreased by about 1 centimeter [nearly half an inch] per three-minute interval,” Fairbairn said in a university news release.

Those who drank nonalcoholic beverages with strangers did not draw significantly closer to one another, the researchers noted.

According to study lead author Laura Gurrieri, a psychology researcher at the university, “This study shows that over time, alcohol reduces physical distance between people who are not previously acquainted. This finding is particularly important in the context of the COVID-19 pandemic because it suggests that alcohol might facilitate virus transmission and impede the following of social distancing guidelines.”

The study participants’ ability to move closer to one another was somewhat limited because they sat across from one another at a table, and the study was conducted in a quiet, spacious laboratory and not a bar, Fairbairn said.

“Folks would likely draw even closer to one another in a crowded bar with loud music when compared with our laboratory environment,” she said. “That would have to be the subject of another study.”

The report was published May 10 in the journal Proceedings of the National Academy of Sciences.

To prevent COVID-19 transmission, it’s recommended that you stay 6-feet apart from people who don’t live with you.

More information

The U.S. Centers for Disease Control and Prevention has more on social distancing.

SOURCE: University of Illinois Urbana-Champaign, news release, May 10, 2021

Originally Appeared Here

A court battle is likely in the state’s future after the Missouri Senate last week voted against paying to expand the state’s Medicaid program, scheduled to roll out July 1 after a majority of the state’s voters approved the constitutional amendment in 2020.

At this stage, it is unclear what will happen this summer as those newly eligible for the program seek coverage.

“As elected officials, we have a responsibility and that is to uphold our oath to the Constitution, but also the will of the people,” State Sen. Brian Williams (D-St. Louis) said.

“So, it’s very frustrating and disappointing that we didn’t fully fund Medicaid expenditures.”

The Senate voted April 28 after hours of debate. The funding failed to pass, with a vote of 14-20 to reject — four Republicans broke ranks with the rest of their party and voted in favor of funding the expansion.

The Missouri House had previously separated the expansion funding and passed the budget bill without it.

“I feel like my…” – Dr. Heidi Miller

“I feel like my hands are tied and I cringe when I see patients incur negative and long-term consequences from medical conditions that could have been prevented.” —Dr. Heidi Miller

Williams noted that the fate of the expansion is now in the hands of Gov. Mike Parson, as lawmakers are required to present a budget to the governor by Friday, May 7.

Williams said that even though the House and Senate voted to exclude expansion funding, Parson could decide to include funding in the budget. It will then go back to the General Assembly where lawmakers will work on a solution.

Parson has previously said he doesn’t support expanding Medicaid, but he supports funding the expansion because it is the will of the voters.

Robin Rudowitz, Kaiser Family Foundation vice president and co-director for the Program on Medicaid and the Uninsured, said the state of Maine experienced the longest lag between voters approving Medicaid expansion and its implementation. Former Gov. Paul LePage vetoed a $55 million Medicaid expansion bill in June 2018. It was not implemented until January 2019, when new Gov. Janet Mills took over.

“I think Missouri is unique —because the ballot measure was a constitutional amendment and not a state legislative change,” she said.

“There have been a number of states that have adopted the expansion through ballot measure, and it hasn’t always been a straightforward process in implementing.”

She noted that Oklahoma currently is in the middle of implementing Medicaid expansion as well, and is the only other state that did so through an amendment to the state’s constitution.

Because expansion was not implemented prior to the American Rescue Act, Missouri should receive about $2.8 billion in federal funding.

The expansion would cover working-age adults who earn up to 138 percent of the federal poverty guideline, or $17,774 a year for a single person.

That is equal to working about 33 hours a week at the state minimum wage of $10.30 per hour.

For a household of four, the limit is $36,570, the income of one person working full time at $17.58 an hour or two people working a combined 68 hours a week at minimum wage.

Without expansion, Missouri has one of the most restrictive Medicaid eligibility levels for parents and childless adults in the nation, according to the Missouri Budget Project. As it stands, the program provides coverage for low-wage parents earning no more than $388 per month for a family of three, the lowest level allowed under federal law and the third-lowest eligibility level in the nation.

“I feel like my hands are tied and I cringe when I see patients incur negative and long-term consequences from medical conditions that could have been prevented,” Dr. Heidi Miller said about her uninsured patients.

“… I know that we need to be stewards of our limited resources and so when I see our system is designed to pick up the tab for a very costly hospitalization, but not for the very affordable preventable steps, I feel really sad for our patients and this state.”

Miller has practiced internal medicine as a primary care doctor since 2013 at Family Care Health Centers, one of the Federally Qualified Health Centers in St. Louis. She also serves as Regional Health Commission medical director.

She said most of her patients are employed and fall in the coverage gap — meaning their income is too low to be eligible for premium tax credits, but too high to qualify for Medicaid coverage.

“Patients are hyper aware of their ability to access care or not, and if they don’t access care, they neglect their health and when you neglect your health you can have catastrophic outcomes,” she said.

Originally Appeared Here

MONDAY, May 10, 2021 (HealthDay News) — The number of applicants and number of applications submitted per applicant to internal medicine (IM) residency and most subspecialty fellowships for 2021 were higher than in previous application cycles, according to a research letter published online April 28 in JAMA Network Open.

Laura A. Huppert, M.D., from the University of California at San Francisco, and colleagues used Electronic Residency Application Service application data (2016 to 2021) for IM residency and 11 subspecialty fellowships to assess the impact of the COVID-19 pandemic compared with the five prior application cycles.

The researchers found that for IM residency, the number of applicants increased every year, from 21,947 applicants in 2016 to 24,509 applicants in 2021. There was a 6.0 percent annual increase from 2020 to 2021, which was more than twice the rate of annual increase in any prior year studied. With the exception of gastroenterology for 2020 to 2021, the number of applicants for IM subspecialty fellowships increased for all subspecialties between 2016 and 2021 (with year-to-year variation) and between 2020 and 2021. In 2021, the mean number of applications submitted per applicant increased for all programs, except geriatric medicine.

“We hypothesize that the increase in the number of applicants may be associated with a lower barrier to apply because of decreased time and costs related to virtual interviews or because fellowship training offered more short-term job security in the setting of widespread hiring freezes,” the authors write.

Abstract/Full Text

Originally Appeared Here

Genesis MedTech, a medical device company, is working to get its articulating laparoscopic devices to China and Singapore.

It recently signed a strategic distribution deal with Korean medical device firm LivsMed to market its ArtiSential instruments, which were first brought to South Korea in 2018.

WHAT IT’S FOR

The ArtiSential series of articulating laparoscopic instruments provide users with fully articulating, wristed motion during laparoscopic surgery. What makes the device different from conventional laparoscopic instruments is its ergonomic design, having a double joint structure which allows 360 multi-degree motion. It serves as an extension of the surgeon’s arm into a surgical site, intuitively mimicking the movement of the user’s hand, wrist and fingers.

WHY IT MATTERS

The latest laparoscopic technology enables access to narrow surgical sites and precision surgery. It is particularly helpful for difficult suturing and dissection cases in tight spaces under complicated tissue structures, especially those around important vessels and organs.

With 150 working end-effectors with three different lengths, the ArtiSential devices can be used for various surgical operations different professional fields such as general surgery, thoracic, urology, or gynaecology.

THE LARGER TREND

Minimally invasive surgical instruments have not changed much since their introduction in the past three decades, LivsMed CEO Jung Jee Lee notes.

The latest technologies in this space are surgical robotics, introduced by developers such as CMR Surgical with its Versius Surgical Robotic System and Intuitive with its da Vinci Xi HD 4 arm robotic system. The market for such products was valued at $5.1 billion in 2017 and estimated to grow to $12.6 billion by 2025.

ON THE RECORD

“With this new technology, surgeons can now perform more minimally invasive surgery over open surgery, despite procedures being more challenging, which translates to lesser patient risks and faster recovery time,” Genesis MedTech Chairman and CEO Warren Wang said.

Originally Appeared Here

SACRAMENTO, Calif. — California Gov. Gavin Newsom has embraced Silicon Valley tech companies and health care industry titans in response to the covid-19 pandemic like no other governor in America — routinely outsourcing life-or-death public health duties to his allies in the private sector.

At least 30 tech and health care companies have received lucrative, no-bid government contracts, or helped fund and carry out critical public health activities during the state’s battle against the coronavirus, a KHN analysis has found. The vast majority are Newsom supporters and donors who have contributed more than $113 million to his political campaigns and charitable causes, or to fund his policy initiatives, since his first run for statewide office in 2010.

For instance, the San Francisco-based software company Salesforce — whose CEO, Marc Benioff, is a repeat donor and is so tight with the governor that Newsom named him the godfather of his first child — helped create My Turn, California’s centralized vaccine clearinghouse, which has been unpopular among Californians seeking shots and has so far cost the state $93 million.

Verily Life Sciences, a sister company of Google, another deep-pocketed Newsom donor, received a no-bid contract in March 2020 to expand covid testing — a $72 million venture that the state later retreated on. And after Newsom handed another no-bid testing contract — now valued at $600 million — to OptumServe, its parent company, national insurance giant UnitedHealth Group dropped $100,000 into a campaign account he can tap to fight the recall effort against him.

Newsom’s unprecedented reliance on private companies — including health and technology start-ups — has come at the expense of California’s overtaxed and underfunded public health system. Current and former public health officials say Newsom has entrusted the essential work of government to private-sector health and tech allies, hurting the ability of the state and local health departments to respond to the coronavirus pandemic and prepare for future threats.

“This outsourcing is weakening us. The lack of investment in our public health system is weakening us,” said Flojaune Cofer, a former state Department of Public Health epidemiologist and senior director of policy for Public Health Advocates, which has lobbied unsuccessfully for years for more state public health dollars.

“These are companies that are profit-driven, with shareholders. They’re not accountable to the public,” Cofer said. “We can’t rely on them helicoptering in. What if next time it’s not in the interest of the business or it’s not profitable?”

Kathleen Kelly Janus, Newsom’s senior adviser on social innovation, said the governor is “very proud of our innovative public-private partnerships,” which have provided “critical support for Californians in need during this pandemic.”

State Health and Human Services Secretary Dr. Mark Ghaly echoed the praise, saying private-sector companies have filled “important” roles during an unprecedented public health crisis.

The state’s contract with OptumServe has helped dramatically lower covid test turnaround times after a troubled start. Another subsidiary of UnitedHealth Group, OptumInsight, received $41 million to help California rescue its outdated infectious disease reporting and monitoring system last year after it crashed.

“Not only are we much better equipped on all of these things than we were at the beginning, but we are also seeing some success,” Ghaly said, “whether it’s on the vaccination front, which has really picked up and put us in a place of success, or just being able to do testing at a broad scale. So, I feel like we’re in a reasonable position to continue to deal with covid.”

The federal government finances most public health activities in California and significantly boosted funding during the pandemic, but local health departments also rely on state and local money to keep their communities safe.

In his first year as governor, the year before the pandemic, Newsom denied a budget request from California’s 61 local public health departments to provide $50 million in state money per year to help rebuild core public health infrastructure — which had been decimated by decades of budget cuts — despite warnings from his own public health agency that the state wasn’t prepared for what was coming.

After the pandemic struck, Newsom and state lawmakers turned away another budget request to support the local health departments driving California’s pandemic response, this time for $150 million in additional annual infrastructure funding. Facing deficits at the time, the state couldn’t afford it, Newsom said, and federal help was on the way.

Yet covid cases continued to mount, and resources dwindled. Bare-bones staffing meant that some local health departments had to abandon fundamental public health functions, such as contact tracing, communicable disease testing and enforcement of public health orders.

“As the pandemic rages on and without additional resources, some pandemic activities previously funded with federal CARES Act resources simply cannot be sustained,” a coalition of public health officials warned in a late December letter to Newsom and legislative leaders.

Newsom has long promoted tech and private companies as a way to improve government, and has leaned on the private sector throughout his political career, dating to his time as San Francisco mayor from 2004 to 2011, when he called on corporations to contribute to his homelessness initiatives.

And since becoming governor in January 2019, he has regularly held private meetings with health and tech executives, his calendars show, including Facebook CEO Mark Zuckerberg, Google CEO Sundar Pichai and Apple CEO Tim Cook.

“We’re right next door to Silicon Valley, of course, so technology is our friend,” Newsom wrote in his 2013 book, “Citizenville,” arguing that “government needs to adapt to this new technological age.”

With California’s core public health infrastructure already gutted, Newsom funneled taxpayer money to tech and health companies during the pandemic or allowed them to help design and fund certain public health activities.

Other industries have jumped into covid response, including telecommunications and entertainment, but not to the degree of the health and technology sectors.

“It’s not the ideal situation,” said Daniel Zingale, who has steered consequential health policy decisions under three California governors, including Newsom. “What is best for Google is not necessarily best for the people of California.”

Among the corporate titans that have received government contracts to conduct core public health functions is Google’s sister company Verily.

Google and its executives have given more than $10 million to Newsom’s gubernatorial campaigns and special causes since 2010, according to state records. It has infiltrated the state’s pandemic response: The company, along with Apple, helped build a smartphone alert system called CA Notify to assist state and local health officials with contact tracing, a venture Newsom hailed as an innovative, “data-driven” approach to reducing community spread. Google, Apple and Facebook are sharing tracking data with the state to help chart the spread of covid. Google — as well as Facebook, Snapchat, TikTok, Twitter and other platforms — also contributed millions of dollars in free advertising to California, in Newsom’s name, for public health messaging.

Other companies that have received lucrative contracts to help carry out the state’s covid plans include health insurance company Blue Shield of California, which received a $15 million no-bid contract to oversee vaccine allocation and distribution, and the private consulting firm McKinsey & Co., which has received $48 million in government contracts to boost vaccinations and testing and work on genomic sequencing to help track and monitor covid variants. Together, they have given Newsom more than $20 million in campaign and charitable donations since 2010.

Private companies have also helped finance government programs and core public health functions during the pandemic — at times bypassing local public health departments — under the guise of making charitable or governmental contributions, known as “behested payments,” in Newsom’s name. They have helped fund vaccination clinics, hosted public service announcements on their platforms, and paid for hotel rooms to safely shelter and quarantine homeless people.

Facebook and the Chan Zuckerberg Initiative, the philanthropic organization started by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, have been among the most generous, and have given $36.5 million to Newsom, either directly or to causes and policy initiatives on his behalf. Much of that money was spent on pandemic response efforts championed by Newsom, such as hotel rooms and child care for front-line health care workers; computers and internet access for kids learning at home; and social services for incarcerated people leaving prison because of covid outbreaks.

Facebook said it is also partnering with the state to deploy pop-up vaccination clinics in hard-hit areas like the Central Valley, Inland Empire and South Los Angeles.

In prepared statements, Google and Facebook said they threw themselves into the pandemic response because they wanted to help struggling workers and businesses in their home state, and to respond to the needs of vulnerable communities.

Venture capitalist Dr. Bob Kocher, a Newsom ally who was one of the governor’s earliest pandemic advisers, said private-sector involvement helped California tremendously.

“We’re doing really well. We got almost 20 million people vaccinated and our test positivity rate is at an all-time low,” Kocher said. “Our public health system was set up to handle small-scale outbreaks like E. coli or hepatitis. Things work better when you build coalitions that go beyond government.”

Public health leaders acknowledge that private-sector participation during an emergency can help the state respond quickly and on a large scale. But by outsourcing so much work to the private sector, they say, California has also undercut its already struggling public health system — and missed an opportunity to invest in it.

Take Verily. Newsom tapped the company to help expand testing to underserved populations, but the state chose to end its relationship with the company in January after county health departments rejected the partnership, in part because testing was not adequately reaching Black and Latino neighborhoods. In addition to requiring that residents have a car and Gmail account, Verily was seen by many local health officials as an outsider that didn’t understand the communities.

It takes years of shoe leather public health work to build trusted relationships within communities, said Dr. Noha Aboelata, founder and CEO of the Roots Community Health Center in the predominantly Black and Latino neighborhood of East Oakland.

“I think what’s not fine is when these corporations are claiming to be the center of equity, when in fact it can manifest as the opposite,” she said. “We’re in a neighborhood where people walk to our clinic, which is why when Verily testing first started and they were drive-up and you needed a Gmail account, most of our community wasn’t able to take advantage of it.”

To fill the gap, the clinic worked with Alameda County to offer old-fashioned walk-up appointments. “We’re very focused on disparities, and we’re definitely seeing the folks who are most at risk,” Aboelata said.

The state took a similar approach to vaccination. Instead of giving local health departments the funding and power to manage their own vaccination programs with community partners, it looked to the private sector again. Among the companies that received a vaccination contract is Color Health Inc., awarded $10 million to run 10 vaccine clinics across the state, among other covid-related work. Since partnering with California, Color has seen its valuation soar to $1.5 billion — helping it achieve “unicorn” start-up status.

As the state’s Silicon Valley partners rake in money, staffing at local health departments has suffered, in part because they don’t have enough funding to hire or replace workers. “It is our biggest commodity and it’s our No. 1 need,” said Kat DeBurgh, executive director of the Health Officers Association of California.

With inadequate staffing to address the pandemic, the state is falling further behind on other basic public health duties, such as updating data systems and technology — many county health departments still rely on fax machines to report lab results — and combating record-setting levels of sexually transmitted diseases such as syphilis.

“We’ve put so many resources into law enforcement and private tech companies instead of public health,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network. “This is having a devastating impact.”

Dr. Karen Smith, former director of the state Department of Public Health, left the state in July 2019 and now is a consultant with Google Health, one of Big Tech’s forays into the business of health care.

She believes Silicon Valley can improve the state’s crumbling public health infrastructure, especially when it comes to collecting and sharing data, but it can’t be done without substantial investment from the state. “Who the heck still uses fax? Public health doesn’t have the kind of money that tech companies have,” said Smith, who said she wasn’t speaking on behalf of Google.

Without adequate funding to rebuild its infrastructure and hire permanent workers, Smith and others fear California isn’t prepared to ride out the remainder of this pandemic — let alone manage the next public health crisis.

Statewide public health advocacy groups have formed a coalition called “California Can’t Wait” to pressure state lawmakers and Newsom to put more money into the state budget for local public health departments. They’re asking for $200 million annually. Newsom will unveil his latest state budget proposal by mid-May.

“We’re in one of those change-or-die moments,” Capitol health care veteran Zingale said. “Newsom has been at the vanguard of the nation in marshaling the help of our robust technological private sector, and we’re thankful for their contributions, but change is better than charity. I don’t want to show ingratitude, but we should keep our eyes on building a better system.”

KHN data editor Elizabeth Lucas and California politics correspondent Samantha Young contributed to this report.

Methodology: How KHN compiled data about political spending and the role of technology and health care companies in California’s covid response.

Private-sector companies from Silicon Valley and the health care industry have participated in California’s public health response to covid-19 in a variety of ways, big and small. Some have received multimillion-dollar contracts from the state of California to perform testing, vaccination and other activities. Others have donated money and resources to the effort, such as free public health advertising time.

KHN identified the companies that received pandemic-related contracts or work from the state by filing Public Records Act requests with state agencies; searching other sources, including California’s “Released COVID-19 Response Contracts” page; and contacting state agencies and companies directly.

We then searched the California Fair Political Practices Commission website for tech and health care companies that didn’t receive contracts but played a role in the state’s pandemic response by donating money and resources. Through what are known as “behested payments,” these companies donated to charitable causes or Gov. Gavin Newsom’s policy initiatives on his behalf. These contributions included money to help fund and design state public health initiatives such as quarantine hotel rooms.

Based on those searches, we found at least 30 health or technology companies that have participated in the state’s pandemic response: Google and its sister company Verily Life Sciences; Salesforce; Facebook; Apple; McKinsey & Co.; OptumServe and OptumInsight — subsidiaries of national health care company UnitedHealth Group; Netflix; Pandora; Spotify; Zoom Video Communications Inc.; electric car manufacturer BYD; Bloom Energy; Color Health Inc.; DoorDash; Twitter; Amazon; Accenture; Skedulo; Primary.Health; Pfizer; HP Inc.; Microsoft; Snapchat; Blue Shield of California; Kaiser Permanente; Lenovo Inc.; YouTube; and TikTok. The Chan Zuckerberg Initiative, the philanthropic organization started by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, also participated.

We then searched the California secretary of state’s website to determine which of those companies, and their executives, gave direct political contributions to Newsom’s personal campaign accounts and a ballot measure account run by the governor called “Newsom’s Ballot Measure Committee” during his five campaigns for statewide office since 2010, plus the ongoing recall effort against him.

We found that at least 24 of the tech or health companies that participated in the state’s pandemic response, or their executives, gave direct political contributions to Newsom, made behested payments in his name or both.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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Good Samaritan Society staff members love being an integral part of the cities and counties they work and live in.

‘Really important’ community services

Many times, the services the Society is providing can’t be found for miles. Good Samaritan Society – Battle Lake in Minnesota offers skilled nursing care, assisted living, and senior living apartments.

“There isn’t a ton of senior living options in our area. What we provide in our community is really important because otherwise people would have to travel 20, 30, 40 miles to receive care in a setting like that,” Casey Ward, administrator at Battle Lake, says.

No one needs to travel outside of the area for outpatient rehabilitation either, Casey says it’s happening right here. All this makes his building a go-to facility for people in Battle Lake and residents in Otter Tail County.

“We have a beautiful overlook of west Battle Lake and we have a dock and a pontoon. We’re just a very beautiful, unique campus,” Casey says.

It’s one of the reasons why the senior living apartments are always full. With nice weather on the way, Casey is looking forward to taking on the role of pontoon captain soon.

“Favorite part of the job description for the summer,” Casey says.

National Skilled Nursing Care Week

During National Skilled Nursing Care Week, Casey is sharing his gratitude for the caregivers who are making residents feel special and for all the families trusting the Society with their loved ones.

“It brings a lot of value to the community and the community is so grateful. We’re so grateful for the ways they show it to us,” Casey says.

Throughout the pandemic, local grocery stores have been dropping off flowers to brighten up residents’ rooms. Families are also bringing treats to say thank you to staff members.

“The community has really done a lot,” Casey says.

While he admits battling coronavirus in Battle Lake has been challenging, the location is in a good spot now thanks to safety precautions and the COVID-19 vaccine.

“There were times where it was pretty tough but everybody pitched in to make it work,” Casey says. “We’re all in this together. We’re all in the boat together.”

Hopefully propelling our way towards an end to the pandemic. Casey says new options for visitation are bringing hope. Vaccinated residents and visitors can get together with fewer restrictions.

“We’re starting to see more and more people in the building. It’s just nice to see all that traffic again,” Casey says.

Looking back at skilled nursing care

This past year has brought a lot of changes to skilled nursing facilities. Rochelle Rindels, Society Vice President of Nursing and Clinical Services, says the organization continues to adapt to meet the needs of residents.

“Right now with our vaccination rates, our facilities are some of the safest places to be,” Rochelle says.

Safe places for people to live, stay active and receive care.

“What we’ve seen in today’s skilled nursing facility is vastly different from what we’ve seen 10-20 years ago. I think that ranges across a variety of things from the services that are offered in a nursing facility to the complexity of the resident or the patient that we care for,” Rochelle says.

Those residents will have even more amenities at their fingertips in the future.

“We’re kind of on the edge of virtual care and telehealth and what that looks like in nursing homes. I think in the next 5-7 years, we’ll see a change in how care is delivered in a nursing facility,” Rochelle says.

Right now, you can count on a familial atmosphere wherever the Society is caring for others.

“The one thing that hasn’t changed about nursing facilities is the sense of community that is created between residents and also the relationship between nurses and residents. They become like your family members. You’re sharing birthdays and anniversaries with them and you get to know their immediate family and loved ones just like your own family,” Rochelle says.

‘Thank you for trusting us’

For those celebrating skilled nursing facilities, their staff and their residents this week, Rochelle says thank you.

“We are highlighting and appreciating our skilled nursing facilities and the employees and residents and family members that are involved in those facilities. We thank you for trusting us with the care of your loved ones and really being a part of creating community and moving forward day to day in our locations,” Rochelle says.

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Good Samaritan Society residents are preparing to get social, safely, on Mother’s Day 2021. More in-person visits are allowed at the Society thanks to new guidance from the Centers for Medicare and Medicaid Services. It’s bringing a much-needed boost to those living and working at locations across the country.

“Oh yes. Oh my goodness. Even just starting visits in the last couple months, staff has been pumped,” Lara Carlson at Good Samaritan Society – Park River in North Dakota says.

Pumped to see residents in such good spirits surrounded by loved ones.

“These residents have had a long year and they deserve to have their families with them,” Lara says.

‘Thankful to see each other’

Lara’s family is one of a few at the Society with a unique situation. Her grandmother, Inez Laugtug, lives in the skilled nursing facility in Park River. The proximity has been invaluable during the pandemic.

“We still have that connection here, her and I. We’ve been very thankful to see each other,” Lara says.

Especially after Inez, a former schoolteacher, came down with COVID and beat it.

“I cried. I was scared,” Lara says. “She even got pneumonia afterward. A little scary but she pulled through.”

Now, the 88-year-old hopes to see her three kids and eight grandkids more often.

“We used to have to interview in the window, but we don’t have to do that anymore,” Inez says.

100-percent of Park River’s residents are vaccinated.

“We can even leave our masks off in certain places,” Inez says.

Activities and dinner with neighbors are back on the table.

“We just went back to full community dining here,” Lara says. “They can have their meals at a table together again. Instead of one at a table or roommates at a table. That’s huge for them. Activities have resumed. Bingo and devotions here and there. They need that interaction.”

Celebrating Mother’s Day with family

Mary Voboril is interacting once again with her big family too. The 77-year-old resident at Good Samaritan Society – Albion in Nebraska is getting plenty of visitors and is the proud mom of five daughters.

“The first four were born within five years. It was busy. Then the last was born 14 years after,” Mary says.

As for what happened with the last one, “We don’t know. We thought we had it figured out before but we didn’t.”

Kassie Voboril is that youngest and last piece to the family puzzle. She’s also a resident and medication assistant at the Albion location where her mom lives.

“It’s nice. I like to be able to take care of her,” Kassie says.

Being nearby during the pandemic is a blessing.

“It was easier for me and my family. If they had questions or trouble getting ahold of her on the phone or the portal, I could help her personally,” Kassie says.

She’s been there for less than a year but Mary says life in assisted living is where it’s at.

“It’s the place to be. You get fed, you get a place to sleep,” Mary says. “You can walk around the halls, you can see people.”

‘Spending time with all my mothers’

Working on Mother’s Day this year, Kassie will get to see her mom and her cherished residents.

“I’ll be spending time with all my mothers, as I call them,” Kassie says. “They all hold a special place.”

A treasured spot in her heart she doesn’t take lightly.

“I think in the last year we’ve really learned to not take the little things for granted. Spending time with your loved ones and being able to hug your family member,” Kassie says.

Mary says hug your loved ones and remember nothing is guaranteed.

“Enjoy whatever minutes you can have because you never know if that’s going to be your last minute with them,” Mary says.

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If we want to get past the COVID-19 pandemic, or return to some form of normalcy, vaccinations are critical.

It’s what Sanford Health chief physician Jeremy Cauwels, M.D. wants everybody to understand.

“The vaccine is a win. I don’t want anyone to walk away thinking that it’s not,” said Dr. Cauwels.

Dr. Cauwels and other experts at Sanford Health have encouraged everyone, not just those with compromised immune systems or the elderly, to get vaccinated when they have the chance.

In other words, even if you’re young and healthy, you still need the vaccine.

When referencing recent COVID-19 rates and hospitalizations during a Sanford Health News interview, Dr. Cauwels said more providers are seeing more young people hospitalized with the virus.

“The people that are being hospitalized are consistently younger than we’ve seen previously,” he said.

‘It’s the responsible thing to do’

Jack Nachtigal is 24-years-old. After his second dose of the COVID-19 vaccine, he spoke with Sanford Health News.

He got the vaccine because he’s not risking infection, hospitalization, or community spread. He asks that everyone his age wouldn’t either.

“It’s the responsible thing to do. The more than young people get it, the less variants will affect other people. It’s a great security blanket,” he said.

A security blanket not only for himself, but everyone.

“There’s definitely long term affects that we still don’t know about, so it’s a great way to protect yourself, your family, and loved ones,” he said.

“It’s something that makes you feel a lot safer as we start to re-enter normalcy. It’s something that feels good to have,” he added.

Rollout

Dr. Cauwels said taking a dose away from someone who’s immune compromised or older is a common reason some younger individuals haven’t been vaccinated. However, he said Sanford Health has done a great job, “getting the vaccines to the people that needed them.”

“We’ve gotten them to our elderly folks. We’ve gotten them to roughly 90 percent of our long term care residents. We’re getting to over 90 percent of our physicians.”

So, the vaccinations of younger people are now critical to end the fight against COVID-19.

“It’s time now. We have the supplies. If you want a dose, get a dose. It’s okay to find your own spot in line,” said Dr. Cauwels.

Two doses

Across the nation, reports have surfaced of individuals only receiving one of the two Pfizer or Moderna vaccinations, for fear of side effects after the second dose.

More: New mom and Society senior pastor gets COVID-19 vaccine

Dr. Cauwels said while the first dose does a good job of building up some immunity, it’s not clear exactly how much.

“The other thing we’re unsure of is how durable that is, or how long it will last. So, the correct way to get your vaccination, if you’re getting one of the two-dose vaccines, is still to get the two doses.

“Our recommendation is, and has remained, stick with the CDC’s recommendation, stick with the FDA approval, and get two doses,” he said.

Gathering after vaccination(s)

Along with the CDC’s guidance on vaccinations, Dr. Cauwels also said to follow their suggestions for gathering, even after you’ve been vaccinated.

“There are places where you’re going to feel very comfortable, like at your house, at your friends, in your yard. Those are places you don’t need to wear a mask, because the CDC has said that’s okay.

“The CDC has not stepped away from saying that in large crowds that you shouldn’t wear a mask, so for right now, that’s still the way we’re going to move forward.”

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