According to USA TODAY, For over a year, LA County’s Department of Public Health has been developing a comprehensive strategy to track patient debt and hospital collections, boost medical bill forgiveness for low-income patients, and directly purchase and eliminate billions in outstanding medical debt.

A Public Health Crisis, Not Just a Financial One

What sets LA County’s approach apart is its framing of medical debt as a urgent public health threat on par with conditions like asthma and diabetes, rather than merely an economic or political problem.

“Nobody in LA County facing economic limitations should have that impact their ability to access essential healthcare services and support for optimal well-being,” said Barbara Ferrer, director of the public health department, at a recent medical debt symposium.

Mona Shah of the national health equity organization Community Catalyst praised the county’s “bold” efforts to address both immediate debt relief and the root causes of medical debt. She highlighted the significance of tackling this issue in a region with around 10 million residents.

Pushback from Hospital Industry

However, on the eve of the April 10th symposium, the powerful Hospital Association of Southern California urged LA County to revise its plan. In a letter, the association’s CEO George Greene argued the proposed debt relief program would “only burden hospitals with unnecessary requirements, without ultimately helping to address the underlying issue.”

Many of the county’s recommendations would require hospitals to change billing and reporting processes. For example, LA County wants hospitals to notify it when sending patient debt to collections and improve access to financial assistance programs, which patient advocates say are often difficult to navigate despite state requirements.

The association’s LA County VP Adena Tessler told KFF Health News that hospitals already provide ample financial aid, claiming the county places too much emphasis on hospitals when other healthcare sectors like insurers share blame for the medical debt crisis.

A Widespread and Inequitable Burden

But the scale of the problem in LA County is staggering. Analysis by the public health department found nearly 785,000 county residents were burdened with $2.9 billion in total medical debt in 2022 alone.

The data shows this debt disproportionately affects people of color, low-income families, and households with children. Having outstanding medical bills more than doubled the likelihood of delaying care, struggling to afford housing, or going hungry.

While a few states have begun limiting medical debt collection or mandating hospital financial assistance, LA County’s public health-centered approach is unprecedented. Some jurisdictions have provided direct debt relief, and new state and federal laws ban including medical debt on credit reports, which can cripple someone’s ability to find housing, jobs, and loans.

“Medical debt is a huge public health problem,” said Naman Shah, the LA public health department’s medical and dental affairs director. “We try to shift societal determinants that deeply and widely impact health. Medical debt fulfills both – it’s important we see this as a health issue, not just a regulatory one.”

A Phased, Collaborative Approach

With backing from the County Board of Supervisors, which labeled medical debt a “pervasive” cause of harm to marginalized communities, the public health department developed a phased plan after releasing initial recommendations last year.

Over the next several months, LA County will score hospitals on the accessibility of their financial assistance and provide templates to simplify byzantine billing practices, similar to efforts in Washington, Oregon and Maryland.

The county also aims to prevent future medical debt through consumer education on avoiding surprise billing and out-of-network charges in collaboration with health plans and providers.

While agreeing hospitals should not be the sole focus, Naman Shah defended starting with a major debt source, noting nearly 75% of adults owe some medical debt to hospitals.

“We want to get the most bang for our buck,” Shah said. “The largest bill a patient receives is not a dental or office bill – it’s a hospital bill.”

Despite the hospital lobby’s resistance, Shah said the county is moving forward with its plan after addressing some “misunderstandings” through ongoing dialogue with the association.

A National Model for Justice

By asserting that medical debt is first and foremost a critical public health equity issue, Los Angeles County is charting new territory in the nationwide struggle against a burden impacting two out of every five U.S. adults.

Through strategic debt relief, systematic reforms to make hospital billing more consumer-friendly, and preventative efforts across the healthcare system, LA’s sweeping initiative could become a model for other states and localities aiming to proactively tackle an injustice that perpetuates poverty and barriers to care.

As Barbara Ferrer powerfully stated, optimal health and wellbeing should be possible for all LA County residents regardless of economic status. By confronting the medical debt crisis as a public health imperative, this diversity-rich region is taking major strides toward that ideal. I sincerely hope you find this “Los Angeles County Really Erase Medical Debt? Here’s What’s Happening” article helpful.

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The Tiny Home Villages Sweeping LA

According to The New York Times, Over the past two years, the city has rapidly expanded its network of tiny home communities as an emergency measure to get people out of tents and off sidewalks. There are now 14 of these sites operating, housing around 1,000 formerly homeless Angelenos in 64-square-foot aluminum and fiberglass shelters.

At the largest village called Branford Village in Sun Valley, roughly 150 people live in the pint-sized dwellings. While a major upgrade from sidewalk living, conditions are still austere. Each prefab unit is just big enough for a twin bed and has no bathroom, kitchen or privacy – many are shared between two people. Communal bathrooms, lack of greenspace, and poor drainage that causes flooding during rainstorms are common sources of frustration.

“The city brands these as tiny homes like they’re a real housing solution, but they’re just tiny sheds,” says Shayla Myers, an attorney at the Legal Aid Foundation of Los Angeles. “They’re not humane long-term.”

A Cheap, Rapid Alternative to Traditional Shelters

So why have city officials embraced tiny homes so fervently? The primary drivers are cost and speed. Erecting a traditional homeless shelter with supportive services can cost over $550,000 per unit and take years. Tiny home villages like Branford can be built for around $42,000 per bed in a matter of months using prefab units from companies like Pallet Shelter.

Tiny homes offer a relatively private, stand-alone living space compared to congregate shelters where clients sleep in shared rooms or open bays. This semi-private model aims to provide more dignity, stability and autonomy to get people transitioning from life on the streets.

“Interim tiny homes are absolutely not the end goal, but they have saved lives and served as an important bridge to permanent housing for thousands in LA,” says LA mayoral spokesperson Zach Seidl.

A Temporary Fix, Not a Long-Term Solution

While effective as an emergency triage, the tiny home model has major limitations in solving chronic homelessness long-term. Residents frequently complain about feeling trapped in the cramped, dorm-like conditions with minimal services and programming beyond basic food, showers and case management.

“These were designed to be temporary stops, not places for people to live for years,” says Todd Ferry from Portland State University, who has studied tiny home communities. “If the goal is just to warehouse people with minimal resources in inhumane conditions, you’ll get really poor outcomes.”

At Branford Village, only 25 out of 369 people who moved out in the past year transitioned to permanent housing. 92 returned to the streets, a reality check on the challenges of rapidly rehousing people with complex needs.

“We’re still waiting to get placed somewhere bigger, a real apartment,” says 65-year-old resident Sharon Hill. “I’m starting to lose hope this is meant to be real housing.”

Uncertain Futures

As the tiny home pilot program continues expanding across Los Angeles, its long-term viability remains an open question. Proponents argue it’s better than leaving people on the streets while more affordable housing gets built. Critics decry warehousing people in cramped shelters indefinitely, slowing momentum on developing enough permanent supportive housing.

Most agree the tiny home model needs refinement and can only be one part of the solution, not a substitute for policies promoting housing construction and homelessness prevention. More spacious units, private bathrooms, greenspace and comprehensive onsite services could help enhance quality of life. But securing ongoing funding from stretched municipal budgets will be a perennial challenge.

For cities like LA in crisis mode, tiny homes offer a something-is-better-than-nothing stopgap. But the clock is ticking to prove these “temporary” communities don’t become permanent standins for the affordable housing and services people truly need to rebuild their lives.

As the old adage goes, there are no tiny solutions to big problems. Tackling homelessness requires a holistic, well-resourced approach – something LA’s tiny home experiment has yet to achieve. At best, it’s an imperfect stepping stone toward the ultimate goal of secure, sustainable housing for all. I sincerely hope you find this “Can Tiny Homes Solve LA Homelessness Crisis? Find Out Here” article helpful.

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In 2022 alone, 2,374 homeless individuals died in LA County. This marks an incredible 100% increase in deaths compared to just four years prior in 2018. Tragically, people experiencing homelessness are now 40 times more likely to die from a drug overdose, 18 times more likely to be murdered, and 4 times more apt to die from heart disease than the general county populace.

Overdoses Fueling the Surge in Homeless Deaths

While many factors contribute to this crisis, the primary driver is a shocking spike in lethal overdoses. The overdose mortality rate among the unhoused skyrocketed over 120% between 2020 and 2021 alone. Last year, methamphetamine and/or fentanyl were involved in over 95% of homeless overdose deaths countywide.

Fentanyl, an extremely potent synthetic opioid, has hit the streets hard in recent years. Detectable in just 12.5% of overdoses in 2018, it was found in a staggering 67% last year – a fivefold increase in four short years. Thankfully, the overdose death rate did plateau somewhat in 2022, signaling that harm reduction efforts like naloxone distribution and outreach may be slowing the acceleration.

Violence and Heart Disease Also Major Threats

While overdoses were the leading cause of death for those experiencing homelessness in 2022, violence and heart disease also took a major toll. The homicide rate climbed over 60% in just two years, likely fueled by the social instability and desperation brought on by the pandemic.

Coronary heart disease remains the second leading cause of death for this vulnerable population as well. Though the number of cardiac-related deaths did fall slightly last year, the rate is still four times higher than for housed county residents.

Transportation Accidents Another Factor

After overdoses, heart attacks, and violence, accidents involving vehicles were the fourth leading cause of death for the unhoused. The mortality rate from traffic collisions has begun to decline but remains troublingly high at almost 250 deaths per 100,000 people last year. Experts believe removing people from dangerous street locations into housing has prevented more of these avoidable fatalities.

Recommendations to Save Lives

While the statistics are profoundly troubling, the county health department researchers emphasize they can guide life-saving policy decisions. Their recommendations include:

• Expanding housing and shelter capacity
• Increasing harm reduction services like naloxone access
• Enhancing targeted street outreach and case management
• Identifying dangerous traffic areas to improve pedestrian safety

The report’s authors stress that the data clearly demonstrates targeted interventions like these can stem the rising tide of deaths among our most vulnerable citizens. With compassion, commitment, and smart policy changes, we have the power to reverse these alarming trends and preserve precious human life. I sincerely hope you find this “Los Angeles homeless dying at a faster rate, Discover what a new study reveals” article helpful.

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“Invasive Aedes mosquitoes have significantly altered the outdoor lifestyle for millions of Los Angeles residents,” the agency said. “These aggressive daytime biters not only disrupt outdoor activities but also raise concerns about diseases like dengue, chikungunya, and Zika.”

The technique, called Sterile Insect Technique (SIT), has been used successfully before to control agricultural pests. But this will be one of the first major trials using sterile insects to suppress disease-carrying mosquitoes in a major U.S. metropolitan region.

How the Sterile Insect Technique Works

SIT relies on sterilizing male insects before releasing them to mate with wild females. Female mosquitoes only mate once in their lifetime. So when they mate with a sterile male, they produce no viable eggs, reducing the next generation’s population.

With sustained releases, SIT can dramatically cut mosquito numbers without using insecticides. Over time, the small number of females that mate with fertile males is not enough to maintain the population.

Other Benefits of SIT Mosquito Control

Releasing sterile mosquitoes also avoids problems with insecticide resistance. Many mosquitoes have evolved defenses against common chemicals. SIT instead works by overwhelming the population with sterile mating partners.

The technique also specifically targets the invasive Aedes aegypti mosquitoes, which aren’t native to California. Other native mosquitoes that are less aggressive biters shouldn’t be affected.

SIT Has Succeeded Against Other Insects

California has already used SIT to eliminate the destructive Mediterranean fruit fly. The screwworm fly was eradicated from North and Central America using the method. So there is ample precedent of SIT protecting health, agriculture, and biodiversity.

The Pilot Mosquito Program in Los Angeles County

The vector control district will begin releasing sterile male Aedes mosquitoes in two Los Angeles neighborhoods: Sunland and Tujunga. The agency chose these areas because invasive mosquitoes are abundant there.

Residents may notice more mosquitoes after the releases start. But only male mosquitoes don’t bite. So the district predicts biting rates will decline as more sterile insects mate with wild females.

The pilot project will allow the agency to evaluate SIT’s effectiveness against Aedes aegypti. They will monitor mosquito population levels and biting activity compared to control areas without SIT.

If successful, the vector control district plans to expand sterile insect releases to other parts of Los Angeles County and Orange County.

SIT Requires Community Participation

The district warns that SIT depends on community participation. Residents should allow the released sterile mosquitoes access to breeding sites on their property.

They also need to continue draining small containers of standing water where mosquitoes lay eggs. Reducing breeding spots will maximize SIT’s impact.

The district will continue using conventional control methods like insecticides as needed. But SIT offers a complementary approach to suppress invasive mosquitoes without chemicals.

Many public health experts are enthused about SIT for controlling diseases like dengue and Zika. If it works for Los Angeles, the sterile insect technique could be adopted nationally and globally. The results of this pilot project will be pivotal. I sincerely hope you find this “Los Angeles Unconventional Mosquito Strategy? More Mosquitoes to Fight The Off?” article helpful.

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