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How to protect yourself from the smoke caused by L.A. wildfires

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Wednesday, January 8, 2025

You don’t have to live close to a wildfire to be affected by its smoke. With severe winds fanning the fires in and around Pacific Palisades, the Pasadena foothills and Simi Valley, huge swaths of the Southland are contending with dangerous air quality.Wildfire smoke can irritate your eyes, nose, throat and lungs. The soot may contain all kinds of dangerous pollutants, including some that may cause cancer. The tiniest particles in smoke can travel deep into your lungs or even enter your bloodstream.Conditions like these aren’t good for anyone, but they’re particularly bad for people in vulnerable groups, including children, those with asthma or other respiratory conditions, people with heart disease and those who are pregnant.Here’s what you should know to keep yourself safe.Stay indoorsMinimize your exposure to unhealthy air by staying inside and keeping your doors and windows shut.If you have a central heating and air conditioning system, you can keep your indoor air clean by turning it on and keeping it running. Make sure the fresh-air intake is closed so that you’re not drawing in outdoor air.Keep your pets insideThey shouldn’t breathe the unhealthy air either.Check your air filtersClean filters work better than dirty ones, and high-efficiency filters work better than regular ones. The California Air Resources Board and the South Coast Air Quality Management District recommend filters with a MERV rating of 13 or higher.You might consider using portable high-efficiency air cleaner in a room where you spend the most time. The U.S. Environmental Protection Agency has information about them here, and CARB has a list of certified cleaning devices here.Don’t pollute your indoor airThat means no burning candles or incense. If your power is out and you need to see in the dark, you’re much better off with a flashlight or headlamp.If you’re cold, bundle up. This is not the time to start a cozy fire in the fireplace. Don’t use a gas stove or wood-fired appliances, since these will make your indoor air quality worse, not better, the AQMD says.The CDC also advises against vacuuming, since it can stir up dust and release fine particles into the air.Take care when cleaning upYou don’t want your skin to come into contact with wildfire ash. That means you should wear long sleeves, pants, gloves, socks and shoes. The AQMD even wants you to wear goggles.If you’re sweeping up ash outdoors, get a hose and mist it with water first. That will keep it from flying up in the air as you move it around. Once the ash is wet, sweep it up gently with a broom or mop. Bag it up in a plastic bag and throw it away.It’s a good idea to wash your vehicles and outdoor toys if they’re covered in ash. Try not to send ashy water into storm drains. Direct the dirty water into ground areas instead, the AQMD advises.Discard spoiled food...If you lost power for a significant length of time, the food in your refrigerator or freezer may be spoiled.Food kept in a fridge should stay safe for up to four hours if you’ve kept the door closed. If you’ve been without power for longer than that, you’ll need to toss all perishable items, including meat, poultry, fish, eggs, milk and cut fruits and vegetables. Anything with “an unusual smell, color, or texture” should be thrown out as well, according to the U.S. Centers for Disease and Control Prevention.Refrigerated medicines should be OK unless the power was out for more than a day. Check the label to make sure....even if it was in the freezerYour freezer may be in better shape, especially if it’s well-stocked. Items in a full freezer may be safe for up to 48 hours if it’s been kept shut, and a half-full freezer may be OK for up to 24 hours. (The frozen items help keep each other cold, so the more the better.)If items have remained below 40 degrees Fahrenheit (4 degrees Celsius) or you can still see ice crystals in them, they may be OK to use or refreeze, according to the federal government’s food safety website. Ice cream and frozen yogurt should be thrown out if the power goes out for any amount of time. Meat, poultry, seafood, eggs, milk and most other dairy products need to go if they were exposed to temperatures above 40 degrees F for two hours or longer. The same goes for frozen meals, casseroles, soups, stews and cakes, pies and pastries with custard or cheese fillings. Fruit and fruit juices that have started to thaw can be refrozen unless they’ve started to get moldy, slimy or smell like yeast. Vegetables and vegetable juices should be discarded if they’ve been above 40 degrees F for six hours or more, even if they look and smell fine.Breakfast items like waffles and bagels can be refrozen, as can breads, rolls, muffins and other baked goods without custard fillings.Consider alternative shelterIf you’ve done everything you can but your eyes are still watering, you can’t stop coughing, or you just don’t feel well, seek alternative shelter where the air quality is better.Hold off on vigorous exerciseDoing anything that would cause you to breathe in more deeply is a bad idea right now. Mask up outdoorsIf you need to be outside for an extended time, be sure to wear a high-quality mask. A surgical mask or cloth mask won’t cut it — health authorities agree that you should reach for an N95 or P-100 respirator with a tight seal.Are young children at greater risk of wildfire smoke?Very young children are especially vulnerable to the effects of wildfire smoke because their lungs are still rapidly developing. And because they breathe much faster than adults, they are taking in more toxic particulate matter relative to their tiny bodies, which can trigger inflammation, coughing and wheezing.Any kind of air pollution can be dangerous to young children, but wildfire smoke is about 10 times as toxic for children compared to air pollution from burning fossil fuels, said Dr. Lisa Patel, clinical associate professor of pediatrics at Stanford Children’s Health. Young children with preexisting respiratory problems like asthma are at even greater risk.Patel advises parents to keep their young children indoors as much as possible, create a safe room in their home with an air purifier, and try to avoid using gas stoves to avoid polluting the indoor air. Children over the age of 2 should also wear a well-fitting KN95 mask if they will be outdoors for a long period of time. Infants and toddlers younger than that don’t need to mask up because it can be a suffocation risk, Patel said.What are the risks for pregnant people?Pregnant people should also take extra precautions around wildfire smoke, which can cross the placenta and affect a developing fetus. Studies have found that exposure to wildfire smoke during pregnancy can increase the risk of premature birth and low birth weight. Researchers have also linked the toxic chemicals in smoke with maternal health complications including hypertension and preeclampsia. What about other high-risk populations?Certain chronic diseases including asthma, chronic obstructive pulmonary disease or other respiratory conditions can also make you particularly vulnerable to wildfire smoke. People with heart disease, diabetes and chronic kidney disease should take extra care to breathe clean air, the CDC says. The tiny particles in wildfire smoke can aggravate existing health problems, and may make heart attacks or strokes more likely, CARB warns.Get ready for the next emergencyLiving in Southern California means another wildfire is coming sooner or later. To prepare for the bad air, you can:Stock up on disposable respirators, like N95 or P-100s.Have clean filters ready for your A/C system and change them out when things get smoky. Know how to check the air quality where you live and work. The AQMD has an interactive map that’s updated hourly. Just type in an address and it will zoom in on the location. You can also sign up to get air quality alerts by email or on your smartphone.Know where your fire extinguisher is and keep it handy.If you have a heart or lung condition, keep at least five days’ worth of medication on handy.

The fires in L.A. have caused terrible air quality conditions across the county. Here are ways you can protect yourself, and your children, from the health impacts of wildfire smoke.

You don’t have to live close to a wildfire to be affected by its smoke. With severe winds fanning the fires in and around Pacific Palisades, the Pasadena foothills and Simi Valley, huge swaths of the Southland are contending with dangerous air quality.

Wildfire smoke can irritate your eyes, nose, throat and lungs. The soot may contain all kinds of dangerous pollutants, including some that may cause cancer. The tiniest particles in smoke can travel deep into your lungs or even enter your bloodstream.

Conditions like these aren’t good for anyone, but they’re particularly bad for people in vulnerable groups, including children, those with asthma or other respiratory conditions, people with heart disease and those who are pregnant.

Here’s what you should know to keep yourself safe.

Stay indoors

Minimize your exposure to unhealthy air by staying inside and keeping your doors and windows shut.

If you have a central heating and air conditioning system, you can keep your indoor air clean by turning it on and keeping it running. Make sure the fresh-air intake is closed so that you’re not drawing in outdoor air.

Keep your pets inside

They shouldn’t breathe the unhealthy air either.

Check your air filters

Clean filters work better than dirty ones, and high-efficiency filters work better than regular ones. The California Air Resources Board and the South Coast Air Quality Management District recommend filters with a MERV rating of 13 or higher.

You might consider using portable high-efficiency air cleaner in a room where you spend the most time. The U.S. Environmental Protection Agency has information about them here, and CARB has a list of certified cleaning devices here.

Don’t pollute your indoor air

That means no burning candles or incense. If your power is out and you need to see in the dark, you’re much better off with a flashlight or headlamp.

If you’re cold, bundle up. This is not the time to start a cozy fire in the fireplace. Don’t use a gas stove or wood-fired appliances, since these will make your indoor air quality worse, not better, the AQMD says.

The CDC also advises against vacuuming, since it can stir up dust and release fine particles into the air.

Take care when cleaning up

You don’t want your skin to come into contact with wildfire ash. That means you should wear long sleeves, pants, gloves, socks and shoes. The AQMD even wants you to wear goggles.

If you’re sweeping up ash outdoors, get a hose and mist it with water first. That will keep it from flying up in the air as you move it around. Once the ash is wet, sweep it up gently with a broom or mop. Bag it up in a plastic bag and throw it away.

It’s a good idea to wash your vehicles and outdoor toys if they’re covered in ash. Try not to send ashy water into storm drains. Direct the dirty water into ground areas instead, the AQMD advises.

Discard spoiled food...

If you lost power for a significant length of time, the food in your refrigerator or freezer may be spoiled.

Food kept in a fridge should stay safe for up to four hours if you’ve kept the door closed. If you’ve been without power for longer than that, you’ll need to toss all perishable items, including meat, poultry, fish, eggs, milk and cut fruits and vegetables. Anything with “an unusual smell, color, or texture” should be thrown out as well, according to the U.S. Centers for Disease and Control Prevention.

Refrigerated medicines should be OK unless the power was out for more than a day. Check the label to make sure.

...even if it was in the freezer

Your freezer may be in better shape, especially if it’s well-stocked. Items in a full freezer may be safe for up to 48 hours if it’s been kept shut, and a half-full freezer may be OK for up to 24 hours. (The frozen items help keep each other cold, so the more the better.)

If items have remained below 40 degrees Fahrenheit (4 degrees Celsius) or you can still see ice crystals in them, they may be OK to use or refreeze, according to the federal government’s food safety website.

Ice cream and frozen yogurt should be thrown out if the power goes out for any amount of time. Meat, poultry, seafood, eggs, milk and most other dairy products need to go if they were exposed to temperatures above 40 degrees F for two hours or longer. The same goes for frozen meals, casseroles, soups, stews and cakes, pies and pastries with custard or cheese fillings.

Fruit and fruit juices that have started to thaw can be refrozen unless they’ve started to get moldy, slimy or smell like yeast. Vegetables and vegetable juices should be discarded if they’ve been above 40 degrees F for six hours or more, even if they look and smell fine.

Breakfast items like waffles and bagels can be refrozen, as can breads, rolls, muffins and other baked goods without custard fillings.

Consider alternative shelter

If you’ve done everything you can but your eyes are still watering, you can’t stop coughing, or you just don’t feel well, seek alternative shelter where the air quality is better.

Hold off on vigorous exercise

Doing anything that would cause you to breathe in more deeply is a bad idea right now.

Mask up outdoors

If you need to be outside for an extended time, be sure to wear a high-quality mask. A surgical mask or cloth mask won’t cut it — health authorities agree that you should reach for an N95 or P-100 respirator with a tight seal.

Are young children at greater risk of wildfire smoke?

Very young children are especially vulnerable to the effects of wildfire smoke because their lungs are still rapidly developing. And because they breathe much faster than adults, they are taking in more toxic particulate matter relative to their tiny bodies, which can trigger inflammation, coughing and wheezing.

Any kind of air pollution can be dangerous to young children, but wildfire smoke is about 10 times as toxic for children compared to air pollution from burning fossil fuels, said Dr. Lisa Patel, clinical associate professor of pediatrics at Stanford Children’s Health. Young children with preexisting respiratory problems like asthma are at even greater risk.

Patel advises parents to keep their young children indoors as much as possible, create a safe room in their home with an air purifier, and try to avoid using gas stoves to avoid polluting the indoor air.

Children over the age of 2 should also wear a well-fitting KN95 mask if they will be outdoors for a long period of time. Infants and toddlers younger than that don’t need to mask up because it can be a suffocation risk, Patel said.

What are the risks for pregnant people?

Pregnant people should also take extra precautions around wildfire smoke, which can cross the placenta and affect a developing fetus. Studies have found that exposure to wildfire smoke during pregnancy can increase the risk of premature birth and low birth weight. Researchers have also linked the toxic chemicals in smoke with maternal health complications including hypertension and preeclampsia.

What about other high-risk populations?

Certain chronic diseases including asthma, chronic obstructive pulmonary disease or other respiratory conditions can also make you particularly vulnerable to wildfire smoke. People with heart disease, diabetes and chronic kidney disease should take extra care to breathe clean air, the CDC says. The tiny particles in wildfire smoke can aggravate existing health problems, and may make heart attacks or strokes more likely, CARB warns.

Get ready for the next emergency

Living in Southern California means another wildfire is coming sooner or later. To prepare for the bad air, you can:

  • Stock up on disposable respirators, like N95 or P-100s.
  • Have clean filters ready for your A/C system and change them out when things get smoky.
  • Know how to check the air quality where you live and work. The AQMD has an interactive map that’s updated hourly. Just type in an address and it will zoom in on the location. You can also sign up to get air quality alerts by email or on your smartphone.
  • Know where your fire extinguisher is and keep it handy.
  • If you have a heart or lung condition, keep at least five days’ worth of medication on handy.
Read the full story here.
Photos courtesy of

Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds

The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution

Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution Lillian Ali - Staff Contributor April 25, 2025 12:50 p.m. For 25 of the 26 years the American Lung Association has reported State of the Air, Los Angeles—pictured here in smog—has been declared the city with the worst ozone pollution in the United States. David Iliff via Wikimedia Commons under CC BY-SA 3.0 Since 2000, the American Lung Association has released an annual State of the Air report analyzing air quality data across the United States. This year’s report, released on Wednesday, found the highest number of people exposed to unhealthy levels of air pollution in a decade. According to the findings, 156 million Americans—or 46 percent of the U.S. population—live with levels of particle or ozone pollution that received a failing grade. “Both these types of pollution cause people to die,” Mary Rice, a pulmonologist at Harvard University, tells NPR’s Alejandra Borunda. “They shorten life expectancy and drive increases in asthma rates.” Particle pollution, also called soot pollution, is made up of minuscule solid and liquid particles that hang in the air. They’re often emitted by fuel combustion, like diesel- and gasoline-powered cars or the burning of wood. Ozone pollution occurs when polluting gases are hit by sunlight, leading to a reaction that forms ozone smog. Breathing in ozone can irritate your lungs, causing shortness of breath, coughing or asthma attacks. The 2025 State of the Air report, which analyzed air quality data from 2021 to 2023, found 25 million more people breathing polluted air compared to the 2024 report. The authors link this rise to climate change. “There’s definitely a worsening trend that’s driven largely by climate change,” Katherine Pruitt, the lead author of the report and national senior director for policy at the American Lung Association, tells USA Today’s Ignacio Calderon. “Every year seems to be a bit hotter globally, resulting in more extreme weather events, more droughts, more extreme heat and more wildfires.” Those wildfires produce the sooty particles that contribute to particulate pollution, while extreme heat creates more favorable conditions for ozone formation, producing smog. While climate change is contributing to heavy air pollution, it used to be much worse. Smog has covered cities like Los Angeles since the early 20th century. At one point, these “hellish clouds” of smog were so thick that, in the middle of World War II, residents thought the city was under attack. The Optimist Club of Highland Park, a neighborhood in northeast Los Angleles, wore gas masks at a 1954 banquet to highlight air pollution in the city. Los Angeles Daily News via Wikimedia Commons under CC-BY 4.0 The passage of the Clean Air Act and the creation of the federal Environmental Protection Agency (EPA) in 1970 marked a turning point in air quality, empowering the government to regulate pollution and promote public health. Now, six key air pollutants have dropped by about 80 percent since the law’s passage, according to this year’s report. But some researchers see climate change as halting—or even reversing—this improvement. “Since the act passed, the air pollution has gone down overall,” Laura Kate Bender, an assistant vice president at the American Lung Association, tells CBS News’ Kiki Intarasuwan. “The challenge is that over the last few years, we’re starting to see it tick back up again, and that’s because of climate change, in part.” At the same time, federal action against climate change appears to be slowing. On March 12, EPA administrator Lee Zeldin announced significant rollbacks and re-evaluations, declaring it “the greatest day of deregulation our nation has seen.” Zeldin argued that his deregulation will drive “a dagger straight into the heart of the climate change religion.” Included in Zeldin’s push for deregulation is a re-evaluation of Biden-era air quality standards, including those for particulate pollution and greenhouse gases. The EPA provided a list of 31 regulations it plans to scale back or eliminate, including limits on air pollution, mercury emissions and vehicles. This week, the EPA sent termination notices to nearly 200 employees at the Office of Environmental Justice and External Civil Rights. “Unfortunately, we see that everything that makes our air quality better is at risk,” Kate Bender tells CBS News, citing the regulation rollbacks and cuts to staff and funding at the EPA. “If we see all those cuts become reality, it’s gonna have a real impact on people’s health by making the air they breathe dirtier.” Get the latest stories in your inbox every weekday.

Nearly Half of Americans Breathe Unhealthy Air, New Report Finds

By I. Edwards HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting...

FRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting your health at risk.A new American Lung Association report shows that 156 million people live in areas with unhealthy air.The group’s annual "State of the Air" report found that smog and soot pollution are getting worse, not better. The report looked at air quality data from 2021 to 2023. It found that 25 million more people than in the group's last report were breathing "unhealthy levels of air pollution." That's more than in any other "State of the Air" report in the last decade, the association said.Since the Clean Air Act became law in 1970, air pollution has gone down overall, said Laura Kate Bender, an assistant vice president at the lung association, told CBS News."The challenge is that over the last few years, we're starting to see it tick back up again and that's because of climate change, in part," she said. "Climate change is making some of those conditions for wildfires and extreme heat that drive ozone pollution worse for a lot of the country."The city with the worst year-round and short-term particle pollution? Bakersfield, California, for the sixth year in a row.What's more, it was ranked third worst for high ozone days. In contrast, Casper, Wyoming, was listed as the cleanest city for year-round particle pollution, CBS News said.Here are the top 10 cities with the worst year-round particle pollution, according to the association:Bakersfield-Delano, Calif. Visalia, Calif. Fresno-Hanford-Corcoran, Calif. Eugene-Springfield, Ore. Los Angeles-Long Beach, Calif. Detroit-Warren-Ann Arbor, Mich. San Jose-San Francisco-Oakland, Calif. Houston-Pasadena, Texas Cleveland-Akron-Canton, Ohio Fairbanks-College, Ark. The report warned that pollution isn't just an issue in the west. Extreme heat and wildfires are spreading pollution across the country.In fact, smoke from Canada's wildfires in 2023 caused unhealthy air quality even in the eastern parts of the U.S., the report pointed out.Some of the findings came as a surprise, according to Kevin Stewart, the association’s environmental health director."I think we knew that the wildfire smoke would have an impact on air quality in the United States," he told CBS News. "I think we were surprised at the Lung Association by how strong the effect was, especially in the northeastern quadrant of the continental United States." Last month, the U.S. Environmental Protection Agency (EPA) announced it will roll back 31 environmental rules, including ones pertaining to vehicle emissions, CBS News reported.Bender said that puts decades of progress at risk."Unfortunately, we see that everything that makes our air quality better is at risk," she said. "The EPA is at risk — the agency that is protecting our health — through staff cuts, funding cuts. The regulations that have cleaned up our air over time are at risk of being cut. If we see all those cuts become reality, it's gonna have a real impact on people's health by making the air they breathe dirtier."Lee Zeldin, the EPA administrator, argued that, instead, the deregulation will drive "a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the U.S. and more," according to CBS News."This air pollution is causing kids to have asthma attacks, making people who work outdoors sick and unable to work, and leading to low birth weight in babies," Kezia Ofosu Atta, the Lung Association’s advocacy director, told CBS News.The report also found that Black Americans are more likely to suffer serious health problems from air pollution.SOURCE: CBS News, April 23, 2025Copyright © 2025 HealthDay. All rights reserved.

Umbilical Cord Could Contain Clues For Child's Future Health

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health...

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health outlook, by analyzing their umbilical cord blood, a new study says.Genetic clues found in cord blood can offer early insight into which infants are at higher risk for health problems like diabetes, stroke and liver disease later in life, researchers will report at the upcoming Digestive Disease Week meeting in San Diego.“We’re seeing kids develop metabolic problems earlier and earlier, which puts them at higher risk for serious complications as adults,” lead researcher Dr. Ashley Jowell, a resident physician in internal medicine at Duke University Health System in Durham, N.C., said in a news release. “If we can identify that risk at birth, we may be able to prevent it.”For the study, researchers performed genetic analysis on the umbilical cord blood of 38 children enrolled in a long-term study based in North Carolina.The analysis looked for chemical patterns in infants’ DNA that switch genes on or off. When these switches occur in critical parts of DNA, their health effects can persist through fetal development and into later life.The research team compared these DNA changes to the kids’ health at ages 7 to 12, and identified multiple areas where genes in cord blood predicted health problems in childhood.For example, changes in a gene called TNS3 were linked to fatty liver, liver inflammation or damage, and excess belly fat as measured by waist-to-hip ratio, results show.Changes in other genes were connected to blood pressure, waist-to-hip ratio, and liver inflammation or damage, researchers said.“These epigenetic signals are laid down during embryonic development, potentially influenced by environmental factors such as nutrition or maternal health during pregnancy,” co-researcher Dr. Cynthia Moylan, an associate professor in the division of gastroenterology at Duke University Health System, said in a news release.Researchers noted that the sample size was small, but the links so powerful that these findings warrant further investigation. A larger follow-up study funded by the National Institutes of Health is underway.“If validated in larger studies, this could open the door to new screening tools and early interventions for at-risk children,” Moylan added.Jowell said disease may be preventable even with these markers."Just because you're born with these markers doesn't mean disease is inevitable," she said. "But knowing your risk earlier in life could help families and clinicians take proactive steps to support a child’s long-term health."Researchers are scheduled to present their findings May 4. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.SOURCE: American Gastroenterological Association, news release, April 25, 2025Copyright © 2025 HealthDay. All rights reserved.

Biden let California get creative with Medicaid spending. Trump is signaling that may end

California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs.

In summary California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs. In 2022, California made sweeping changes to its Medi-Cal program that reimagined what health care could look like for some of the state’s poorest and sickest residents by covering services from housing to healthy food. But the future of that program, known as CalAIM, could be at risk under the Trump administration.  In recent weeks, federal officials have signaled that support for creative uses of Medi-Cal funding is waning, particularly uses that California has invested in such as rent assistance and medically tailored meals. Medi-Cal is California’s name for Medicaid. The moves align with a narrower vision of Medicaid espoused by newly confirmed Centers for Medicare and Medicaid Services head Dr. Mehmet Oz, who said during his swearing-in ceremony that Medicaid spending was crowding out spending on education and other services in states with the federal government “paying most of the bill.” “This one really bothers me. There are states who are using Medicaid — Medicaid dollars for people who are vulnerable — for services that are not medical,” Oz said. It also fits with broader GOP calls to slim down the federal government. Medicaid is under scrutiny as part of a GOP-led budget process in the House of Representatives that calls for $880 billion in cuts over 10 years to programs including Medicaid. “The messaging that we want to go back to the basics of Medicaid puts all of these waiver programs in jeopardy,” said John Baackes, former chief executive of L.A. Care, the state’s largest Medi-Cal health insurer. CalAIM is authorized under a federal waiver that allows states to experiment with their Medicaid programs to try to save money and improve health outcomes. Under the waiver, California added extra benefits for high-cost users to help with food insecurity, housing instability,  substance use and behavioral health challenges. Roughly half of all Medi-Cal spending can be attributed to 5% of high-cost users, according to state documents. But in March, the federal government rescinded guidelines supporting Medi-Cal spending for social services. It also sent states a letter in April indicating that the Centers for Medicare and Medicaid Services would no longer approve a funding mechanism that helps support CalAIM, although that money will continue until 2026. Together, these moves should worry states that operate programs like CalAIM, said Kathy Hempstead, senior policy officer at the Robert Wood Johnson Foundation. “Under the Biden administration states were encouraged to experiment with things like that: To prescribe people prescriptions to get healthy food, to refer people to community-based services,” Hempstead said. “This administration is not receptive at all to … that vision of the Medicaid program.” In a press release, CMS said it is putting an end to spending that isn’t “directly tied to health care services.” “Mounting expenditures, such as covering housekeeping for individuals who are not eligible for Medicaid or high-speed internet for rural healthcare providers, distracts from the core mission of Medicaid, and in some instances, serves as an overly-creative financing mechanism to skirt state budget responsibilities,” the press release states. These signals from the federal government apply to future applications for Medicaid changes, and do not change California’s current programs or funding. The state’s CalAIM waiver expires at the end of 2026, and another similar waiver that supports California’s efforts to improve behavioral health care expires in 2029. According to a statement from the Department of Health Care Services, the agency that oversees Medi-Cal, all programs “remain federally approved and operational.” “We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes,” the department said. Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local Paul Shafer, co-director of the Boston University Medicaid Policy Lab, said decades of public health research show that people have worse health outcomes that require more expensive treatment when their social needs aren’t met. “We’ve spent the last few decades in public health and health policy, arguing that so much of health and medical costs is driven by environmental factors — people’s living conditions, income, etc.” Shafer said. But, Shafer said, programs like CalAIM are relatively recent and the research hasn’t had enough time to show whether paying for non-traditional services saves money. For example, California’s street medicine doctors who take care of people who are homeless say that their patients often cycle in and out of the emergency room — the most expensive point of service in the health care system. They have no place to recover from medical procedures, no address to deliver medications, and the constant exposure to the elements takes years off of their lives, doctors say.  CalAIM gives them options to help their clients find housing.  The federal government’s decision not to fund programs like this in the future is a “step backward,” Shafer said.  “I think we can all read the tea leaves and say that that means they’re sort of unlikely to be renewed,” he said. Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more. more on california health care They live in California’s Republican districts. They feel betrayed by looming health care cuts March 11, 2025March 12, 2025 California has big plans for improving mental health. Medicaid cuts could upend them April 7, 2025April 7, 2025

Chattanooga Just Became North America's First National Park City. Here's What That Means

The designation was awarded by a London-based charity that aims to make cities more like national parks: "greener, healthier and wilder"

Chattanooga Just Became North America’s First National Park City. Here’s What That Means The designation was awarded by a London-based charity that aims to make cities more like national parks: “greener, healthier and wilder” Sarah Kuta - Daily Correspondent April 23, 2025 4:20 p.m. Chattanooga was once one of the most polluted cities in the country. Now, it's North America's first National Park City. larrybraunphotography.com via Getty Images Chattanooga has been named North America’s first National Park City, a designation that acknowledges the city’s abundant green spaces and commitment to environmental stewardship. The city in southeast Tennessee, home to roughly 190,000 residents, is now the third National Park City in the world, following behind London and Adelaide, Australia. The title comes from the National Park City Foundation, a London-based charity that envisions a better future by thinking of cities more like national parks. The movement is not connected to the National Park Service, the federal agency that manages America’s national parks, monuments, historic sites and other protected lands. “[National parks] are special places where we have a better relationship with nature, culture and heritage and can enjoy and develop ourselves,” according to the foundation. “Combining the long-term and large-scale vision of national parks with cities has the potential to shift our collective understanding of what and who a city is for.” In Chattanooga, city leaders have used the initiative to encourage residents to “think about Chattanooga as a city in a park, rather than a city with some parks in it,” says Tim Kelly, the mayor of Chattanooga, in a video announcing the designation. “The outdoors is our competitive advantage,” he adds. “It’s at the heart of our story of revitalization, and it’s at the core of our identity as Chattanoogans. We’ve always known how special Chattanooga’s connection to the outdoors is, and now it’s going to be recognized around the world.” Chattanooga has been working toward the designation for nearly two years, per a statement from the city. In late 2023, officials collected more than 5,600 signatures of support and created a National Park City charter. Then, they filed an application describing how Chattanooga met the nonprofit’s criteria—such as being “a place, vision and community that aims to be greener, healthier and wilder.” Last month, delegates from the foundation visited Chattanooga to experience it first-hand. They toured an urban farm, explored several parks and met with various community leaders, per NOOGAtoday’s Haley Bartlett. The foundation’s experts were impressed by Chattanooga’s “culture of outdoor activity,” its “unrivaled access to nature,” its commitment to “inclusive and sustainable development” and its food and agriculture scene, among other factors. “We saw first-hand the extraordinary breadth and depth of engagement with the Chattanooga National Park City vision informed by outstanding experts in design, ecology, culture and arts,” says Alison Barnes, a trustee of the foundation, in a statement. “National Park City status introduces a new chapter for a city with a long history of revitalization and renewal through connecting its unique landscape and the history of its people.” Chattanooga has come a long way since 1969, when the federal government declared it the worst city in the nation for particulate air pollution. Hazy skies were the norm back then, as factories and railroads spewed unregulated emissions into the air, according to the Chattanooga/Hamilton County Air Pollution Control Bureau. Air pollution was so bad that residents sometimes had to drive with their headlights on in the middle of the day. But the pollution was more than just an eyesore. It was also causing the city’s residents to become sick—and sometimes die—from diseases like tuberculosis. Eventually, voters approved aggressive new rules to reduce emissions. By 1989, Chattanooga’s air quality had improved so much that it met all federal health standards. Today, it’s a vibrant, outdoorsy city with more than 100 parks and more than 35 miles of trails—plus many more within a short drive. The once-neglected riverfront downtown has been revitalized, and Chattanooga has experienced steady population growth in recent years. What does the National Park City designation mean for the city’s future? That remains to be seen. But officials hope it will help guide policy decisions and “help city government and community partners prioritize connecting more people to the outdoors that have long defined our identity,” according to a statement from the Chattanooga Area Chamber. It will also encourage citizens and leaders to embrace “all aspects of outdoor life,” from forests and lakes to native plants, according to the chamber. Mark McKnight, who serves as the president and CEO of Chattanooga’s Reflection Riding Arboretum and Nature Center, hopes that the new status will “yield some really cool stuff that we can’t even imagine today.” “Hopefully, we’re having this conversation in ten years, and it’s like, ‘Oh, wow, we never knew we would get to there,’” he tells the Chattanooga Times Free Press’ Sam Still. Get the latest stories in your inbox every weekday.

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