‘Crisis intervention’ where police once went

The ideas and innovators shaping health care

Aug 02, 2023 View in browser   By Ben Leonard, Erin Schumaker and Evan Peng POLICY PUZZLE Congress passed legislation in 2021 to fund new approaches to helping people in crisis. | Getty Images The Biden administration is boosting an experiment in downsized policing sparked by George Floyd’s murder by a Minneapolis police officer in 2020. California and Kentucky are the latest states to win the Centers for Medicare and Medicaid Services’ approval to offer mobile crisis intervention in Medicaid. If they succeed, it could reduce the number of 911 calls to which police respond. Both states received permission to deploy intervention teams to respond to people experiencing mental health and substance use crises. Why it matters: The teams are part of an effort Congress endorsed in the American Rescue Plan, a 2021 Covid-relief law, to reduce police involvement in some volatile situations. The law appropriated more than $1 billion to help as many as 22 states pay for crisis response teams. The idea was to see whether trained health care workers could replace police in some instances. CMS approved proposals from California that will enable the state to facilitate “a warm handoff” and follow-up check-ins, and Kentucky is adding stabilization services. CMS is pitching the program as a way to avert expensive inpatient services. On the road: It’s also the latest effort to make health care more nimble. Mobile clinics have gained momentum since the pandemic’s beginning, with 40 percent growth since 2019, according to the National Association of Community Health Centers. They were widely used as vaccination sites to help reach people where they live.   A NEW PODCAST FROM POLITICO: Our new POLITICO Tech podcast is your daily download on the disruption that technology is bringing to politics and policy around the world. From AI and the metaverse to disinformation and cybersecurity, POLITICO Tech explores how today’s technology is shaping our world — and driving the policy decisions, innovations and industries that will matter tomorrow. SUBSCRIBE AND START LISTENING TODAY.     WELCOME TO FUTURE PULSE Ninh Bình, Vietnam | Evan Peng This is where we explore the ideas and innovators shaping health care. Canada will require tobacco companies to affix a label to each individual cigarette starting next summer, advising smokers that "cigarettes cause cancer" and that there's "poison in every puff." Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Megan Messerly talks with Megan R. Wilson and David Lim about the legislation Congress needs to pass before funding for crucial health programs runs out on September 30. Listen to today’s Pulse Check podcast THE NEXT CURES Why Lyme disease's effects linger for some is still a mystery. | Centers for Disease Control and Prevention The National Institutes of Health wants to find out what causes lingering Lyme disease symptoms like pain, fatigue and brain fog. The NIH’s National Institute of Allergy and Infectious Diseases is funding research into post-treatment Lyme disease syndrome. The agency awarded $3.2 million last month in first-year funding for five projects investigating the causes of chronic Lyme disease. “As tickborne diseases, including Lyme disease, become more common and widespread in the United States, it is increasingly urgent that we understand all facets of the disease, including the root causes of PTLDS,” Hugh Auchincloss, NIAID’s acting director, said in a statement. What we know: — Lyme disease is spread to humans by ticks infected with the Borrelia burgdorferi bacterium. — Most people who contract Lyme respond to a short-term course of oral antibiotics, but some continue to report symptoms after their infection clears. — Chronic Lyme disease has no standard treatment. Despite little evidence that long-term antibiotics are effective, some doctors prescribe them, but the drugs carry their own risks and side effects. What we don't know: Chronic Lyme disease’s cause. Some scientists hypothesize that chronic Lyme could be an autoimmune response to the Borrelia burgdorferi bacterium, meaning patients’ immune systems are attacking their own cells. Effective treatments are difficult to develop without understanding the biological mechanism causing chronic Lyme. Why it matters: The Centers for Disease Control and Prevention estimates that 476,000 people in the U.S. become infected with Lyme disease each year. As many as 1 in 5 have lingering symptoms. What’s next? In addition to better treatments, understanding the biological mechanisms that trigger post-treatment Lyme disease syndrome could further understanding of other infection-related chronic diseases, like long Covid and chronic fatigue syndrome.   YOUR TICKET INSIDE THE GOLDEN STATE POLITICAL ARENA: California Playbook delivers the latest intel, buzzy scoops and exclusive coverage from Sacramento and Los Angeles to Silicon Valley and across the state. Don't miss out on the daily must-read for political aficionados and professionals with an outsized interest in California politics, policy and power. Subscribe today.     AROUND THE AGENCIES There's a changing of the guard coming at the NIH's National Institute of Allergy and Infectious Diseases. | AP The NIH's National Institute of Allergy and Infectious Diseases — led for decades by Dr. Anthony Fauci — has a new director. Dr. Jeanne Marrazzo, who currently directs the University of Alabama at Birmingham's Division of Infectious Diseases, will lead the agency, NIH Acting Director Lawrence Tabak said Wednesday in announcing his selection. Marrazzo is an infectious disease expert known for her research on sexually transmitted infections. She focuses on the human microbiome as it relates to female reproductive tract infections and hormonal contraception. She served on the governor of Alabama’s Covid-19 task force during the pandemic. Why it matters: The $6.3 billion NIAID conducts and supports research on the causes of infectious diseases, as well as how to prevent, diagnose and treat them. It also responds to emerging public health threats, including infectious disease outbreaks, such as HIV, Ebola and Covid-19. Fauci, who led the agency for nearly 40 years, stepped down in December 2022. What’s next? Marrazzo will start her role in the fall.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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