PORT-AU-PRINCE, Haiti (AP) — Haiti's online media association said two reporters were killed and a number of other others injured in a gang attack Tuesday on the reopening of Port-au-Prince's largest public hospital.

Street gangs have taken over an estimated 85% of Haiti's capital Port-au-Prince and compelled the closure of the General Hospital earlier this 12 months. Authorities had promised to reopen the ability on Tuesday, but as journalists gathered to cover the incident, suspected gang members opened fire in a brutal attack on Christmas Eve.

Robest Dimanche, a spokesman for the Online Media Collective, identified the dead journalists as Markenzy Nathoux and Jimmy Jean. Dimanche said an unspecified variety of reporters were also injured within the attack, which he blamed on the Viv Ansanm gang coalition.

Haiti's interim president, Leslie Voltaire, said in an address to the nation that journalists and police were among the many victims of the attack. He didn’t say what number of casualties there have been, nor did he provide a breakdown of those killed or wounded.

“I express my condolences to the victims, the national police and the journalists,” Voltaire said, promising that “this crime will not go unpunished.”

A video posted online by reporters trapped within the hospital showed what gave the impression to be two lifeless bodies of men on stretchers, their clothes covered in blood. One of the lads wore a lanyard with a press badge around his neck.

Radio Télé Métronome initially reported that seven journalists and two cops were injured. Police and officials didn’t immediately reply to requests for information concerning the attack.

Video previously posted online showed reporters contained in the constructing and no less than three people lying on the bottom, apparently injured. This video also couldn’t be immediately verified.

Johnson “Izo” André, considered Haiti's strongest gang leader and a part of a gang called Viv Ansanm that has seized control of much of Port-au-Prince, posted a video on social media claiming responsibility for took over the attack.

The video said the gang coalition didn’t approve the reopening of the hospital.

There have been attacks on journalists in Haiti before. In 2023, two local journalists were killed inside weeks of one another – radio reporter Dumesky Kersaint was fatally shot in mid-April of that 12 months, while journalist Ricot Jean was found dead later that month.

In July, former Prime Minister Garry Conille visited the National University of Haiti Hospital, higher generally known as the General Hospital, after authorities took back control of it from gangs.

Gang attacks have pushed Haiti's health system to the brink of collapse, with looting, fires and the destruction of medical facilities and pharmacies within the capital. The violence has led to a rise within the variety of patients and a scarcity of resources to treat them.

Haiti's health system faces additional challenges through the rainy season, which is prone to increase the chance of water-borne diseases. Poor conditions in camps and makeshift settlements have increased the chance of diseases reminiscent of cholera. According to UNICEF, there are over 84,000 suspected cases within the country.

policy

WASHINGTON (AP) — Former President Bill Clinton was admitted to Georgetown University Medical Center in Washington on Monday after developing a fever.

The 78-year-old was admitted to the hospital within the “afternoon for evaluation and observation,” Angel Urena, Clinton's deputy chief of staff, said in a press release.

“He remains in good spirits and deeply appreciates the excellent care he is receiving,” Urena said.

Clinton, a Democrat who served two terms as president from January 1993 to January 2001, gave a speech on the Democratic National Convention in Chicago this summer and endorsed Democratic Vice President Kamala Harris' unsuccessful bid for the White House ahead of November's election a.

In the years since Clinton left the White House, he has faced numerous health problems.

In 2004, he underwent quadruple bypass surgery after affected by persistent chest pain and shortness of breath. Clinton returned to the hospital in 2005 for surgery for a partially collapsed lung and had a pair of stents implanted in a coronary artery in 2010.

Clinton responded by adopting a largely vegan food plan, which led to weight reduction and improved health.

In 2021, the previous president was hospitalized in California for six days while being treated for an infection unrelated to COVID-19, when the pandemic was still near its peak.

An aide to the previous president said on the time that Clinton had a urological infection that spread to his bloodstream but was on the mend and had never suffered septic shock, a potentially life-threatening condition. The aide said Clinton was within the hospital's intensive care unit on the time, but was not being treated within the intensive care unit.

Despite criticism from some city leaders in recent weeks over HCA Healthcare's previous service cuts, the San Jose City Council won’t stand in the way in which of the health care provider's plans to construct a brand new facility at Good Samaritan Hospital.

Instead, the City Council voted unanimously Tuesday to rezone the hospital's campus in order that the permitting process could move forward to construct recent facilities that comply with state seismic laws. The project received overwhelming support from patients, work groups and healthcare professionals.

“We will not address the lack of behavioral health capacity in our community by delaying a seismic rehabilitation and rebuilding of a hospital that has provided excellent health services to so many in our community,” said San Jose Mayor Matt Mahan.

Due to the age of most of its facilities, HCA must rebuild all but one structure on Good Samaritan's campus to satisfy seismic requirements that take effect January 1, 2030.

Without the seismic setbacks, the state could revoke the Good Samaritan's license to offer acute care beds, which might place greater strain on the health care system. HCA estimates it is going to invest $1.2 billion within the project to permit the present hospital to stay operational during construction.

The recent project could create 1,000 construction jobs along with supporting the hundreds currently working on the hospital.

“We are grateful for the San Jose City Council’s approval of the proposed $1.2 billion investment to meet the state’s seismic safety requirements,” the hospital wrote in a press release to The Mercury News. “This investment is critical to ensuring our 55,045 annual patients continue to have access to essential community health care now and into the future. We greatly appreciate the Council’s decision and the extraordinary support of the San Jose community.”

The city approved an analogous project last month when Kaiser Permanente received approval to start construction of its recent hospital in South San Jose.

HCA initially attempted to rezone its property to extend the allowable floor area for the brand new hospital. The company still needs to acquire its permits before it may possibly begin construction.

But as a substitute of its application being treated as an easy land use issue prematurely of Tuesday's meeting, like Kaiser's project, HCA faced stiff opposition from community groups, planning commissioners and even City Council members due to impression that profits were more essential than patients Compromise care and harm the healthcare system.

In a symbolic vote last month, town's Planning Commission decided to not recommend approval of the Good Samaritan project after a flood of critical comments about HCA's business practices.

Similarly, the Rescue Our Medical Care campaign – a coalition of community advocacy groups – targeted HCA for previously reducing services at various facilities in Santa Clara County.

They remembered the downgrading of East San Jose Regional Medical Center's trauma unit, which ultimately led to the county purchasing the hospital to revive care.

The group also cited the closure of San Jose Medical Center, the closure of the maternity ward at Regional Medical Center and the elimination of acute psychiatric beds at one other facility.

Fearing possible cuts to services at Good Samaritan Hospital, the campaign demanded that HCA establish a patient protection fund and restore acute psychiatric beds.

“I’m not against development,” said Darcie Green, executive director of Latinas Contra Cancer. “I am opposed to HCA, the company, writing a blank check to worsen our quality of life and create health disparities that would not otherwise exist in this city. Our general plan includes equal access to health care. HCA’s closures and divestitures undermine the City’s vision of a connected, healthy community with access to essential services.”

fifth District Councilman Peter Ortiz was sympathetic and sought to delay the method so HCA officials could meet with more community members and hearken to their demands. Ortiz also claimed that town could take HCA's previous actions into consideration during deliberations.

“I just want to note that the council has the right and responsibility to consider the community benefit of a health care organization when making land use decisions,” Ortiz said. “Furthermore, the General Plan requires us to support development that meets the health needs of the residents of this city, not just a portion of the city, but the entire city, and we must ensure that there is no adverse impact.” on your complete health system of the district.”

However, the prosecution disagreed.

“We have a lot of guidelines that are very broad, but ultimately the decision has to be related to the location, the neighborhood, the location and that particular use,” said Assistant District Attorney Johnny Phan.

Although HCA acknowledged it had reduced inpatient psychiatric services, the corporate said it might consider adding them to the ability under the suitable circumstances. Complicating matters, nevertheless, was the dearth of psychiatrists to satisfy the county's behavioral health needs.

“This community currently has a shortage of 61 psychiatrists to meet the need, and so I think we need to work together to figure out how we can close that deficit so we can meet the need,” said Jackie Van Blaricum , President of HCA's Far West Division. “It’s not just about the beds. It’s about having doctors who support these patients.”

HCA has also signaled its support for establishing a community advisory board, like those found at other facilities, to advertise dialogue about operations and make sure the hospital is a great steward.

As a part of the advantages package negotiated by District 9 Councilmember Pam Foley, HCA agreed to pay $3 million to town for emergency shelter and inexpensive housing construction, although the project is exempt from business connection fees.

“The connection between housing and health care is undeniable,” Foley said. “People in stable housing are going to have better outcomes, health outcomes, which is why I look at these funds not just as housing, but as health funds.”

While Good Samaritan warns San Jose officials against delaying approval of its latest hospital, a newly released construction schedule revealed the ability may not open in time to interchange the present hospital, which can meet the state's seismic requirements in 2030 now not meeting will place greater strain on local health services.

The Good Samaritan campus – owned by HCA Healthcare – is currently going through the rezoning approval process.

Good Samaritan CEO Patrick Rohan revealed at a committee meeting Wednesday that the hospital is already behind schedule as he seeks to have the City Council consider the corporate's rezoning application on Nov. 19.

“The first phase of the project alone will take six years, meaning any delay will jeopardize state-mandated seismic schedules and the hospital’s ability to remain open,” Rohan said. “The postponement of the decision is not just a delay. It effectively ensures that a vital community hospital will be closed and this area of ​​San Jose will be left without access to acute care.”

Under California law, all older hospitals that provide acute care beds, meaning beds for patients who need around-the-clock medical care, must meet seismic requirements by the tip of this decade. Good Samaritan officials warned that the state could revoke its facility's license by that date without retrofitting or replacing the present hospital.

To avoid disruption to patient care, the healthcare provider intends to proceed operating the present hospital while it builds the brand new facilities, which include a parking garage and a central power plant.

Rohan estimated the project will cost $1.2 billion. Since the brand new hospital will sit in the present car parking zone, Rohan said Good Samaritan will construct the parking garage first, which he estimated would take 12 to 14 months. The power plant would follow an analogous schedule before construction of the hospital begins.

Although Kaiser Permanente Hospital in San Jose goes through the identical process the town approved last month, HCA and Good Samaritan faced a way more difficult path.

Last month, the town's Planning Commission really helpful that the City Council reject the hospital's plan as several commissioners criticized HCA for its past business practices that they said put “profits over people.”

At the center of their dissatisfaction were Good Samaritan's decision to now not offer acute psychiatric beds and HCA's plan to downgrade the trauma unit at East San Jose Regional Medical Center before the county purchased the hospital and restored services.

Nursing staff also questioned how HCA would have the opportunity to offer effective patient care with the brand new facility when the present hospital cannot provide adequate staffing.

HCA called the Planning Commission's decisions arbitrary and illegal in a transient filed by its attorneys at Cox, Castle & Nicholson LLP.

The hatred toward the Good Samaritan and the HCA continued Wednesday when District 5 Councilman Peter Ortiz requested a postponement to get more feedback from the community, adding that the town “rewards bad actors or holds them accountable.” “can pull”.

“Our general plan holds the city accountable for ensuring our health resources are planned with equity in mind and that everyone has access to services,” Ortiz said. “We as council members have this responsibility.”

Jaria Jaug, associate director of nursing policy at Working Partnerships USA, said stakeholders need to be on the table negotiating a patient protection fund with community oversight to revive psychiatric care on the hospital and forestall future divestitures.

“The city is committed to helping address the homelessness and mental health crisis,” Jaug said. “Companies that are exacerbating these crises should give back to the community and help solve the problems we face. HCA has a reputation for divesting wherever it is not profitable, even at the expense of the community and mental health care.”

sixth District Councilmember Dev Davis also got right into a tense dialogue with Rohan after she repeatedly asked him what happens to individuals who need acute mental health care and received no response.

“I’m not just for preserving, protecting and expanding medical services,” Davis said. “I think you need to restore health care, particularly the very urgent mental health needs that we have in this county and this community. I think it’s horrible that you closed your mental health facilities and you have another chance.”

However, ninth District Councilwoman Pam Foley, who represents the world where the hospital is situated, declined to support the postponement request, citing concerns concerning the negative impact delays could have on the community.

Foley said her office has provided significant community engagement beyond the necessities outlined in city policy and is in energetic negotiations with HCA to create greater community advantages.

“It bothers me a little that my office, in coordination with city staff and the Good Samaritan, did not do our due diligence regarding outreach and community engagement,” she said.

The Good Samaritan didn’t reply to questions from The Mercury News about its plans and the impact on services if the brand new hospital just isn’t operational by January 1, 2030.

Instead, the hospital continued to attract attention to the devastating impact of delaying its approval.

“Good Samaritan Hospital has been a faithful steward of the San Jose planning process and has extensively communicated the benefits and impacts of our $1.2 billion proposal and state-mandated seismic retrofit,” Good Samaritan Hospital said in an announcement. “We incorporated this feedback into the plan presented to the city council. Any delay in our proposal assuming more feedback is needed jeopardizes the state’s enormous legal deadlines and jeopardizes the hospital’s ability to remain operational.”

Originally published: November 8, 2024 at 6:05 am PST

On Wednesday, registered nurses protested outside the ability, accusing Good Samaritan Hospital and its parent company HCA Healthcare of jeopardizing patient care. They alleged the health care provider failed to deal with staffing shortages and inadequate meal breaks.

The California Nurses Association said hospital management had not yet adequately addressed greater than 100 cases of unsafe staffing conditions or missed breaks, claiming the health agency was putting profits over people.

“We take care of a lot of sick people, and as a nurse I only have two hands,” said Chris Shulga, a registered nurse on the hospital for greater than 12 years. “I can only do as much as these two hands can do. So when we have seriously ill patients, we simply need more people. We need more bodies, we need more hands and we need more minds just to do all the tasks required for these very sick patients. We are not given the opportunity to care for your family members in this hospital.”

At the guts of the issue is compliance with Title 22, the federal regulations that set the required ratio of registered nurses to patients. The nurses gathered outside the hospital also accused the hospital of attempting to game the system to make it appear that it was complying with regulations. At the identical time, they said the fact reflects that nurses are getting used for other duties since the hospital can also be understaffed in other positions, which has affected the hospital's ability to offer care in a timely manner.

“It looks like they're actually giving their numbers, but that's not the case,” said registered nurse John Pasha. “What I mean by them making their numbers is that they hit everyone and do it in a reasonable amount of time. But they delay treatment for hours and hours, so things like medications are delayed, and then there will be an increase in pressure sores, which are usually caused by things like that. When we start losing bedside nurses, other things fall by the wayside.”

HCA Healthcare denied the allegations in an announcement to The Mercury News.

“Facts matter, especially in healthcare,” said a spokesperson for Good Samaritan Hospital. “We fully appreciate the incredible work our nurses do, so it is disappointing that their union leadership chooses to misrepresent the care they provide. To be clear, Good Samaritan Hospital is 100% compliant with Title 22 requirements, hired 83 nurses in 2024, reduced nursing staff turnover by nearly 7%, and is ranked among the top 100 hospitals in America each year according to Healthgrades. Our hospital, our nurses and our doctors are here 24 hours a day, every day, to care for our community.”

HCA's history in San Jose, particularly because it pertains to operations on the Regional Medical Center, has change into a hot topic amongst nurses and residents.

Earlier this yr, HCA initially decided to shut the trauma center at Regional Medical Center before changing course and downgrading it from a Level II facility to a Level III facility. At the time, doctors and nurses were outraged by the HCA due to its impact on residents in East San Jose, who were forced to travel longer distances to receive treatment for more serious procedures. While Santa Clara County stepped in on the last minute to purchase the hospital and save the trauma center, critics of HCA say its actions are further evidence of its business model and that the corporate is putting patient well-being above profits.

The unresolved concerns facing HCA were highlighted at a recent San Jose Planning Commission meeting, where the advisory panel really useful the City Council deny its request to rezone the Good Samaritan campus to accommodate a brand new facility in compliance with state regulations to ascertain earthquake laws and expand operations.

Several commission members said HCA's profit motive harms residents and wondered what would stop Good Samaritan from cutting more services, because it did when it closed its psychiatric unit.

Although the Planning Commission's decision was purely symbolic for the reason that City Council is the ultimate arbiter, some nurses were pleased to listen to San Jose officials defy the HCA.

“It is a very profitable institution, and if you expand it, it will only become more profitable,” Pasha said. “The problem is that if we can't staff it now and they cut corners now with the size they have now, how are they going to not cut corners over time? They have simply proven that they will do anything to save money, not by innovating more, but by eliminating their work.”

Originally published: October 30, 2024 at 3:13 pm PDT

The 49ers had the grim task of reflecting on one other mistake-filled loss on Monday, but Deebo Samuel wasn't there to see it.

Samuel, who called in sick to work Sunday morning before the 49ers' 28-18 loss to the world champion Kansas City Chiefs, was within the hospital recovering from pneumonia.

“He had some fluid in his lungs, so technically pneumonia,” Shanahan told local media during a conference call. “He went in last night. It started acting up in the middle of the night on Saturday night or early Sunday morning, and it kind of evolved throughout the day. After the game, when we found out there was fluid in his lungs, they took him to the hospital. I found out Sunday night when I was home.”

Samuel needed an oxygen mask at one point early in the sport and was out of uniform within the second half.

Samuel's illness, combined with a season-ending knee injury to Brandon Aiyuk just before halftime and a hip injury that sidelined Jauan Jennings, caused the 49ers to regulate their receiving plans on the fly.

It's conceivable that Samuel and Jennings may very well be available when the 49ers host the Dallas Cowboys on Sunday night, but that's not certain.

Despite the missing receivers, Shanahan saw enough while watching the film to imagine that the 49ers' fifth straight loss to Kansas City during his tenure was self-inflicted, just like the losses to the Rams and Cardinals earlier this season.

The players first met with Shanahan to get an outline of all three phases (offense, defense and special teams) after which adjourned for position group meetings where each positive and negative plays were examined intimately. Considering the 49ers cut Kansas City's result in 21-12 and had loads of time to tie inside one rating, the message was the potential for a win moderately than one other tough loss.

“It’s always hard to come in and watch after a game like that,” Shanahan said. “But I thought the boys handled it well. I wanted to show, no matter how bad it felt, how many times we had a chance to win. I'm not trying to take anything away from Kansas City, but we hurt ourselves and there are things we dictate.

“We managed it at times, were close, but made too many mistakes. . . If you don't correct that, it doesn't matter who you play. At the end of the day, you're a .500-type team.

Middle linebacker Fred Warner really wanted to move to Dallas.

“You can do one of two things: You can sulk over a loss or you can see what the reality is, fix the problem, move on and win a game next week,” Warner said. “So much will be said about our current situation and this team. That won't get us anywhere. That won't help us next week. We have to deal with reality, put it behind us, move on and win a game.”

THE BROCK CONVERSATION

Shanahan was talking a few postgame conversation with quarterback Brock Purdy at his locker. Purdy had perhaps his worst game as a 49er when he went 17 of 31 for 212 yards, no touchdowns and three interceptions and a passer rating of 36.7, the bottom of his profession.

The two spoke for five minutes in front of a gaggle of reporters.

“I didn’t know you all had my back and were spying on us,” Shanahan said. “I just went back and he was standing right there. . . I didn't know everyone was still in there. Then when I looked behind you, I was afraid of you. I didn't know everyone was feeling so bad.

Commenting on Purdy’s performance, Shanahan said: “Brock has had a heck of a year. He didn't have his best game yesterday.

POST-BYE REINFORCEMENTS

Running back Christian McCaffery continues to make progress as he recovers from Achilles tendonitis in both ankles. He is still unlikely to play against Dallas, although he could be included in the reinforcements after the bye week in Week 9.

“Christian is still making progress in his rehab,” Shanahan said. “He hasn’t suffered any setbacks so it’s only been good news so far. I would be surprised if I got him back this week, but I hope the bye week goes well and we have a much better chance after the bye week.”

Other additions after the bye, although not necessarily in Week 10, include linebacker Dre Greenlaw (Achilles) and place-kicker Jake Moody (high ankle sprain).

Players who left the Chiefs game with injuries included tight end George Kittle (foot) and wide receiver Chris Conley (ankle).

QUICK JUDGMENTS

A take a look at the distribution of playing time within the 49ers' loss to the Chiefs. . .

70: After missing the Seattle game with a knee injury, Charvarius Ward played every snap together with safety Ji'Ayir Brown, cornerback Deommodore Lenoir, Warner and safety Malik Mustapha.

54: Left tackle Trent Williams missed the ultimate nine snaps of the sport, leaving Jaylon Moore after he was sent off for a success on the Chiefs' Bryan Cook. The remainder of the starting lineup, Aaron Banks, Colton McKivitz, Jake Brendel and Dominick Puni, played all 63 snaps.

44: Defensive tackle Jordan Elliott played a season-high in snaps and had three solo tackles and one assisted tackle.

39: Linebacker Dee Winters played the very best variety of snaps of his profession, while Demetrius Flannigan-Fowles didn’t play on defense but had 16 snaps on special teams.

36: Defensive end Sam Okuayinonu played the very best variety of snaps this season. His role increases within the absence of Yetur Gross-Matos with 19, 24 and 32 snaps within the last three games with the Chiefs.

25: Brandon Aiyuk won't play his next snap until 2025 after being injured late in the primary half.

5: Cornerback Isaac Yiadom was coming off a game in Seattle where he played a season-high 77 snaps (99 percent). The rookie Green replaced played a season-low five snaps against the Chiefs.

4: Samuel tried to play but ended up within the hospital.

Originally published: October 21, 2024 at 5:08 p.m

LOS ANGELES – A Richmond man sentenced to life in a psychiatric hospital for a brutal, random murder in 2009 is back behind bars this week after police arrested him for escaping his rehabilitation center and spent a month on the run from court, records show.

Michael Villalobos, 41, became a wanted man on August 21 after he escaped from a mental health rehabilitation center in Los Angeles. He was arrested by Los Angeles County sheriff's deputies on Sept. 23 and extradited to Contra Costa County, where prosecutors will try a second time to steer a judge to carry Villalobos in a locked facility, something they didn’t do in court Date back in May, records show.

In 2009, Villalobos beat 79-year-old Euvaldo Sisneros to death because the two passed one another on a sidewalk. The two didn’t know one another and there was no apparent motive for the murder, police said on the time. Villalobos later pleaded guilty to second-degree murder, but in a pre-arrangement agreement with prosecutors, he was found not guilty by reason of insanity and received psychiatric treatment as a substitute of prison time.

At the time of his sentencing, prosecutors warned that Villalobos would grow to be dangerous to others if he didn’t take medication and that he had multiple assault convictions before the murder.

Villalobos has spent the last 18 years in various psychiatric facilities, most recently one in a Hover Street neighborhood in Los Angeles, authorities said.

Back in May, Contra Costa Superior Court Judge Julia Campins rejected a prosecutor's request to transfer him from that facility to Napa State Hospital, a locked facility that frequently houses incarcerated individuals with mental illnesses. Campins was criticized last yr for an identical situation, when a person who had held a Lafayette family hostage escaped from a halfway house after the judge allowed him to qualify for a mental health diversion program over prosecutors' objections .

The Contra Costa District Attorney's Office is renewing its motion in light of Villalobos' alleged escape attempt. He is due in court on Wednesday at 1:30 p.m.

Originally published: October 1, 2024 at 5:28 p.m

Some states and hospital systems have updated their drug testing policies for pregnant women and newborns to higher support substance use disorder treatment and recovery for patients and to deal with racial disparities in testing and reporting.

According to federal lawHealth professionals must notify child protection authorities if an infant is affected by the mother's substance use, including alcohol consumption. However, the federal rules apply – which were Updated 2016 in response to the opioid epidemic – emphasize that independent substance use disorder doesn’t constitute child abuse and requires states to develop their very own “Safe Care Plans” to advertise the long-term health of the newborn and the mother.

But federal law doesn’t define “affected,” and testing and reporting policies vary from state to state and even hospital to hospital. As the opioid crisis continues, among the nation's major hospital systems and a handful of states have taken or are considering taking less punitive measures so long as the infant will not be in immediate danger.

One impetus for change is research showing that black women are pregnant they usually tend to be drug tested and long-standing disparities in the best way Black and Indigenous families live treated by child welfare institutions. Mental illness and substance use have also occurred Main causes the reason for maternal deaths, in response to the federal Centers for Disease Control and Prevention.

“Data on bias in reporting on child well-being related to substance use by pregnant/birthing people has existed for decades,” Sarah Roberts, a legal epidemiologist and professor on the University of California, San Francisco, wrote in an email to Stateline. Roberts Sense Testing policies across the country.

What has modified, Roberts said, is a growing awareness of the harms related to over-testing and over-reporting to child protective authorities.

Only two states, Minnesota and North Dakota, have laws requiring drug testing of pregnant patients in certain circumstances, reminiscent of complications during childbirth that indicate possible drug or alcohol use, they are saying an evaluation by If/When/How, a reproductive justice nonprofit. And only 4 states (Louisiana, Minnesota, North Dakota and Wisconsin) require drug testing of newborns under certain circumstances.

But hospitals and doctors are sometimes confused about their very own states' laws, Joelle Puccio said. Director of Education on the Academy of Perinatal Harm Reduction, which provides information for pregnant women and drug-using parents.

“What is actually happening is more and more punitive, more surveillance than required by law, and it is increasingly affecting Indigenous, Black and other families of color,” said Puccio, who has worked as a registered nurse in perinatal and perinatal surgery for twenty years within the intensive care unit working for newborns.

Mass General Brigham in Boston, one in all the country's most respected hospital systems, announced changes to its perinatal reporting policies in April as a part of a broader effort to eliminate practices that might “unintentionally perpetuate structural racism.”

Provided that the infant will not be in imminent danger, the hospital will only conduct toxicology tests with the written consent of the pregnant patient and can report positive results to child protection authorities provided that doctors determine that the infant is suffering or in imminent danger. Mass General Brigham may also move away from considering a baby's exposure to drugs or alcohol — including the mother's medication treatment for opioid use disorder — as an automatic reason for reporting abuse or neglect. This is meant to counteract the stigma that pregnant patients often face during treatment with such medications and which causes them to fear health care.

“The biggest deterrent for people seeking care was the concern that if they received buprenorphine or methadone, a life-saving treatment for opioid use disorder, they would have an open case with the Department of Children and Families,” said Dr. Davida Schiff, director of perinatal and familial substance use disorder care at Mass General Brigham. “We know that buprenorphine and methadone reduce the risk of overdose.”

Dr. Allison Bryant Mantha, a gynecologist and deputy chief health equity officer at Mass General Brigham, said a priority of the policy change is to cut back the scope for bias.

“When you give people a lot of leeway, sometimes prejudice creeps in,” she said. “Sometimes minimizing variability leads to equity.”

legislation was introduced within the Massachusetts Senate to guard parents from scrutiny by child protective services or criminal prosecution if their infant was exposed to a substance in utero.

Other states have already approved such policies. Since 2019, Connecticut has directed health care providers to maintain parents' identities private when reporting a positive test to child protective authorities and as a substitute provide supportive services. This 12 months, New Mexico A law was also passed that not considers substance use disorders to be abuse or neglect.

And in 2020 Colorado has updated its definition of kid abuse and neglect to exclude cases by which a newborn tests positive for substance or alcohol exposure and the mother is on medication.

But hospital staff still express confusion about state laws, said Britt Westmoreland, a doula and addiction recovery specialist on the University of Colorado College of Nursing.

“I have had hospitals whose policies were more punitive than state law,” Westmoreland said, “and I addressed that head-on by educating them about state law.”

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