Philadelphia is addressing its opioid crisis by deploying mobile medical units to provide Medicaid-funded "street medicine" to the unhoused population.

This initiative was made possible by a recent Pennsylvania policy change, allowing the city to bill Medicaid for outreach site medicine.

Maire St. Ledger, family nurse practitioner from Project HOME's Epstein Street Medicine program, said the opioid epidemic has significantly increased homelessness in Philadelphia, and its mobile units aim to offer both essential care and dignity to unhoused people.

"There are a number of organizations that are providing medical care to people who are unhoused," said St. Ledger. "But we're the only team that we know of providing primary care. So, there are a lot of people that will go out with vans who will do point-of-care testing for HIV, for example. There's another van that just does wound care, but we do all of that."

St. Ledger highlighted the program's significant impact on participants -- aiming to improve medical outcomes, build trust, and enhance access to health-care and support services with holistic, trauma-informed and harm-reduction care.

She noted a few years ago, MPOX spread rapidly, but collaboration with the local health department and community partners helped prevent further spread through vaccination.

St. Ledger said they rely heavily on their outreach teams to build relationships with the participants, which helps the mobile unit assist people by providing them with resources.

"They try to engage with patients or with people who were unhoused," said St. Ledger. "It might just be, in the beginning, bringing them some water, bringing them clean socks or a blanket - building those relationships, getting them referred to housing, to shelters, to detox, to rehab, whatever it might be."

Dr. Judy Chertok is a physician and associate professor at the University of Pennsylvania, collaborating with Prevention Point Philadelphia on the Overdose Surge Response Bus, launched in the summer of 2020.

Using city data to identify overdose hotspots, the team deploys its mobile unit to provide crucial resources to the hardest-hit communities.

"We collaboratively work to do some canvassing and provide lots of harm-reduction supplies, Narcan," said Chertok, "and then, for people that are interested, they can meet with the doctor and do same day starts of medication like Buprenorphine for addiction."

Chertok said a new survey on the Mobile Overdose Response Program examines several aspects, including the general demographics of around 200 patients.

It also analyzes housing rates, substance-use severity, and predictors of engagement and care after using the mobile unit.

"So the unit sees people for a few weeks, and then links them to ongoing care," said Chertok. "And so we try to look to see if there are any facilitators of what help someone get from this mobile space into ongoing care and stay on medication."

Support for this reporting was provided by The Pew Charitable Trusts.




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The Conservation Fund, which works to protect land and nature across the U.S. has announced it has protected more than 1 million acres of working forests lands across the country, including in Oregon.

The organization's milestone comes as forests are rapidly disappearing -- as many as 13 million acres in the next few decades.

Brian Dangler, director of the Working Forest Fund with The Conservation Fund, said valuable work continues on the protected land which adds to the nearby economy.

"The beauty of these projects is that the receipts from the timber, the sustainable management of forests, timber harvest really helps local folks to keep the schools going, the fire department, the local services," he explained.

He added The Conservation Fund has helped protect forestland in the Columbia River Gorge near Hood River and Deep River Woods near Astoria. Nationwide, it's secured forests in 21 states. The organization uses community and private partnerships to protect nature.

Dangler said large, intact forests support jobs in rural communities, through logging, trucking, building roads and other activities.

"And, of course, the wildlife habitat that goes along with it. Good forest management usually improves wildlife habitat for lots of different species," he continued.

Dangler noted development is one of the biggest threats to forests, and said it's important to keep forestlands as units rather than smaller parcels.

"Eventually more and more development just nibbles away at these large, intact forests. It's very important for them to be large in landscape," he said. "It's like Humpty Dumpty -- you can't put it back together again when it gets fragmented so much."

Summer in Indiana produces a variety of festivals, outdoor concerts, and athletic competitions.

These attractions produce large crowds and hundreds of pounds of trash and food containers which could end up in a landfill.

"The Indianapolis Event Waste Guide" is an environmentally-focused publication with resources and contact information for nonprofits and vendors wanting to reduce waste.

Ecosystems Events Owner Julia Spangler said the publication is for events attended by a dozen or thousands of people.

"Bringing people together, especially if you're feeding them or decorating, often generates waste," said Spangler. "So, this guide is all about first, how to reduce the amount of waste generated in the first place, and then how to keep that waste out of the landfill."

Spangler described the publication as a "one-stop shop starting point" for recycling or composting food, waste, leftover lanyards, or banners.

In 2021, Indiana collected more than nine million tons of garbage, refuse, office waste and other similar materials.

The Indianapolis Event Waste Guide was released to coincide with the U.S. Olympic swimming trials held in Indianapolis last month.

As the state continues to draw large crowds at amateur and professional athletic competitions, event planners are looking for ways to reduce their carbon footprint.

Sustain Indy Community Manager, and City of Indianapolis Office of Sustainability Community Engagement Manager Lyndsay Trameri noted the guide is intended for local residents and out-of-town organizers.

"Just because you're planning an event in the town you live in," said Trameri, "that doesn't mean you're aware of all the different contacts and organizations that are local that can help you decrease your footprint."

Trameri added that city leaders have a plan for Indianapolis to be net zero emissions by 2050. Trameri said you can download the free guide on the Visit Indy website.

Weather researchers at Iowa State University say a shifting climate and warmer ocean temperatures are partially responsible for a record number of tornadoes this spring.

More than 100 were reported in Iowa, in May alone.

Eleven hundred tornadoes were reported regionwide in May -- from Texas to Minnesota, and from West Virginia to Georgia. That's more than twice the 30 year average.

One of the fiercest killed five people and injured dozens in rural Greenfield, Iowa.

ISU Severe Weather Meteorologist and Professor of Meteorology William Gallus said extreme heat from a changing climate has increased ocean temperatures, and is one contributing factor to this year's storms.

"Mexico and Texas were having record high temperatures," said Gallus. "That was allowing the Gulf of Mexico to rapidly warm up, get much warmer than normal, which means that is our main source of energy."

Gallus said the weather pattern known as El Niño -- characterized by warmer ocean temperatures that prompt more precipitation and provide fuel for severe weather -- is now shifting to La Niña, marked by cooler seas and drier weather.

That could cause the rest of the tornado season to be less active.

Gallus said the high number of tornadoes in the region was unusual, since climate change models predict Iowa and neighboring states west of the Mississippi should being seeing below average numbers, which they have in recent years.

"The long-term trend has been for tornadoes to be hitting more places east of the Mississippi River," said Gallus.

Gallus said data show tornadoes occurring on fewer days each year, but coming in clusters and with greater intensity.

He says some storms that have been listed as Category F3 are probably F5's, but measurement methods in some areas are not adequate to gauge the storms' intensity.




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