Share
Tradeoffs
The Fifth Branch: The Last Line of Care
Alternative response teams are being asked to tackle vexing problems: mental illness, homelessness, addiction. How much can they actually do? We explore how Durham grapples with connecting people to long-term care and support, and where the city draws the line between crisis response and social services.
Guests:
Ryan Smith, Director, Durham Community Safety Department
Sammetta Cutler, Peer Support Specialist, Durham Community Safety Department
Sarah Hall, Durham resident
David Prater, Peer Support Specialist, Durham Community Safety Department
John Warasila, Real estate developer and architect, Alliance Architecture
Bo Ferguson, Deputy City Manager, Durham
Patrice Andrews, Police Chief, Durham Police Department
Christie Thompson, Staff Writer, The Marshall Project
Allison Casey, EMT, Durham Community Safety Department
EMS, Fire, Police and the 911 Call Center make up the existing four branches of the public safety system. A special series from Tradeoffs and The Marshall Project explores how a city radically changes its response to people in crisis, by creating a fifth branch.
Nearly half of the country’s 50 largest cities - including San Francisco, New York, Houston, Chicago - have launched programs to send unarmed responders to 911 calls historically handled by cops. In the process creating a new generation of first responders made up of clinicians, EMTs and unarmed mental health workers all responding to people who struggle with addiction, homelessness and mental illness.
To understand this work we head to Durham, North Carolina, which has - in the face of skepticism and downright opposition - built one of the most comprehensive programs in the country.
How did Durham pull off what so many cities have struggled to do? Tradeoffs and The Marshall Project examine this groundbreaking work and the challenges it’s facing, both in Durham and around the country.
Learn more on our website.
Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.
Support this type of journalism today, with a gift.
More episodes
View all episodes
368. ‘It Sucks’: Spiking Health Insurance Costs Hit Small Businesses
21:05||Season 1, Ep. 368An employer in Chicago describes how another year of rising premiums forced her to consider dropping her workers’ insurance.Guest:Rachel Bernier-Green, Founder and CEO, EJ ConsortiumLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.367. 'We Can’t Afford All These Humans’: A Doctor's Take on AI in Health Care
25:51||Season 1, Ep. 367We talk with physician and writer Bob Wachter about why he’s cautiously optimistic that artificial intelligence will usher in a ‘golden age’ of medicine — and the questions he still has about these powerful new tools.Guest:Bob Wachter, Chair, Department of Medicine, UC San Francisco; Author, A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our FutureLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.366. Immigration Enforcement’s Twin Threats to Health Care
26:15||Season 1, Ep. 366Patients are afraid to show up to medical appointments, while workers are being detained, deported or losing their visa statuses.Guests:Sahida Martinez, promotora, EnlaceJadhira Sanchez, director of community health, EnlaceSteph Willding, CEO, CommunityHealthJordan Herring, Postdoctoral scholar, Emergency medicine, StanfordHannah Janeway, Emergency medicine physician, Los AngelesLaura Messineo, CNO, WorldWide HealthStaff Solutions Learn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.365. As States and CDC Split on Vaccines, What's Next?
19:58||Season 1, Ep. 365Half of states have rejected federal vaccine guidance on childhood vaccines after controversial changes by the CDC. Public health experts say the split is sowing confusion and increasing the risk of outbreaks. Guests:Michelle Fiscus, physician, chief medical officer, Association of Immunization ManagersJen Kates, senior vice president; director, global and public health policy, KFF Tao Sheng Kwan-Gett, physician, health officer, Washington Department of HealthPhilip Landrigan, physician and director, program for global public health and the common good, Boston College Dorit Reiss, law professor, University of California, San FranciscoLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.364. A Better Way to Care for Older Adults with Opioid Addiction
24:59||Season 1, Ep. 364How one addiction clinic in Baltimore has found success combining addiction care with support for the many other health problems older Americans often face.Guests:Malik Burnett, Medical Director, REACH Health ServicesLisa Clemans-Cope, Senior Research Fellow, Urban InstituteRenee Gray, Patient, REACH Health ServicesPhyllis Lindsay, Peer Recovery Specialist, REACH Health ServicesMaggie Lowenstein, Assistant Professor, Medicine, University of Pennsylvania Perelman School of MedicineVickie Walters, Executive Director, REACH Health ServicesLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.363. Mental Illness Left Their Loved Ones on the Streets. California’s Big Fix Hasn’t Helped
24:10||Season 1, Ep. 363How Gov. Gavin Newsom’s ambitious plan to force more people into treatment left many families still searching for help.Guest(s):June DudasMarisa Kendall, homelessness reporter, CalMattersRead CalMatters full “Courting Disappointment” series here. Learn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.362. One State's Sprint for its Share of $50 Billion for Rural Health: Part 2
24:27||Season 1, Ep. 362Maryland finds out how much the state will get from a nationwide competition for federal rural health investment.Guest(s):Christina Koontz, paramedic Elizabeth Kromm, assistant secretary for population health and strategic initiatives, Maryland Department of HealthMike Salvadge, chief of emergency medical services, Allegany County, Md. Meena Seshamani, Maryland secretary of healthHemi Tewarson, executive director, National Academy for State Health PolicyLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.361. One State's Sprint for its Share of $50 Billion for Rural Health: Part 1
27:35||Season 1, Ep. 361We follow Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.Guests:Bonita Baer, Maryland residentMark Boucot, president and CEO of Garrett Regional Medical Center and Potomac Valley Hospital Elizabeth Kromm, assistant secretary for population health and strategic initiatives, Maryland Department of HealthLevi Lantz, ALL Produce & GreenhouseKen Ulman, former executive, Howard County, Maryland; president of Margrave StrategiesLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.360. Race to the Bottom: Where's the Cavalry?
29:11||Season 1, Ep. 360Many potent new medicines pose a host of challenges for drug companies trying to copy and sell similar versions on the cheap. Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?Guests:Christine Baeder, MBA, President, Apotex USAAlfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Industry AssociationJeremy Greene, MD, PhD, Professor of Medicine and the History of Medicine, Johns Hopkins UniversityCandy Meyer, PatientBhaven Sampat, PhD, Professor, Arizona State University School for the Future of Innovation in SocietyMarta Wosińska, PhD, Senior Fellow, Brookings InstitutionLeslie Walker, Senior Reporter/Producer, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.