Into fires. Serious questions about taxpayer funded medical care and a Contra Costa County program. A Whistleblower Comes Forward only to nbc bay area full body infection happened. He needed to have his leg amputated. A Sexual Assault charge is pled down to just five days in jail. The alleged victim is blindsided. You know, they just kept saying to me, well, you know, this stuff doesnt happen. And all i could keep looking at him is, but why did it happen to me . Like, why didnt i matter . And bart spends millions on new lights to make the tunnel safer. But years later, almost all are still in boxes. Sometimes i do look at some of these things and say, gosh, you know, thats pretty. That could be pretty absurd. I can see how the public would say that we investigate how it happened and what bart plans to do about it. Good evening, and thanks for joining us. Im candace when we start tonight with an nbc bay area exclusive, californians are paying billions of dollars into a new Health Care Initiative to help our most vulnerable. Like our seniors, the unhoused, and people with mental illness. A whistleblower tells us Contra Costa Health plan is ignoring some medical needs, inflating caseloads and harming patients. Its been heartbreaking. Its been mysterious. Heartbreaking, because we are supposed to be, helping these patients. This Contra Costa Health nurse says some of the countys most fragile and medically complex patients are being left in the lurch. There are people who are unhoused, some of them have been going to the hospital, er, multiple times in a week. A patient who has had a diabetic ulcer was given to a nonmedical staff, nonclinical staff. They then didnt address it. A full body infection happened. He needed to have his leg amputated. Its not just this one case and she says its not the staffers fault. Incidents like this, she says, occur regularly through Contra Costa Healths enhanced Care Management, or ecm benefit, provided through californias new cal aim program. Were transforming medical. Its our journey to a healthier california for all, according to the department of Health Care Services, cal aims ecm benefit is supposed to address clinical and nonclinical needs, meaning both medical and social care assistance. But in contra costa, the nurse and three other sources familiar with the system tell us the program has abandoned medical assistance altogether after, they say, ecm case managers who are nurses who were already with the system before the program started, are now being instructed to focus only on social needs, like a members access to a shelter or fresh food, or their nonclinical staff, like housing specialists who arent trained to properly refer medical issues at all. Theyve been told if they dont understand what a Health Condition is, they just should google it. That sounds potentially dangerous. Its extremely dangerous. Its negligent. Do you have firsthand knowledge of patients being harmed or dying as a result of this . Yes yes they do. One fatal case, she warned supervisor and county officials about through email last year involved a patient saying he couldnt get out of bed. A non clinical staff member unknowingly labeled this patient as bed bound, and the rest of his care team treated him as such by only providing telephone visits. As a result, the patient didnt get out of bed for months, and his bed sores turned into bone infections. He later passed away , according to her email. Another ecm patient she emailed about received no discussion of health needs or Health Interventions for a year when he was clearly sick, he was on deaths doorstep, then passed away a month later. I tried so hard to report this internally and those concerns were both dismissed. And then i also received just the extreme hostility, abusive treatment. We reached out to Contra Costa Health ceo anna roth. She declined our interview request. Instead, kim mccarl, their communications officer, spoke with us. Our members Clinical Care needs address. So the way that our model is set up, no, except that ecm is a part of the entire care model. But i was looking at the states description of ecm, and it seems to be pretty clear. It says here ecm is a comprehensive Care Management benefit to address both clinical and nonclinical needs for the highest needs members. So why isnt that happening in Contra Costa County . Because we dont need to. So so Contra Costa County is what we call an integrated system. So we have a whole clinical arm and we have a whole ecm arm. And so we dont need to have our ecm program provide Clinical Care because our our clinic system does that. But it doesnt always. And cases fall through the cracks. Thats what the department of Health Care Services found in a 2023 audit of Contra Costa Health, after receiving anonymous complaints, the state found patients complained about not receiving enhanced Care Management services. In one case, a comprehensive history and physical examination wasnt completed and without proper assessment, the state said patients may not receive important behavioral and medical Health Screenings that can help identify and prevent illnesses. This the state know that Contra Costa County is not providing Clinical Care through its ecm program. Yes, when we reached out to the state, a spokesperson repeated in an email, both clinical and nonclinical needs must be addressed by ecm teams. There are a lot of taxpayer dollars involved. Contra costa health took in nearly 3 billion in medical revenue in 2022 and 2023. Of that, it spent 56 million on ecm, according to the state. I think that its wrong. This nurse says shes concerned cutting corners on medical allows the system to report more patients to the state to get more funding. It gives them an excuse to really inflate caseload sizes and, because by ignoring clinical needs, theyre then its then okay, its totally manageable to manage. Just the social needs of 100 patients. Contra costa health denies that serving more medical members means more money for the system. The state actually determines the formula upon which we get paid. So having more of them is not a financial benefit to us. So we checked what other Health Systems are doing la care planned and San Francisco health plan tell us their ecm benefits, address clinical and nonClinical Care. But in alameda county, alameda Alliances Program appears to be similar to contra costas. Although we havent heard of any issues there. Contra costa health says it is working to correct the problems detailed in that audit is the San FranciscoFire Departments own gear, putting firefighters at risk. We investigate the Health Concerns and how sf is working to become the first city in the nation to protect our firefighters. This way. Sailing. Its actually super intense. Im danielle amoros, im in sailing and im from San Francisco, california. Naomi girma, san jose, california soccer. Really exciting. Well be sailing in the south of france for the olympics. Paris would be a dream come true. The paris Olympic Games coming this summer. Brought to you locally on nbc by monterey bay aquarium. Inspiring conservation of the ocean. It may be small, but it can bear over 4000 times its own weight. And thats just the door hinge. Sturdy design all the way down to the smallest detail. The toes up in. Its a vw get 0 apr financing for 60 months on the 2024 taos s, or lease one for just 259 per month. Limited inventory available. San francisco is taking major steps to extinguish a possible health hazard, threatening more than a million firefighters nationwide. Recently, the city was the first in the country to ban certain firefighter gear made with cancer causing chemicals. But as Senior Investigative reporter bigad shaban found, there are concerns the fix could create more hazards. This needed water coming. Lieutenant miguel sadie is teaching the next generation of firefighters about what to expect on the front lines. Our whole job is to work under pressure, manage your emotions and your fears, and get the job done, regardless of how dangerous it may be. Regardless, that includes the risks they can see and the ones they cant. I definitely dont want someone else to have to go through what i did. Sadie is a two time cancer survivor. She underwent radiation and ultimately a double mastectomy here in San Francisco, female firefighters have a six times higher rate of Breast Cancer than the national average. The department has lost more than 300 firefighters to cancer over the past 20 years. Were in ongoing exposure to smoke and other chemicals is so serious. The World Health Organization now classifies firefighting as an actual carcinogen. Nice work. And in recent years, studies have also shown the jackets and pants firefighters rely on to stay safe during emergencies are made with materials proven to cause cancer to put something in the equipment to people who are already there at a risk of their life. For you, seems really malicious. These socalled pfas chemicals help clothing repel Flammable Liquids and resist extreme heat. But researchers say the compounds can be harmful when absorbed through the skin. The level of exposure for firefighters and exact health risks are still being studied. What is it like knowing that the very thing thats supposed to protect you may actually have been part of the reason you got cancer . You know, we cant stop the job from being dangerous. We cant not run into fires, but we can change the future. We can make it so that someone else doesnt have to go through this. Were tired and were dying. Reporter on the steps of San Francisco city hall. Behind a mound of uniforms. Firefighters and lawmakers recently announced plans to enact a first in the nation ban on firefighter clothing made with pfas. Those uniforms, known as turnouts, would need to be replaced over the next two years. Fundamentally, whats at stake is, is peoples lives. San francisco supervisor aaron peskin authored the legislation. He says while outfitting an entire department wont be cheap , doing nothing could force the city to pay an even higher price. The approximately 10 million that will cost is so small compared to a human life is so small compared to the cost of health care, is so small compared to the cost of settling lawsuits. It is morally right, and its financially right. But alternative gear that doesnt use pfas still isnt widely available, even though the potential Health Hazards have been known for years. Critics, including the Firefighters Union, argue thats because industry standards released by the National FireProtection Association continue to be written in a way that favor the use of pfas chemicals by including certain requirements that cant easily be met using other materials, the nfpa tells us. It doesnt create or dictate standards, but instead relies on expert volunteers, including many representatives of the firefighting community. The nfpa and the Firefighters Union remain locked in a heated lawsuit about what the standards should say. We contacted some of the largest manufacturers of firefighter gear to understand why pfas continues to be used only, viking responded, telling us theres been a lack of pfas free fabrics approved by the nfpa. But says its now testing alternative materials and plans to release a new line of gear by the end of the year. Manufactured without pfas. At least two other companies, fire decks and lion, are already advertising pfas free uniforms that are now being tested at Fire Departments across five cities, including San Francisco, where firefighters say so far the gear is working. We dont want to just trade one hazard for another, so well burn the first one. Chemist brian ormond is trying to find out if those alternatives will be safer long term at his lab at Nc State University in raleigh, he and his team are testing fabrics for reliability. Theres a little bit of char right here so far, he says. His research has shown removing pfas can make uniforms less breathable and more flammable. Were introducing a potential hazard for flammability on the fire scene, where firefighters didnt have that before. But he cautions what hes seeing in the lab could differ from what firefighters might experience on the front lines. Regardless, First Responders across the country continue to suit up. So even with the risks, youre still willing to put on the uniform in a heartbeat. Its not a choice when we have to do our job. Its our job. Nice work buddy, but lieutenant sadie is concerned about her trainees who were just issued the same type of Standard Clothing shes worn for decades. Her fight for safer gear, she says, is for them so firefighters can focus on saving lives instead of worrying about their own. This would affect the future, and if it changes and legislation goes forward, then yeah, then it was all worth it. With the Investigative Unit on bigad, siobhan, if approved, the ban on fire gear made with pfas will go into effect in two years. Coming up was an accused rapist let off the hook . Prosecutors offered a plea deal despite a confession and an apology. We investigate. The lessons of the past can guide us moving forward. So all month long, nbc bay area is highlighting the rich history of our asian american, native hawaiian and Pacific Islander communities. Well explore their vibrant cultures and spotlight some Extraordinary People making a positive impact on others. Join us as we amplify aanhpi heritage, because knowing each others stories brings us together, and that moves the bay area forward. Im doug hopkins with brothers by homes. Com and i want to buy your house. Ill make you an aces cash offer on your house within 24 hours. Whether its a total fixer upper or in perfect condition. Brothers by homes. Com is the easiest way to sell your house. When you sell your house to brothers by homes. Com. Theres no fees, no commissions, no banks and no repairs. Just go to brothers by homes. Com for your free, no obligation cash offer. 24 hours a day. Thats brothers by homes. Com. A peninsula woman says her alleged rapist was let off the hook too easily, taking a plea deal and serving no additional jail time. And now her trust in the legal system is shattered. Investigative reporter Hilda Gutierrez looks at how often defendants charged with certain sex crimes take plea deals. This was originally brought as a rape case that police say included a videotaped confession and an apology note by the defendant. So the victim wonders why prosecutors offer him a deal that leaves him with no sex crime on his record, and says she was not consulted. Korey banks grew up believing in the justice system. She comes from a Law Enforcement family. Her father and uncle worked for the Belmont Police department, and i grew up knowing that if you did wrong, youd get in trouble and the police would help you, and the police did. But she says her trust was shattered when she was raped. But i knew, like, the process would work. At least i thought it was the summer of 2021. Banks, a mother of two, was at a local piano bar in san carlos where she recalls talking to an acquaintance she had met the year before. At some point, she says, she realized she had enough to drink and walked outside with a friend to order a rideshare home. The acquaintance followed them, and he comes up to the bench. Were waiting on and starts kissing on me again. Like similar to the year prior. And my buddys like, hey, hey hey. And when he does say that, the guy runs off. Bank says her friend helped her get home and snapped this photo of her in bed before leaving her apartment. Clearly had enough. So pass out, from drinking. When banks woke up, she says. The acquaintance Fernando Altuna mendoza was standing by her bed. Hes there and im like, what are you doing . You know, get out of here, get out of here. And i remember getting up, chasing him out, and i really, truly believed id stopped him. And i saw on my phone there were all these. You know, missed calls through instagram. Screenshots show Altuna Mendoza tried to reach her in the middle of the night before entering her apartment. Banks says she reported the incident to the San Mateo Sheriffs Office and obtained this restraining order. You dont have the right to come in my house. Ive never invited you to my house. This is. You know this is not okay. Banks says it was the sheriff who, upon questioning Altuna Mendoza a week later, led her in on what really happened that night. According to the sheriffs report. Altuna mendoza wrote an apology note that in part r