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The University of Maryland Medical System, rocked by a self-dealing scandal this year involving board members that caused Baltimore’s mayor to resign, has repeatedly “delayed and hindered” the work of state auditors, according to a letter from the chief auditor made public Tuesday. Maryland Legislative Auditor Gregory Hook wrote to leading state lawmakers late last month that 37 employees in his office have spent a cumulative total of 600 days working on the audit, with fieldwork beginning April 16. He also wrote that the office has spent “countless days sifting and analyzing electronic records” it has received. (11/19)

State auditors tasked with investigating the University of Maryland Medical System after a self-dealing scandal involving its board of directors have complained UMMS “delayed and hindered” their work, requiring an extension of their deadline to produce a report to the General Assembly. ...UMMS interim President and CEO John Ashworth responded that UMMS officials have “always endeavored to work collaboratively and transparently” with the Office of Legislative Audits and "look forward to the issuance of their report.” (Rector, 11/19)

Pennsylvania’s mental health laws, passed in 1976, are some of the most restrictive in the nation, requiring a person to be a “clear and present danger” to be involuntary committed to a hospital, which some critics say makes it difficult for people to receive help before tragedy strikes. ...Most states have revised their laws to increase treatment and care options. But Pennsylvania’s remain largely unchanged, the result of a lack of political motivation, access to funds, and a long-running debate within the mental health community. (Rushing, 11/20)

The District’s mental health agency acknowledged Tuesday that it failed to properly monitor a discharged psychiatric patient with a homicidal history before he allegedly killed a neighbor in an unprovoked shooting in March. But the agency assumed no blame for the attack, asserting that “any attempt” to link its lax supervision to the victim’s death “would require undue speculation.” (Duggan, 11/19)

Gov. Ron DeSantis on Monday called for legislators to pump hundreds of millions of dollars into programs for people with intellectual and developmental disabilities, as well as $20 million into the state’s prescription-drug importation effort --- or about $5 million less than what a top state health official sought. The DeSantis budget proposal recommends $94.8 million in new Medicaid funding for people with disabilities and another $239 million to offset deficits that have accumulated in past years in the Agency for Persons with Disabilities. (Sexton, 11/19)

State regulators have suspended the license of a central Minnesota home day care operator after an infant under its care suffered a serious injury and later died. The infant boy was found unresponsive at a home day care in Brainerd around 2 p.m. on Nov. 12. Deputies along with other emergency responders responded with lifesaving measures, but the infant died a short time later at Essentia Health-St. Joseph's Medical Center in Brainerd, according to a statement issued Tuesday by the Crow Wing County Sheriff's office. (Serres, 11/19)

A civil jury has awarded $58 million Tuesday to 10 people who alleged a now-closed body donation facility mishandled the donated remains of their relatives and deceived them about how the body parts would be used. The trial against Stephen Gore, owner of the Biological Resource Center of Arizona, ended with jurors finding in favor of 10 of 21 plaintiffs, awarding $8 million in compensatory damages and $50 million in punitive damages. (11/19)

It was an ordinary cram session, around midnight, when the screed appeared on students’ phones. A racist manifesto, sent to a small clutch of people sitting at a Syracuse University library on Tuesday morning, warned of “the great replacement,” a right-wing conspiracy theory that predicts white genocide at the hands of minority groups. (Randle and McKinley, 11/19)

Over a decade ago, it wasn’t uncommon for more than 100 people to be shot each year in Providence -- victims of street gangs or rival family feuds going back generations, domestic disputes, fights that broke out as the nightclubs closed. Even as Providence police were seizing more than 130 or so guns off the streets, the wave of violence plagued neighborhoods and busied hospital emergency rooms.And then, almost imperceptibly, the tide began to turn. (Milkovits, 11/20)

Postings for Anthem health insurance plans have again misinformed customers on the Affordable Care Act exchange, telling them WellStar Health System will be in the insurer’s individual network. It won’t. (Hart, 11/19)

A Texas family that disagrees with a Fort Worth hospital’s plan to take a 9-month-old girl off life support has been given more time to find a facility to take her. Texas Right to Life, which represents Tinslee Lewis’ family, said a judge Tuesday extended a temporary restraining order against Cook Children’s Medical Center until Dec. 10. The hospital didn’t immediately comment. (11/19)

At least 30 people have been charged in connection with a string of South Florida pharmacies state authorities say fraudulently billed Medicare — a scam that continues to be one of Miami’s most lucrative illegal industries. Police officers on Tuesday began arresting dozens associated with Tata Pharmacy Discount, Lozano Health Care, and in a separate case, Wynwood Family Pharmacy and Santander Pharmacy. (Ovalle, 11/20)

Multnomah County officials failed to follow-up on several reports of abuse or neglect from the first year of Unity Center for Behavioral Health’s operation, the Multnomah County District Attorney’s office acknowledged Tuesday. But District Attorney Rod Underhill announced that his office did not find any reason to press criminal charges against any county employee. The DA’s office launched an investigation in the midst of an internal review by Multnomah County of the county health department’s procedures. (Harbarger, 11/19)

Single, older people in Massachusetts are more likely to face economic insecurity than their peers in any other state, according to a new UMass Boston report. The study estimates that 61.7% of state residents older than 65 and living alone do not have enough income to cover basic expenses such as housing, food, health care, transportation, clothing and household supplies. (Ma, 11/19)

The Trump administration flouted federal law with a rule that would allow any health care worker, from doctors to receptionists, to refuse to provide abortions or other procedures for religious or moral reasons, a federal judge in San Francisco ruled Tuesday. Federal law since 1973 has allowed physicians and others directly involved in providing medical care to refuse to take part in abortions or sterilizations, as long as the refusal did not cause “undue hardship” to their employer. (Egelko, 11/19)

Pacific Gas & Electric Co. was set to begin shutting off power Wednesday to some 150,000 homes and businesses in parts of 18 Northern and central California counties as the region faced extreme fire weather that's lasted since October, CBS Sacramento reports. A virtually rainless fall has left brush bone-dry and forecasts called for low humidity and winds gusting at times to 55 mph, which could fling tree branches or other debris into power lines, causing sparks that could set off catastrophic fires in the region, PG&E officials said. (11/20)

Kaiser Health News: New California Law May Expand Use Of HIV Prevention Drugs, With Caveats

Kellen Willhite was 24 when he learned he’d been exposed to HIV. What followed was, as he describes it, a second trauma: trying to obtain the drugs that could save him before it was too late. In 2016, a day after Willhite and his then-boyfriend had engaged in unprotected sex, they visited the small offices of Golden Rule Services, a nonprofit community clinic about 7 miles south of the state Capitol. (Kreidler, 11/20)

MGP Ingredients Inc., a leading producer of distilled spirits and specialty proteins and starches, has agreed to pay a fine of $1 million in connection with a toxic chemical release at its plant in Atchison, Kansas, three years ago. MGP agreed to the fine after pleading guilty Monday to a misdemeanor charge of negligently violating the Clean Air Act. U.S. District Judge Daniel Crabtree will decide whether to accept the plea at a hearing set for Feb. 24. In exchange for MGP’s plea, the government agreed to dismiss two other charges against the company. (Margolies, 11/19)

Kaiser Permanente announced plans Tuesday a big expansion the Baltimore market as the health insurer triples the number of health care centers in the area and add tens of thousands of new patients in the next decade. Kaiser said it would invest and spend a combined $13 billion by 2028 to increase the number of Kaiser centers in the Baltimore region to 15 from 5 in an effort to expand coverage to an estimated 200,000 people from about 64,000 today. (Cohn and Reed, 11/19)

With tens of thousands of people sleeping outside every night in L.A. County, one of the most contentious debates is over what to do about homeless encampments and who should do it. A new poll conducted for the Los Angeles Times and the Los Angeles Business Council Institute found that a sizable majority of voters countywide think law enforcement should assume a larger role, despite court rulings and settlements limiting such involvement. (Oreskes, 11/19)