Kaiser Health News

A New Orleans Neighborhood Confronts the Racist Legacy of a Toxic Stretch of Highway

Published

1 month ago

March 15, 2024

Drew Hawkins, Gulf States Newsroom
Fri, 15 Mar 2024 09:00:00 +0000

Aside from a few discarded hypodermic needles on the ground, the Hunter's Field Playground in New Orleans looks almost untouched. It's been open more than nine years, but the brightly painted red and yellow slides and monkey bars are still sleek and shiny, and the padded rubber tiles feel springy underfoot.

For people who live nearby, it's no mystery why the equipment is in relatively pristine shape: Children don't come here to play.

“Because kids are smart,” explained Amy Stelly, an artist and urban designer who lives about a block away on Dumaine Street. “It's the adults who aren't. It's the adults who built the playground under the interstate.”

Hunter's Field is wedged directly beneath the elevated roadbeds of the Claiborne Expressway section of Interstate 10 in the city's 7th Ward.

There are no sounds of laughter or children playing. The constant cuh-clunk, cuh-clunk of the traffic passing overhead makes it difficult to hold a conversation with someone standing next to you. An average of 115,000 vehicles a day use the overpass, according to a 2012 study.

“I have never seen a child play here,” Stelly said.

Stelly keeps a sharp eye on this area as part of her advocacy work with the Claiborne Avenue Alliance, a group of residents and business owners dedicated to revitalizing the predominantly African American community on either side of the looming expressway.

For as long as she can remember, Stelly has been fighting to dismantle that section of the highway. She's lived in the neighborhood her entire life and said the noise is oftentimes unbearable. “You can sustain hearing damage,” she said. Now, she's helping collect new noise and air pollution data to show it needs to be taken down.

The Claiborne Expressway was built in the 1960s, when the construction of interstates and highways was a symbol of progress and economic development in the U.S.

But that supposed progress often came at a great cost for marginalized communities — especially predominantly Black neighborhoods.

When it was built, the “Claiborne Corridor,” as it's still sometimes known, tore through the heart of Tremé, one of the nation's oldest Black neighborhoods.

For more than a century before the construction of the expressway, bustling Claiborne Avenue constituted the backbone of economic and cultural life for Black New Orleans. Back then, the oak-lined avenue was home to more than 120 businesses. Today, only a few dozen remain.

What happened to Claiborne Avenue isn't unique. Federal planners often routed highways directly through low-income minority neighborhoods, dividing communities and polluting the air.

In Montgomery, Alabama, I-85 cut through the city's only middle-class Black neighborhood and was “designed to displace and punish the organizers of the civil rights movement,” according to Rebecca Retzlaff, a community planning professor at Auburn University. In Nashville, planners intentionally looped I-40 around a white community, and sent it plowing through a prominent Black neighborhood, knocking down hundreds of homes and businesses. Examples like this exist in major cities across the country.

The federal government has started working on ways to confront the damage highway construction continues to do to low-income and minority communities. An initiative established in the Infrastructure Investment and Jobs Act called the Reconnecting Communities Pilot seeks to do just that: reconnect neighborhoods and communities that were divided by infrastructure.

But there's wide disagreement on the best way to do that, and some strategies are likely to do little to limit the health effects of living near these highways. What's unfolding in New Orleans shows how challenging it is to pick and fund projects that will help.

Competing Visions for the Claiborne Expressway

Stelly's group, the Claiborne Avenue Alliance, submitted a proposal for Reconnecting Communities Pilot money. It wanted $1.6 million in federal funds primarily for public engagement, data collection, and feasibility planning to work to assess whether it would be possible to remove the expressway altogether, with a plan to raise $400,000 more to cover costs.

And it seemed possible its grant proposal would succeed, since even the White House cited the Claiborne Expressway as a textbook example of the biased planning history in a published statement about the Reconnecting Communities Pilot. Ultimately, though, the federal Department of Transportation, the agency charged with allocating the program's money, denied the Claiborne Avenue Alliance's grant request.

Instead, the Department of Transportation offered a small fraction of the money requested in a competing joint proposal made by the city of New Orleans and the state of Louisiana. That plan called for a $47 million grant from Reconnecting Communities to do overpass improvements, remove some on- and off-ramps, and, most significantly, create the “Claiborne Innovation District” to promote public life and cultural activities under the highway. DOT granted just $500,000 for the project.

Stelly said she likes a few aspects of the city-state proposal, notably the plan to remove on- and off-ramps to improve pedestrian safety beneath the expressway and other public safety projects, like better lighting and dedicated pedestrian and bicycle lanes.

But, notably, Stelly called the idea of creating an entertainment space and market beneath the highway misguided and ridiculous. Would it be a waste of scarce government funds?

“It's a foolish idea because you're going to be exposed to the same thing” as the neglected playground, Stelly said. “You're going to be exposed to the same levels of noise. It's not a wise decision to build anything under here.”

Using Science to Inform Policy

Since her group's proposal was denied, Stelly and her organization are turning to a new strategy: helping with a new study funded by the Environmental Protection Agency on the expressway's health impacts. They hope the data will support them in their efforts to remove the highway from their neighborhood.

In addition to noise impacts, the EPA-funded study is looking at the health impacts of pollution under the Claiborne Expressway — especially harmful pollutants like particulate matter 2.5, or PM 2.5.

These microscopic particles, measuring 2.5 microns or less in diameter, are released from the tailpipes of passing vehicles, said Adrienne Katner, an associate professor at the Louisiana State University School of Public Health, who is the principal investigator on the EPA study. They're so small that, when inhaled, they lodge deep in the lungs. From there, they can migrate to the circulatory system, and then spread and potentially affect every system in the body.

“So the heart, the brain,” said Katner. “If a woman is pregnant, it can cross the placental barrier. So it has a lot of impacts.”

Katner and her team of researchers are beginning the study by taking preliminary readings with monitors at different points along the expressway. Completing the research and publishing the data will likely take two to three years.

One of Katner's monitoring sites is Hunter's Field Playground. Graduate researcher Jacquelynn Mornay said the noise levels registered there could cause permanent hearing damage after an hour or so of exposure. The pollution levels recorded hover around 18 micrograms per cubic meter.

“It should be at most — at most — 12,” said Beatrice Duah, another graduate student researcher. “So it is way over the limits.”

Residents and workers occupying the homes and businesses lining the area under the expressway are exposed daily to these levels of noise and pollution. When complete, this EPA study will join a decades-long body of research about how traffic pollution affects the human body.

“We're not inventing the science here,” Katner said. “All I'm doing is showing them what we already know and then documenting it, giving them the data to then inform and influence policy. That's all I can do.”

‘Removal Is the Only Cure'

Eventually, the study's findings could help other communities divided by infrastructure across the country, Katner said.

“A lot of cities are going through this right now and they're looking back at their highway systems,” she said. “They're looking back at the impacts that it's had on a community and they're trying to figure out what to do next. I'm hoping that this project will inform them.”

Amy Stelly said she's always known the air she and her neighbors breathe isn't safe, but she's hopeful that having concrete data to support her efforts will do more to persuade policymakers to address the problem. That could mean taking down the dangerous on- and off-ramps — or scrapping what she considers to be the wasteful plan of putting a market and event space under the highway overpass.

Stelly sees only one true solution to the problems posed by the Claiborne Expressway, only one way to really right the wrongs done to her community.

“Removal is the only cure,” Stelly said. “I'm insisting on it because I'm a resident of the neighborhood and I live with this every day.” And, she said, “the science tells us there's no other way.”

This article is from a partnership that includes WWNO, NPR, and KFF Health News.

——————————
By: Drew Hawkins, Gulf States Newsroom
Title: A New Orleans Neighborhood Confronts the Racist Legacy of a Toxic Stretch of Highway
Sourced From: kffhealthnews.org/news/article/new-orleans-noise-pollution-highway-divide-infrastructure-racist-legacy/
Published Date: Fri, 15 Mar 2024 09:00:00 +0000

Post Views: 143

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Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.

Published

3 days ago

April 26, 2024

Staff Editor

Phil Galewitz, KFF Health News
Fri, 26 Apr 2024 13:55:00 +0000

Private Medicaid health plans lost millions of members in the past year as pandemic protections that prohibited states from dropping anyone from the government program expired.

But despite Medicaid's unwinding, as it's known, at least two of the five largest publicly traded companies selling plans have continued to increase revenue from the program, according to their latest earnings reports.

“It's a very interesting paradox,” said Andy Schneider, a research professor at Georgetown University's McCourt School of Public Policy, of plans' Medicaid revenue increasing despite enrollment drops.

Medicaid, the state-federal health program for low-income and disabled people, is administered by states. But most people enrolled in the program get their health care through insurers contracted by states, including UnitedHealthcare, Centene, and Molina.

The companies persuaded states to pay them more money per Medicaid enrollee under the assumption that younger and healthier people were dropping out — presumably for Obamacare coverage or employer-based health insurance, or because they didn't see the need to get coverage — leaving behind an older and sicker population to cover, their executives have told investors.

Several of the companies reported that states have made midyear and retrospective changes in their payments to plans to account for the worsening health status of members.

In an earnings call with analysts on April 25, Molina Healthcare CEO Joe Zubretsky said 19 states increased their payment rates this year to adjust for sicker Medicaid enrollees. “States have been very responsive,” Zubretsky said. “We couldn't be more pleased with the way our state customers have responded to having rates be commensurate with normal cost trends and trends that have been influenced by the acuity shift.”

Health plans have faced much uncertainty during the Medicaid unwinding, as states began reassessing enrollees' eligibility and dropping those deemed no longer qualified or who lost coverage because of procedural errors. Before the unwinding, plans said they expected the overall risk profile of their members to go up because those remaining in the program would be sicker.

UnitedHealthcare, Centene, and Molina had Medicaid revenue increases ranging from 3% to 18% in 2023, according to KFF. The two other large Medicaid insurers, Elevance and CVS Health, do not break out Medicaid-specific revenue.

The Medicaid enrollment of the five companies collectively declined by about 10% from the end of March 2023 through the end of December 2023, from 44.2 million people to 39.9 million, KFF data shows.

In the first quarter of 2024, UnitedHealth's Medicaid revenue rose to $20.5 billion, up from $18.8 billion in the same quarter of 2023.

Molina on April 24 reported nearly $7.5 billion in Medicaid revenue in the first quarter of 2024, up from $6.3 billion in the same quarter a year earlier.

On April 26, Centene reported that its Medicaid enrollment fell 18.5% to 13.3 million in the first quarter of 2024 compared with the same period a year ago. The company's Medicaid revenue dipped 3% to $22.2 billion.

Unlike UnitedHealthcare, whose Medicaid enrollment fell to 7.7 million in March 2024 from 8.4 million a year prior, Molina's Medicaid enrollment rose in the first quarter of 2024 to 5.1 million from 4.8 million in March 2023. Molina's enrollment jump last year was partly a result of its having bought a Medicaid plan in Wisconsin and gained a new Medicaid contract in Iowa, the company said in its earnings news release.

Molina added 1 million members because states were prohibited from terminating Medicaid coverage during the pandemic. The company has lost 550,000 of those people during the unwinding and expects to lose an additional 50,000 by June.

About 90% of Molina Medicaid members have gone through the redetermination process, Zubretsky said.

The corporate giants also offset the enrollment losses by getting more Medicaid money from states, which they use to pass on higher payments to certain facilities or providers, Schneider said. By holding the money temporarily, the companies can count these “directed payments” as revenue.

Medicaid health plans were big winners during the pandemic after the federal government prohibited states from dropping people from the program, leading to a surge in enrollment to about 93 million Americans.

States made efforts to limit health plans' profits by clawing back some payments above certain thresholds, said Elizabeth Hinton, an associate director at KFF.

But once the prohibition on dropping Medicaid enrollees was lifted last spring, the plans faced uncertainty. It was unclear how many people would lose coverage or when it would happen. Since the unwinding began, more than 20 million people have been dropped from the rolls.

Medicaid enrollees' health care costs were lower during the pandemic, and some states decided to exclude pandemic-era cost data as they considered how to set payment rates for 2024. That provided yet another win for the Medicaid health plans.

Most states are expected to complete their Medicaid unwinding processes this year.

——————————
By: Phil Galewitz, KFF Health News
Title: Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.
Sourced From: kffhealthnews.org/news/article/medicaid-unwinding-insurer-revenue/
Published Date: Fri, 26 Apr 2024 13:55:00 +0000

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Kaiser Health News

California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.

Published

3 days ago

April 26, 2024

Staff Editor

Molly Castle Work
Fri, 26 Apr 2024 09:00:00 +0000

With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.

Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.

“We believe they're going to have not just great impact, but wide impact across California, especially in places where maybe it's not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom's health secretary, Mark Ghaly, during the Jan. 16 announcement.

The apps represent one of the Democratic governor's major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.

However, the rollout has been slow. So slow that one of the companies has missed a deadline to make its app available on Android phones. Only about 15,000 of the state's 12.6 million children and young adults have signed up for the apps, and school counselors say they've never heard of them.

Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies' coaches won't properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.

An App for That

Newsom's administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It's part of Newsom's sweeping $4.7 billion master plan for kids' mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.

“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom's Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”

The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.

But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.

“It's fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children's Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don't see it as fundamental. And we don't believe the youth mental health crisis will be solved by technology projects built by a professional class who don't share the lived experience of marginalized communities.”

The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth's Pennsylvania pilot, 6% of students who had access to the app signed up.

Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.

Although the service is intended to be free with no insurance requirement, Brightline's app, BrightLife Kids, is folded into and only accessible through the company's main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.

The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.

‘It's Like Crickets'

Despite being months into the launch and having millions in marketing funds, the companies don't have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”

“It's a big state — 58 counties,” Bob McCullough of Kooth said. “It'll take us a while to get to all of them.”

Brightline's contract states that the company was required to launch downloadable apps for iOS and Android phones by January, but so far BrightLife Kids is available only on Apple phones. Brightline said it's aiming to launch the Android version over the summer.

“Nobody's really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We're very much in the early innings. We're already learning a lot.”

The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom's virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.

The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.

KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.

“I'm not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It's like crickets.”

Whitson said she doesn't think the apps are on “anyone's” radar in schools, and she doesn't know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn't reach out to plan the meeting; she did.

Concern Over Referrals

Whitson isn't comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she's concerned that the coaches, who aren't all licensed therapists, won't have the training to detect when users need more help and refer them to clinical care.

This sentiment was echoed by other school-based social workers, who also noted the apps' duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.

While the state is also funneling money to the schools as part of Newsom's master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.

Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they'd prefer in-person therapy.

“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they're on the waitlist,” Merchant said. “And, like, you're seeing all these people struggle.”

Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.

Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.

“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

——————————
By: Molly Castle Work
Title: California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won't Pay Off.
Sourced From: kffhealthnews.org/news/article/california-youth-teletherapy-apps-rollout-slow/
Published Date: Fri, 26 Apr 2024 09:00:00 +0000

Post Views: 43

Kaiser Health News

KFF Health News’ ‘What the Health?’: Abortion — Again — At the Supreme Court

Published

4 days ago

April 25, 2024

Staff Editor

Wed, 24 Apr 2024 20:30:00 +0000

The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

Some justices suggested the Supreme Court had said its piece on abortion law when it overturned Roe v. Wade in 2022. This term, however, the court has agreed to review another abortion case. At issue is whether a federal law requiring emergency care in hospitals overrides Idaho's near-total abortion ban. A decision is expected by summer.

Meanwhile, the Centers for Medicare & Medicaid finalized the first-ever minimum staffing requirements for nursing homes participating in the programs. But the industry argues that there are not enough workers to hire to meet the standards.

This week's panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins University's nursing and public health schools and Politico Magazine, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico.

Panelists

Joanne Kenen
Johns Hopkins University and Politico

@JoanneKenen

Read Joanne's articles.

Tami Luhby
CNN

@Luhby

Read Tami's stories.

Alice Miranda Ollstein
Politico

@AliceOllstein

Read Alice's stories.

Among the takeaways from this week's episode:

This week's Supreme Court hearing on emergency abortion care in Idaho was the first challenge to a state's abortion ban since the overturn of the constitutional right to an abortion. Unlike previous abortion cases, this one focused on the everyday impacts of bans on abortion care — cases in which pregnant patients experienced medical emergencies.
Establishment medical groups and doctors themselves are getting more vocal and active as states set laws on abortion access. In a departure from earlier political moments, some major medical groups are campaigning on state ballot measures.
Medicaid officials this week finalized new rules intended to more closely regulate managed-care plans that enroll Medicaid patients. The rules are intended to ensure, among other things, that patients have prompt access to needed primary care doctors and specialists.
Also this week, the Federal Trade Commission voted to ban most “noncompete” clauses in employment contracts. Such language has become common in health care and prevents not just doctors but other health workers from changing jobs — often forcing those workers to move or commute to leave a position. Business interests are already suing to block the new rules, claiming they would be too expensive and risk the loss of proprietary information to competitors.
The fallout from the cyberattack of Change Healthcare continues, as yet another group is demanding ransom from UnitedHealth Group, Change's owner. UnitedHealth said in a statement this week that the records of “a substantial portion of America” may be involved in the breach.

Plus for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:

Julie Rovner: NBC News' “Women Are Less Likely To Die When Treated by Female Doctors, Study Suggests,” by Liz Szabo.

Alice Miranda Ollstein: States Newsroom's “Loss of Federal Protection in Idaho Spurs Pregnant Patients To Plan for Emergency Air Transport,” by Kelcie Moseley-Morris.

Tami Luhby: The Associated Press' “Mississippi Lawmakers Haggle Over Possible Medicaid Expansion as Their Legislative Session Nears End,” by Emily Wagster Pettus.

Joanne Kenen: States Newsroom's “Missouri Prison Agency To Pay $60K for Sunshine Law Violations Over Inmate Death Records,” by Rudi Keller.

Also mentioned on this week's podcast:

American Economic Review's “Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector?” by Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, and Lev Klarnet.
KFF Health News' “Medical Providers Still Grappling With UnitedHealth Cyberattack: ‘More Devastating Than Covid,” by Samantha Liss.

Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

And subscribe to KFF Health News' “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.

——————————
Title: KFF Health News' ‘What the Health?': Abortion — Again — At the Supreme Court
Sourced From: kffhealthnews.org/news/podcast/what-the-health-344-abortion-supreme-court-april-25-2024/
Published Date: Wed, 24 Apr 2024 20:30:00 +0000

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