Former Baltimore City Health Commissioner Dr. Leana Wen was forced out as president of Planned Parenthood Tuesday by the organization’s board of directors over leadership and management differences.

Just last November, Wen became the second doctor to lead the organization in its now 103-year history.

In a statement posted to Twitter, Wen said yesterday she was, “leaving because the new Board Chairs and I have philosophical differences over the direction and future of Planned Parenthood.” She added that she, “will always stand with Planned Parenthood, as I continue my life’s work and mission of caring for and fighting for women, families, and communities.”

Specifically, Wen said those philosophical differences came down to her vision of expanding Planned Parenthood’s maternal health care and cancer detection efforts, as well as tackling some of the critical social determinants of health—as she did in Baltimore—including housing instability and food insecurity.

In light of new legislative limits in several states and ongoing efforts to curtail access to legal abortion in other states, plus a conservative shift in the make up of U.S. Supreme Court, Wen said she understands the board’s decision to seek a more aggressive political leader.

“The new Board leadership has determined that the priority of Planned Parenthood moving forward is to double down on abortion rights advocacy,” Wen wrote. “With the landscape changing dramatically in the last several months and the right to safe, legal abortion care under attack like never before, I understand the shift in the Board’s prioritization.”

After the announcement of her departure, Rep. Elijah Cummings, whose district includes part of Baltimore, issued a statement of support.

“Dr. Wen’s entire career has been focused on fighting for quality healthcare for women, families and children,” Cummings wrote. “I have witnessed her extraordinary leadership in public health, both nationally and in Baltimore as the Baltimore City Health Commissioner.”

Planned Parenthood said board member Alexis McGill, who previously served as the organization’s acting chair, will assume acting CEO duties while the women’s health and reproductive rights group searches for Wen’s successor.

In her Twitter statement, Wen wrote that she joined the organization “to run a national health care organization and to advocate for the broad range of public health policies that affect our patients’ health.”

A former emergency room physician, Wen took over the City Health Department in 2015 when she was appointed by then-Mayor Stephanie Rawlings-Blake. Under Wen, the Baltimore City Health Department became a leader in public health innovation. She pushed, for example, for the free prescription access for citizens to naloxone—which reverses an opioid overdose and was named Local Health Department of the Year by the National Association of County and City Health Officials.

A Chinese immigrant, Wen was also been at the forefront of advocacy for women’s health and reproductive rights during her tenure in Baltimore, fighting against Trump Administration cuts to teen pregnancy prevention and local health care clinics. She also helped lead a legal action against the Trump Administration that alleged it intentionally and unlawfully undermines the Affordable Care Act, thereby putting thousands of Baltimoreans at risk of losing access to health care.

In a 2018 Washington Post profile Wen asserted that she is not, by nature, a politician.

“My identity, first and foremost, is always as a doctor,” she said.

“Standard medical care should not be political,” she added. “The fact that it is political means that we as Planned Parenthood need to stand up and fight for it.”

In the midst of restrictive abortion legislation being passed in Alabama, Ohio, Georgia, and other states, there is a dissonance, and according to local leaders, a tinge of fear, for what it could mean for Baltimore and the state of Maryland as a whole.

“As a city, as a state, and as a nation, we’ve made such tremendous gains with maternal mortality because abortion has been legal,” says Dr. Shelly Choo, senior medical advisor for the Baltimore City Health Department. “It’s now safe. If something were to happen where we roll back the gains and abortion becomes illegal, I am concerned and many other people would be concerned about the increase in mortality and in morbidity for families.”

It should be reiterated: A women’s right to choose is fully protected in the state of Maryland, which has legislators who support these rights and make their stances known. But restrictive laws around the country could potentially create a situation where a woman living in one state has vastly different rights under the law. “[Legislators] are going to set up a system where, depending on where you live in the country, you may or may not be able to receive healthcare,” says Karen Nelson, president and CEO of Planned Parenthood of Maryland.

Former Baltimore City Health commissioner—and current Planned Parenthood president—Leana Wen has been particularly outspoken about the dangers of these abortion bans, taking to national media outlets and political rallies to make her stance heard.

Yet, as the national narrative focuses on these states passing sweeping laws—which many see as a broader effort to reverse the Supreme Court’s decision in Roe v. Wade—there is uncertainty in places like Maryland. “It’s confusing when the national media is driving the conversation and something like this is lifted up so much,” Nelson says. She adds that, because of this, it is more important than ever for organizations like Planned Parenthood, as well as the Baltimore City Health Department, which shares the view that a woman has a right to choose, get their message across and provides education to women as to what their options are.

“Even with the restrictive bills that are being passed in other states, it doesn’t stop the work the clinics already provide,” Choo says. “If anything, it does strengthen the need for messaging to make sure that everyone knows that in Maryland and in Baltimore City, that services and education is still being provided as well.”

Choo worries, too, that should laws like the ones passed in Alabama and Georgia percolate across the country, it could further highlight inequities in healthcare: who has access to it and the means by which it can be accessed. “There’s an understanding that this is an equity issue as well,” she says. “These restrictive abortion laws will be disproportionately affecting communities of color and communities who are experiencing low incomes.”

Maryland officially codified its support for Roe v. Wade in 1992, and there are calls for a state constitutional amendment that further enshrines these rights, which Maryland House Speaker Adrienne Jones has supported. Organizations that advocate for abortion rights see this moment as a potential catalyst for change. Those in favor of these rights are making their stance known. Where there is anger, there is action. Rallies across the state have been held over the past few days in support of abortion rights, including one in Baltimore at the War Memorial.

“People are standing up,” Nelson says. “The general public feels that this is just going too far. We’re taking hold of the narrative and continuing to tell people where they can get services and how they can access services.”

Planned Parenthood Federation of America announced Wednesday that Baltimore City Health Department Commissioner Dr. Leana Wen will serve as its sixth president and become the second doctor to lead the organization in its 102-year history.

A former emergency room physician, Wen has led the City Health Department since January 2015 when she was appointed by then-Mayor Stephanie Rawlings-Blake. Under Wen, the Baltimore City Health Department has become recognized as a leader in public health innovations—pushing for free prescription access for citizens to naloxone, which reverses an opioid overdose, for example—and was recently named Local Health Department of the Year by the National Association of County and City Health Officials.

Wen, a Chinese immigrant, has also been at forefront of advocacy for women’s health and reproductive rights, including leading the city’s fight against Trump Administration cuts to teen pregnancy prevention and local health care clinics. Last month, she also helped lead a legal action against the Trump Administration that alleges an effort by the administration unlawfully undermines the Affordable Care Act and puts thousands of Baltimoreans at risk of losing access to health care.

“Providing healthcare and fighting to protect that access to care—that’s what I have been doing my entire life. I am so proud to do this at the Baltimore City Health Department, and soon, at Planned Parenthood: to lead the fight for healthcare access, for gender equality, and for our core values in support of women, children, families, and vulnerable communities,” Wen said in a statement. “The cost of taking on this fight is leaving a job I love and colleagues I admire and draw inspiration from every day. But at this critical juncture in our nation’s history, it is my obligation to take on this challenge and fight with everything I have.”

Wen’s last day as health commission will be October 12. She officially joins Planned Parenthood Nov 12.

As we wrote in our 2016 profile, Wen, 35, was born in Shanghai, China. Her parents were political dissidents and she was 8 years old when they were granted asylum, settling first in Utah and then Compton, California. At 18, she graduated summa cum laude from UCLA and earned her medical degree from Washington University School of Medicine before becoming a Rhodes Scholar.

In Compton, she witnessed firsthand how low wages and poverty impact the health of communities and individuals.

“I saw neighbors go for years without access to care for their diabetes and then end up dying from it,” Wen told Baltimore. “I saw children die from asthma, from other preventable illnesses, because they didn’t have access to health care for any number of reasons, whether it was cost or fear or stigma.”

Growing up, Wen, her mother, and younger sister often relied on Planned Parenthood for healthcare. While earning her medical degree in St. Louis, she volunteered at a local Planned Parenthood health center.

She was also elected president of the American Medical Student Association during medical school, taking a year off to fulfill her responsibilities, including leading 65,000 physicians-in-training to campaign for reproductive rights and universal healthcare. She graduated summa cum laude from California State University, Los Angeles at the age of 18, and earned her medical degree from Washington University School of Medicine before becoming a Rhodes Scholar.

“I depended on Planned Parenthood for medical care at various times in my own life, and as a public health leader, I have seen firsthand the lifesaving work it does for our most vulnerable communities,” Wen said in a post to her Facebook page.

Wen’s appointment comes at a time of considerable concern over women’s health, contraceptive and reproductive rights. With the likely addition of conservative U.S. Circuit Judge Brett Kavanaugh before the upcoming mid-term elections, the Supreme Court is expected to move further right as women’s healthcare cases and issues continue to advance through the legal justice system.

In a press release, Maryland Congressman Elijah Cummings alluded to the current political climate as well as specific pressure directed at Planned Parenthood and various state capitols around the country. He also said Wen will be missed in the city.

“Dr. Wen will follow the dynamic leadership of Cecile Richards, who fought tirelessly against heinous and misinformed attacks on women’s reproductive rights and defended Planned Parenthood as a trusted healthcare provider,” Cummings said. “I am certain that Dr. Wen will continue the fight to protect women’s healthcare. She is a brilliant physician and a passionate public health leader. Although she will be sorely missed by Baltimore, I look forward to continuing our shared mission to ensure that all of our citizens have access to quality, affordable healthcare.”

Among other Baltimore initiatives under Wen’s direction, B’More for Healthy Babies has continued to help lower infant mortality rates, which have fallen nearly 40 percent over the past four years. Wen launched the city’s Vision for Baltimore campaign, which provides free glasses to every child in need of corrective eyewear.

She also helped secure funding for Safe Streets, a program staffed by ex-offenders to tackle gun violence, and led public campaigns on childhood obesity and vaccinations.

During her tenure, Wen has been an outspoken and leading advocate for the need for more state and federal funding for addiction treatment, and she often is called to testify in Annapolis and Washington. Pointing to her state and national influence on key health issues, she has more than 25,000 followers on Twitter.

“This has been a dream job [serving as Baltimore’s health commissioner]—not only to work alongside the most dedicated public servants I’ve ever known, but to join with them in a common mission to combat disparities and improve health and well-being in Baltimore,” Wen said.

In 2016, American Public Health Association awarded Wen its highest award for local public health work. Last year, Governing magazine named her one its Public Officials of the Year.

“Today is a historic day for Planned Parenthood and the millions of people it serves,” said Naomi Aberly, chair of the Planned Parenthood Federation of America Board of Directors. “A dynamic public health leader and practicing physician, Dr. Wen is the first doctor to lead Planned Parenthood in nearly 50 years. Not only will she help Planned Parenthood continue to provide high-quality care to women, men, and young people across the country, she will be a powerful voice in our fight to ensure women have the ability to make their own healthcare decisions—no matter what.”

It’s no secret that Baltimore City has had its issues with rats. (We even have an acclaimed documentary and the satirical bumper stickers to prove it.) But when the rodents invade our dining spaces, the ironic affection turns to serious health concerns.

Last week, a video of a rat scurrying over pastries in a bakery showcase at Lexington Market went viral, eclipsing more than 800,000 views on Facebook in 48 hours. Four days later, another video showing a pair of furry creatures frolicking down the aisles at Northeast Market was posted on social media. Both markets, which are operated by the Baltimore Public Markets Corporation (BPMC), shut down voluntarily to evaluate the premises after the incidents occurred, and have since reopened.

“Sometimes doing business in downtown Baltimore can be tricky,” says Stacey Pack, marketing and communications manager for the BPMC. “We have active construction going on around Lexington Market at the moment. And anytime you have roads being dug up within a few blocks radius of a property, especially a food property, you’re going to attract things.”

Now, officials are coming together to improve the inspection system so that these issues become less frequent. Pack says that the BPMC works with a third-party pest control company that conducts preventative inspections weekly. But, in light of the recent infestations, the operations team plans to make that protocol even more aggressive.

She adds that the open communication between merchants and the community (both markets posted frequent updates to Facebook during the inspections) has been “key” throughout the past few days.

Transparency is something that Councilman Brandon Scott has been advocating for in the Baltimore City Health Department for years. In 2012, he introduced a bill to assign letter grades to food service facilities based on their inspection reports—a system enforced in many big cities including New York.

Though that original piece of legislation has since died, he is hopeful that a new bill requiring restaurants to post their latest inspection reports (which could potentially include the letter grades pending further amendments) visibly in their establishments will pass in some form by the end of this year.

“Folks are clamoring for that information to be more readily available,” says Scott, who was a major player in getting closure notices posted for the public to view online. “On a legislative side, we have to push progressive and bold policy to bring Baltimore in alignment with other major cities so that our citizens feel like they’re valued.”

Giving diners the freedom to choose where they eat based on visible health code reports has become a controversial issue among lawmakers and restaurant owners alike. Helmand Karzai, who owns four city eateries including The Helmand in Mt. Vernon and Tapas Teatro in Station North, admittedly has mixed feelings on the subject. While he supports posting reports for diners, he questions the need for a letter-grading system.

“I feel like it should be a pass-fail type of thing,” Karzai says. “Why would a restaurant even be open if it’s getting a ‘C’ or a ‘D’ and it didn’t fit the necessary guidelines? If it isn’t safe enough for the public, it should be closed.”

But Scott says that many of his constituents appreciate the autonomy that the visible grades have provided them while visiting other cities.

“The letter grades make the choice really easy for them,” he says. “And they feel like they should have the same thing at home. Things shouldn’t be in a cloud of secrecy like they have been for so long.”

Above all, Karzai—who says his restaurants receive unannounced inspections up to three times per year—stresses the importance of staff training and working together with Health Department officials to ensure better experiences for diners across the board.

“I wish there wasn’t so much animosity,” he says.“We’re all in this for the sake of food safety. If you talk to any restaurateur out there, they will tell you that food safety for your guests is always the top priority.”

That is certainly the case for Pack of Baltimore Public Markets, who says they have been “working around the clock” to address the health and sanitation issues.

“Public markets are so important when you think of community hubs and food access,” she says. “When it comes to food and public safety, you don’t mess around.”

On Monday morning, Mayor Catherine Pugh and Baltimore City Health Commissioner Dr. Leana Wen announced a new initiative to combat the opioid epidemic in the city. The Levels of Care initiative involves identifying best practices for responding to the opioid epidemic and will be based in 11 Baltimore hospitals included Bon Secours, Mercy Medical Center, St. Agnes, University of Maryland, and Johns Hopkins Bayview. 

“Among Baltimore’s greatest assets is Baltimore’s unparalleled hospital system which, arguably, is the finest in the world,” Pugh said in a statement. “I am calling on the leaders and medical professionals of our hospitals to join us in fighting the opioid crisis, which continues to claim far too many lives not only in our community, but across our nation. This is a national health crisis and it needs to be treated with the advanced medical resources that we know can be effective and which for sure will save lives.”

The levels of care were developed with input from hospital administrators and will be based on criteria like a hospitals’ ability to provide treatment to patients who screen positive for addiction, distribute overdose medication naloxone to patients, connect patients with peers or other support services, and educate how doctors prescribe opioids. The levels will range from one to three—with one being the highest—to rate a hospital’s comprehensive response to opioid treatment. Currently, the levels of care are open to the public for comment until May 31 and will be finalized this summer.

“We are in the midst of the deadliest drug epidemic in American history,” Wen said in a press conference. “And Baltimore City—with the highest age-adjusted overdose fatality rate of any metropolitan county in the United States—is one of its epicenters.”

The initiative is based on a similar program in Rhode Island, one of the only places in the country where overdose deaths decreased last year. Dr. Wen and the health department have been approaching the opioid crisis in Baltimore aggressively since the number of opioid-related deaths have increased each year. As of June 1, 2017, legislators enacted a standing order for a blanket prescription of naloxone at all pharmacies in the city.

In the spring of 2019, the Baltimore City health department will also open the state’s first-ever Stabilization Center for those under the influence of drugs to receive short-term medical and social interventions as part of the city’s plan to create a 24/7 behavioral health emergency department. Services provided will include medical screening and monitoring, connections to behavioral health and social services, and buprenorphine induction to treat opioid addiction. The Stabilization Center will be located in the Coppin Heights/Rosemont community.

“We are leading the nation to provide evidence-based treatment for the disease of addiction,” Wen said. “The only way to combat it is to ensure that resources and treatment are available.”

A local tech entrepreneur is trying to curb the massive spike in deaths related to the opioid epidemic one text at a time.

The Bad Batch Alert app is made for heroin addicts and their loved ones and essentially notifies them of any bad batches of opioids in the area. When an abnormal amount of overdoses in a neighborhood is detected, a text is sent out alerting users that a bad batch is in the area.

“It’s similar to an Amber Alert,” says creator Mike LeGrand, who started up Code In Schools in order to spread computer science education around Baltimore.

With the help of six teens and one mentor from that program, they started up Bad Batch Alert in October. He says, “Loved ones might use it, because they often care more about the people in the grips of addiction, than the people themselves do.”

In order to receive an alert, you must provide a phone number, which could initially be a turnoff for some users who don’t want to be tracked. “The app is an SMS app, not something you download from the App Store,” says LeGrand. He offers assurance that this app is meant to help and not catch people in the act.

“All phone numbers are encrypted, so they can’t be tracked back,” he says. “Also keep in mind that signing up doesn’t necessarily mean that you’re a user because a lot of friends and family of users will sign up in order to protect the user they know from dying.”

Whenever there’s an overdose, the local EMS is alerted and paramedics fill out the proper paperwork. After that, this information goes to the Baltimore City Health Department and, if there is an abnormal number of overdoses in an area, that information then goes over to the Bad Batch Alert app, which triggers an alert to go out to all of its subscribers.

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“A lot of these users are isolated, so them having access to this app could save their lives,” says LeGrand. More than 700 people a year die from opioid overdoses in Baltimore City, and a huge part of that is caused by Fentanyl, a powerful drug typically used as an anesthetic or pain medicine, being laced into batches of heroin.

According to health commissioner Dr. Leana Wen, the Health Department strives to recruit “members of Baltimore’s thriving technology and design communities to address local public health challenges.”

Dr. Wen explains that reaching out to local tech companies with health interests isn’t new to them. “Baltimore is known for public health and for tech and design,” she says. “We want to increase awareness of potentially dangerous substances and provide resources to help with treatment and recovery.”

The Bad Batch Alert team is happy with their growth, as the app hit 200 registered users this past July, and LeGrand mentions plans of these alerts eventually growing to be statewide.

“I took a leave of absence from my job to work on this product,” he says “and I don’t regret it.”

Every day at least two people die from opioid overdose in Baltimore City, according to health commissioner Dr. Leana Wen. There are only 4,000 doses remaining of the life-saving drug, naloxone, to last until July 2018 with no set date for replenishment.

“If we didn’t ration it, we would use it up in the next two weeks,” said Wen. “Right now, we are making the decision every day about who are the most vulnerable people, and rationing it accordingly.”

Naloxone, or more specifically Narcan, is a medication­ administered as a nasal spray or injection that reverses the effects of opioids during an overdose. Since 2015, residents administering Narcan to victims of overdose saved over 950 lives in Baltimore.

As of June 1, legislators enacted a standing order for a blanket prescription of Narcan at all pharmacies in the city. Unfortunately, the Baltimore City Health Department has run out of funds to purchase the medicine, and has been relying on the generosity of drug companies for donations.

“It’s very safe and effective. It’s got no side effects to someone who is not using opioids,” Wen said. “It’s not addictive—this is a life saving antidote that should be available to every single person.”

Back in March, Governor Larry Hogan declared a state of emergency for the opioid epidemic in Maryland. He also announced a supplemental budget of $50 million in new funding over five years for opioid overdose prevention and treatment.

Katie Kuehn, communications director for the Opioid Operational Command Center, said that as part of the first $10 million in the budget, funding would be available “soon” to local jurisdictions to purchase more naloxone.

“Recognizing the urgency of providing additional naloxone to Baltimore, Behavioral Health System Baltimore requested . . . that a portion of its current budget be allocated to purchase more naloxone to be used by the end of this fiscal year,” she said in an email. “Behavioral Health System Baltimore and the Department of Health and Mental Hygiene’s Behavioral Health Administration worked together to determine that $150,000 was needed, and it was approved the same day.”

According to Wen, Baltimore City has over one-third of all overdoses in the state, so she believes that Baltimore should receive at least one-third of that $10 million.

“We need Narcan, but we also definitely need treatment,” Wen said. “It’s important to save someone’s life if they’re overdosing, but we also need to get them into long-term treatment. That’s what will help them get their lives back.”

Kuehn said that more information about state funding would be announced in the coming days. Currently, the Baltimore City Health Department is awaiting a response from the state for the funding request, but Wen is being proactive with the fight against opioid abuse and overdose. Initiatives like the needle exchange program, which provides clean needles and substance abuse counseling, service about 3,500 people a year.

In addition, the Start Talking Act, which was passed this year, requires public schools to offer drug education as early as third grade, including the dangers of heroin and other opioids.

“Everyone has the ability to save a life. Unfortunately, in our community there are people dying who are mothers, fathers, siblings,” Wen said. “We strongly believe that everyone should have naloxone in their medicine cabinet.”