exposure visit report pdf

National Report on Human Exposure to Environmental Chemicals

The National Report on Human Exposure to Environmental Chemicals is a series of ongoing assessments of the U.S. population’s exposure to environmental chemicals using biomonitoring . The Report presents nationally representative and cumulative biomonitoring data gathered from 1999-2000 through 2017-2018.

The  Report provides information using individual and pooled blood or urine samples tested by Centers for Disease Control and Prevention (CDC) scientists in the Division of Laboratory Sciences. The samples are from people who took part in CDC’s National Health and Nutrition Examination Survey ( NHANES ). Because of NHANES’ study design, the measurements of chemicals in participants are representative of exposures in the U.S. civilian population.

The  Report does not provide health or toxicity information, state- or community-specific data, specific product or environmentally related information, regulatory guidelines or recommendations.

• March 28, 2024: Updated and Revised Chemical Data Tables Available
• September 29, 2023: Enhancements to Data Accessibility
• September 29, 2023: Updated Tables – New and Updated Chemical Data Tables Available
• Overview of the National Exposure Report
• Overview of Analysis of Pooled Serum Samples for Select Chemicals, NHANES 2005-2016
• Overview of Analysis of Chemicals Found in Cigarette Smoke in a Special Sample of U.S. Adults, NHANES 2011-2016
• Biomarker Groups in the National Exposure Report [PDF – 236 KB]
• Chemicals in the National Exposure Report
• Chemical Selection
• Biomonitoring Summaries
• Chemical Factsheets
• Interpretation of Data: Important Considerations
• Data Sources and Data Analysis
• References for Biomonitoring Analytical Methods
• SAS Code Example  [TXT – 10 KB]
• Calculation of Inorganic-related Arsenic Species
• Calculation of PFOS and PFOA as the Sum of Isomers
• About CDC’s Biomonitoring Program
• Suggested Citation
• Frequently Asked Questions
• Chemical and Toxicological Information
• National Biomonitoring Program
• Division of Laboratory Sciences
• How-To Guide

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Sustainable Agriculture

Training and exposure visits, income generation programs.

GREEN conducts training within communities so that they are empowered to adopt sustainable agricultural practices. Over 450 training sessions have been held in 2011 alone through our efforts. These workshops include teaching farmers how to make biopesticides and organic fertilizers such as vermicompost, training them on practices such as the Guli method for ragi cultivation and the SRI method for dry land paddy cultivation, educating them on proper seed storage and crop improvement techniques, among many others.

Sustainable agriculture is the production of plant and animal products in a way that uses farming techniques to protect the environment, ensure social and economic equity as well as gain economic profitability.

Exposure Visits

Exposure visits enable farmers from different regions to interact with and learn from each other, allowing them to view practical examples of successful integration of sustainable practices in farming communities like their own. They are integral to sensitizing the farmer to GREEN’s message of sustainable agriculture. “We had heard of seed banks from GF staff before but we understood the concept only after they took us to a community seed bank. As soon as we saw it, we were very eager to start one in our village,” says Jayamma of Kanavemadhapura.

GREEN facilitates approximately 6 to 8 exposure visits per year. These visits also include rare variety demonstrations that inform farmers of the characteristics and advantages of indigenous crops.

Farmers are also asked to select which varieties presented would be best suited to their needs and agroclimatic zone, so that we may popularize those varieties within the area. At least once a year, GREEN also facilitates exposure visits to other non-profits working in Indian agriculture in order to initiate information exchange. These visits often instill a sense of purpose and enthusiasm among farmers as they are able to see, first hand, the results of adopting the organic practices GREEN advocates. This is particularly useful in convincing farmers to aim for organic farming certification, because it shows them the advantages certified farmers in other areas have, when marketing their produce.

Get in Touch

Registered office, #36, vinayaka layout, bhoopasandra main road, bhoopasandra, bangalore – 560094. india, © 2024 green foundation.

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How to Write a Visit Report

Last Updated: March 30, 2024 References

This article was co-authored by Madison Boehm . Madison Boehm is a Business Advisor and the Co-Founder of Jaxson Maximus, a men’s salon and custom clothiers based in southern Florida. She specializes in business development, operations, and finance. Additionally, she has experience in the salon, clothing, and retail sectors. Madison holds a BBA in Entrepreneurship and Marketing from The University of Houston. This article has been viewed 654,479 times.

Whether you’re a student or a professional, a visit report helps you document the procedures and processes at an industrial or corporate location. These reports are fairly straightforward. Describe the site first and explain what you did while you were there. If required, reflect on what you learned during your visit. No additional research or information is needed.

Writing a Visit Report

Explain the site's purpose, operations, and what happened during the visit. Identify the site's strengths and weaknesses, along with your recommendations for improvement. Include relevant photos or diagrams to supplement your report.

Describing the Site

• Reports are usually only 2-3 pages long, but in some cases, these reports may be much longer.
• In some cases, you may be asked to give recommendations or opinions about the site. In other cases, you will be asked only to describe the site.
• Ask your boss or instructor for models of other visit reports. If you can't get a model, look up samples online.

• If you visited a factory, explain what it is producing and what equipment it uses.
• If you visited a construction site, describe what is being constructed and how far along the construction is. You should also describe the terrain of the site and the layout.
• If you’re visiting a business, describe what the business does. State which department or part of the business you visited.
• If you’re visiting a school, identify which grades they teach. Note how many students attend the school. Name the teachers whose classes you observed.

• Who did you talk to? What did they tell you?
• What did you see at the site?
• What events took place? Did you attend a seminar, Q&A session, or interview?
• Did you see any demonstrations of equipment or techniques?

• For example, at a car factory, describe whether the cars are made by robots or humans. Describe each step of the assembly line.
• If you're visiting a business, talk about different departments within the business. Describe their corporate structure and identify what programs they use to conduct their business.

Reflecting on Your Visit

• Is there something you didn’t realize before that you learned while at the site?
• Who at the site provided helpful information?
• What was your favorite part of the visit and why?

• For example, you might state that the factory uses the latest technology but point out that employees need more training to work with the new equipment.
• If there was anything important left out of the visit, state what it was. For example, maybe you were hoping to see the main factory floor or to talk to the manager.

• Tailor your recommendations to the organization or institution that owns the site. What is practical and reasonable for them to do to improve their site?
• Be specific. Don’t just say they need to improve infrastructure. State what type of equipment they need or give advice on how to improve employee morale.

Formatting Your Report

• If you are following a certain style guideline, like APA or Chicago style, make sure to format the title page according to the rules of the handbook.

• Don’t just say “the visit was interesting” or “I was bored.” Be specific when describing what you learned or saw.

Sample Visit Report

Community Q&A

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• ↑ http://services.unimelb.edu.au/__data/assets/pdf_file/0010/471286/Site_Reports_for_Engineers_Update_051112.pdf
• ↑ https://www.examples.com/business/visit-report.html
• ↑ https://www.thepensters.com/blog/industrial-visit-report-writing/
• ↑ https://eclass.aueb.gr/modules/document/file.php/ME342/Report%20Drafting.pdf

About This Article

To write a visit report, start by including a general introduction that tells your audience where and when you visited, who your contact was, and how you got there. Once you have the introduction written out, take 1 to 2 paragraphs to describe the purpose of the site you visited, including details like the size and layout. If you visited a business, talk about what the business does and describe any specific departments you went to. Then, summarize what happened during your visit in chronological order. Make sure to include people you met and what they told you. Toward the end of your report, reflect on your visit by identifying any strengths and weaknesses in how the site operates and provide any recommendations for improvement. For more help, including how to format your report, read on! Did this summary help you? Yes No

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Report Templates

21+ visit report templates.

For every business’s marketing initiative, a customer visit is one of the most vital activities a company’s product manager should do. This is to ensure that you get direct feedback from your customers  regarding how your product has impacted your costumes, in both positive and negative aspects. You get a list of action items that you need to do to improve your product based on customer suggestions.

Customer Visit Report Template Word

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Visit Report Format

Site Visit Report Template

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Customer Visit Report Template

Creating a Visit Report:

1. Describe the Site

2. operations at the site, 3. reflect your visit, 4. format your report, free daily field visit report in pdf format.

Free Company Engineers IT Site Observation Report Template

Free Industrial Visit Site Report Template

Free Data Quality Site in Doc Format

Free One Day Home Training Visit Report Template

How to Write a Visit Report?

• Taking down simple notes during your visit can help you later on, while you make the report. Request reports and other documentation you’ll need to back up the input you are compiling and ensure that you have authorization from your source.
• Begin analyzing raw data for your visit report as soon as possible. You can follow your organization’s format or download and edit any of the above-mentioned printable templates easily.
• Start your visit report with an area emphasizing typical data such as the name of the site, address, contact person, arrival, and purpose and objectives of the visit.
• Write an introduction telling the organization you visited. Mention who are those you interacted with while on site. Exclude sensitive information from your quarterly report .
• Don’t forget to proofread your first draft. Add titles, subheadings, bullet points, and other organizing details.
• Arrange the attachments following your visit report in an organized manner.

Free Property Building Construction Site Inspection Report

Free Weekly Plant Visit Report Template

Free Hospital / Nursing Home Project Site Report

Free Professional Academic Visit Report Template

Free Market Product Monitoring Visit Report

Free NGO Site Visit Summary Report in PDF Format

How to Write a Report?

• Make your research – Ensure you have the right number of sources for your services report.
• Always make sure that your sources are reliable – Make sure to double-check any facts you find. It is recommended to stay with the details gathered by known experts.
• Write a report states – This serves as the main concept of the report layout . This summarizes what you want to prove in your report for your reader.
• Write a precise and engaging introduction – Your goal is to entice readers to read your report. You should provide some background details on your topic.
• Write your content – The body paragraphs are where you describe the evidence that supports your report. Each paragraph contains a topic sentence and supports the proof sentence.
• Create your conclusion – This part should summarize your report and provide your final input.

1. What is a Visit Report?

2. what information does a visit report contain, 3. what is the importance of a visit report, 4. what are the benefits of using a report, 5. what are some examples of visit reports.

• Professional visit report
• Monitoring visit report
• Business visit report
• Site visit report
• Industrial visit report
• Field trip visit report, etc.

More in Report Templates

Simple industry visit report template, hospital site visit report template, it site visit report template, technical site visit report template, project site visit report template, sales site visit report template, hotel site visit report template, security site visit report template, job site visit report template, customer site visit report template.

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Toxic Exposure Screenings: Vets Report Spotty Follow-Up on Questionnaire Meant to Boost Health Care and Benefits

This story, part of a series of investigative reporting projects by Military.com on service member and veteran health, was supported by the Pulitzer Center . 

Confusing. Lackluster. Generic. A little bit of a letdown.

Those are some of the ways veterans are describing toxic exposure screenings they've gotten at Department of Veterans Affairs health centers, screenings that were designed as a tool to get more vets help after medical evidence accumulated that service had made many sick.

Rolled out with great fanfare in November 2022 , toxic exposure screenings for all VA patients were mandated by the PACT Act , the sweeping law passed in August of that year that expanded benefits and health care for millions of veterans exposed to environmental hazards during their military service.

Read Next: They Stood Sentry over America's Nuclear Missile Arsenal. Many Worry It Gave Them Cancer.

Through December, in the first year screenings were available, the VA recorded conducting a little less than 5.1 million screenings, according to data obtained by Military.com through a public records request. That number had risen to about 5.3 million as of the end of March, according to the VA's public PACT Act dashboard.

Whether these screenings are driving a wave of veterans to then get better medical care and benefits is unclear, as vets themselves are painting a mixed picture of the process and experts question whether the screenings are asking the right questions.

Millions of veterans of the post-9/11 wars were exposed to massive trash fires known as burn pits, with many since developing breathing and heart issues, as well as debilitating and fatal cancers such as glioblastoma. Contaminated water at Camp Lejeune , North Carolina; chemical warfare such as using Agent Orange during the Vietnam War; and radiation from working near nuclear weapons have also sickened scores of veterans through the years.

Military.com spoke to a dozen veterans and family members about their experiences with the screenings. Some credited the questionnaire with leading to their doctors conducting more thorough medical exams. But others say it appeared to be a check-the-box exercise that has had no apparent effects on their health care or benefits.

"They didn't do the connecting step, I think is the biggest thing," said Geoffrey Threats, an Army veteran whose deployments included Iraq, Afghanistan, Kuwait and Jordan. "The connecting step of saying, 'OK, now here's how you file a claim if you think you have these things.'"

Threats had a toxic exposure screening in January after scheduling a special appointment for one. A doctor asked him where he had deployed and what his suspected exposures were, then handed him a pamphlet with background information on the PACT Act, he said. He had already filed a disability benefits claim prior to his screening, but he expressed concern for other veterans who may need more guidance on how to file a claim.

"Because you do have veterans who walk in there, they give the survey, and then they walk out, and they continue on with their life," Threats said.

Several veterans who spoke to Military.com said they haven't gotten the follow-up they asked for or that the response was lacking. Military.com solicited feedback on the screenings from its readers, and of 76 people who said they asked for follow-up information, 56 said they did not get it.

In response to the public records request from Military.com, the VA said it isn't systematically tracking any follow-up resulting from the screenings to see whether veterans are getting additional help.

When the agency started the screenings, VA officials promised the three-part questionnaire would help "enhance" benefits for veterans who are already in the system. Lawmakers who wrote the PACT Act touted the screenings as a way to "bolster" VA resources.

Of the patients who were screened as of December, about 2.2 million veterans reported at least one potential exposure. The top issue cited was burn pits as mentioned by just over 1 million veterans, followed by Agent Orange at 708,315 veterans, according to the data obtained by Military.com. Veterans are allowed to name more than one potential exposure.

About one-third of veterans who reported concerns didn't ask for any follow-up information, according to the data. Of those who did want follow-up services, being connected with the Veterans Benefits Administration, or VBA, was the most popular choice, with 807,490 veterans requesting that.

Roughly 600,000 veterans asked for information about the Airborne Hazards and Open Burn Pit Registry, and a little less than that wanted to be connected with a veterans service organization.

Meanwhile, 155,464 veterans asked to be contacted by a "toxic exposure screening navigator." The navigators oversee implementation of the screenings, conduct the screenings when they are done outside of a primary care appointment, and serve as veterans' point of contact when they have follow-up questions or concerns.

But the Veterans Health Administration has no way of tracking whether veterans got the follow-up they asked for, according to the agency's response to Military.com's records request. The VHA is working with the VBA to improve the communication between the two agencies and establish a process to relay important information from the screenings that could help the benefits claims process, the VHA said in its response.

Asked for comment on the veterans who were disappointed in the screenings or said they haven't gotten the follow-up information they requested, VA spokesperson Terrence Hayes told Military.com that veterans with concerns should contact their care team to check on the status of their follow-up or, if they feel their care team is unresponsive, the patient advocate at their local VA facility.

"We will make sure that they get the care they deserve," Hayes said in an emailed statement. "The experience of these screenings varies based on the individual veteran and their circumstances, but our goal is to provide a toxic exposure screening to every veteran we see, and if exposure is reported, to follow up with additional testing. These screenings serve as a resource to provide veterans with the exposure-informed care they deserve."

Are Three Questions the Right Answer?

The screenings were one of the first high-profile actions the VA took after the passage of the PACT Act, a law that's been described as the biggest expansion of veterans benefits in a generation, and the volume of screenings done has become a frequently cited data point for VA officials arguing that the PACT Act has been successful.

The law mandated the screenings be done at least once every five years for every veteran enrolled in VA health care but did not require any specific questions or tests, beyond stipulating that the screening should at a minimum ask about potential exposure to burn pits and about exposures to other toxins "commonly associated" with military service.

The law also didn't mandate any follow-up services after the screenings but said the VA should provide print materials and "outline related resources" available to veterans.

The screenings entail three questions: Do you believe you were exposed to toxins during your military service, what do you think you were exposed to, and do you want any follow-up support?

The screening was developed by the VA's director of primary care operations, according to a September 2022 regulatory filing by the department.

The answers to the questions are being added to patients' medical records to support "longitudinal care" so that physicians can be more alert for symptoms from health problems that may arise later, the VA said in background information included in Hayes' email. Research does not support lab tests or specialty referrals based solely on exposure, so "for most veterans, there will not be testing completed simply as a result of an endorsed exposure," the email said.

Victoria Cassano, a doctor with expertise in occupational and environmental medicine who previously served as the VA's director of radiation and physical exposures, expressed doubt the screenings could provide much useful information, calling the questionnaire "vague." A better screening, she argued, would be for the VA to collect full occupational histories from patients that discuss in detail every job they had in the military.

"Most people, even in the military, don't know what they're exposed to," said Cassano, a Navy veteran. "And so asking those three questions really doesn't help at all, especially when most of the doctors they're talking to don't understand what the exposures are in a given [military occupational specialty] or a given environment."

Cassano agreed that further medical testing wouldn't be warranted after a screening unless a patient has symptoms. Ideally, she said, the screenings should be used to establish a medical surveillance plan to be able to catch "subtle signs" of the development of a disease.

The pamphlets handed to patients after the screening include basic information on types of exposures, web addresses and phone numbers to schedule doctor appointments or file a benefits claim, and a summary of health registries for different types of exposures, according to copies posted on the VA's website and provided to Military.com by a caregiver of a veteran who was screened.

Joe Moss, an Army veteran exposed to toxins when he was stationed at the now-defunct Fort McClellan , went to get a screening at a PACT Act outreach event in March at a VA clinic in Orlando, Florida. There, he discovered his medical records showed he'd already been screened. It turned out that questions he was asked by a VA emergency room doctor when he was having a heart attack months earlier counted as his screening, he said.

"The doctor asked me if I'd ever been exposed to anything, and I said yeah. I thought that was part of their protocol" for diagnosing the heart attack, he said.

The Missing Link

The connection, or lack thereof, between the screening and getting other benefits was one of the top issues cited by veterans who spoke to Military.com.

Tasha Carnahan, an Army veteran who served in Iraq and suffers from chronic sinusitis and rhinitis, said she went into her screening thinking it would help her disability benefits claim, only for the doctor to tell her the screening was just for the VA to collect data.

"You see everything that says about the PACT Act and benefits for veterans that have been exposed to toxic exposures, but when you actually go there, they just say, 'Thank you for letting us know, it's going to be annotated,' and that's it," she said, adding that her primary care doctor has also made no reference to the screening since she had it.

Walter Kenna, a Marine Corps veteran who briefly served at Camp Lejeune, said that, in addition to the pamphlet he was given at his screening, he got a letter in the mail explaining how to file a claim for disability benefits. The letter said it was sent because he had reported a toxic exposure at his screening, Kenna added. But he said he felt the letter wasn't relevant to him because he hasn't been diagnosed with one of the conditions presumed to be connected with service at Camp Lejeune.

Others, though, described more positive outcomes from their screenings.

One Navy veteran who asked for anonymity to discuss his health issues said he had to prod the nurse at his annual exam to give him a screening, which he found out the department was doing only because he spotted a brochure about the PACT Act during a previous VA visit. But after he told the nurse he was concerned he had been exposed to asbestos, she relayed that information to his doctor and the doctor immediately ordered a CT scan, which revealed scarring in his lungs, the veteran said.

He's also been contacted by a toxic exposure screening navigator since that appointment, he said. Despite believing the VA could do a better job informing veterans about the screenings, he said he thinks his outcome shows the screenings are "an outstanding idea."

To make the screenings more useful, there should be better coordination between VHA and VBA so that any information gleaned by the questionnaire could help with benefits claims, said Cassano, who now runs a consulting firm that works with veterans advocates on disability claims.

"I think that questionnaire is helpful to an extent," she said, "but I don't think it's enough."

Related: VA Starts Doing Toxic Exposure Screenings as Advocates Press for Medical Testing

Rebecca Kheel

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The U.S. labor market is shifting toward skilled labor as white-collar hiring slows

America's job market increasingly appears to be splitting into two tracks, economists say, alongside a steady demand for skilled workers and a flagging interest in hiring more "knowledge-based" professionals.

The evidence can be found in the data, which shows a higher unemployment rate for professional and business services workers, and a lower one for people who work in manufacturing.

"It's a buyer's market for brain and a seller's market for brawn," said Aaron Terrazas, chief economist at the jobs and workplace search site Glassdoor.

On Friday, the Bureau of Labor Statistics reported the latest monthly payroll data for the U.S. economy. Total employment rose by 175,000 in April. The unemployment rate rose slightly to 3.9% from 3.8% in March.

That came in below estimates of 240,000 jobs for April.

The softness in the jobs report was greeted with some positive reactions. Stock futures jumped after the news. Concerns about the U.S. economy have been focused on overheating — whether inflation will continue to rise and force the Federal Reserve to keep interest rates higher in an effort to slow the economy and bring rising prices under control.

Jason Furman, who served as President Barack Obama's top economic advisor, said on CNBC's "Squawk Box" that it was a "goldilocks" report , showing an economy that could be headed to the soft landing of reasonable inflation and low unemployment.

“The bottom line is this report is quite reassuring," said Furman, who now teaches at Harvard.

It's not that America is only — or even mostly — producing low-wage jobs. The health care industry continues to lead the employment boom, with an approximately 4.5% gain in payrolls over the past year, equating to some 750,000 new jobs. Other industries seeing strong growth include government jobs, certain sectors of social work, travel, tourism and the arts — alongside some manufacturing sectors.

But the overall labor market remains at something of a standstill, as seen in a report earlier this week showing the hiring rate continuing to drift sideways. At the same time, the rate of workers quitting or being laid off is also not showing much change. Economists led by Guy Berger at The Burning Glass Institute research group call it the "great stay."

"It’s a good time to have a job, but a not-so-good time to be actively looking for one," he wrote in his Substack newsletter Wednesday.

Many American consumers have also begun reporting signs of a deteriorating job situation. In its latest report on consumer confidence, the Conference Board business group said respondents to its monthly survey reported feeling less positive about the current labor market and more concerned about future business conditions, job availability and income.

That echoed findings of the New York Federal Reserve's monthly survey of consumer expectations, which reported more survey respondents feeling pessimistic about losing their job or finding a new job. Respondents rated the average probability of losing their job in the next 12 months at almost 1 in 6 — above pre-pandemic levels and the highest reading since September 2020.

"On the margin, businesses are not as eager to add staff," said Sarah House, managing director and senior economist at Wells Fargo.

But why has payroll data remained strong? One reason is increased supply, thanks to rising participation rates in the workforce, as well as booming immigration .

"There is increased labor 'supply' for businesses that do want to hire or add staff," House said.

Yet, those trends are likely to diminish too, if they haven't already, she said.

One sign that the job market remains strong is that the number of individuals collecting unemployment is still very low.

"We're seeing a gradual and orderly slowing" in workers quitting and firms with job openings, said Joe Brusuelas, principal and chief economist for RSM US LLP. That is consistent with private sector firms "carefully managing their labor force."

On Wednesday, Federal Reserve Chair Jerome Powell said the central bank does not intend to change its key interest rate anytime soon even as its fight against accelerating price increases has stalled — and despite the apparent softening of the labor market.

He said the central bank had "the luxury of strong growth and a strong labor market" that will allow it to maintain interest rates until inflation comes down further — and ruled out any implication that there might be "stagflation" in the economy .

But he invoked the prospect of a rate cut should the labor market "unexpectedly" weaken.

As inflation continues to moderate, Powell said, "We’re now focusing on the other goal," referring to the Fed's dual mandate of balancing price growth with jobs.

"The employment goal now comes back into focus. So we are focusing on it,” he said.

Some economists saw Friday's jobs report as sign that Powell's plans are coming to fruition.

"These are the #jobs numbers that Jay Powell was hoping for," David Wessel, director of the Hutchins Center on Fiscal and Monetary Policy at the Brookings Institution, posted on X .

Rob Wile is a breaking business news reporter for NBC News Digital.

Health insurance giant Kaiser will notify millions of a data breach after sharing patients’ data with advertisers

U.S. health conglomerate Kaiser is notifying millions of current and former members of a data breach after confirming it shared patients’ information with third-party advertisers, including Google, Microsoft and X (formerly Twitter).

In a statement shared with TechCrunch, Kaiser said that it conducted an investigation that found “ certain online technologies, previously installed on its websites and mobile applications, may have transmitted personal information to third-party vendors.”

Kaiser said that the data shared with advertisers includes member names and IP addresses, as well as information that could indicate if members were signed into a Kaiser Permanente account or service and how members “interacted with and navigated through the website and mobile applications, and search terms used in the health encyclopedia.”

Kaiser said it subsequently removed the tracking code from its websites and mobile apps.

Kaiser is the latest healthcare organization to confirm it shared patients’ personal information with third-party advertisers by way of online tracking code , often embedded in web pages and mobile apps and designed to collect information about users’ online activity for analytics. Over the past year, telehealth startups Cerebral , Monument and Tempest have pulled tracking code from their apps that shared patients’ personal and health information with advertisers.

Kaiser spokesperson Diana Yee said that the organization would begin notifying 13.4 million affected current and former members and patients who accessed its websites and mobile apps. The notifications will start in May in all markets where Kaiser Permanente operates, the spokesperson said.

The health giant also filed a legally required notice with the U.S. government on April 12 but made public on Thursday confirming that 13.4 million residents had information exposed.

U.S. organizations covered under the health privacy law known as HIPAA are required to notify the U.S. Department of Health and Human Services of data breaches involving protected health information, such as medical data and patient records. Kaiser also notified California’s attorney general of the data breach, but did not provide any further details.

The Kaiser Foundation Health Plan is the parent organization of several entities that make up Kaiser Permanente, one of the largest healthcare organizations in the United States. The Kaiser Foundation Health Plan provides health insurance plans to employers and reported 12.5 million members as of the end of 2023.

The breach at Kaiser is listed on the Department of Health and Human Services’ website as the largest confirmed health-related data breach of 2024 so far.

To contact this reporter, get in touch on Signal and WhatsApp at +1 646-755-8849, or by email . You can also send files and documents via  SecureDrop .

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House Approves $95 Billion Aid Bill for Ukraine, Israel and Taiwan

After months of delay at the hands of a bloc of ultraconservative Republicans, the package drew overwhelming bipartisan support, reflecting broad consensus.

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By Catie Edmondson

Reporting from the Capitol

The House voted resoundingly on Saturday to approve $95 billion in foreign aid for Ukraine, Israel and Taiwan, as Speaker Mike Johnson put his job on the line to advance the long-stalled aid package by marshaling support from mainstream Republicans and Democrats.

In four back-to-back votes, overwhelming bipartisan coalitions of lawmakers approved fresh rounds of funding for the three U.S. allies, as well as another bill meant to sweeten the deal for conservatives that could result in a nationwide ban of TikTok.

The scene on the House floor reflected both the broad support in Congress for continuing to help the Ukrainian military beat back Russia, and the extraordinary political risk taken by Mr. Johnson to defy the anti-interventionist wing of his party who had sought to thwart the measure. Minutes before the vote on assistance for Kyiv, Democrats began to wave small Ukrainian flags on the House floor, as hard-right Republicans jeered.

How the House Voted on Foreign Aid to Ukraine, Israel and Taiwan

Here’s how each member of the House voted on the foreign aid bills.

The legislation includes $60 billion for Kyiv; $26 billion for Israel and humanitarian aid for civilians in conflict zones, including Gaza; and $8 billion for the Indo-Pacific region. It would direct the president to seek repayment from the Ukrainian government of $10 billion in economic assistance, a concept supported by former President Donald J. Trump, who had pushed for any aid to Kyiv to be in the form of a loan. But it also would allow the president to forgive those loans starting in 2026.

It also contained a measure to help pave the way to selling off frozen Russian sovereign assets to help fund the Ukrainian war effort, and a new round of sanctions on Iran. The Senate is expected to pass the legislation as early as Tuesday and send it to President Biden’s desk, capping its tortured journey through Congress.

“Our adversaries are working together to undermine our Western values and demean our democracy,” Representative Michael McCaul, Republican of Texas and the chairman of the Foreign Affairs Committee, said Saturday as the House debated the measure. “We cannot be afraid at this moment. We have to do what’s right. Evil is on the march. History is calling and now is the time to act.”

“History will judge us by our actions here today,” he continued. “As we deliberate on this vote, you have to ask yourself this question: ‘Am I Chamberlain or Churchill?’”

The vote was 311 to 112 in favor of the aid to Ukraine, with a majority of Republicans — 112 — voting against it and one, Representative Dan Meuser of Pennsylvania, voting “present.” The House approved assistance to Israel 366 to 58; and to Taiwan 385 to 34, with Representative Rashida Tlaib, Democrat of Michigan, voting “present.” The bill to impose sanctions on Iran and require the sale of TikTok by its Chinese owner or ban the app in the United States passed 360 to 58.

“Today, members of both parties in the House voted to advance our national security interests and send a clear message about the power of American leadership on the world stage,” Mr. Biden said. “At this critical inflection point, they came together to answer history’s call, passing urgently needed national security legislation that I have fought for months to secure.”

Minutes after the vote, President Volodymyr Zelensky of Ukraine thanked lawmakers, singling out Mr. Johnson by name “for the decision that keeps history on the right track.”

“Democracy and freedom will always have global significance and will never fail as long as America helps to protect it,” he wrote on social media. “The vital U.S. aid bill passed today by the House will keep the war from expanding, save thousands and thousands of lives, and help both of our nations to become stronger.”

Outside the Capitol, a jubilant crowd waved Ukrainian flags and chanted, “Thank you U.S.A.” as exiting lawmakers gave them a thumbs-up and waved smaller flags of their own.

For months, it had been uncertain whether Congress would approve new funding for Ukraine, even as momentum shifted in Moscow’s favor. That prompted a wave of anxiety in Kyiv and in Europe that the United States, the single biggest provider of military aid to Ukraine, would turn its back on the young democracy.

And it raised questions about whether the political turmoil that has roiled the United States had effectively destroyed what has long been a strong bipartisan consensus in favor of projecting American values around the world. The last time the Congress approved a major tranche of funding to Ukraine was in 2022, before Republicans took control of the House.

With an “America First” sentiment gripping the party’s voter base, led by Mr. Trump, Republicans dug in last year against another aid package for Kyiv, saying the matter should not even be considered unless Mr. Biden agreed to stringent anti-immigration measures. When Senate Democrats agreed earlier this year to legislation that paired the aid with stiffer border enforcement provisions, Mr. Trump denounced it and Republicans rejected it out of hand.

But after the Senate passed its own $95 billion emergency aid legislation for Ukraine, Israel and Taiwan without any immigration measures, Mr. Johnson began — first privately, then loudly — telling allies that he would ensure the U.S. would send aid to Kyiv.

In the end, even in the face of an ouster threat from ultraconservative members, he circumvented the hard-line contingent of lawmakers that once was his political home and relied on Democrats to push the measure through. It was a remarkable turnabout for a right-wing lawmaker who voted repeatedly against aid to Ukraine as a rank-and-file member, and as recently as a couple of months ago declared he would never allow the matter to come to a vote until his party’s border demands were met.

In the days leading up to the vote, Mr. Johnson began forcefully making the case that it was Congress’s role to help Ukraine fend off the advances of an authoritarian. Warning that Russian forces could march through the Baltics and Poland if Ukraine falls, Mr. Johnson said he had made the decision to advance aid to Kyiv because he “would rather send bullets to Ukraine than American boys.”

“I think this is an important moment and important opportunity to make that decision,” Mr. Johnson told reporters at the Capitol after the votes. “I think we did our work here and I think history will judge it well.”

Mr. Johnson structured the measures, which were sent to the Senate as one bill, to capture different coalitions of support without allowing opposition to any one element to defeat the whole thing.

“I’m going to allow an opportunity for every single member of the House to vote their conscience and their will,” he had said.

In a nod to right-wing demands, Mr. Johnson allowed a vote just before the foreign aid bills on a stringent border enforcement measure, but it was defeated after failing to reach the two-thirds majority needed for passage. And the speaker refused to link the immigration bill to the foreign aid package, knowing that would effectively kill the spending plan.

His decision to advance the package infuriated the ultraconservatives in his conference who accused Mr. Johnson of reneging on his promise not to allow a vote on foreign aid without first securing sweeping policy concessions on the southern border. It prompted two Republicans, Representatives Thomas Massie of Kentucky and Paul Gosar of Arizona to join a bid by Representative Marjorie Taylor Greene of Georgia to oust Mr. Johnson from the top job.

Ms. Greene claimed the Ukraine aid bill supported “a business model built on blood and murder and war in foreign countries.”

“We should be funding to build up our weapons and ammunition, not to send it over to foreign countries,” she said before her proposal to zero out the money for Kyiv failed on a vote of 351 to 71.

Much of the funding for Ukraine is earmarked to replenish U.S. stockpiles after shipping supplies to Kyiv.

Since Russia’s invasion in 2022, Congress has appropriated $113 billion in funding to support Ukraine’s war effort. $75 billion was directly allocated to the country for humanitarian, financial and military support, and another $38 billion in security assistance-related funding was spent largely in the United States, according to the Institute for Study of War , a Washington-based research group.

Hard-right Republican opposition to the legislation — both on the House floor and in the critical Rules panel — forced Mr. Johnson to rely on Democrats to push the legislation across the finish line.

“If Ukraine does not receive this support that it requires to defeat Russia’s outrageous assault on its sovereign territory, the legacy of this Congress will be the appeasement of a dictator, the destruction of an allied nation and a fractured Europe,” said Representative Rosa DeLauro of Connecticut, the top Democrat on the Appropriations Committee. “Gone will be our credibility, in the eyes of our allies and of our adversaries. And gone will be the America that promised to stand up for freedom, democracy, and human rights, wherever they are threatened or wherever they are under attack.”

Thirty-seven liberal Democrats opposed the $26 billion aid package for Israel because the legislation placed no conditions on how Israel could use American funding, as the death toll in Gaza has reached more than 33,000 and the threat of famine looms. That showed a notable dent in the longstanding ironclad bipartisan backing for Israel in Congress, but was a relatively small bloc of opposition given that left-wing lawmakers had pressed for a large “no” vote on the bill to send a message to Mr. Biden about the depth of opposition within his political coalition to his backing for Israel’s tactics in the war.

“Sending more weapons to the Netanyahu government will make the U.S. even more responsible for atrocities and the horrific humanitarian crisis in Gaza which is now in a season of famine,” said Representative Jonathan L. Jackson, Democrat of Illinois.

Carl Hulse , Annie Karni , and Kayla Guo contributed reporting from Washington and Marc Santora from Kyiv.

Catie Edmondson covers Congress for The Times. More about Catie Edmondson

Our Coverage of the War in Ukraine

News and Analysis

President Biden and Ukraine’s allies have invoked a sense of urgency over weapon deliveries. But there are logistical hurdles , and Ukraine has little time to lose.

The United States has accused Russia of using chemical weapons , including poison gas, “as a method of warfare” against Ukrainian forces, in violation of a global ban on the use of such weapons.

Russian troops have captured or entered around a half-dozen villages on Ukraine’s eastern front, highlighting the deteriorating situation in the region  for Ukrainian forces as they wait for long-needed U.S. military aid.

Signs of Trauma: As Ukrainian prisoners of war return with physical and psychological wounds stemming from torture by their Russian captors, they are being sent back to active duty — often without adequate treatment .

Patriotism or Survival: As the war drags on, communities in western Ukraine that were steadfast  in their commitment to the war effort have been shaken by the unending violence on the front line.

Resuming U.S. Military Aid: Weapons from the support package, considered “a lifeline” for Ukraine’s military , could be arriving on the battlefield within days . But experts say it could take weeks before there is a direct impact on the war . What would $60 billion buy ?

How We Verify Our Reporting

Our team of visual journalists analyzes satellite images, photographs , videos and radio transmissions  to independently confirm troop movements and other details.

We monitor and authenticate reports on social media, corroborating these with eyewitness accounts and interviews. Read more about our reporting efforts .