stymied by disagreements about a program to prop up struggling state and local governments.
Its legally mandated report to Congress was delayed for weeks, and a member of the panel, Bharat Ramamurti, accused his Republican colleagues of stalling the group’s work. Mr. Ramamurti has since left to work for the Biden administration, and the five-person panel now has three commissioners and no chair. Its latest report was only 19 pages.
WASHINGTON — President Biden ordered the Labor Department on Monday to ensure that unemployed Americans cannot draw enhanced federal jobless benefits if they turn down a suitable job offer, even as he rejected claims by Republicans that his weekly unemployment bonus is undermining efforts to get millions of Americans back to work.
Stung from a weekend of criticism over a disappointing April jobs report, Mr. Biden struck a defiant tone, seeking to make clear that he expects workers to return to jobs if they are available, while defending his signature economic policy effort thus far and blaming corporate America, in part, for not doing more to entice people to go back to work.
The president told reporters at the White House that child care constraints, school closures and fears of contracting the coronavirus had hindered job creation last month, and he challenged companies to help workers gain access to vaccines and to raise their pay.
“The last Congress, before I became president, gave businesses over $1.4 trillion in Covid relief,” Mr. Biden said. “Congress may have approved that money, but let’s be clear: The money came from the American people, and it went from the American people to American businesses, many of them big businesses, to help them get through this pandemic and keep their doors open.”
legal confrontation over whether states can cut taxes after taking relief money and using it to solidify their budgets.
the guidance said.
Treasury and White House officials made clear that they would scrutinize how the funds were being used to ensure that state budgets were not being gamed to violate the intent of the law. A new recovery office at the Treasury Department will coordinate with states to help determine if their policies are in line with conditions set forth in the law.
The relief money also cannot be paid into state pension funds to reduce unfunded liabilities.
A White House official would not comment on whether initiatives like Montana’s return-to-work bonuses could be funded using relief money. States and cities are being given broad discretion on how they can use the money, which is intended to replace public sector revenue that was lost during the pandemic; to provide extra pay for essential workers; and to be invested in sewer, water and broadband infrastructure.
Treasury Secretary Janet L. Yellen’s guidance failed to clarify the matter.
“Arizona should not be put in a position of losing billions of dollars because the federal government wants to commandeer states’ tax policies,” Mr. Brnovich said.
The allocation of the funds is also likely to be a contentious matter as the money starts to flow. Some states have complained that states that managed the pandemic well are essentially being penalized because the formula for awarding aid is based on state unemployment rates.
The Treasury Department said on Monday that the states that were hardest hit economically by the pandemic would also get their money faster.
Local governments will generally receive half of the money this month and the rest next year. But states that currently have a net increase in unemployment of more than two percentage points since February 2020 will get the funds in a lump sum right away.
Officials also said Monday that the administration would issue new guidelines meant to speed money from the recovery act to help child care centers reopen, and that the Labor Department would highlight a program that allows some unemployed workers to accept offers of part-time jobs without losing access to the federally supplemented benefits.
Mr. Biden said that the efforts would help the economy recover — and that the rebound from recession remained on track.
“Let’s be clear: Our economic plan is working,” he said. But he said recovery would not always prove to be easy or even. “Some months will exceed expectations,” he said, “others will fall short.”
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JERUSALEM — Hundreds were injured as clashes between Israeli police and Palestinian protesters broke out Monday morning at the Aqsa mosque compound in Jerusalem, a site sacred to both Muslims and Jews, after a week of rising tension in the city. Police fired rubber-tipped bullets and stun grenades at stone-throwing Palestinians who had stockpiled stones at the site in expectation of a standoff with Jewish far-right groups.
By midmorning, more than 50 people had been transferred to the hospital, according to a representative of the Palestinian Red Crescent. One person was hit in the head by a bullet and was in a critical condition, the medical aid group said. Nine police officers were injured, a police spokesman said.
Videos posted on Twitter showed chaos both outside and inside the mosque, where some worshipers could be seen sheltering from explosions while others threw stones and set off fireworks. In another clip, police officers were seen striking a man being detained in part of the mosque compound.
Another video released by the police showed young men throwing stones from the perimeter of the mosque compound onto the land below. A separate clip, taken by a surveillance camera, appeared to show a Jewish man driving into a passer-by after stones hit his car.
Jerusalem Day is always fraught. But the atmosphere was especially febrile on Monday because the confrontations followed weeks of escalating tensions in the city, where restrictions on Palestinian access to the Old City during the holy month of Ramadan, a far-right march through the city center in April, and street assaults by both Jews and Arabs have all contributed to a feverish atmosphere.
the looming expulsion of several Palestinian families from their homes in Sheikh Jarrah, East Jerusalem. For Palestinians and their advocates, the case has become a stand-in for the wider campaign to force out Palestinians from parts of East Jerusalem and for their past displacement in the occupied territories and within Israel.
Tensions escalated again Friday night, as the police fired rubber-tipped bullets and stun grenades and Palestinians threw stones following prayers at the Aqsa compound. Video showed some grenades landing inside the mosque.
Militants in Gaza fired rockets into Israel overnight Sunday, after sending incendiary balloons into Israeli farmland for the past several days. Israel has returned fire, barred fishermen from the territory from accessing the sea and shut a key crossing between Gaza and Israel — but avoided a major escalation.
was postponed on Sunday, in part to diffuse these rising tensions. The Israeli police also made a last-minute decision Monday morning to block Jews from accessing the Aqsa compound, known to Jews as the Temple Mount and to Muslims as the Noble Sanctuary.
The Palestinian Authority recently canceled what would have been the first Palestinian elections in 15 years.
And after a fourth Israeli election in just two years, Israeli opposition parties are locked in negotiations to form a coalition government and replace Benjamin Netanyahu, the country’s prime minister. Mr. Netanyahu is serving in a caretaker capacity as he stands trial on corruption charges.
Myra Noveck contributed reporting from Jerusalem and Iyad Abuheweila from Gaza City.
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BAGHDAD — In a country where most people believe that God will protect them but their government won’t, it has taken a popular Shiite cleric to give Iraq’s stumbling vaccination program a boost.
Iraq has been bracing for a dangerous summer, with widespread skepticism over coronavirus precautions, a limited vaccine supply and a troubled health care system.
But last week, Moktada al-Sadr, whose lineage from a revered Shiite family commands respect among millions of Iraqis, was shown on video rolling down his robe and baring his arm for a Chinese Sinopharm vaccine in the holy city of Najaf.
Vaccination clinics throughout Najaf Province had until then recorded only around 300 vaccinations a day. Two days after the video was released, that number climbed to almost 2,000 a day until clinics ran out of vaccines on Wednesday. They expect to receive more in two weeks.
Covax, the global vaccine-sharing partnership, has allocated 1.7 million doses for the country of 40 million people.
Covax, Chinese donations of Sinopharm, and purchases of the Pfizer-BioNTech vaccine funded through a $100 million World Bank loan.
The vaccination program was meant to start with the elderly, health care workers, those with chronic conditions and security forces. Yet a significant number of Iraq’s roughly 200,000 health care workers are refusing vaccines, according to officials.
a fire swept through a Baghdad hospital for Covid patients after an oxygen canister exploded, killing more than 100 people, most of them patients and their relatives. The hospital lacked smoke detectors or sprinkler systems.
The health minister was forced to resign and other officials were arrested. Iraqi ministries are divvied up among powerful political parties with the health ministry under the control of the Sadr political bloc.
Mr. Sadr, who has tried to portray himself as above politics while still playing a key role in Iraq’s political system, has said any officials convicted of wrongdoing should be punished.
The health ministry has struggled to get its message across.
“Some people still do not believe in the existence of the virus and they do not believe in the effectiveness of the vaccine,” said Dr. Ruba Falah Hassan, in the ministry’s media office.
At many vaccination clinics outside the Sadr strongholds, there has been so little demand that any Iraqi with ID or foreigner with a passport can be vaccinated after a few minutes wait.
Near central Baghdad’s Palestine Street, about 30 people waited for a Sinopharm vaccine on plastic chairs in the Al Edreesi health care center on Thursday. In this middle-class neighborhood most of those waiting appeared to be professionals or university students.
“We ask anyone who took the vaccine to send a message of reassurance in their groups. ” said Afraa al-Mullah, from the health center’s media department. “Anyone who took the vaccine must speak and say, ‘Here I am. I’m fine, get vaccinated.’”
The more that word spreads that vaccines are not harmful, she hopes, the more Iraqis would agree to be vaccinated.
“Iraq’s population is 40 million, 20 million must get vaccinated,” she said, calling the 400,000 who have been inoculated “a drop in the ocean.” She added: “We have people that do not believe in coronavirus. How can we convince them to vaccinate?”
Falih Hassan and Nermeen al-Mufti contributed reporting.
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NEW DELHI — Adar Poonawalla made big promises. The 40-year-old chief of the world’s largest vaccine maker pledged to take a leading role in the global effort to inoculate the poor against Covid-19. His India-based empire signed deals worth hundreds of millions of dollars to make and export doses to suffering countries.
Those promises have fallen apart. India, engulfed in a coronavirus second wave, is laying claim to his vaccines. Other countries and aid groups are now racing to find scarce doses elsewhere.
At home, politicians and the public have castigated Mr. Poonawalla and his company, the Serum Institute of India, for raising prices mid-pandemic. Serum has suffered production problems that have kept it from expanding output at a time when India needs every dose. He has come under criticism for departing to London amid the crisis, though he said it was only a quick trip. He told a British newspaper he had received threats from politicians and some of India’s “most powerful men,” demanding that he supply them with vaccines. When he returns to India, he will travel with government-assigned armed guards.
In an interview with The New York Times, Mr. Poonawalla defended his company and its ambitions. He had no choice but to hand over vaccines to the government, he said. He cited a lack of raw materials, which he has partially blamed on the United States. Making vaccines, he said, is a painstaking process that requires investment and major risks. He said he would return to India when he had finished his business in London. He shrugged off his earlier comments about threats, saying they were “nothing we can’t handle.”
backed waiving intellectual property protections for vaccines, which could make it easier for Indian factories to make them. Still, that won’t help India’s current crisis, which as of Friday had claimed more than 230,000 lives — a figure that likely represents a vast undercount.
a horse breeder turned vaccine billionaire. Before the crisis, he was extolled in the Indian media as an example of a new class of young, worldly entrepreneurs. Photos of him and his wife, Natasha, were a staple of fashion spreads.
Serum received a $300 million grant from the Gates Foundation to supply as many as 200 million doses of Covishield and another vaccine in development to the Gavi Alliance, the public-private partnership that is overseeing Covax, the program to donate vaccines to poor countries.
Serum pledged between January and March to sell about 1.1 billion vaccine doses in coming months, according to a review of purchase agreements supplied by UNICEF. By the time India largely stopped vaccine exports, Serum had exported only about 60 million doses, about half to Gavi. India had claimed more than 120 million.
AstraZeneca has served Serum a legal notice over delivery delays. Serum has just “temporarily deferred” its commitments, Mr. Poonawalla said, citing the Indian government’s halt of exports.
“This is something coming from India,” he said. “It’s not the supplier that is defaulting.”
The world is grappling with the ripple effect. A spokesman for Gavi said that India’s decision to prioritize “domestic needs” is having “a knock-on effect in other parts of the world that desperately need vaccines.” Still, in a sign of the lack of options for getting vaccines, Gavi on Thursday signed a purchase deal with an American vaccine company, called Novavax, involving doses to be made by Serum.
people are being turned away from vaccination centers that have run out of doses.
Serum has missed its expansion targets. Mr. Poonawalla said last fall that by early this year, Serum Institute would be pumping out 100 million doses per month, of which about four in 10 would go overseas.
But after a fire at a facility that was supposed to help the company ramp up vaccine production, Serum’s capacity has remained at about 72 million doses per month. A grant of more than $200 million from the Indian government should help the company reach its goal by summer, he said.
Mr. Poonawalla has also cited raw materials supplies. In April, he asked President Biden on Twitter to “lift the embargo” on raw material used to make Covid-19 vaccines. White House officials said Mr. Poonawalla mischaracterized his situation. Still, the United States said it would send raw materials to the Serum Institute to increase its vaccine production, though Mr. Poonawalla said they haven’t yet arrived.
Mr. Poonawalla has also come under scrutiny for charging different prices to the central government, to India’s states and to private hospitals. Two weeks ago, Serum said it would charge state governments about $5 per dose, about $3 more than what it charges Mr. Modi’s government.
Last week, following criticism, Mr. Poonawalla lowered the price to $4. Still, the critics point to an interview in which Mr. Poonawalla said that he was making a profit even at the central government’s price.
Mr. Poonawalla said that Serum could sell at a lower price to India’s central government because it was ordering larger volumes.
“People don’t understand,” Mr. Poonawalla told The New York Times. “They just take things in isolation and then they vilify you, not realizing that this commodity is sold at $20 a dose in the world and we’re providing it for $5 or $6 in India. There’s no end to the cribbing, the complaining, the criticizing.”
includes four to five armed personnel.
In an interview with The Times of London newspaper published last week, he described receiving constant, aggressive calls demanding vaccines immediately. “‘Threats’ is an understatement,” he told the paper.
He played down the threats in his interview with The New York Times, and his office declined to disclose further specifics. Still, the comments caused an uproar in India. Some politicians demanded that he name names.
tweeted that Mr. Poonawalla’s departure to London was “shameful” and that he should reduce prices.
The Serum Institute is planning a major expansion in Britain, investing nearly $335 million for research and development, to fund clinical trials, to build out its sales office and to possibly construct a manufacturing plant, Mr. Poonawalla’s office said.
“Everyone is depending on us to be able to give this magic silver bullet in an almost infinite capacity,” Mr. Poonawalla said. “There’s this tremendous pressure from state governments, ministers, the public, friends, and they all want the vaccine. And I’m just trying to equitably distribute it as best I can.”
Selam Gebrekidan in London and Bhadra Sharma in Kathmandu, Nepal, contributed reporting.
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CVS, which merged with the insurance provider Aetna three years ago, aims to reduce overall health costs with its mental health pilot program, Dr. Knecht said. Mental health issues that are not addressed become crises, he added, “so our aspiration is to make mental health services accessible and locally available so we can address these issues before they continue to expand and result in substantial morbidity and poor outcomes.”
Removing obstacles to mental health care by making providers more accessible is helpful, said Vaile Wright, senior director of health care innovation at the American Psychological Association, “but they are never the No. 1 barrier to accessing treatment,” she said. “Cost is.”
Psychiatrists are less likely to take insurance than other types of physicians, and many psychologists, social workers and others who offer therapy likewise decline insurance because they say payments by insurers are relatively low and managed care companies sometimes subject them to intrusive audits.
The mental health services provided by the CVS MinuteClinics are covered by many major health insurers and Employee Assistance Program plans, a spokeswoman said.
“Pricing options without insurance range between $129 for an initial assessment to $69 for a 30-minute session, with many options in between,” she added.
At Walmart, the initial therapy session is $60 and the 45-minute follow-up sessions cost $45, according to the company’s website.
If you’re considering using a retail location to receive therapy, be sure to ask the same questions you would of any new therapist, experts advise. Some examples include:
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Where were you trained?
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What kind of license do you have?
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What is your specialty?
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How will we monitor my progress?
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How long will my session last, and how many sessions are available to me?
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Is there follow-through if I need a referral?
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How much will this cost?
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How will my data be stored and shared?
In addition, if you identify as L.G.B.T. or are a member of another minority group — or if you already know that you suffer from a particular condition like anxiety or depression — it’s helpful to know whether the therapist has worked with similar populations in the past and whether they have had cultural competence training, said Alfiee Breland-Noble, a health disparities researcher and founder of the AAKOMA Project, a mental health nonprofit for teenagers and their families.
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