chick fell from a nest in san mateo county on caltrans property. it was dehydrated but healthy enough to be returned to the nest this weekend. falcons stay in your nest. yeah, we're back at 11. yeah male announcer: this is an nbc bay area news special, "we investigate." magaly saade: i definitely don't want someone else to have to go through what i did. announcer: she's a two time cancer survivor and a san francisco firefighter. concerns that chemicals in her protective fire suit could be causing cancer has san francisco blazing a trail for fire departments nationwide. magaly: we can't not run into fires. announcer: serious questions about taxpayer-funded medical care and a contra costa county program. a whistleblower comes forward only to nbc bay area. female: full body infection happened. he needed to have his leg amputated. announcer: a sexual assault charge is pled down to just five days in jail. the alleged victim is blindsided. carrie banks: you know, they just kept saying to me, "well, you know, this stuff doesn't happen," and all i could keep

looking at him and i was like, "but why did it happen to me?" like, why didn't i matter? announcer: and bart spends millions on new lights to make the tunnel safer, but years later, almost all are still in boxes. debora allen: sometimes i do look at some of these things and say, "gosh, you know, that's pretty-- that could be pretty absurd. i can see how the public would say that." announcer: we investigate how it happened and what bart plans to do about it. candice nguyen: good evening, and thanks for joining us, i'm candice nguyen. we start tonight with an nbc bay area exclusive. californians are paying billions of dollars into a new healthcare initiative to help our most vulnerable, like our seniors, the unhoused, and people with mental illness. a whistleblower tells us contra costa health plan is ignoring some medical needs, inflating case loads, and harming patients. female: it's been heartbreaking. it's been just really heartbreaking, because we're

supposed to be helping these patients. candice: this contra costa health nurse says some of the county's most fragile and medically-complex patients are being left in the lurch. female: there are people who are unhoused. some of them have been going to the hospital, er multiple times in a week. a patient who had a diabetic ulcer was given to a non-medical staff, non-clinical staff. they then didn't address it. a full-body infection happened. he needed to have his leg amputated. candice: it's not just this one case, and she says it's not the staffer's fault. incidents like this, she says, occur regularly through contra costa health's enhanced care management, or ecm benefit, provided through california's new calaim program. female: we're transforming medi-cal. it's our journey to a healthier california for all. candice: according to the department of health care

services, calaim's ecm benefit is supposed to address clinical and non-clinical needs, meaning both medical and social care assistance, but in contra costa, the nurse and three other sources familiar with the system tell us the program has abandoned medical assistance altogether. they say ecm case managers who are nurses, who were already with the system before the program started, are now being instructed to focus only on social needs, like a member's access to a shelter, or fresh food, or their non-clinical staff, like housing specialists who aren't trained to properly refer medical issues at all. female: they've been told if they don't understand what a health condition is, they just should google it. candice: that sounds potentially dangerous. female: it's extremely dangerous, it's negligent. candice: do you have firsthand knowledge of patients being harmed or dying as a result of this? female: yes, yes, i do.

candice: one fatal case she warned supervisors and county officials about through email last year involved a patient saying he couldn't get out of bed. a non-clinical staff member unknowingly labeled this patient as bedbound, and the rest of his care team treated him as such by only providing telephone visits. as a result, the patient didn't get out of bed for months, and his bedsores turned into bone infections. he later passed away, according to her email. another ecm patient she emailed about received no discussion of health needs or health interventions for a year. when he was clearly sick, he was on death's doorstep, then passed away a month later. female: i tried so hard to report this internally, and those concerns were both dismissed, and then i also received just the extreme hostility, abusive treatment. candice: we reached out to contra costa health ceo, anna roth.

she declined our interview request. instead, kim mccarl, their communications officer, spoke with us. candice: are member's clinical care needs addressed? kim mccarl: so, the way that our model is set up, no, except that ecm is a part of the entire care model. candice: but i was looking at the state's description of ecm and it seems to be pretty clear. it says here, "ecm is a comprehensive care management benefit to address both clinical and non-clinical needs for the highest-needs members." so, why isn't that happening in contra costa county? kim: because we don't need to. so, contra costa county is what we call an integrated system. so, we have a whole clinical arm, and we have a whole ecm arm, and so we don't need to have our ecm program provide clinical care, because our clinic system does that. candice: but it doesn't always, and cases fall through the cracks. that's what the department of health care services found in a

2023 audit of contra costa health after receiving anonymous complaints. the state found patients complained about not receiving enhanced care management services. in one case, a comprehensive history and physical examination wasn't completed, and without proper assessments, the state said patients may not receive important behavioral and medical health screenings that can help identify and prevent illnesses. candice: does the state know that contra costa county is not providing clinical care through its ecm program? kim: yes. candice: when we reached out to the state, a spokesperson repeated in an email, "both clinical and non-clinical needs must be addressed by ecm teams." there are a lot of taxpayer dollars involved. contra costa health took in nearly $3 billion in medi-cal revenue in 2022 and 2023. of that, it spent $56 million on ecm according to the state. female: i think that it's wrong. candice: this nurse says she is concerned cutting corners on

medical allows the system to report more patients to the state to get more funding. female: it gives them an excuse to really inflate caseload sizes, and because by ignoring clinical needs there, then it's then okay, it's totally manageable to manage just the social needs of a hundred patients. candice: contra costa health denies that serving more medi-cal ecm members means more money for the system. kim: the state actually determines the formula upon which we get paid, so having more of them is not a financial benefit to us. candice: so, we checked what other health systems are doing. la care plan and san francisco health plan tell us their ecm benefits address clinical and non-clinical care. but in alameda county, alameda alliance's program appears to be similar to contra costa's, although we haven't heard of any issues there. contra costa health says it is working to correct the problems detailed in that audit.

is the san francisco fire department's own gear putting firefighters at risk? we investigate the health concerns and how sf is working to become the first city in the nation to protect our firefighters this way.

candice: san francisco is taking major steps to extinguish a possible health hazard threatening more than a million firefighters nationwide. recently, the city was the first in the country to ban certain firefighter gear made with cancer-causing chemicals. but as senior investigative reporter bigad shaban found, there are concerns the fix could create more hazards. male: needed water coming. bigad shaban: lieutenant magaly saade is teaching the next generation of firefighters about what to expect on the front lines. magaly: our whole job is to work under pressure, manage your emotions and your fears, and get the job done. bigad: regardless of how dangerous it may be.

that includes the risks they can see and the ones they can't. magaly: i definitely don't want someone else to have to go through what i did. bigad: saade is a two time cancer survivor. she underwent radiation and ultimately a double mastectomy. here in san francisco, female firefighters have a six times higher rate of breast cancer than the national average. the department has lost more than 300 firefighters to cancer over the past 20 years. ongoing exposure to smoke and other chemicals is so serious the world health organization now classifies firefighting as an actual carcinogen. and in recent years, studies have also shown the jackets and pants firefighters rely on to stay safe during emergencies are made with materials proven to cause cancer. magaly: to put something in the equipment to people who are already there to risk their life for you seems really malicious.

bigad: these so-called pfas chemicals help clothing repel flammable liquids and resist extreme heat, but researchers say the compounds can be harmful when absorbed through the skin. the level of exposure for firefighters and exact health risks are still being studied. bigad: what is it like knowing that the very thing that's supposed to protect you may actually have been part of the reason you got cancer? magaly: you know, we can't stop the job from being dangerous. we can't not run into fires, but we can change the future. we can make it so that someone else doesn't have to go through this. male: we're tired and we're dying. bigad: on the steps of san francisco city hall, behind a mound of uniforms, firefighters and lawmakers recently announced plans to enact a first-in-the-nation ban on firefighter clothing made with pfas. those uniforms, known as turnouts, would need to be replaced over the next two years. aaron peskin: fundamentally, what's at stake is people's lives.

bigad: san francisco supervisor aaron peskin authored the legislation. he says while outfitting an entire department won't be cheap, doing nothing could force the city to pay an even higher price. aaron: the approximately $10 million it will cost is so small compared to a human life. it's so small compared to the cost of healthcare. it's so small compared to the cost of settling lawsuits. it is morally right and it's financially right. bigad: but alternative gear that doesn't use pfas still isn't widely available, even though the potential health hazards have been known for years. critics, including the firefighters union, argue that's because industry standards released by the national fire protection association continue to be written in a way that favor the use of pfas chemicals by including certain requirements that can't easily be met using other materials. the nfpa tells us it doesn't create or dictate standards, but instead relies on expert volunteers, including many representatives of the firefighting community.

the nfpa and the firefighters union remain locked in a heated lawsuit about what the standards should say. we contacted some of the largest manufacturers of firefighter gear to understand why pfas continues to be used. only viking responded, telling us there's been a lack of pfas-free fabrics approved by the nfpa, but says it's now testing alternative materials and plans to release a new line of gear by the end of the year, manufactured without pfas. at least two other companies, fire dex and lion, are already advertising pfas-free uniforms that are now being tested at fire departments across five cities, including san francisco, where firefighters say so far the gear is working. bryan ormond: we don't want to just trade one hazard for another. so, we'll burn the first one. bigad: chemist bryan ormond is trying to find out if those alternatives will be safer long term. at his lab at nc state university in raleigh, he and

his team are testing fabrics for reliability. bryan: there's a little bit of char right here. bigad: so far, he says, his research has shown removing pfas can make uniforms less breathable and more flammable. bryan: we're introducing a potential hazard for flammability on the fire scene where firefighters didn't have that before. bigad: but he cautions what he's seeing in the lab could differ from what firefighters might experience on the front lines. regardless, first responders across the country continue to suit up. bigad: so, even with the risks, they're still willing to put on the uniform. magaly: in a heartbeat. it's not a choice when we have to do our job, it's our job. bigad: but lieutenant saade is concerned about her trainees, who were just issued the same type of standard clothing she's worn for decades. her fight for safer gear, she says, is for them, so firefighters can focus on saving lives instead of worrying about their own.

magaly: this would affect the future, and if it changes, and legislation goes forward, then, yeah, then it was all worth it. bigad: with the investigative unit, i'm bigad shaban. candice: if approved, the ban on fire gear made with pfas will go into effect in two years. coming up, was an accused rapist let off the hook? prosecutors offered a plea deal despite a confession and an apology, we investigate.

candice: a peninsula woman says her alleged rapist was let off the hook too easily, taking a plea deal and serving no additional jail time, and now her trust in the legal system is shattered. investigative reporter hilda gutierrez looks at how often defendants charged with certain sex crimes take plea deals. hilda gutierrez: this was originally brought as a rape case that police say included a videotaped confession and an apology note by the defendant, so the victim wonders why prosecutors offered him a deal that leaves him with no sex crime on his record, and says she was not consulted. hilda: carrie banks grew up believing in the justice system. she comes from a law enforcement family. her father and uncle worked for the belmont police department. carrie: and i grew up knowing that if you did wrong, you'd get in trouble, and the police would help you, and the police did. hilda: but she says her trust was shattered when she was raped. carrie: but i knew, like, the process would work, at least i thought.

hilda: it was the summer of 2021. banks, a mother of two, was at a local piano bar in san carlos, where she recalls talking to an acquaintance she had met the year before. at some point, she said she realized she had enough to drink and walked outside with a friend to order a right shared home. the acquaintance followed them. carrie: and he comes up to the bench we're waiting on, and starts kissing on me, again, like, similar to the year prior, and my buddy is like, "hey, hey, hey," and when he does say that, the guy runs off. hilda: banks says her friend helped her get home and snapped this photo of her in bed before leaving her apartment. carrie: clearly had enough, so pass out from drinking. hilda: when banks woke up, she says the acquaintance, fernando altuna mendoza, was standing by her bed. carrie: he's there, and i'm like, "what are you doing, you know, get out of here, get out of here," and i remember getting up, chasing him out, and i really truly believed i had stopped him. and i saw on my phone, all the, you know, missed calls through instagram. hilda: screenshots show altuna mendoza tried to reach her in

the middle of the night before entering her apartment. banks says she reported the incident to the san mateo sheriff's office and obtained this restraining order. carrie: you don't have the right to come into my house. i've never invited you to my house. this is, you know, this is not okay. hilda: banks says it was the sheriff who, upon questioning altuna mendoza a week later, let her in on what really happened that night. according to the sheriff's report, altuna mendoza wrote an apology note that in part read, "i shouldn't have opened your door and gone into bed with you." in the narrative, altuna mendoza also agreed that having sex with someone who was too intoxicated to consent is rape. he was booked and charged with two felony counts of rape and sexual penetration with a foreign object. hilda: in november of last year, banks says she was ready to go to trial, but as she sat in this court, she was told the defendant was ready to enter a last-minute plea deal for false imprisonment, a charge she had never heard of before, and wasn't even a sex crime.

carrie: and i begged her to please not do this, that i was ready. i said i would rather lose on the stand than to let him get away with false imprisonment, which meant nothing. shin-mee chang: even though we were ready to go to trial on that day, we decided to offer some charges that were felonious but did not carry sex registration. hilda: shin-mee chang was not the prosecutor in banks's case, but supervises the sex assault unit within the san mateo county da's office. we asked why they accepted a plea down when the sheriff's report states they had a taped confession. shin-mee: the trial deputy, after having listened to it, decided that there were some issues because of the tone of the conversation. hilda: banks says the prosecutor never mentioned the confession tape or its tone. chang says the timing of the plea was unfortunate, and in hindsight wishes they would have asked for a continuance to consult with banks and give her time to process it. we reached out to altuna mendoza and his attorney, but never

heard back. it turns out the plea agreement in banks's case is not an isolated one. nbc bay area's investigative unit reviewed records for rape and sexual battery cases from the san mateo sheriff's office dating back to 2018. through public records request, we obtained information on 60 cases and cross referenced their original charges with the final outcome. we found 32% of the cases were either rejected by the da's office or later dismissed; 11% are ongoing; and about half, only 57%, were resolved. of the 31 cases where the da charged the defendant with a sex crime, 19 resulted in a sex crime conviction; four were convicted of a sex crime by jury; but in eight cases, 26% of the time, the defendant negotiated a non-sex related plea deal. shin-mee: sometimes the facts or the witness statements change after we file the case, and if our case is weaker than we

originally assessed it to be, then we are going to enter into negotiations with defense. hilda: but a law enforcement source with direct knowledge of banks's case told us, "we expected a harsher sentence. this was a no fail case, meaning everything was put together with a legal confession in a box and ribbon for them to prosecute accordingly." the sheriff's office has not released a confession tape to the investigative unit or to banks, but told us, "as the charging entity, the district attorney's office determines the strength of a case for the purposes of prosecution." carrie: you know, they just kept saying to me, "well, you know, this stuff doesn't happen," and all i could keep looking at them and saying, "but why did it happen to me?" like, why didn't i matter? hilda: altuna mendoza only spent five days in jail, but was put on probation and told to abstain from alcohol and drugs. two months ago, he was caught driving under the influence and is now serving six months in jail for violating his probation. that's more time than he ever served in connection with the banks case. banks is now working with civil rights attorney aaron zisser,

who's reached out to the department of justice, citing our findings and requesting a practice investigation into the san mateo county da's office. with the investigative unit, i'm hilda gutierrez. candice: coming up, bart spent millions of dollars to buy new lights, but never installed them. we investigate next. when migraine strikes, you're faced with a choice. accept the trade offs of treating? or push through the pain and symptoms? with ubrelvy, there's another option. one dose quickly stops migraine in its tracks. treat it anytime, anywhere without worrying where you are or if it's too late. do not take with strong cyp3a4 inhibitors. allergic reactions to ubrelvy can happen. most common side effects were nausea and sleepiness. migraine pain relief starts with you. ask about ubrelvy. learn how abbvie could help you save. my dry eye's made me a burning, stinging, 5-times-a-day,... ...makeup smearing drops user.

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javed khan: so, we are going up considerably on the lighting. jaxon: then bart project manager, javed khan, pitched the plan to install more than 2,100 new lights, twice as many as bart had in the tunnel, saying it would bring ten times more light into the subway, and bring the lighting up to current code, so train operators could see better and passengers could evacuate more quickly during an emergency. javed: for emergency egress, you wanna be able to see the walkway and find the exit. jaxon: but today, six years later, bart has yet to install those lights, so what happened? bart inspector general, claudette biemeret, says the problem goes back to 2020, two years after the lighting contract was approved, when a whistleblower complained that bart was not getting its money's worth. claudette biemeret: it didn't meet the standards of the specifications that they set out. jaxon: the inspector general confirms the new lights were not

as bright as bart wanted, and wouldn't last as long as the contract specified, still, bart liked them because they would be easy to install and lower projected maintenance costs. after the inspector general's office got involved, bart fired the lighting contractor and settled with them for $2.4 million, and vowed to install all 2,182 fixtures itself. this video we took in the subway shows that another four years later, those old, dim, fluorescent fixtures still line the tunnel, and those new lights bart promised to install? most are in storage with time running out on their warranties. claudette: that's wasteful, yeah, you want to make sure that you're getting the best use out of your purchases. jaxon: bart board member debora allen, a frequent critic of bart management, has another word for it. debora: sometimes i do look at some of these things and say, "gosh, you know, that's pretty-- that could be pretty absurd."

i can see how the public would say that. jaxon: we reached out to bart, they wouldn't answer any specific questions about what's going on with the lighting, saying only that they're reviewing the inspector general's findings, and the agency acknowledges the procurement process did not meet our high standards, and we will work to do better in the future. during a recent audit committee meeting, bart deputy general manager, michael jones, suggested the audit process itself is to blame for all the delays, but quickly added-- michael jones: there's multiple reasons why that project was not completed at, you know, at that time and at this point in time. debora: okay, well, i'd love to know all the other reasons. jaxon: bart officials now say they've installed roughly 30% of the lights they bought for san francisco, mostly in the berkeley hills tunnel. but when allen asked whether any of the uninstalled lights are still under warranty... debora: is it gone?

i mean, we're past the warranty? female: i really don't know. jaxon: it's not clear how long it will take for bart to finish installing the replacement lights in san francisco. back in 2018, bart predicted it would take a dedicated contractor two years, because crews can only work during a four-hour window while the system is down overnight. jaxon van derbeken, nbc bay area news. candice: now, if you have a story for our investigative unit, just call 888-996-tips, or go to our website, nbcbayarea.com/investigations. i'm candice nguyen, thanks for watching nbc bay area, where we investigate.

doug mcconnell: hello, i'm doug mcconnell, and we've got some great discoveries for you out here along the open road. dan herz: we've all seen the devastation that catastrophic fires can cause. well, meet the men and women who are tasked with preventing them and doing their best to keep us all safe. we'll learn what to do if you're caught in a fire, how to make the right decisions to make it out safely, as we take you along on a mock fire evacuation. and we'll get tips from an expert about how to keep your home and families fire safe. ♪♪♪ ♪♪♪