MaineCare is seeing two big changes this month. Children under 21 and Mainers who are pregnant now are eligible for coverage regardless of their immigration status, and adults enrolled in MaineCare now have access to comprehensive dental care.
Immigrants with legal status are eligible for certain public benefits, but for most who want MaineCare coverage, there’s a five-year waiting period. As of July 1, that’s now no longer the case for children and pregnant people.
Crystal Cron, president of Presente Maine, noted that Maine is one of just a handful of states that extends Medicaid coverage to some noncitizens.
“Beyond offering comprehensive care and dental and prenatal care to these newly eligible groups,” she said, “it’s really a monumental win, because this community for so long has been voiceless and been ignored.”
Cron said she thinks MaineCare should cover all Mainers regardless of immigration status, not just kids and those who are pregnant. She added that the estimated budget for all adults is only a few million dollars more than is already allocated – and a small amount, relative to the overall cost of MaineCare.
MaineCare already includes dental coverage for children, and adults could get certain treatments for pain and infection. But now, adults can also get preventive, diagnostic and restorative dental care.
For many low-income people, said Kathy Kilrain del Rio, advocacy and programs director for Maine Equal Justice, this means being able to have cavities filled, fix broken teeth and more.
“People were often getting their care in emergency rooms, or once a condition had gotten too bad to do anything to stave it off,” she said, “and that’s really unfortunate. A lot of people lost teeth, a lot of people were afraid to smile; they felt like it impacted the way they interacted with people and they felt like it impacted their ability to get a job.”
Kilrain del Rio noted that it may take some time to get a first appointment. She pointed out that Maine has fewer dental providers than other New England states, and not all of them accept MaineCare. The state also is boosting reimbursement rates for providers.
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Wyoming lawmakers are set to distribute $85 million in federal pandemic relief for capital-improvement projects, and Tracy Brosius – the CEO of HealthWorks, a safety-net health center in Cheyenne – is getting in line.
While everyone wants to be finished with COVID, she said COVID is not finished with us. And as winter months creep closer, she said she does not want to see clinicians treating patients in parking lots in the snow again this year because of lack of space.
“So I just really think an investment in capital construction at this point in time,” said Brosius, “would really be able to help us with the dignity of both my providers and our patients.”
Brosius – who is also the incoming executive director of the Wyoming Primary Care Association – called the American Rescue Plan Act money a once-in-a-generation opportunity to access capital for Wyoming’s federally qualified health centers that serve some 50,000 residents each year regardless of their ability to pay.
Senate File 0066, passed in the last session, tasks the State Loan and Investment Board – which includes Gov. Mark Gordon – to decide who will receive funding.
Brosius said the need for counseling and other behavioral health services exploded during the pandemic. She noted that expanding facilities will be critical for addressing COVID’s long-term ripple effects on mental health.
“We have five clinicians at this point,” said Brosius, “but physically we do not have enough space to hire another staff member, because we just don’t have a space to put them. So therefore we can’t expand our services and treat more patients.”
Wyoming’s health centers contribute $71 billion a year in economic impact, but Brosius said they face unique challenges raising large sums required for construction projects.
She said she believes health centers are a good fit for federal funds because they predominately serve the state’s most vulnerable populations.
“In many cases in Census tracts where people have low income levels and/or difficulties seeking care,” said Brosius. “So this funding would allow us to build and access capital that most of our clinics are not able to generate for themselves.”
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Southern states including Tennessee are in the grip of an unrelenting heat wave. According to the National Weather Service, heat indices could reach 110 degrees Fahrenheit in more than a dozen states.
According to the Environmental Protection Agency, heat is the number one weather-related cause of death, and climate change is driving increases in those numbers.
Dr. Tobi Adeyeye Amosun, assistant commissioner of the Tennessee Department of Health Division of Family Health and Wellness, explained in prolonged high temperatures, people are more likely to experience heat exhaustion, which can trigger skin redness, heavy sweating, nausea and vomiting. She added in addition to young children and the elderly, certain groups are at higher risk.
“So those are people who sometimes cannot regulate their core body temperature as easily as everyone else,” Amosun explained. “They’re also more likely to get dehydrated. So those are people who might have conditions like obesity, diabetes, high blood pressure, heart conditions, sickle cell anemia.”
Amosun pointed out heat stroke symptoms are severe and include seizures, loss of consciousness and confusion, and advised anyone experiencing such symptoms to seek emergency medical help.
She added staying hydrating and avoiding exercise or work in extreme heat, or seeking shade, are ways to stay safe.
She emphasized high temperatures makes spending time in cars, no matter how briefly, extremely dangerous. She urged residents not to leave children or pets in cars under any circumstance, and to double-check all back seats before locking your doors to make sure no one has been left inside.
“Leaving your cellphone or your purse or your car or whatever what have you in the back seat is a checkpoint to make sure that you’re always checking in the back,” Amosun suggested. “To make sure your child doesn’t get inadvertently left in the back seat.”
Research has shown within one hour, the interior of a car parked in the sun on a 95-degree Fahrenheit day can reach an average 116 degrees.
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California’s aid-in-dying law could be halted, depending on the outcome of a hearing tomorrow in federal court.
The Christian Medical and Dental Association is asking the judge to put Senate Bill 380 on hold while the group’s lawsuit proceeds. The law allows terminally ill patients with less than six months to live to get a prescription to end their suffering if they choose to use it.
Andrew Flack, 35, a terminally ill patient from Oceanside, just got his from a pharmacy, in case the judge grants a preliminary injunction.
“I like having this option, because there is a tremendous amount of anxiety that comes with dying from cancer, and also the day-to-day pain that you experience,” Flack explained. “Knowing that I have a way out versus the inevitable suffering, it’s relieving.”
The plaintiffs argued the law violates their rights by forcing them to tell patients they do not offer this type of end-of-life care. They must note it in the medical records and transfer the patient’s records to another physician upon request.
John Kappos, an attorney, represents Mr. Flack, two doctors and the Compassion & Choices Action Network, all of whom are intervenors in the case.
“This is a law that is requiring physicians to do little or nothing more than they’re already required to do,” Kappos contended. “It is not an infringement on First Amendment rights, freedom of religion, freedom of speech. It’s more, at most, an incidental impact on those rights.”
Dr. Catherine Sonquist Forest, an intervenor in the case whose husband used the medication last summer to end his suffering,
Dr. Catherine Sonquist Forest, a family medicine physician at a University of California-San Francisco residency in Salinas, who treats terminally ill patients and trains other physicians across the Bay Area, said last summer, her husband of 37 years used medical aid-in-dying when his motor neuron disease became unbearable.
“It only takes one personal experience of a beloved or a near-family member, whose suffering is not answered by hospice or palliative care, to understand why that decision needs to be between a person and their care team,” Sonquist Forest asserted.
The California Department of Health reports more than 2,800 terminally ill Californians received prescriptions from 2016 to 2020, and about 1,800 individuals chose to use their medication.
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