TALLAHASSEE, Fla. – The Florida Legislature is considering bills that would make it easier for people to get some of their healthcare services – possibly including eye care – online.

The "telehealth" bills help doctors use technology to provide services to patients remotely. It's a big change that has many industry groups at odds over the regulatory framework.

However, supporters say the expansion should include ocular telehealth, or online eye care. They say it can provide affordable and much-needed access to people in hard-to- reach communities.

Mari Corugedo, Florida state director of the League of United Latin American Citizens – or LULAC, says her group supports the idea.

"Sometimes online, you are able to get deals as long as you have a prescription, and it doesn't eliminate the doctor,” says Corugedo. “It just makes it a little more accessible for people to be able to fulfill those prescriptions and needs."

But industry groups like the American Optometric Association have been lobbying against ocular telehealth, citing safety concerns and that in-person comprehensive eye exams should remain the gold standard.

For now, efforts to restrict the online options have been removed from the Florida bills as other differences are being hammered out by lawmakers.

The American Academy of Ophthalmology, which represents medical doctors, says it supports telehealth as a means to expand the physician-patient relationship beyond the exam room.

Linda Sherry, director of national priorities with the group Consumer Action, says safeguards would remain in place when being checked by a doctor online, who can ultimately decide whether an in-person visit is necessary.

"If you think about it, this is really kind of pushing in on the gravy train of optometrists, because optometrists would love to have you back in the office for a full-scale exam, even though that may only be a year from when you got your eyes tested," says Sherry.

Both the Florida House and Senate are moving closer to agreement on their respective telehealth bills. For instance, the House version would establish permanent tax credits for insurers and Health Maintenance Organizations, while the Senate wants to offer the credits for a limited time.


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September is Health Literacy Month, and a Denver-based group is working to help health professionals break a persistent pattern of discrimination linked to high disparities in maternal death rates.

Danyelle Gilbert, CU Nursing alumna and a member of the Colorado Council of Black Nurses, points to research showing that between 2016 and 2020, nearly all pregnancy-related deaths of Black women could have been prevented through timely interventions - at the patient, provider or system level.

"That report specifically found that discrimination played a role in over half of pregnancy-associated deaths. And approximately 90% of those pregnancy-related deaths were identified as preventable," she said.

Black women in Colorado are twice as likely to die - during their pregnancy, or within one year of giving birth - than the state's overall pregnant population. The leading cause of maternal death overall is self-harm and unintentional overdose. But for Black women, the number one cause of death is heart failure.

Gilbert added that common forms of discrimination facing Black women include simply being dismissed, or not being taken seriously, by health care providers. She says their pain and symptoms are routinely minimized, and there are delays in their care.

"They may face a lack of shared decision making, and poor communication from their health care provider. They just don't feel educated, they are not able to make informed decisions. And all of that is leading to negative health outcomes," she continued.

Gilbert recalls one Black woman experiencing contractions who was turned away to fill out paperwork, even though her information was already on file, and ended up giving birth in a hallway. She said health professionals can do better, in terms of showing patients they are valued.

"And when we value someone, we pour life into them. So when caring for a Black woman, see her. Empathize with her, connect with her. Feel her pain, her joys, her cries. Hear her, because she is both strong and fragile," she added.


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In North Carolina, the gap between Medicaid reimbursement rates and the actual cost of dental care has reached a crisis point, impacting both patients and providers.

Dr. Rafael Rivera, a member dentist with the North Carolina Dental Society and owner of Smile Starters, said the gap is impacting quality dental care around the state.

"It's about 30 cents on the dollar, about 30% of what we should be getting paid for the procedures. And that's not exact, but 30 to 35% somewhere in that range. It's actually a lot worse if you're an oral surgeon in the state treating the patient population," he said.

Those reimbursement rates haven't been updated since 2008. Rivera added that a lack of funding hinders dental practices from attracting and retaining skilled professionals. He said as a result, Medicaid patients often resort to emergency rooms for dental issues-an option that is both more expensive and less effective.

To address these challenges, Rivera suggested expanding the network of Community Dental Health Coordinators. He believes these coordinators could play a crucial role in bridging the gap between patients and dental providers, particularly for those who face language barriers or lack knowledge about available services. He also called for increased funding and safeguards that help dental offices keep up with inflation.

"Our legislator ideally will find a way to not only just put an increase in place, but more importantly have a mechanism that requires them to reevaluate it on a regular basis so that we don't have to go another 16 years before an increase is in place again," he said.

Rivera underscored that this issue extends beyond just dental care, pointing out that data show strong dental health is linked to better overall well-being. Since the expansion of Medicaid, the program has enrolled over 500,000 people.

September is Self-Care Awareness Month and the American Heart Association in Missouri is urging caregivers to take some much-needed time for themselves.

Missouri has around 600,000 family caregivers, many of whom provide unpaid care to loved ones with heart disease, cardiac events and other debilitating illnesses. The emotional and physical toll can be severe, with 21% of caregivers reporting their own health has declined.

Dr. Ravi Johar, chief medical officer for UnitedHealthcare and a board member of the American Heart Association of St. Louis, wants caregivers to understand proper self-care is not selfish.

"It's really important that after an acute event, whenever you've had a chance to kind of catch your breath, sit down and think about exactly what they need and exactly what you need and how much you can give," Johar recommended. "That's not being selfish. That's not, not taking care of them. That's doing the right thing for both of you."

According to the American Heart Association, it is important for caregivers to have someone they can confide in about their fears and doubts; a person who can offer reassurance and emotional support.

A 2023 AARP survey showed nearly 40% of family caregivers spend more than 20 hours a week assisting their loved ones from driving to appointments to providing direct care, many while also working and raising children. Johar stressed the importance of caregivers using time off from work wisely, which includes new mothers with babies in neonatal intensive care.

"The baby's getting the best care in the hospital and there's nothing you can do to help," Johar pointed out. "Go ahead and go back to work. Save that time, go in every evening. Spend all night or as much time as you want with the baby. But save your time off, because when this baby comes home, then you're really going to need to be there."

Doctors also emphasized the critical role of regular exercise, like brisk walks and the need for caregivers of all ages to maintain a heart-healthy diet. The habits help manage stress and boost energy levels.