DENVER -- Colorado's community dental clinics are open again, after a brief closure due to an executive order by Gov. Jared Polis in response to the coronavirus pandemic, and demand for services is high.
An Nguyen, chief dental officer at Clinica Family Health, said the downtime allowed the state's safety-net facilities to secure enough personal protective equipment, and make changes to ensure the safety of patients and staff.
Since social distancing is impossible during most procedures, clinics invested in technologies that recirculates air about every 6 minutes, using HEPA filtration and ionization to capture and remove bio-aerosols, and high-vacuum suction units.
"So essentially what happens is it keeps the air contained in one area, treats it before it has a chance to move to other spaces, which is really crucial when you have people moving in and out of a small space," Nguyen explained.
Most staff that were laid off or furloughed are also back, with some taking on different roles.
Some now screen patients before and during visits, others are 'runners' who move between rooms so other staff can stay in place.
Nguyen said all patients and staff get a temperature reading before entering the clinic, and must clear a COVID screening.
Erin Major, chief dental officer at Summit Community Care Clinic said workers wear N95 masks, covered by a Level 3 mask, and face shields during appointments.
She added when they were able to reopen, she was surprised that people were clamoring for services even if they weren't in pain. She said Summit has been booked solid since June, and staff are going above and beyond to ensure that everyone who needs care can get it.
"But we're doing our best, we're booked out about six weeks now," Major noted. "We can still get patients in, and we do, we have a commitment to seeing all patients that are in pain. So we do have openings every day for immediate and acute appointments."
Nguyen said while the closures created short- and long-term challenges, there was a silver lining. In addition to fast-tracking innovations such as tele-dentistry, and redesigning spaces and workflows, the pause allowed clinics to step back and focus on what was most important and in sync with their values.
"Our response to the pandemic has been ensuring safety for our patients and staff, and bringing our staff back to work," Nguyen stated. "Because without great, highly skilled staff, it is really hard for us to continue to provide the kind of high-quality access that we're known for."
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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.
Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.
"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained
Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.
Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.
"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.
Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.
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New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.
The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.
"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.
Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.
Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."
"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.
Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.
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The California State Assembly is considering a bill to require schools to have a cardiac arrest response plan. Assembly Bill 2887 would make sure schools update their safety plans to include CPR training and an automatic external defibrillator or AED onsite.
Dr. Stephen Sanko, a professor of clinical emergency medicine at USC, and a founding member of the Cardiac Arrest Survivor Alliance, is a volunteer expert for the American Heart Association. He said having a plan in place is critical.
"The American Heart Association is promoting that schools have a cardiac arrest response plan. A written protocol for what to do in order to decrease the likelihood that if somebody collapses, that they die," he said.
Two years ago, 15-year-old Cash Hennessy collapsed on the football field due to a previously unknown heart defect. Two off-duty medics in the stands gave him CPR. The school brought out its AED - but it was useless, because the batteries were dead.
Hennessy said the experience was traumatic.
"I feel blessed that I had people there for me, that could give me C-P-R. But I think about if those people weren't there and that was another kid, who knows what would have happened? Because there wouldn't have been an AED to save them," he explained.
An AED walks people through the steps to deliver a life-saving shock to a person's heart until an ambulance arrives. Studies show that 70% of kids who suffer sudden cardiac arrest at school recover if an AED is deployed correctly - whereas the survival rate for kids and adults not in the hospital is less than 12%.
Disclosure: American Heart Association Western States Region contributes to our fund for reporting on Health Issues. If you would like to help support news in the public interest,
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