Con en el regreso a la escuela, muchos niños de Colorado acceden a la atención médica, conductual y dental a través de los Centros de Salud Escolares, clínicas en funcionamiento que ofrecen servicios a pocos pasos de las aulas.
Kendra Nagey dirige las cinco clínicas escolares de Mountain Family Health Center. Ella dice que el comienzo de cada año escolar conlleva un aumento de la atención pediátrica.
"Hacemos muchas visitas de bienestar infantil, esas visitas son periódicas anuales para ver como se encuentran todos, comprobar el crecimiento y el Desarrollo," dice Nagey. "Y con los pacientes mayores, hacemos exámenes físicos deportivos."
La atención en la escuela es especialmente importante ya que los niños de Colorado y de todo Estados Unidos luchan contra los problemas de salud mental relacionados con la pandemia.
Nagey afirma que el enfoque del equipo integral de Mountain Family respecto a la salud y el bienestar, que da prioridad a la salud mental junto con la atención médica y dental, ofrece a los estudiantes acceso a servicios de primera categoría. Los médicos también pueden ofrecer referencias de especialistas según sea necesario.
Mountain Family es uno de los 20 centros de salud de la red de seguridad de Colorado, la mayor red de atención primaria del estado que atiende a más de uno de cada siete habitantes de Colorado, independientemente de su capacidad de pago.
La mayoría de los centros de salud funcionan en las escuelas, y muchos están abiertos todo el año, incluso durante las vacaciones escolares.
Nagey dice que Mountain Family acepta seguros privados y Medicaid, y las familias sin seguro pueden inscribirse en un programa que utiliza una escala móvil basada en ingresos familiares.
"Tenemos un departamento de extensión e inscripción que permite a las familias solicitar este programa de descuentos," asegura Nagey. "Como centro de salud calificado por el gobierno federal, el costo nunca debe ser una barrera para cualquier familia que busque cualquier tipo de atención."
Los padres pueden inscribir a los alumnos en el programa escolar a través del sitio web de su centro de salud local, o en las clínicas. También pueden optar por permitir que los estudiantes vean a los médicos sin que los padres tengan que estar presentes.
Nagey dice que esto es especialmente conveniente para asegurarse de que los niños y niñas tengan revisiones dentales regulares.
"Esas limpiezas dentales, no se si eres un padre, pero aparecen cada seis meses muy rápido," reconoce Nagey. "Así que es muy agradable poder tener a alguien que venga y pueda hacerse una limpieza dental en algún momento del día, y que los padres no tengan que interrumpir su horario para que se haga."
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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.
Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.
Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.
"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."
Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.
Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.
"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."
Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.
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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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