A new development in Denver's Elyria-Swansea neighborhood that combines affordable housing, a healthcare provider, a pharmacy - and next, a grocery store offering fresh produce - is proving how collaborative partnerships with real community input can meet the needs of historically underserved neighborhoods.
Tepeyac Community Health Center Founder and CEO Jim Garcia said the innovative mix makes it just a little bit easier for people working two and three jobs to meet their family's basic needs.
"A family that has very limited time during the course of a day or course of a week to go to a medical appointment, or a dental appointment, or get a prescription filled," said Garcia. "And so, to be able to offer those services all under one roof represents a huge benefit for working families."
Tepeyac is just blocks away from bus and light rail stops, which Garcia said was key to the decision to build a new 24,000 square foot health center that serves all patients regardless of their ability to pay.
A Georgia-based developer added 150 affordable apartments to the site, and more affordable units for seniors and a community center are expected to open across the street next year.
In a time when virtually all new housing construction delivers luxury units for hedge fund investors and the very rich, Tepeyac represents a working model for addressing what has become a national affordable housing and homelessness crisis.
Garcia said his advice for future multi-use developers is to be open to partnerships that can deliver key components for complex projects with many moving parts.
"The level of health care services, affordable housing, and offering fresh food as part of the overall project," said Garcia. "So I would just say to be open to innovative ideas, and to be open to being able to collaborate with partners who you may not intuitively think represent an opportunity for collaboration."
Tepeyac launched in 1995, operating out of a north Denver two bedroom bungalo. In 2022, Tepeyac served some 4,600 clients, 90% of whom identified as Hispanic or Latino.
Garcia said the impact of the new facility has been significant since opening last year.
"We were able to significantly expand our ability to serve more patients," said Garcia. "We anticipate that we will be able to eventually triple the number of patients we can serve and provide high quality medical, dental, mental health and pharmacy services."
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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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