LGBTQ+ Americans are twice as likely to experience discrimination in health care, including as they age, according to a new survey from the Kaiser Family Foundation.

Now, a nonprofit advocacy group called Sage has created the LGBTQ+ LGBTQ+ Advance Care Planning Toolkit.

Eliza Giles, a nurse practitioner specializing in geriatric care, created the online resource.

"The toolkit is an A to Z guide on conversations, documentation and considerations if you're well, or if you have a serious illness and want access to caregiver resources, advice about palliative care," Giles outlined.

The toolkit explains how to appoint a health care proxy who can visit you in the hospital and make medical decisions if you are incapacitated. The site also helps people spell out their wishes on caregivers, hospice and palliative care and funeral or memorial arrangements.

Osha Towers, LGBTQ+ engagement director for the nonprofit Compassion & Choices, said without advance planning, end-of-life decisions can bypass people closest to you and fall to family members who may have had little to no contact for years.

"There's plenty of us that have gone to funerals with people that don't look like they looked as they live their lives," Towers noted. "Because their family decided to make the choice that they want to erase that part of their identity."

The toolkit also covers estate planning, creating a will, and organ donation.

Advocates are urging Maryland lawmakers to support a bill that would approve medical aid in dying for people who are terminally ill.

A poll last December found more than 70% of Marylanders supported medical aid-in-dying legislation - and more than 60% said they want that option for themselves if they were terminally ill.

Donna Smith, campaign director with the end-of-life care advocacy group Compassion & Choices, said the End of Life Option Act is about creating options for people -- options that are available to those in 10 states and the District of Columbia.

"It's just an option. No one is forced to do anything," said Smith. "The doctors aren't forced to be involved, to write a prescription; the pharmacists aren't forced to do anything. It's just an option for the very few who need it."

Opponents of the bill worry some people may be coerced into pursuing aid in dying, and some religious groups believe it violates what they view as the sanctity of life.

Advocates have tried to pass medical aid-in-dying legislation for 11 years in Maryland. In 2019, the legislation failed on the floor of the Senate in a 23-23 tie. The bill did narrowly pass in the House of Delegates.

Smith said this time, early whip counts of lawmakers show the legislation has the support to pass the General Assembly.

Smith said many of her volunteers have been terminally ill people, who spend their last days advocating for this legislation. She added she is trying to explain to lawmakers the consequences of not approving the bill.

"Their inaction leads directly to people suffering, and I want them to understand that," said Smith. "Because, personally, I'm tired of going to funerals and sending flowers because they have not acted."

Medical aid-in-dying legislation has strong support across party lines. Polling shows more than two-thirds of Republicans support the legislation, as do more than 70% of Democrats and Independents.

Open enrollment for health insurance from the online marketplace is over, but Wyoming experts are reminding tribal members that they qualify to enroll at any time.

As a health insurance navigator with Enroll Wyoming, Molly Holt helps people in her district sign up for coverage - including many from the Wind River Reservation.

Over the last seven years, Wyoming tribes have replaced all federal Indian Health Service units with tribally-operated ones.

The Northern Arapaho Tribe operates Wind River Family and Community Health Care facilities in three locations - and the Eastern Shoshone Tribe recently transformed the former-IHS Fort Washakie clinic to Warm Valley Health Care.

Holt said members often don't realize that being insured can benefit the Tribe.

"If you have insurance, then they can do a third-party billing," said Holt, "and so those funds will come back into the organization and it will help everybody."

According to the most recent Department of Health and Human Services report, the uninsured rate among non-elderly American Indians and Alaska Natives nationally was about 20% in 2022.

Tribal members qualify for a special enrollment period, which lasts all year. More information is online at enrollwyo.org.

People without a tribal affiliation may also qualify for a special enrollment period this year. Holt said she and other navigators can help people find out if they qualify.

"Individuals can sign up outside of the open enrollment period if you've had certain life-changing events," said Holt, "which include losing health coverage, moving, getting married, having a baby, or adopting a child. Those are a few of them."

Other qualifying changes include divorce or abandonment through domestic violence, loss of job-based coverage, leaving incarceration, certain changes in residence, or a death that would affect health coverage.

Health officials across Texas remain on high alert after a deadly measles outbreak in the South Plains region.

The state health department said one child has died and 146 people have been diagnosed with the illness. A majority of those infected are unvaccinated children.

Dr. Donna Persaud, medical director for homeless outreach medical services at Parkland Hospital in Dallas, said they have seen a steady decline in vaccinations in recent years.

"The vaccine rate amongst kindergartners has decreased throughout the 2000s, and part of that has been the inclusion and addition of nonmedical exemptions," Persaud explained. "They've fallen to rates where outbreaks are likely."

She pointed out the vaccine rate among kindergartners is less than 95%. Among the victims, 70 are between the ages of 5 and 17.

Most of the current patients live within a Mennonite community but cases are also being diagnosed in other parts of the state. Measles is an airborne illness and highly contagious. Persaud emphasized the medical community is concerned.

"All the clinics and health care entities, we're about to convene a special committee," Persaud noted. "We're looking at putting up signs, posters and looking at the CDC recommendations. These are now the questions: What about adults? Should I get another vaccine? Should I get a booster?"

Persaud stressed if you have had the measles, if you were born in or before 1957, or if you have proof of receiving two vaccines, you are immune. She added some measles vaccines in the '60s were not effective, and anyone born during that decade should check with their doctor.


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