A new federal program launching next year is designed to help hospitals struggling to stay afloat in rural places such as South Dakota.

About 360 rural hospitals across the U.S. - and four in South Dakota - are at immediate risk of closing because of severe financial problems, according to the Center for Healthcare Quality and Payment Reform.

That's why the National Rural Health Resource Center is launching the federal Rural Hospital Stabilization Pilot Program.

Alyssa Meller is the center's chief operating officer. She said the program will offer technical assistance for up to two years, to an initial cohort of eight hospitals, and virtual community support to 12 more.

"It is a program that's aiming to improve the health care in rural communities by really helping keep health-care services available locally," said Meller, "to increase patient volume and improve revenue."

Meller said the program will help engage the hospitals' communities to promote services, too. The application period opens Wednesday and closes January 15.

Meller said several things contribute to hospitals' financial woes - including when residents bypass local services and opt to go elsewhere, fixed costs that exceed reimbursement rates from Medicare and Medicaid, and a lack of services tailored to meet community needs, leading to operating losses.

"And so this program then will help stabilize their current service line," said Meller, "but also will help them dive into what is needed at that local level and provide technical assistance and support."

Meller said that as of Friday, about 300 hospitals were registered for Wednesday's virtual informational session.



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A new study found more than 1.4 million children in the U.S., including many in California, have lost a family member to overdose, emphasizing the collateral damage of the drug epidemic.

The study focused on children younger than 18 as of 2019 who had lost one or more parents, siblings, grandparents, aunts or uncles, or cousins to overdose.

Emily Smith-Greenaway, professor of sociology at the University of Southern California-Dornsife and a co-author of the report, explained the effects overdoses have on those left behind.

"Being exposed to drug overdose is a particularly pernicious experience in young kids' lives, because we know drug overdoses are really traumatizing deaths to undergo," Smith-Greenaway explained. "There's probably a lot of hardship leading up to the death. Those deaths are probably very confusing for young kids to process and to understand."

Researchers found most kids who lose family members to drug overdose are between ages 10 and 18. Data show the reach of the problem is getting dramatically worse, because kids younger than 10 are experiencing drug overdoses in their family at younger ages relative to their slightly older peers.

A 2024 study in the Journal of the American Medical Association Psychiatry looked at children who have lost parents to overdose and found the highest rate among non-Hispanic American Indian and Alaska Native families.

Smith-Greenaway pointed out there is currently no system in place to identify, track or monitor children affected by overdose and offer them specialized counseling.

"We need clear supports for identifying this population," Smith-Greenaway urged. "But then also providing them the supports to ensure that there's not a cyclical trauma here that replicates across generations."

Help is out there for parents or caregivers in California looking after a child who is coping with loss due to overdose. Some options include the website of the nonprofit Eluna, or Ronnie's House of Hope, based in Palm Desert.

From hosting family to higher credit card bills and increased alcohol consumption, the holiday season, while fun, is not always friendly to our health.

A Minnesota expert said to avoid a cardiac event, give yourself a gift by not letting bad habits take hold. Findings from the American Heart Association show that more cardiac deaths occur on Dec. 25 than on any other day of the year. Coming in second is Dec. 26, while Jan. 1 rounds out the top three.

Dr. Sameh Hozayen, assistant professor of medicine at University of Minnesota Physicians and a board member of the American Heart Association-Twin Cities, said there is no firm reason behind the spikes this time of year but he argued it is fair to link them with temporary lifestyle changes.

"People are sleeping less, changing the way we eat, changing the frequency in which we drink alcohol," Hozayen outlined.

He pointed out because of travel or health clinics scaling back availability, people sometimes have gaps over the holidays when it comes to screenings or other appointments. Hozayen recommended trying to fit in as much exercise as possible and limit unhealthy foods when not at a holiday party. Drinking alcohol in moderation is another tip.

As for those with existing medical conditions, Hozayen noted the holidays are not meant to take a vacation from your special health needs. He emphasized it is important to keep taking your medications and make sure they are refilled. As for the research, he observed the higher death totals are not exclusive to colder climates, where blood flow can be restricted when the temperature drops.

"This has been shown in the United States (but) has also been shown in a country like New Zealand, where the Christmastime and the New Year time is actually in summer," Hozayen added.

Health experts said it is important to know the warning signs such as chest discomfort, discomfort in the arms, and shortness of breath. When there are obvious signs, calling 911 right away is deemed vital, as well as knowing how to provide hands-only CPR.

A Supreme Court decision in U.S. v. Skrmetti, challenging Tennessee's ban on gender-affirming care for minors, is expected by mid-2025.

Since 2021, 24 states have enacted categorical bans on gender-affirming medical care.

Lucas Cameron-Vaughn, staff attorney for the ACLU of Tennessee, said the initial lawsuit is on behalf of Samantha and Brian Williams of Nashville and their 16-year-old transgender daughter, as well as two other plaintiff families filing anonymously, and a Memphis-based physician. They are anticipating the decision, which is expected next year.

"This is the first case to look at whether the equal-protection clause of the U.S. Constitution protects transgender people, in this case, transgender youths," Cameron-Vaughn explained. "And whether or not it is constitutional that the state of Tennessee passed a ban on health care for transgender youths."

The ACLU reported more than 100,000 transgender minors live in states with bans on their health care. Tennessee Attorney General Jonathan Skrmetti stated they were defending Tennessee's law safeguarding children from irreversible and unverified gender transition procedures. Tennessee argued its ban does not discriminate based on sex.

Cameron-Vaughn pointed out the broader implications of the case will depend on the justices' ruling but it could influence whether states such as Tennessee can pass sex-based laws, such as those banning IVF or birth control, and whether such laws will be seriously reviewed by courts. He argued some recently passed laws negatively target transgender youths.

"It's important for Tennesseans to understand that the Legislature, over the past few years, has passed lots of laws directed at transgender young people," Cameron-Vaughn emphasized. "It is really affecting them and their mental health."

With the new administration, Cameron-Vaughn noted politicians made many claims about gender-affirming care during the campaign. Whether the claims will materialize is uncertain. He added the ACLU is prepared to continue to fight to protect rights and stop any additional gender-affirming healthcare ban laws from passing.