Some anesthesiologists hope this is the year Tennessee passes legislation to allow Certified Anesthesiologist Assistants to practice in the state.

Assistants are authorized to work in 20 states but not in Tennessee.

Sasi Duggirala, certified anesthesiologist assistant and managing partner at Harmony Anesthesia in Atlanta, a former Tennessean, said the state's shortage of anesthesiologists as well as Certified Registered Nurse Anesthetists delays surgeries. He is advocating for licensure of certified assistants to increase the number of anesthesia providers, saying it would ultimately improve patient care.

"After coming out of COVID, there's been just a huge backlog on necessary procedures and surgeries that need to be done," Duggirala pointed out. "The mid-level anesthetist coming only from CRNA pool is just not enough to fill that gap."

Last year, Senate Bill 453 would have allowed certified assistants to practice in Tennessee but the bill stalled in the House. Some Tennessee Certified Registered Nurse Anesthetists opposed it, claiming the assistants lack the comprehensive training of nurse anesthetists. Backers want to see the bill reintroduced.

David Ryan Diehl, certified anesthesiologist assistant at Diehl Anesthesia in Atlanta, explained his son was born with a congenital disorder requiring prosthetics. The family receives support from the Jordan Thomas Foundation in Nashville. Diehl said new legislation would allow him to practice anesthesiology in Tennessee.

"Legislation needs to be passed that allows us to practice there, to bill insurance, Medicare, Medicaid, all those types of things, and for the groups to be reimbursed," Diehl outlined. "Also for us to be insured there as well, to practice."

Dr. Richard Duncan, orthopedic surgeon and medical director of the Center for Advanced Bone and Joint Surgery at Watauga Orthopedics in Johnson City, Tennessee, pointed out both Certified Registered Nurse Anesthetists and Certified Anesthesiologist Assistants can administer anesthesia during surgeries. He highlighted their extensive training, and suggested Tennessee institutions could offer such training as an additional educational benefit.

"A Certified Anesthesia Assistant is a person that has a bachelor's degree with some prerequisites that they have to have, and testing that they do," Duncan explained. "Once they're admitted into their training, it's 24 to 28 months of didactic training, and then clinical training."

Duncan added the critical shortage of anesthesia providers affects hospitals, surgery centers and patient care across the board.


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As Congress considers cuts to safety net programs in what Republicans are calling the "One Big Beautiful Bill Act," a new analysis from the nonpartisan Congressional Budget Office estimates 16 million Americans, including 140,000 in Colorado, would lose Medicaid health insurance.

Josh Bivens, chief economist at nonpartisan think tank the Economic Policy Institute, said if the bill passes as-is, health providers would see a steep increase in what is known as uncompensated care, when people without coverage get sick but cannot afford to pay their medical bill.

"It means hospitals and doctors no longer receive that income stream from Medicaid payments," Bivens pointed out. "Lots of them are going to be forced out of business and there's going to be closures of hospitals, especially in rural counties."

Republicans have cast doubt on the Congressional Budget Office projections and claimed cutting $715 billion from Medicaid by eliminating fraud and adding work requirements for adults would not reduce coverage. The GOP bill aims to fund Trump administration priorities, including more immigration raids and border wall construction, and extending tax cuts passed in 2017.

Bivens stressed if the bill becomes law, it would result in what he describes as the direct transfer of income from vulnerable families to the richest Americans. He noted the average cuts to Medicaid, which would kick in after the 2026 midterm elections, would be more than $70 billion a year.

"Then if you look at the tax cuts that will be received by just people making over $1 million per year, those are $70 billion as well," Bivens explained. "We're going to take $70 billion away from poor families on Medicaid, and we're going to give it to families who are making more than $1 million per year."

Six Nobel laureate economists have signed an open letter opposing cuts to safety net programs in the budget reconciliation bill, warning the measure would add $5 trillion to the national debt.

While headlines about the latest Trump-Musk feud may catch more people's attention, Bivens added the bill will have the biggest effects on Coloradans.

"I think the fact that six Nobel Prize winners said, 'This is important enough for me to try to draw attention to the implications of this bill,' should make people realize the stakes are really large," Bivens emphasized.


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A New Mexico coalition is stressing an urgent need for the state to adopt the strongest possible heat risk standards for indoor and outdoor workers.

New Mexico is the sixth-fastest-warming state in the nation, according to the Union of Concerned Scientists, fueled by climate change which makes heat waves more common.

Carlos Matutes, community advocate for the environmental group GreenLatinos, said 80% of those working in agriculture are Latino, as are 64% of those working in the building trades. He added Latino workers are overrepresented in oil and gas production and need to be protected.

"Depriving them of paid rest periods, of shade, of water during the summer months is unconscionable," Matutes asserted. "We're trying to make sure New Mexico Environment Department establishes these rules as quickly as possible."

Two states, Texas and Florida, have passed laws limiting local governments' ability to require employers to provide water breaks to outdoor workers. In contrast, California adopted protections in 2006. Matutes noted the Environmental Department has already announced the process to consider a heat-protection rule has been delayed and will not take effect before workers endure this summer's heat.

It is not just workers who suffer from extreme heat but also kids in school classrooms.

Whitney Holland, president of the American Federation of Teachers-New Mexico, said the days of putting a box fan in a classroom window on hot days are long past and the number of sweltering days increases each year.

"Thinking through a student's day, from the time they get on the bus, with buses that don't have air conditioning, in the cafeteria, in the library, all of those places," Holland outlined. "If they don't have proper ventilation and good air quality, research shows students feel fatigued, they are unable to focus, all of those things."

As might be expected, Holland added late afternoon, following the lunch break, is when students are most miserable, which disrupts the learning environment. This summer's forecast calls for hotter-than-normal temperatures from coast to coast, according to NOAA's Climate Prediction Center.


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Missouri Foundation for Health and its partners are putting $500,000 toward tornado recovery, boosting local relief efforts after storms devastated parts of St. Louis in May.

The emergency funds will help support groups already on the ground distributing supplies, repairing homes, and feeding families - especially in the hardest-hit areas.

Ivory Clarke is the vice president of strategic relations at the Missouri Foundation For Health. She shared the motivation behind stepping up and helping those in need.

"We've seen the effects of this tornado on St. Louis and communities that have traditionally been marginalized," said Clarke. "We've always been focused on ensuring that everyone in Missouri has a fair opportunity to thrive and be healthy."

The funds will be distributed among a dozen local groups that are involved in the relief efforts.

Missouri Gov. Mike Kehoe has asked President Donald Trump to issue a federal emergency declaration for the state due to the severe storms. If approved, it would unlock up to $5 million in federal aid.

Following the storms, hundreds of volunteers, first responders, and humanitarian groups mobilized for cleanup and food distribution.

Clarke stressed that her organization's mission is something they can't do alone, and said the effort is rooted in collaboration and collective strength.

"This response involves a network of non-profits, local organizations, and community leaders," said Clarke, "who are all working towards a shared goal of recovery."

Missouri averages 30 to 45 tornadoes per year, although the number can fluctuate depending on weather patterns.

Most tornadoes in the state occur between April and June, with May typically being the most active month.