Tensions are rising in Ohio between doulas and the state Board of Nursing, as only a small number of doulas have been able to be certified for Medicaid reimbursement - despite a statewide push to reduce infant mortality.

More than 60,000 births in Ohio each year are covered by Medicaid. Research shows having a doula can lower risks for both moms and babies.

But only 132 doulas statewide are certified to receive Medicaid payments.

Dr. Marie McCausland, who chairs the state's Doula Advisory Group, said to meet the demand, about 3,000 need to be certified.

But she contended the certification process has been anything but collaborative - and called it "top-down and exclusionary."

"Day one, the first meeting, they already had almost all the rules written," said McCausland. "They sent it to us and we were supposed to start there, versus any sort of collaborative writing of the rules."

She said she recently discovered she's being removed as chair after a quiet legislative change that stripped doulas of their ability to lead the advisory group, effective April 9.

The Ohio Board of Nursing said in a statement the leadership change was made for consistency with other professions.

But McCausland said even doulas serving non-Medicaid families are sometimes being turned away, because they don't hold the new certification.

Guillermo Bervejillo, research manager with Children's Defense Fund Ohio, said the governor made doula access a priority, but the Board of Nursing may be undermining that effort.

"Gov. DeWine made it a priority to reduce infant mortality, especially amongst Black children," said Bervejillo. "He created a doula advisory group. The doula advisory group has faced obstacle after obstacle. It's been kind of wild. It feels like the governor doesn't even know what's going on."

McCausland said there also are concerns about racial bias and representation.

She said Black voices on the advisory group have been ignored, even scrubbed from official meeting records - prompting the group to hire a court reporter.

"Doulas are happy to come into hospital systems and work with doctors and nurses," said McCausland. "We want to be able to work as a team for our client success."

The Board of Nursing says it values the input of doulas and that the advisory group includes health professionals from a range of backgrounds.

The board says it is committed to improving maternal health outcomes and continuing to refine the certification process.

Illinois is the first state to block the federal government from accessing state data on autism.

The order, signed by Gov. JB Pritzker last week, is in response to federal efforts to create a mass data collection on autism.

Health and Human Services Secretary Robert F. Kennedy Jr. plans to use Medicare and Medicaid data to create an autism registry with the goal of finding the cause of what he called an "autism epidemic." Pritzker's order prohibits the collection in Illinois without consent from an individual or guardian.

Jeff Chan, associate professor of special education at Northern Illinois University, said along with concerns about accidental disclosure of protected health information, right now there is no single cause or cure for autism and he is skeptical a database could change it

"I don't even know if we will ever find that one, single cause," Chan acknowledged. "There's a variety of factors in play on the genetic side and the environmental side that are all affecting parents and mothers and children, which eventually lead to the expression of those symptoms."

Federal agencies said they would protect sensitive health information. More than a dozen autism organizations and advocates are pushing back against the planned database and any rhetoric claiming autism is "curable" or is caused by vaccines.

One in 31 children in the U.S. is diagnosed as being on the autism spectrum. Chan noted in Illinois the rate increased from one in 333 children in 2002 to one in 51 children in 2023. He added while cases are rising, the numbers are also influenced by earlier diagnosis and improved data collection.

Chan emphasized the importance of oversight of data and interpretation and cautioned about the potential for drawing conclusions from incomplete information or cherry-picking evidence.

"Anyone could collect data and they can interpret it differently, and they can spin it differently," Chan stressed. "That happens all the time. And that's happened in the past, especially about the causes of autism."

Chan advised caution regarding individuals with extreme theories. He acknowledged the difficulty parents and caregivers face in evaluating information and the importance of institutions to help navigate the evidence.

"There's people out there that, for whatever reason, are true believers about a particular narrative about autism," Chan explained. "You have to be a very careful consumer about what you take in and what evidence you choose to believe."


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By Tim Spears for WISH-TV.
Broadcast version by Terri Dee for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

The intensity on the track during the Indianapolis 500 just might be matched inside the Indianapolis Motor Speedway's Infield Medical Center.

"I think there's lots of jokes about emergency physicians out there," IMS Medical Director Julia Vaizer said. "[Being] adrenaline junkies is one of them that floats around."

When the IMS draws more than 350,000 people for the "Greatest Spectacle in Racing," Vaizer says this the Infield Medical Center becomes the busiest emergency department in Indiana.

Vaizer says the most common issues for fans in the stands are cuts, bruises, and dehydration. While the race crews can need attention for anything from a common cold to a multi-car crash.

"A lot of times on race day, people think 'Oh, you just have intoxicated people there,' but we see patients with any kind of medical emergency," said Laura Stasila, assistant clinical operations manager at Infield Care Center.

The 18-bed clinic is split, separating the fans from the drivers and race teams receiving treatment. The driver's side is also equipped with a x-ray machine, ultrasound, and stocked with blood reserves.

IU Health, which operates the center, also has a helicopter on standby.

First built in the 1940s, Vaizer considers the Infield Medical Center at IMS to be one of the top motorsports medical facilities in the country.

The 200-plus member medical team working the Indianapolis 500 are also deployed in key areas across the track, staff first aid centers, and follow IndyCar to keep teams healthy on the road. It includes a mix of professionals: Nurses, residents, emergency medicine physicians, and specialists, such as a trauma surgeon and a neurosurgeon.

On race day, Stasila says the medical team often arrives in the morning, with some staying at the track already waiting for care. While the end of the race usually brings a rush of race team members who waited until the event ended to get something checked out.

But no matter how quiet or intense it gets, the goal remains the same: Safety.

"When you get this many people in one place, there's bound to be any kind of emergency that would happen," Stasila said.


Tim Spears wrote this article for WISH-TV.


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May is Lyme Disease Awareness Month and the latest state data show Wisconsin recently recorded the highest number of Lyme disease cases in state history.

Experts are urging residents to be mindful of the ticks carrying it as they become more active across the state. There are 16 confirmed tick species in Wisconsin and experts are focused on the "black-legged tick," or "deer tick," in the transmission of Lyme disease. Experts recommended taking preventive measures when spending time outdoors like wearing protective clothing and using insect repellent. They added you should perform tick checks and shower after any outdoor activity.

Dr. Xia Lee, public health entomologist at the Wisconsin Department of Health Services, said some ticks, especially younger ones, may be harder to spot.

"Those are usually the ones that we associate with a lot of the cases of Lyme disease or tick-borne diseases, most active in June and July," Lee explained. "This is also reflected in the number of people who go into the emergency department or go into the physician for tick bite-related illness."

The number of reported Lyme disease cases has tripled over the past 15 years, according to state data. Lee noted the Wisconsin Department of Health Services conducts surveillance and tracking of ticks for the public, including a tick identification service and a dashboard reporting ER visits for tick bites.

Deer ticks have spread from northwestern Wisconsin to every county in the state over the past 30 years. Experts said changes in land use, wildlife management and the environment have helped spread the disease.

PJ Liesch, entomologist at the University of Wisconsin-Madison, said the deer tick is a generalist feeder and can be found on many small mammals, in addition to deer. He added the increasing prevalence of the species has led to an emerging health threat.

"They are still spreading outwards," Liesch pointed out. "They seem to be moving into newer areas, in some cases that can be more like suburban backyards, areas where we haven't seen them historically. And they're still potentially expanding and we don't know when they are going to stop."

Liesch stressed if you are bitten by a tick in Wisconsin, there's about a 50-50 chance it is carrying Lyme disease. He emphasized the risk of Lyme disease transmission increases with the duration of tick attachment, which is why prevention and detection are so important.

"That's a pretty high rate of infectivity, kind of a scary number," Liesch acknowledged. "Even if you have a deer tick that is Lyme-positive, if you are checking yourself and making sure they are not attached to you for very long, that's going to greatly reduce the chances of transmission."

Some early symptoms of Lyme disease include fever, headache, fatigue, swollen lymph nodes, joint and muscle pain and a rash. If left untreated, more complicated conditions can develop.


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