SACRAMENTO, Calif. – La ley “CARE Act” lleva casi cinco meses vigente, y los defensores afirman que ha logrado convertir lo que antes era una buena práctica, en ley.

A casi cinco meses de que entró en vigor, los defensores de la salud dicen que la ley CARE está marcando una gran diferencia en la cantidad de instrucción que reciben los pacientes y los cuidadores de pacientes.

La “Hospitals and Family Caregiver Act” (Ley de Prestación de Cuidados para Hospitales y Familias) exige que los hospitales designen una persona para brindar cuidados a cada paciente en cuanto es admitida o admitido, y luego dar instrucciones detalladas al familiar o cuidador que atenderá al paciente cuando éste es dado de alta. La idea es mejorar los resultados del paciente y reducir los reingresos por complicaciones posteriores.

Heidi Kelly, de Camarillo, apoya la ley luego de que su madre fue dada de alta del hospital con una hemorragia interna mientras recibía adelgazantes para la sangre, y posteriormente falleció sin que la familia hubiera recibido instrucciones suficientes y claras.

“No preguntaron a quién podían darle toda la información, y yo soy la mayor de seis. Y estuvieron hablando con nosotros en diferentes momentos, dándonos información diferente.”

Las cifras de re-admisión hospitalaria no planeada en 2016 no están listas aún, pero las estadísticas estatales indican que en la primera mitad de 2015 más de 124 mil personas, el 13.1 por ciento, tuvieron que regresar al hospital a los pocos días de haber sido dadas de alta, lo que representó una leve mejoría respecto al 2014.

Surani Hayre-Kwan, de la Asociación Californiana de Practicantes de Enfermería (“California Association for Nurse Practitioners”), dice que la nueva ley obliga a los hospitales a darle al paciente, y a quienes le cuidan, las herramientas necesarias para asegurar una recuperación saludable.

“En vez de que ignoren al cuidador mientras se prepara al paciente para salir del hospital, ahora el cuidador puede decir ‘Hey, momento, tienen la obligación de incluirme en este proceso para que este paciente sea atendido correctamente.’”

Una medición de la AARP encontró que 4.4 millones de californianos brindan cuidados no remunerados a un familiar o ser querido. Casi la mitad desempeñan complejas tareas médicas y casi el 80 por ciento administran medicamentos. En su página de internet, la AARP tiene una tarjeta que puede ser bajada e imprimida; es sobre la ley CARE, y puede llevarse en la cartera como recordatorio de los derechos que tenemos cuando ingresamos a un hospital.

Encuentre más información (en inglés) sobre la tarjeta para su cartera, en: http://states.aarp.org/ca-new-law-helps-family-caregivers/.


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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"