SALEM, Ore. - Any Oregonian who needs in-home assistance with daily living and some medical needs will be able to use the Oregon Home Care Commission registry and referral system to help find it, when Senate Bill 1542 is signed into law on May 29. Until now, the list of trained and qualified home-care aides has been for use only by people whose care is paid for by the State of Oregon. The new legislation allows anyone to use it, and was prompted in part by reports of shortages of private home-care services in some areas.

Members of the caregivers' union SEIU Local 503 stand to gain more business from the change, although home-care workers' union president Rebecca Sandoval notes that the primary benefit is that more Oregonians should be able to get care at home.

"If you have an individual who has complicated medical issues, if they have a trained professional to help track every aspect of their care - diet, their rest and their medication - that just makes their whole care plan work so much better," Sandoval says.

There was some push-back in the legislature from private home-care service companies that said the change puts them in competition with state-funded caregivers. However, advocates for the bill argued that people should be able to hire home-care workers from a variety of sources.

In-home care has not always been unionized in Oregon. When Adam Riggs started as a caregiver in Eugene 13 years ago, he says it was a minimum-wage job with no benefits. With the aging population and the soaring need for in-home services, Riggs thinks organizing to add training and improve wages made sense.

"That, I think, has really helped change our industry from being one where we had a lot of turnover to one where people are actually beginning to make it into a career now," Riggs says. "I feel proud to have been a part of a lot of those changes."

State-paid home-care workers now make about $13 an hour.

Sandoval says most of the union's work in Salem benefits home-care clients as much as its membership. For example, she says, every year there are attempts to trim the home-care service hours of lower-income clients.

"We've been able to organize and make the point repeatedly that this is a program you don't want to cut, for a lot of reasons, because of the matching federal dollars we get for every hour of home-care that the State of Oregon pays for," she explains. "And we give people the ability to live in their own home and/or in a care setting that they choose."

Caring for people at home rather than in nursing-care facilities saves the State of Oregon close to a half-billion dollars a year, she adds.

The bill signing is Wednesday, May 29, at 11 a.m. at the State Capitol.




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.