ASTORIA, Ore. – Syringe exchange programs are opening up access to health care for some Oregonians.

Exchanges provide clean needles to prevent the spread of disease, and a Clatsop County program that started in October 2017 has made a big impact.

County Public Health Director Michael McNickle says the program has provided 250,000 needles since it began.

Just as important, he says, is distribution of naloxone, a drug used to fight overdoses.

The county estimates naloxone handouts have saved at least 36 lives.

McNickle says the program plays another important role.

"We're the gateway for the users who have no other alternative,” he explains. “And after the trust is built, they know that we're going to be there every week, and we're still there trying to help them recover and get into recovery.

“So, at some point if they take advantage of that, then we'll help them get to that point in their life where they're ready to take on that next challenge."

The Public Health Department facilitates the program in collaboration with the addiction support group Jordan's Hope for Recovery, with funding from the Columbia Pacific Coordinated Care Organization.

A recent National Safety Council study confirms the U.S. still is deep within the opioid crisis.

Americans are more likely to die from accidental overdoses than car crashes. On average, 130 people die of a drug overdose every day, according to the Centers for Disease Control and Prevention.

Tanya Phillips is health promotion manager for Jackson County Health and Human Services, which runs a syringe exchange program with an estimated 300 to 400 visits a month.

Phillips says exchanges are a proven way to stop the spread of diseases such as Hepatitis C and HIV. She says Jackson County's program also increases folks' access to care on the spot.

"We're able to provide health education and resources and if anyone does, after their test, show that they are positive for HIV or Hep C, we're able to make referrals for them to get further testing, but also treatment as well, which is really important," Phillips states.

Phillips points out that the stigma surrounding opioid addiction can prevent treatment.

"It's a chronic health condition, and so how can we change the care that we offer and the mindset that we have around that, to kind of support individuals who do suffer from this addiction in getting help?" she states.


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Open enrollment begins soon for employer-sponsored health insurance for coverage starting Jan 1.

Most people will have multiple options to choose from. Some are complex, so now is the time to do your research. According to the website USA Facts.org, about 7.5% of Indiana residents do not have health insurance. Experts say it is important to shop for plans, see exactly what they offer, and if a choice fits a family's needs and budget.

Dr. Rhonda Randall, chief medical officer of Employer and Individual for UnitedHealthcare, said understanding some of the basic insurance jargon is a good place to start.

"Things like deductibles, copays, coinsurance, premiums, etc.," Randall outlined. "Be familiar with what those terms are and what the costs associated with each one is for the plans that you're offered and the plans that you're considering."

Randall advised paying close attention to out-of-pocket costs and monitoring changes which can occur within a plan each year. She suggested the online health insurance glossary Just Plain Clear, which UnitedHealthcare has compiled. In 2021, more than one-third of Indiana's population was covered by public health insurance funded by governments at the federal, state or local level.

Nearly 17% of Indiana's population is 65 or older and eligible for Medicare. But it does not cover everything, so most people also buy a supplemental policy for added coverage, and a prescription drug plan. The Medicare annual enrollment period starts Oct. 15 and ends Dec. 7, when people can get new coverage or change what they've had.

Randall noted UnitedHealthcare has also compiled an online guide to help people navigate those plans.

"Medicare beneficiaries want to make sure they're understanding and learning the difference between original Medicare -- Medicare Parts 'A' and 'B' -- and Medicare Advantage, Medicare Part 'C' and 'D,' the prescription drugs," Randall explained.

Randall encouraged Hoosiers to consider insurance plans including coverage for telehealth -- virtual 24-hours-a day, 7-days-a-week mental and behavioral health services, or management of chronic conditions, such as migraines, plus physical therapy and wellness visits.

Health care advocates are urging Gov. Gavin Newsom to sign four bills aiming to lower medical bills, improve transparency, and make health care more accessible.

Assembly Bill 665 would allow minors over age 12 to use Medi-Cal benefits for treatment they consent to on their own, while still allowing providers to involve a parent or guardian when appropriate.

Angela M. Vázquez, policy director for The Children's Partnership, said teens may avoid getting help if they have to give intimate details to their parents.

"Surveys show that making parental opt-in mandatory reduces the likelihood that teens will seek timely treatment, especially among LGBTQ+, and youth of color," Vázquez reported.

The bill would also allow Medi-Cal to cover services even if the youth is not a danger to him or herself or the victim of child abuse or incest. Opponents say the bill interferes with parental rights.

A second bill would stop surprise bills from out-of-network ambulance companies, instead requiring patients to pay only the in-network cost-sharing amount.

Danielle Miele, a mom from Citrus Heights, said after her teenage son tried to take his own life, the hospital transferred him via ambulance to a treatment center several hours away, resulting in a huge bill.

"Within a month we received an ambulance bill of over $9,000," Miele recounted. "Adding insult to injury, literally. Why is this practice commonplace? Why is it even considered acceptable?"

Debt collectors have objected to a section of the bill dealing with wage garnishment.

A third bill would add physicians' groups of 50 or more to the list of organizations required to make public financial data they report to two state agencies.

Sonia Pellerin, a health care worker in Sacramento and a member of the Service Employees International Union-United Healthcare Workers, said it is a matter of transparency.

"With health care costs rising, we all deserve to know where our health care dollars are going and what's driving up the costs," Pellerin contended. "Many times our patients are struggling to afford their health care. Those patients have the right to know how these medical groups are spending their money."

Medical groups have called the bill an unnecessary layer of regulation. A fourth bill would extend Medi-Cal's Comprehensive Perinatal Services Program from 60 days to 12 months postpartum. The program helps arrange housing and food assistance, job training, and breastfeeding support. Opponents cite budget concerns.


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In the wake of the devastating overdose epidemic in North Carolina, the state's Department of Health and Human Services is stepping up to aid families and provide resources for youths battling substance abuse disorders.

State data show in 2021 alone, overdose deaths in North Carolina spiked by 22%, and nationwide, teen overdose deaths rose by 20%.

Kelly Crosby, director of developmental disability and substance use services for the North Carolina Division of Mental Health, said recognizing many adults with substance use disorders start using during their teenage and young adult years, it is crucial to educate and support young people in preventing substance abuse and overdoses.

"In North Carolina, among kids 12 to 17 years old, around 5% had a substance use disorder in the past year," Crosby reported. "That's more than 41,000 kids."

Crosby pointed out the COVID-19 pandemic exacerbated mental health challenges and substance use, with increased reports of anxiety, depression and substance misuse.

Sara Howe, CEO of Addiction Professionals of North Carolina, said to help address youth substance use challenges, a range of resources are available in the state. Some resources include education, harm reduction and treatment and mental health support.

Howe noted parents can get additional help at AlcoholDrugHelp.org.

"They can look, they have a list of what they provide, what insurance they take, do they take Medicaid, do they take commercial insurance, and do they have intensive outpatient, residential," Howe outlined. "This is a resource that we have right in our backyard that we can take advantage of today."

Research from the Centers for Disease Control and Prevention showed other protective factors to youth substance abuse disorder are family engagement, conversations around the disapproval of substance use, and mental health support.


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