RALEIGH, N.C. -- Some doctors in North Carolina are voicing their support for legislation to cut red tape for Advanced Practice Registered Nurses (APRNs).

More than 20 states and the District of Columbia already grant licensed APRNs full practice authority, meaning they don't need to pay a doctor to supervise them.

The SAVE Act, introduced in North Carolina this year, would remove supervision requirements.

Dr. Elizabeth Golding, medical director for palliative care services at Cone Health, said there wouldn't be enough palliative medical care available in the state without APRNs, and believes supervision requirements, which often cost APRNs thousands of dollars, are a hindrance to patients' getting high-quality care.

"They really do nothing to improve the quality of care, and in my opinion are really, in truth, unnecessary and are just costly administrative hoops," Golding argued.

While individual physicians are speaking out, the North Carolina Medical Society has repeatedly opposed allowing APRNs to practice independently, arguing eliminating doctor supervision would increase safety risks for patients.

Dr. William Long, a primary care and geriatric physician in Charlotte, explained supervision requirements do not require doctors and APRNs work closely together. Long added some supervising physicians live hours away, or even in another state, from their collaborating APRN.

"I just don't think that's the spirit of what the law is," Long contended. "I think the law should be modified so that after a certain period of time, and pick your number, two years, three years, whatever, those individuals are very competent in the scope of practice that they're in."

Dr. Jessica Cannon, a retired OB/GYN physician in Wilmington, pointed out full-practice APRNs could help more North Carolina women have healthy pregnancies and healthy babies, especially in rural counties.

"We know that in states where certified nurse midwives have independent practices, that the outcomes are known to be just as safe as traditional OB/GYN outcomes, and in many cases, they have superior outcomes," Cannon observed.

Research shows APRN midwives lower risks for women and babies. Compared with obstetricians, midwifery care has led to much lower intervention rates and reduced the odds of Cesarean delivery by 30% for women having their first baby.

A relatively new virus known as monkeypox has made its way to the state of Washington. About 280 cases have been reported, with 240 occurring in King County, according to the state Department of Health.

Dr. Mark Cook, medical director of gender health for Kaiser Permanente in Seattle, said monkeypox has been known to medical professionals since the 1970s, but the virus has now begun a troubling trend of spreading from person to person.

"The symptoms are fever, body aches, swollen glands, fatigue and a characteristic rash; little round vesicles that can appear on your skin and many different parts of your body," Cook explained.

Cook emphasized monkeypox is spread through skin-to-skin contact, and so the best way to prevent getting the disease is not to touch people who are infected. He pointed out it is related to smallpox but is much less severe. A vaccine is available, but it is in short supply. There are close to 12,000 cases nationwide.

Cook noted fortunately, there have not been any reported deaths from the virus. But he added monkeypox is uncomfortable and people who are infected have to be isolated for a few weeks. There can also be scarring from the blisters.

"We should be concerned simply because it is a pretty significant illness, and it's miserable to have it for some people," Cook stressed. "That alone, I think, speaks to why we should do our very best to try to control it."

Changes in how to prevent COVID-19 at the start of the pandemic as medical professionals were learning about the disease may have sown distrust in the wisdom of authorities on the issue. Cook acknowledged doctors are more cognizant of it now.

"We've all learned how to try to deliver those messages in a more clear way to help people understand that the message isn't necessarily changing, but the information that we have does evolve over time," Cook stated.

Coloradans struggling economically put their health at risk when they decide not to turn on cooling systems, frequently out of fear of not being able to pay their utility bill and taking a hit on their credit score, or having services cut off.

Luke Ilderton, deputy director of Energy Outreach Colorado, said as homes get hotter, heat stress can come on very quickly. Prolonged exposure can lead to heart attacks, and can cause the body to shut down. Ilderton encouraged all Coloradans to make health priority number one.

"If people are suffering, they should turn on their cooling systems and look for resources -- like Energy Outreach Colorado, the Energy Office's weatherization program -- to be able to afford their cooling bill, but not at the sacrifice of their own personal health," Ilderton advised.

Help is available for those who cannot afford to pay their utility bills or repair or replace broken cooling systems, and for those at risk of being disconnected. To be connected with the right program, call Energy Outreach Colorado's helpline toll-free at 866-432-8435.

Ilderton pointed out there are ways to make your summer utility bill more affordable, especially for households participating in Xcel Energy's time-of-use rates.

"Try to precool your house in the early morning hours when electricity rates are at its lowest," Ilderton suggested. "You will be paying more in the afternoon, and you certainly will pay more from 3-7 p.m."

Climate change is bringing even more summer days above 90 degrees, and the Biden administration is encouraging states to add cooling assistance to programs initially created to help the nation's most vulnerable residents stay warm in winter.

Ilderton added the Inflation Reduction Act recently passed by Congress could help more people find long-term price relief by switching to lower-cost heat pump technology, which can be used to heat and cool homes, and does not require the use of fossil fuels.

"There's a significant amount of rebates and incentives, specifically targeting low- to moderate-income households, that will help with this transition," Ilderton noted.

As a new school year kicks into gear, advocacy groups want to ensure Ohio kids have access to medical coverage to keep them healthy and ready to learn.

It is estimated more than half the roughly four million uninsured children in the U.S. are eligible for Medicaid, and the "Get Covered Ohio" campaign is working to bridge the gaps preventing families from enrolling.

Zach Reat, director of health initiatives for the Ohio Association of Foodbanks, which is doing targeted outreach in Franklin County to help families navigate the enrollment process. He explained they will focus on Hispanic populations, which have higher uninsured rates.

"There's just a lot of confusing requirements," Reat pointed out. "They ask a lot of questions about different types of assets in the application process. And pulling together all those answers and the verification documents that are required can be a really confusing process."

Researchers say children's access to health insurance improves outcomes for children, including educational attainment and economic security.

Reat noted with Medicaid coverage, children can get important routine care services including doctor visits, checkups and immunizations. More information about enrollment is online at getcoveredohio.org.

The Ohio Association of Foodbanks received funding for expanded outreach through the federal "Connecting Kids to Coverage" project.

Pandemic-era policies helped expand Medicaid enrollment, and Reat argued they will continue their work throughout the year to help keep kids covered.

"As the public health emergency around COVID-19 comes to an end, there's going to be a really important need to make sure people are filling out the reinstatement paperwork for Medicaid," Reat emphasized. "We're going to be here to help them with that process."

An estimated 1.3 million Ohio kids have Medicaid coverage. In Ohio, a child is eligible if their household income is below 206% of the federal poverty level; about $4,700 a month for a family of four.