As the pandemic began, the federal government waived certain certification requirements for nurse aides to help with health-care worker shortages. As those waivers are set to end, the federal government is allowing New York and other states to "grandfather" in those nurse aides without having met the pre-pandemic requirements.

The initial training waiver aimed to give nursing homes staffing flexibility to address the pandemic, but Richard Mollot, executive director of the Long Term Care Community Coalition, said it hasn't addressed the industry's underlying burnout issue.

"Federal studies, our studies, have shown that they understaff," he said, "and they exploit the workforce and they count on a workforce that is going to be constantly replenish-able."

Mollot said a return to mandating training hours would help both staff and residents. He contended that nursing homes and long-term care facilities need to invest in proper staffing levels and fair pay for their workforce. As part of the grandfathering process, New York is granting credit for nearly half of a nurse aide's required training hours if they've worked for either 30 days or 150 hours.

In April, the Center for Medicare and Medicaid Services announced it would be phasing the training requirements back in and new nurses will need to meet pre-pandemic requirements. The federal agency acknowledged that waiving requirements gave nursing homes flexibility, but it also led in some cases to poor resident care.

Eric Carlson, directing attorney for the group Justice in Aging, said formal training helps nurse aides build a range of skills to better care for residents.

"It is unfair and inaccurate to just pretend that nurse aides just need to put food in front of people and help them wash up a little bit," he said. "It is much, much more than that, and nursing-facility residents need high-quality care."

A bill now in Congress would extend the training waiver and provide a path to allow using hours on the job to count toward training requirements. Its backers say relaxing training standards would help get more people into the health-care industry. It hasn't been voted on by either the House or Senate.

Some New York health care facilities are getting a funding boost to help train the next generation of doctors and dentists.

The U.S. Department of Health and Human Services is awarding $155 million to Teaching Health Centers nationwide, operating primary-care medical and dental residency programs. More than $12 million will go to centers in New York State.

Carole Johnson, administrator of the Health Resources and Services Administration, said she is excited to see the centers doing the legwork to develop training programs.

"You have to be able to demonstrate that you have the staff to do the training," Johnson asserted. "That you have the predecessors, that you have all those critical parts in place so that we're getting good, skilled clinicians through these programs."

In addition to medical and dental programs, a special emphasis has been placed on psychiatry residencies, with the hope of providing underserved communities with greater access to mental-health services. The funding comes at a time when health care workers are facing burnout in large numbers as a result of the COVID-19 pandemic.

The hope for the programs is medical residents will then stay to set up their practices in the communities where they are trained.

According to Johnson, health-center leaders believe this program will create a conduit to the health care workforce. But she feels it will also allow young health care professionals to understand what it is like to work in different environments.

"We want them to know what it's like to work with clients who have challenges getting child care, or getting transportation to the clinic to make their health care appointment," Johnson noted. "To really experience how to provide care to individuals who lead complicated lives and have other challenges in accessing health care services."

The bulk of the funding for these awards comes from the American Rescue Plan, approved by Congress in March 2021.

California is poised to become the first state in the nation to give health care to all income-eligible residents, regardless of their immigration status.

The Legislature is set to pass the final budget bills this week, which will be signed by Gov. Gavin Newsom shortly thereafter.

Cynthia Buiza, executive director of the California Immigrant Policy Center, said it is the fulfillment of an almost decadelong push by the Health4All campaign.

"This is very timely, but also long overdue," Buiza asserted. "Because for many, many years, many of our immigrant workers who have contributed tremendously to what makes California, California, have gone on without this very important safety net."

The budget deal represents a huge step toward universal health coverage and is expected to benefit about 700,000 people, starting in 2024. Opponents cite the cost: The budget includes $625 million to cover the first six months of 2024, and then allocates $2.1 billion per year.

Beatriz Hernandez, Central Valley organizer for the California Immigrant Policy Center, said it will make a huge difference in people's quality of life.

"This means that they will finally be able to get the health care that they need to care for the chronic illnesses that they've been suffering for many years," Hernandez pointed out. "And also be able to get the checkups that they need."

The deal marks the final push to expand Medi-Cal to all low-income Californians. In 2015, the state expanded Medi-Cal to include undocumented children. In 2020 the program grew to include young adults, up to 26 years old. And this year the program began to accept undocumented adults, age 50 and older.

The ruling on abortion by the U.S. Supreme Court has returned the issue to the states, fulfilling long-held goals of Republican lawmakers in Texas to ban and criminalize abortion.

With the 49-year-old Row v. Wade case overturned, a trigger law takes effect next month, banning abortions from the moment of fertilization - there is no exception for rape or incest.

Texas lawmakers were ahead of the high court, passing legislation last fall to prohibit abortions after six weeks. Aimee Arrambide, executive director of the Texas chapter of the abortion rights group Avow, said she expects half the states to follow Texas' lead.

"We've been ringing the alarm that what is happening in Texas, doesn't stay in Texas," said Arrambide. "And that the public health crisis Texans have been facing for nearly 10 months will be the reality in half the country. Our opponents are not going to stop until abortion is completely inaccessible in the country."

In his concurring opinion with the 6-3 vote, Supreme Court Justice Clarence Thomas said high court rulings that established a right to contraception, as well as gay rights should also be reconsidered.

Following the ruling, Texas GOP Gov. Greg Abbott said abolishing Roe v. Wade, "reinstated the right of states to protect innocent, unborn children."

New Mexico is now the closest state for many Texans seeking an abortion, but getting there may not be possible for low-income people who don't have the time, money or child care to travel out of state. Progress Texas Advocacy Director Diana Gomez said education is the next step.

"There are a lot of folks who don't know about the existence of abortion funds," said Gomez, "of infrastructures that are already in place to help people get abortions, and so we want to let people know about clinics in surrounding states."

In addition to Texas, 25 other states are expected to make abortion illegal, affecting the lives of 36 million people. University of Texas at Austin Associate Professor Kari White said entire regions of the country may soon be in the business of extreme criminalization.

"In a state like Texas," said White, "it's also going to criminalize a whole range of behaviors and practices for people who are trying to help someone get an abortion."

Prior to the court's ruling, a poll by Reuters showed about 71% of Americans - including majorities of Democrats and Republicans - believed pregnancy termination should be a patient-doctor decision.