This fall, a key federal agency will open up applications for providers who want to join a nationwide model to improve Alzheimer's care. South Dakota advocates see it as a promising tool in reducing stress for patients and their caregivers.

Over the summer, the Centers for Medicare and Medicaid Services announced a new voluntary guide in hopes of establishing more coordinated care for individuals diagnosed with dementia.

Thomas Elness, director of public policy for the South Dakota chapter of the Alzheimer's Association, said despite the prevalence of the disease, the U.S. has yet to develop a streamlined process where patients can access consistent, high-quality care.

"More often than not, when people enter the health care system with symptoms or even a diagnosis of Alzheimer's or another type of dementia, they can really be put through a maze of knowing how to navigate the health care system," Elness explained.

The Centers for Medicare and Medicaid Services said the lack of a coordinated approach results in poor outcomes, including high rates of hospitalization. The new model recommends things like establishing care plans at the onset, so caregivers know how to respond in real time. The pilot project launches next summer and will run for eight years. Because of the Medicare connection, providers will be incentivized with reimbursements.

Meanwhile, efforts to help caregivers for dementia patients are taking shape at the state level as well. This year, the South Dakota Legislature approved $2 million to expand adult day services programs, which offer periods of relief for caregivers. Elness added providers got an important boost.

"We were able to increase the reimbursement rates that adult day care providers receive [by] 121%," Elness pointed out. "They were on schedule to receive a 5% increase, so it's a more sustainable model into the future."

According to Centers for Medicare and Medicaid Services data, nearly 7 million Americans have some form of dementia, with 14 million projected cases by 2060. State health officials say Alzheimer's disease was the fifth-most common cause of death in South Dakota between 2017 and 2021.


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Starting Friday, North Carolinians will have greater access to health care as the long-awaited Medicaid expansion is launched.

Medicaid will provide coverage to individuals ages 19 to 64 with higher incomes, allowing eligibility for those earning up to 138% of the federal poverty rate.

Kody Kinsley, North Carolina's Secretary of Health and Human Services, said this expansion will bring essential care to thousands, improving their health and overall well-being.

"That's 600,000 people who will be able to have their medications covered by insurance and that's 600,000 people who -- when they face an emergency event and they have to go to the hospital -- will have the peace of mind to know that they're not going to get stuck with a medical bill that they can't afford," Kinsley said.

In addition to the increased income threshold, the Family Planning Medicaid program will offer reproductive health care at no cost to people with incomes up to 195% of the Federal Poverty Level. This means even a single person earning up to $2,400 per month will have access to essential care.

Kinsley added individuals already receiving family planning benefits and meeting the requirements for full Medicaid will be automatically enrolled on Friday. They should expect to receive notification via mail. He said this expansion not only ensures health care for many throughout the state but also supports hospitals and empowers working families to thrive in the workforce.

"Medicaid expansion helps working families; 80% of the individuals that will benefit from expansion are in working families. It will increase access to mental-health and substance-use treatment and will help build a healthier workforce," he explained.

To support the expansion's non-federal share cost, more than 100 hospitals will also receive about $3 billion through the Healthcare Access and Stabilization Program. North Carolina is now the 40th state to expand Medicaid under the Affordable Care Act.


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Legislation to allow medical aid in dying bill has been introduced in New York State every year since 2015, and its backers say 2024 could be the year it finally passes.

The bill would allow terminally ill people with only six months to live to use this option rather than endure unending pain.

Proponents point out that numerous safeguards are key components of the bill, including requiring two physicians to approve the request.

Assemblymember Amy Paulin - D-Scarsdale, the bill's sponsor - said she is convinced the reason it hasn't passed yet is fear of the unknown.

"Any new concept - and this is relatively new, new for New York, anyway - takes time," said Paulin. "Death is certainly a very sensitive topic - it's going to happen to all of us one day, and people avoid thinking about it. In this context, the concerns are forcing someone to do it, protections around it, all of those things."

Given that it's a complex and emotional issue, Paulin said she finds it's taken quite some time to educate people about it.

Opponents often refer to medical aid in dying as "assisted suicide," but the latest Siena College poll finds more than half of New Yorkers would support a medical aid-in-dying law.

Currently, ten states and Washington, D.C, have medical aid-in-dying laws.

Corinne Carey - campaign director for New York and New Jersey with the nonprofit Compassion & Choices - said she was concerned the pandemic might turn people off to this concept.

Instead, she said she finds it got more people interested in pursuing what she calls a "good death."

"No death is a 'good death,'" said Carey, "but certainly New Yorkers know that they don't want a death where they are separated, isolated from loved ones and suffering at the end."

A substantial number of New York lawmakers cosigned the bill, and Carey noted that it's up to the state's leadership to get this legislation across the finish line.

The American Lung Association has released its annual State of Lung Cancer report - showing Maryland needs to do more for high-risk patients.

While Maryland scored at or above average on a number of metrics, the report found just under 3% of high-risk patients in the state are getting screened for lung cancer - which is below the national average of 5%.

Among Marylanders who are diagnosed with lung cancer the report shows most are getting treatment, as the state was ranked 7th for surgery and had an above average 5-year survival rate.

Aleks Casper, Maryland director of advocacy with the Lung Association, said more outreach needs to be done around screening.

"The good news is that people who are being diagnosed with lung cancer are living longer," said Casper. "Where we have to do some work is that we're still seeing only a fraction of people who are eligible to be screened are receiving that screening."

The U.S. Preventive Services Task Force updated the lung cancer screening guidelines in 2021, expanding them to include a larger age range and more current and former smokers.

Tobacco use is the leading cause of lung cancer, though the smoking rate in Maryland is below the national average.

The second most common cause of lung cancer is radon, an odorless and colorless gas that seeps into homes and buildings from the soil.

In Maryland, over 20% of radon tests results were at or above Environmental Protection Agency action level.

Lung cancer is more curable when detected early. Casper said despite the low screening rate in Maryland, the state is doing a good job of treating lung cancer patients.

"We're above average in making sure that people are getting connected to treatment," said Casper. "You know in Maryland, we're looking at an 11% improvement in our survival rate. So it's about kind of connecting that first piece of screening to all the other components."

Nationally early detection has improved five year survival rates by 22%. You can read the full report at lung.org.





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