HOUSTON - The Lone Star State's four largest metro areas are among the nation's 25 most dangerous for pedestrians, according to a recent study. But that could be changing. One of the nation's leading "livable cities" experts says San Antonio, Dallas and Austin are already making strides, and Houston officials are contemplating policies that could make that city a model of mobility for non-drivers.

Dan Burden, who directs the Walkable and Livable Communities Institute, is in Houston today to provide encouragement. He says most public streets accommodate only about two-thirds of the people who live near them, something the "Complete Streets" movement is trying to rectify.

"The people who have been traditionally left out include our own children, folks who are older, and then a lot of people in between. About a third of our population do not have access to cars. So it's going to create an equity in our country that is long overdue."

It won't happen immediately, he says. The idea is not to mandate expensive overhauls of every urban roadway, as critics fear, but, rather, to persuade engineers and local officials to simply consider the needs of walkers, cyclists and public-transportation users when designing new roadways or improving existing ones.

Tim Morstad, associate state director for advocacy with AARP Texas, says seniors who no longer drive can feel so trapped in their homes they resort to institutionalized care, sacrificing independence. Complete Streets, he says, can make a difference.

"Where there are sidewalks and crosswalks and blinking yellow lights, and there are accommodations made for people to get around. That could mean years and years of staying in the place where people would rather age, and that's in their own homes."

While Morstad supports Complete Streets policies at the federal, state, and local levels, he says ordinary citizens can play a big role in improving their neighborhoods by participating in "pedestrian safety audits" - community-level inventories of mobility obstacles.

"There may be a senior center on one side of the street, and a bus route on the other side of the street, and there's no crosswalk. A pedestrian safety audit is really a top-to-bottom review of what works and what doesn't work."

He says it can show officials and planners problems - and alternatives - that only a block-by-block analysis can reveal.

The Legislature is expected to consider a Complete Streets measure next session. Houston officials will likely debate new city policies this spring.

Learn more about volunteering at safestreetstexas.org

Walkable and Livable Communities Institute: www.walklive.org. Houston events Tuesday: on.fb.me/wwdTYp. Transportation for America study and city rankings: bit.ly/itlHJ1.




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In rural Arkansas, access to healthcare can be a distant dream - literally - as almost 60 counties in the state do not have enough providers to serve their populations. A new initiative with the Health Resources and Services Administration is working to improve access in these areas, through telehealth.

Heather Dimeris, director, Office for the Advancement of Telehealth at the Health Resources and Services Administration, said delivering care remotely online fills a crucial gap. Arkansans can visit telehealth.hhs.gov to explore their options, including behavioral and mental-health services.

"You can look at anxiety or depression screening through telehealth," she said. "You can also receive treatment for your anxiety or depression and other mental health needs, through one-on-one therapy as well as group therapy. And telehealth has also been extremely helpful in treating patients with substance-use disorders."

Dimeris noted 40% of all behavioral healthcare is now done virtually, including therapy, addiction counseling, and mental-health screening. She adds HRSA also provides telehealth services for treatment of chronic diseases, like diabetes, and information for healthcare providers.

However, the growth of telehealth spotlights another challenge for rural Arkansas - the lack of reliable, affordable internet service. Dimeris added some people can use their cell phones for telehealth services. Or they can apply for discounted internet access through two programs offered by the Federal Communications Commission.

"The Affordable Connectivity Program, as well as the Lifeline Program," she continued. "Both of these programs have eligibility requirements. But if you meet them, you really are able to access either free or reduced cost for broadband services and cell phone services."

Lower-income households can get up to $30 a month off their internet service bill, or $75 a month if they live on tribal lands, according to the FCC.

California's medical aid-in-dying law is back in court. Three patients with disabilities and two doctors are asking to intervene in a lawsuit challenging the law - and they want the judge to dismiss the suit.

In April, a coalition of disability rights groups and people with disabilities sued to stop the End of Life Option Act, claiming it is discriminatory and "coerces" people with disabilities into using medical aid in dying.

Jess Pezley is the senior staff attorney with Compassion & Choices, which supports the bill.

"It's not discriminatory to offer an additional end-of-life option," said Pezley. "And there's a lot of safeguards built in within the act to make sure that this law is not being used by people who do not want it. The only people who qualify for it are terminally ill with a prognosis of six months to live, and who have the capacity to make the decision."

California is one of ten states - plus Washington, D.C. - that allow doctors to prescribe medication that would allow mentally capable, terminally ill adults to peacefully end their suffering if they choose to take it.

Peter Sussman is a retired journalist and author from the Bay Area who said he lives with constant and disabling pain after a series of spinal surgeries. He said he supports medical aid in dying, and has joined the motion to intervene in the lawsuit.

"When my time comes and I am certified by doctors to be dying within six months, I do not want to die suffering needlessly," said Sussman. "The government shouldn't be able to tell me the manner of my own death."

The State of California, the defendant in the lawsuit, has also filed a motion to dismiss.

Earlier this year, the same judge dismissed a different challenge to the suit brought by the Christian Medical and Dental Association - after it reached a settlement with the state that said doctors who have a religious objection don't have to record a patient's request for medical aid in dying on their chart.

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.