SALT LAKE CITY – Utahans can comment over the next few weeks on a proposed federal 1115 Waiver that the state needs to implement partial Medicaid expansion.
Officials with the Utah Legislature are seeking federal approval of the plan they came up with to replace the full Medicaid expansion Utah voters approved last November.
Backers of the partial plan say they're optimistic that federal officials will grant their request. But Stacy Stanford, policy analyst with the Utah Health Policy Project, says Medicaid may not approve program exceptions for Utah that they haven't okayed for other states.
"It's kind of a way to get around the law and do things that might not be exactly in line with the intention of the program," says Stanford.
In a controversial move, the Utah Legislature overturned the full Medicaid expansion, replacing it with a more limited plan that backers say would protect the state from cost increases.
Comments on the state plan will be taken at a public meeting June 17 at the Multi Agency State Office Building in Salt Lake City. Comments can also be made by posting on a state website, or by email. The deadline is June 30.
The state wants to limit how much the government spends on each Medicaid enrollee, as a first step toward converting Medicaid to a block-grant program. Partial expansion also would limit eligibility to people with incomes at 100% of the federal poverty rate, instead of the normal 138%. And it would require many people to prove they're working or training for jobs.
So, Stanford says there's a lot for Utahans to comment on.
"Now people can speak up on that work reporting requirement and on the enrollment cap, as well as the per-capita cap and that partial expansion," says Stanford. “So, there are four pretty big things that people will be focusing on."
She adds the modified plan would only cover about 90,000 people, compared to about 150,000 under a full expansion. Information about the limited expansion and how to deliver public comments is online at 'Medicaid.utah.gov.'
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With Black History Month underway, Wisconsin researchers and support groups are highlighting the disparities in cases of Alzheimer's disease.
The Centers for Disease Control and Prevention said older Black Americans are about two times more likely than whites to have Alzheimer's and other dementias.
As drugs designed to treat conditions accelerate toward the market, the University of Wisconsin School of Medicine and Public Health noted Black adults are less likely to be included in the research. The school has made it a priority to focus on the Black population in an ongoing study.
Diane Beckley Milner, director of diversity, equity and inclusion for the Alzheimer's Association Wisconsin Chapter, said participation is important.
"Without us being involved in those clinical trials as Black Americans, then the research, it's not going to lend itself to giving accurate information," Milner pointed out.
The university acknowledged Black individuals can be reluctant to participate in studies, citing historical trauma from events such as the Tuskegee experiment. Officials say when it comes to the UW study, Black volunteers account for 27% of the people enrolled, which is much higher than the state's Black population, suggesting it provides hope in boosting research inclusivity.
Milner emphasized partnerships her group has with organizations such as the African Methodist Episcopal Church can help ease fears and create more awareness within the Black community.
"Having that partnership has proved to be very, very important and critical to making sure that people get information that they can trust," Milner explained.
She added a common challenge her group has found in outreach is many Black Americans view cognitive decline as simply a sign of aging, and not a disease. The association also works with nursing organizations in hopes of educating more people within the Black population.
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Preventing maternal and infant mortality in Georgia is a top priority for health care providers in the state.
Georgia already has the nation's highest maternal mortality rate, with more than 46 deaths per 100,000 live births, and ranks 16th for infant mortality.
In Lawrenceville, Obria Medical Clinics has what it calls a Supportive Pregnancy Care program, where people meet monthly in two-hour group sessions during pregnancy.
Robin Mauck, executive director of Obria, said they ask questions, learn how to take their own vital signs, and also meet with their providers for checkups.
"And then, March of Dimes has provided a curriculum that our facilitator goes through that has been proven to reduce maternal mortality," Mauck explained. "The great thing we see in this program is, it creates community for these girls. A lot of them don't have support in the community, they don't have family close by."
Mauck pointed out the group discussions help the participants build confidence, and the clinic also offers resources to help ensure new parents can take the best care of themselves and their babies.
Shelmekia Hodo, maternal and infant health director for the March of Dimes, said her organization is also focused on reducing health inequities in Georgia, with programs to address postpartum care and preterm birth, plus maternal and infant mortality.
One is a Neonatal Intensive Care Unit Family Support program, to help improve the experience for new parents. Hodo noted the program has been around for more than 20 years, with more than 70 sites across the country.
"March of Dimes provides an in-house coordinator that is on-site in the NICU, that does patient education with the actual moms, as well as staff education," Hodo outlined. "We know that so many moms are facing so many challenges and barriers having to be away from their babies, with their babies being in the NICU."
She added Georgia took a big step last year to address the maternal mortality rate, by extending Medicaid coverage to low-income mothers to a full year after giving birth, instead of only six months.
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With the increasing use of digital devices and computers in daily life, we're all exposed to more and more blue light. They may be convenient and help us stay connected, but prolonged exposure could pose real health risks.
One of those risks is interfering with the body's circadian rhythm, the "internal clock" which regulates a person's sleep cycle. Throwing it off can cause insomnia, headaches and eye strain.
Dr. Joseph Nezgoda, president of the Florida Society of Ophthalmology, said it does not mean a person should completely block out blue light, because a broad spectrum of light is needed throughout the day. But it is important to manage exposure.
"Individuals are just usually on their devices much longer and later than usual," Nezgoda pointed out. "Potentially during those times, it may be good to limit the exposure. Again, there's been convincing data in animal models, but in humans, the jury's still out."
One tip is scheduling an eye exam, others include taking breaks around every 20 minutes from digital screens, by looking at something else at least 20 feet away for 20 seconds. And of course, limit screen times before bed.
Dr. Scott Edmonds, chief eye care officer for UnitedHealthcare Vision, said eye specialists became concerned during the pandemic about blue-light exposure as more people started using digital devices for longer time periods at home. He worries soon, some of the same concerns will surface about blue light that happened with ultraviolet light.
"The photo receptors can certainly process blue light, but it puts a lot of strain on them," Edmonds noted. "We're concerned that over time, the retina will become damaged, and we'll start to see age-related macular degeneration from this, like we did with UV light."
In addition to taking screen breaks, eye-care professionals recommend making sure your computer screens are clear and clean, as researchers continue to study potential dangers.
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