Who’s Eligible?
What’s Involved?
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If you’re at high risk of serious illness or death from Covid-19, it’s time to dust off those N95 masks and place them snugly over your nose and mouth to protect yourself from a recent uptick of the virus, according to a growing number of experts.
That advice should go all the way up to 80-year-old President Joe Biden, said Dr. Jonathan Reiner, a cardiologist.
“Octogenarians comprise the highest-risk group for complications following Covid infection,” Reiner said.
“At least until the numbers start to drop again, it would be appropriate for President Biden to take some precautions and wear a mask in crowds.”
Other high-risk groups include people with diabetes, cancer, chronic liver, kidney or lung disease, organ or stem cell transplants, HIV or other immunocompromising conditions, a history of heart disease or stroke, dementia or mental health issues.
“If you’re a caregiver for somebody who is at increased risk of complication following infection, then I think you should also consider putting a mask on in public places,” said Reiner, a professor at the George Washington University School of Medicine & Health Sciences.
“And since the masks that are most effective are N95 that are now readily available, that’s the kind of mask you should wear,” he added.
Families with individuals who have Intellectual and Developmental Disabilities (IDD) often have plans in place for natural disasters. Wildfires, earthquakes, and flooding are common concerns across Washington. Yet there are other, more mundane emergencies that also need to be planned for. Emergencies happen in almost every home at one time or another. If the emergency is with the individual with a disability, there are often procedures in place with the household as to how to proceed. These include having a go-bag, having a list of diagnosis, medications, and medical history on hand. But emergencies are not also so straightforward, yet it is still possible to prepare for them.
Sometimes the individual with a disability is alone when an emergency occurs, or the caregiver is incapacitated, with only the person with a disability around to help. Under these stressful situations, many people will panic and be unable to help themselves or others, and those with and IDD are even more likely to react poorly to an emergency situation. One option is to have a personal emergency response system (PERS), sometimes known as medical alert system, for both the individual with an IDD and their main caregivers. This will allow for non-verbal communication with emergency services when the person with an IDD or a caregiver is having a medical emergency. PERS are available to those on the Community First Choice Medicaid waiver and can otherwise be purchased by anyone.
Preparation is key to heading off potential disasters when emergencies happen. Experts recommend talking regularly to loved ones with IDD about how to deal with an emergency situation. This can include discussing the importance of listening and following directions of caregivers and first responders. It can also take the form of drills, in the guise of make-believe. Storytelling can be a wonderfully effective way of getting the message across, and several picture books are available to help children understand how to behave in an emergency.
First responders are increasingly being taught about how to deal with individuals with intellectual and developmental disabilities, but first responders displaying this knowledge cannot be counted on in an emergency. Individuals with IDD are more likely to be comfortable with first responders if they have interacted with them in the past in a comfortable environment. Community events often have meet-and-greets with police or firefighters, which can be a fun place to introduce children to emergency personnel. If the individual with a disability is able to regularly visit with first responders, they will be more likely to have a positive reaction to them during an emergency.
Washington State started issuing updated ID cards in 2022, which can now show that an individual has a developmental disability, is deaf or hard of hearing, or has another medical condition. Not only will first responders be able to see an individual’s important medical information on their ID card, having the card will allow most law enforcement departments to see these designations when they look up individuals in the Department of Licensing system. These new ID cards can help first responders recognize that a person has a disability and act accordingly.
Primary caregivers can enlist the help of nearby friends and family in their emergency planning and can be recruited as an emergency caregiver. Emergency caregivers need to be someone who is nearby, trustworthy, easily reachable, and has knowledge as to what the person with a disability needs to stay safe and cared for. They can be put on speed dial and the individual with an IDD can be taught how to contact them in emergencies.
Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.
LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she’d been living with LaFleur, who managed insulin injections for her mother’s Type 1 diabetes, helped her shower and dress, dealt with her incontinence, and made sure she was eating well.
In the hospital after her mother’s hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up, and wished LaFleur well.
That was the extent of help LaFleur received upon her mother’s discharge.
She didn’t know how to change her mother’s diapers or dress her since at that point LaTurner could barely move. She didn’t know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn’t sure how to handle.
“It’s already extremely challenging to be a caregiver for someone living with dementia. The lack of training in how to care for my mother just made an impossible job even more impossible,” said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother passed away in March 2022.
A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends, and neighbors who care for frail, ill, and disabled older adults. For the first time, it would authorize Medicare payments to health care professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.
The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers — also known as family caregivers — play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.
More than half our state is breathing in unhealthy air because of wildfires in Washington and Canada. Air Quality Alerts are issued through Monday morning for many Central and Eastern counties and Tribal Nations. Smoke is also expected in Western Washington this weekend.
When air is unhealthy, everyone should take steps to protect themselves. Track air quality levels on the Washington Smoke Information website and follow related health recommendations. Stay inside with cleaner indoor air by:
If you must be outside, limit how long you’re outside and how intense the activity is. If you have to be outside for long periods of time you can also wear a properly fitted, NIOSH-approved particulate respirator, such as an N95 mask. It’s also important to check on elderly loved ones and neighbors and keep pets inside.
“It wasn’t a matter of if, but when smoke would hit,” said Kaitlyn Kelly, Air Quality Policy Specialist. “Wildfire smoke season is here in Washington, which means we need to be proactive about taking steps to protect ourselves.”
Smoke often affects people with pre-existing conditions the most. Minor symptoms include eye, nose, and throat irritation, headaches, wheezing, coughing, and shortness of breath. More serious symptoms include difficulty breathing, chest pain, and irregular heartbeat. Wildfire smoke can lead to hospitalization and death. Seek medical attention if your symptoms are severe.
For more information on how to protect yourself from wildfire smoke, visit the Washington State Department of Health’s Smoke From Fires webpage.
In April 2023, the Centers for Medicare & Medicaid Services (CMS) approved Washington’s 1115 Waiver request to extend continuous eligibility for any child under six who is enrolled in a free Apple Health (Medicaid) program.
Children under the age of six on free Apple Health will now receive continuous eligibility through their sixth birthday, regardless of changes in household income, if they were eligible in the month of application.
Note: There have been no changes to continuous eligibility for kids over age six on free Apple Health or for those on Apple Health for Kids with premiums, also known as Children Health Insurance Program (CHIP). Coverage for these groups continues to be renewed for 12 months at a time.
What is being done to keep kids covered?
In June 2023, the Health Care Authority (HCA) began work to maintain continuous eligibility for children under the age of six. A manual process is in place to identify eligible children who have lost coverage and reinstate them.
Once the system supports continuous eligibility for kids under age six, children who are active on free Apple Health Kids and meet the eligibility criteria will have their certification period automatically extended through the month they turn six.
This July has been the hottest in human history, and extreme heat has impacted most of the US. The groups most at risk from high temperatures include seniors, children, and people experiencing homelessness. Additionally, there are few protections for outdoor workers.
Resources & Initiatives:
From 2011 to 2022, over half a million lives (539,810) were lost to suicide, with 2022 showing the highest number of deaths on record. Within this period, the adjusted suicide rate increased by 16%. Recognizing the mounting mental health crisis and demand for accessible crisis care, the federal government introduced a new crisis number, 988, available nationwide in July 2022. This easy to remember three-digit number connects callers who are suicidal or experiencing a mental health emergency to a crisis counselor at one of 200+ local crisis call centers. There, they may access crisis counseling, resources, referrals, and connections to other crisis services. Though suicide deaths slowed in 2019 and 2020, they began to increase again in 2021 and 2022, but the cause of this recent rise in suicides is unclear.
Key takeaways from an analysis of aggregate provisional data from 2022 and CDC WONDER data from 2011 to 2021, which represents the most recent and comprehensive data available before the mid-2022 launch of 988, include the following:
When new parents take their infants home from the hospital, they typically have many questions. Is my baby crying too much? Is she nursing enough? Does his poop look normal? During this challenging time, sometimes known as the “fourth trimester,” families need a great deal of support.
To meet this need, the Hospital of University of Pennsylvania (HUP), in partnership with Memora Health, developed a program called “Healing at Home”. The Hospital of the University of Pennsylvania is part of the Institute for Healthcare Improvement (IHI) Eliminating Inequities and Reducing Postpartum Morbidity and Mortality Learning Community. Participants focus on improving clinical and administrative processes to ensure safer and more equitable postpartum care and support for Black mothers and birthing persons.
The Healing at Home program consists of a virtual postpartum assistant, named Penny, which provides automated answers via text message to patients’ questions for the first six weeks after discharge. Penny also administers the Edinburgh Postnatal Depression Scale (EPDS) for screening, and provides blood pressure monitoring for low-risk patients. (High-risk patients participate in a program called Heart Safe Motherhood).
“We launched our program in March of 2020, when COVID-19 was starting when we saw a lot of our parents going home sooner rather than later,” said Laura Scalise, MSN, RN, Nurse Manager at HUP. “We wanted to make sure we could monitor our families that were leaving so soon [after childbirth], provide any connections to support (i.e., lactation referrals), and readily answer the questions they had.”
Read the full article from the Institute for Healthcare Improvement.
The Food and Drug Administration on Monday approved a shot to protect infants and vulnerable toddlers against respiratory syncytial virus, or R.S.V., offering one of the first protections for an illness that fills children’s hospitals year after year.
The monoclonal antibody shot is expected to be available at the start of the fall R.S.V. season. The F.D.A. is also considering approval of an R.S.V. vaccine by Pfizer for pregnant women that is meant to protect infants from the virus.
The treatment approved on Monday, called Beyfortus by its developers Sanofi and AstraZeneca, addresses an illness that can be severe in older adults and young infants. About 80,000 children ages 5 and younger are hospitalized with the virus each year, according to the Centers for Disease Control and Prevention.
“R.S.V. can cause serious disease in infants and some children and results in a large number of emergency department and physician office visits each year,” Dr. John Farley, an official in the F.D.A. Center for Drug Evaluation and Research, said. “Today’s approval addresses the great need for products to help reduce the impact of R.S.V. disease on children, families and the health care system.”