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Big potential changes to how 340B operates plus heightened interest in both new protections and new restrictions for covered entities means there is much to keep track of in the 340B world. 340B Health CEO Maureen Testoni joins us to make sense of recent developments in the nation's courts and beyond.Rebates Get Their Day in Court340B Health, two member hospitals, and the government met drug companies in court in late April to challenge drugmaker attempts to replace 340B discounts with rebates. Testoni says the judge cited potentially devastating consequences to hospitals if rebates proceeded but also had probing questions for the government on how it is working to address drugmaker compliance concerns. The Dept. of Health and Human Services is set to release guidance by early June on the rebate issue, and the court's decision could come out soon.The White House Proposes 340B Big Oversight Shift A leaked copy of the Trump administration's latest budget proposal includes a plan to move the Office of Pharmacy Affairs (OPA) from the Health Resources & Services Administration to the Centers for Medicare & Medicaid Services. Testoni says the oversight shift is concerning because of a stark difference between the purpose of 340B and the operations of Medicare and Medicaid. CMS also imposed years of Medicare payment cuts to 340B hospitals that the U.S. Supreme Court eventually overturned.340B Protections, Mandates Take Center StageStates continue enacting laws to protect hospital access to 340B pricing, but they also are moving forward with reporting mandates and proposals to define how hospitals should use their savings. Testoni said reporting and use-of-savings mandates lead to misdirected views on the purpose of 340B, which goes far beyond direct patient care and cost assistance. On Capitol Hill, a report from a long-running investigation of 340B recently came out, contributing to the debate over possible new restrictions.ResourcesFederal Government Signals Upcoming Guidance on 340B Rebate Models Amid Legal ChallengesBrief Your Leaders on White House Plans for Major 340B ChangesNebraska Is 12th State To Enact Contract Pharmacy ProtectionsIndiana Becomes Fifth State To Mandate 340B Reports From HospitalsKey Senator Concludes 340B Investigation, Calls for Major ReformsNew 340B Health Research340B Impact Profiles
Health Resources & Services Administration (HRSA) audits of hospitals play a key role in ensuring compliance with 340B rules and regulations. In this episode, Dave Lacknauth, executive director of pharmacy services at Broward Health in Fort. Lauderdale, Fla., joins us to discuss the importance of taking a proactive, comprehensive approach to audit readiness with the goal of ensuring clean audit results. Compliance protects 340B accessBeing prepared for HRSA audits serves a crucial function that ultimately benefits the patients whom hospitals serve, Lacknauth explains. Maintaining the integrity of 340B means protecting access to 340B savings that hospitals can invest in crucial care for community members that need it. Continuous audit readinessLacknauth discusses how Broward Health maintains audit readiness by conducting internal audits, bringing in external consultants, and identifying areas of opportunity for improvement. A robust system of internal reviews means that when HRSA comes knocking, Broward Health is already prepared. This was evident after a recent audit of one of the system's hospitals that resulted in zero recommendations for improvement.Organization, resources, transparency are keyPreparing for audits requires a health system to invest time and resources, but Lacknauth stresses that these investments pay off. Engaging a comprehensive team from various departments in the audit readiness process allows for a health system to have the appropriate level of responsiveness and transparency during a HRSA audit.Resources:Nebraska Is 12th State To Enact Contract Pharmacy ProtectionsIdaho Becomes Fourth State To Mandate 340B Reports From Hospitals
Community DC Host Dennis Glasgow speaks with Dr. Sara Kinsman, Director from the Maternal and Child Health Bureau Staff - Division of Child, Adolescent, and Family Health at Her-Sa – also know as the Health Resources and Services Administration. We'll be spending the next 30 mins talking about Poison control – what you can do if a family member, friend, co-worker or someone you know has been poisoned and what you can do quickly do help them or yourself – we should mention that the poison help line is open 365 days a year 24/7 by simply calling 800 222 1222
Updates in classification, evaluation, and treatment Become dexterous with dementia management! We're talking with Dr. Anna Chodos about cognitive domains, diagnostic criteria, patient and caregiver resources, new antibody therapies, and brain health plans! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions The Terminology of Neurocognitive Disorders Cognitive Domains: A Comprehensive Approach Physical Examination Insights Medical Workup for Dementia Imaging and Biomarkers in Dementia Diagnosis Referral Considerations for Dementia Patients Understanding Dementia Stages and Prognosis Implementing Brain Health Plans Medications for Dementia Management Controversies in Monoclonal Antibody Therapies The Importance of Early Detection and Planning Outro Credits Producers, Writers and Show Notes: Leah Witt, MD and Margaret Heller, MD Infographic and Cover Art: Leah Witt, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Anna Chodos, MD Disclosures Dr. Chodos received remuneration from Novo Nordisk for participating in a task force looking at the feasibility of incorporating biomarkers for Alzheimer's disease into primary care. The financial relationship has ended. The Curbsiders report no relevant financial disclosures. The production of this episode was supported by the Penn Geriatrics AGE-SMART Geriatric Workforce Enhancement Grant. This podcast content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services. Sponsor: Locumstory Locumstory.com is simply a free, unbiased educational resource about locum tenens. Sponsor: Grammarly Download Grammarly for free at Grammarly.com/PODCAST Sponsor: Continuing Education Company Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount. Whether live, online, or on-demand, Continuing Education Company makes earning CME easy and rewarding.
Domestic Violence and Sexual Assault stunningly affect one in three women globally. Thankfully, there are efforts to increase awareness and bring an end to those issues in our society.Jane Randel, Co-Founder of No More at NoMore.Org, joined me to discuss it.AND, this week is Poison Prevention Week. Every year millions of Americans are exposed to poison.....more than ¾ of them are unintentionally. I discussed it with Dr. Sara Kinsman, Director of the Division of Child, Adolescent and Family Health in the Maternal and Child Health Bureau of the Health Resources and Services Administration
In what has become an annual tradition for the podcast, we consulted with 340B Health's expert staff to answer our listeners' most pressing 340B questions. As an uncertain and busy year starts for the world of 340B, we want to prepare you by covering your queries about the efforts by drug companies to impose 340B rebates, proposed federal and state legislation on 340B, how Inflation Reduction Act implementation will affect 340B, and more.340B Rebate Lawsuits Heat UpSo far, five drug companies have sued the Health Resources & Services Administration to challenge HRSA's rejections of their backend rebate proposals. 340B Health Vice President of Legal and Policy Amanda Nagrotsky notes that a rebate model would harm 340B hospitals through delayed access to 340B savings and potentially denials of legitimate rebate claims based on drugmaker interpretations of 340B rules. We recorded this episode just before 340B Health filed a motion to intervene as a defendant in the Johnson & Johnson (J&J) rebate lawsuit against HRSA.Lawmakers Eye Ways To Protect or Cut 340BThe new year means a new Congress and the start of new state legislative sessions. 340B Health Senior Vice President of Government Relations Tom O'Donnell notes that members of Congress have floated potential reductions in what the federal government pays for 340B drugs to help fund new spending priorities outside of health care, though it is unclear how seriously they are considering those options. 340B Health Vice President of Legal and Policy Greg Doggett reports that several states are considering new contract pharmacy or payment nondiscrimination protections for 340B hospitals, but others have introduced proposed new mandates for covered entities. Price Caps Will Apply to More Medicare DrugsThe list of drugs eligible for Medicare price caps will grow to 25 starting in 2027 under the Inflation Reduction Act, which will have implications for 340B savings on those drugs. 340B Health Research and Policy Analytics Manager Claudia Escue notes that popular weight loss and diabetes drugs like Ozempic and Wegovy have made the price cap list because of how much they cost Medicare. 340B Health is tracking how these price caps might lower 340B savings and have submitted letters to Medicare officials to represent other hospital concerns about the implementation of the IRA.Resources:340B Health Files Motion To Intervene in J&J Rebate LawsuitOption To Cut Commercial Pay Rates for 340B Drugs Is on Draft Congressional Budget “Menu”Medicare Expands List of Drugs Subject to Price Caps, Decreased 340B Savings340B Coalition Winter Conference Registration
Have you ever wondered what it's like to be a Neonatal PA? Have you dreamed of working in the NICU but don't know where to start? My guest today is here to answer all those questions and more! Lex Mastro is a Neonatal PA and currently the Division of Newborn Medicine Advanced Practice Provider Supervisor and Associate Director of the Advanced Practice Provider Neonatology Fellowship Program. After graduating PA school, Lex initially worked in a surgical subspeciality but then found a passion for neonatology. She completed a postgraduate neonatology fellowship program and has since worked in a variety of NICU settings. In today's episode, Lex discusses the value of postgraduate fellowship programs and how to decide if one is right for you. We also discuss how to become comfortable as a provider in complex, high risk situations as well as the importance of emotional intelligence. Lex and I also talk about how providers can improve healthcare access and address healthcare disparities so that we can provide better care to our patients. I'm excited to share this episode so you can learn not only what it's like to be a NICU PA, but also how to improve your own practice, whatever specialty that may be. SPONSORS AAPA Job Source: aapa.org/pajobsource Freed AI [DISCOUNT CODE: PA50] https://www.getfreed.ai CONNECT WITH LEX LinkedIn: https://www.linkedin.com/in/alexandra-lex-mastro-712095341 RESOURCES MENTIONED IN THIS EPISODE Association of Postgraduate Physician Assistant Programs (APPAP) https://www.appap.org/ 2024 March of Dimes Report Card https://www.marchofdimes.org/report-card Social media kit for 2024 report card: https://socialpresskit.com/march-of-dimes#march-of-dimes-report-card-2024 Full Report Card: https://www.marchofdimes.org/sites/default/files/2024-11/2024_MOD_Report_Card_and_Policy_Actions_Booklet_V1.pdf Abbreviated Card in English: https://www.marchofdimes.org/sites/default/files/2024-11/US_Report_Card_2024_English.pdf Social Determinants of Health Resources https://odphp.health.gov/healthypeople https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health Health Center Resources https://bphc.hrsa.gov/about-health-center-program/what-health-center Find a Health Center: https://findahealthcenter.hrsa.gov/ COACHING 1-ON-1 NEGOTIATION CONSULT https://calendly.com/the-pa-is-in/negotiate FREE 30-MINUTE COACHING CONSULT https://calendly.com/the-pa-is-in/gen-call LINKS TRACY ON INSTAGRAM https://www.instagram.com/mrstracybingaman/ TRACY ON LINKEDIN https://www.linkedin.com/in/tracybingaman/ SUPPORT THIS PODCAST: https://podcasters.spotify.com/pod/show/thepaisin/support
In this episode of Going anti-Viral, Dr Michael Saag speaks with Dr Laura Cheever who was, until recently, the Associate Administrator of the HIV/AIDS Bureau at the Health Resources and Services Administration (HRSA). She joined HRSA in 1999 when she served as the national director of the Ryan White AIDS Education and Training Center program. Dr Cheever is Board Certified in Infectious Diseases and continues to provide clinical care for patients with HIV. Dr Cheever describes her early work at HRSA and the Ryan White HIV/AIDS Program. Dr Cheever and Dr Saag then discuss quality measures adopted to demonstrate program effectiveness and the impact these efforts had on funding. They also discuss the staff in the program and their role in working with local providers. They address the role that private insurance, the Affordable Care Act, and different presidential administrations play in the services of the program as well as work left to be done and look ahead to the next ten years of HIV care.0:00 – Introduction1:40 – A discussion of Dr Cheever's early years at the Health Resources and Services Administration (HRSA)7:51 – Implementation of national quality measures for HIV care using data collection through CAREWare11:41 – How did new information impact decision making regarding Ryan White funding decisions15:04 – Impact of changing guidelines on direction given to the Ryan White clinics19:26 – The staff at HRSA and the impact of potential budget cuts on the program24:05 – The role private insurance and the Affordable Care Act had in providing treatment through the Ryan White program 25:10 – Do different presidential administrations influence the services of the Ryan White program27:34 – Discussion of the work left to be done 29:29 – Predictions for the next ten years of HIV care and closing remarks __________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections. Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...
In this episode of the DUTCH Podcast, Dr. Jaclyn Smeaton and Mark Newman, MS, discuss the advancements and highlights from 2024 in the field of hormonal health and functional medicine. They cover the launch of the new DUTCH website, recent research publications, and the exciting growth of the DUTCH Podcast and DUTCH Webinars. They also delve into: The importance of education in hormone therapy Updates made to the DUTCH report The introduction of new educational resources, such as Mini Guides The upcoming Introduction to Menopausal HRT course DUTCH's commitment to excellence and mission to improve hormonal health for all Show Notes: Check out the new DUTCH website and our new Education Hub, and read the research on DIM's effects on the urinary estrogen profile. For more DUTCH research, visit DUTCHTest.com/research, and check out our estrogen therapy research in Menopause. Get access to our new educational course, Introduction to Menopausal HRT, exclusive for registered DUTCH providers. If you're not a DUTCH Provider, sign up today! Take a look at page 2 of this sample report, which highlights the androgen story Mark Newman, MS mentions in this episode.
Congress is another step closer to finalizing a year-end spending package to keep the government operating, and the plan includes some significant healthcare related spending. The Health Resources and Services Administration demands the French drugmaker Sanofi abandon its controversial 340B credit model. And, fewer children are being vaccinated against the flu. We'll get those stories—and more—coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.
Earlier this year, the Health Resources & Services Administration took a strong stance against drug giant Johnson & Johnson's plan for a proposed 340B rebate model, but the fight over rebates is far from over. 340B Health President and CEO Maureen Testoni joins us to discuss how the company is taking the issue to federal court and how they are not the only drugmaker doing so.J&J Sues HRSA Over RebatesJ&J is arguing in court that HRSA lacks the authority to block a 340B rebate model. Such a model would allow individual drug companies effectively to impose their own rules on 340B drug purchases. These rules would curtail the number of drugs a company would offer a 340B discount on and reduce the number of patients that would be deemed 340B-eligible.Other Drugmakers Pushing RebatesBristol Myers Squibb and Eli Lilly also sued HRSA, claiming the agency does not have the authority to stop a rebate model. Sanofi has not yet filed suit but is saying it will impose its rebate scheme in early January. The Sanofi model raises significant concerns not just because of the imminent effective date but because it would impose far more stringent restrictions on 340B eligibility than HRSA ever has.State Contract Pharmacy Laws Rack Up More WinsIn another 340B issue before the federal courts, state contract pharmacy protections continue obtaining key litigation wins. Several district courts and one appeals court have upheld state laws designed to protect covered entity access to 340B pricing through community and specialty contract pharmacies.Resources:Brief Your Leadership on Drugmaker Rebate SchemesThe Wall Street Journal: “The Economic Imperative of Protecting 340B”Register for the 340B Coalition Winter Conference
In this season finale of AIM for Safer Birth, Christie is joined again by Dr. Veronica Gillispie-Bell to reflect on key themes from the season, including rural maternity care, collaborative models, and the structural barriers impacting maternal health. They discuss the realities of hospital closures, the importance of integrating community birth centers, and the critical need for sustainability in quality improvement efforts. Dr. Gillispie-Bell shares insights on bridging gaps across disciplines, tackling systemic inequities, and how to keep patients' goals at the center of care. Plus, they dive into the transformative power of data and the lessons that can guide future improvements. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
In this episode, Christie explores the intersection of substance use and maternal health with innovators Dr. Nichole Nidey and Michelle Kavouras, focusing on the power of lived expertise to shape equitable, evidence-based care. Dr. Nidey, a maternal and child health epidemiologist and founder of the Empower Project, discusses how her work collaborates with individuals who use substances during pregnancy to inform meaningful research and interventions. Michelle, a peer doula and harm reduction advocate, shares her journey from lived experience to leadership in substance use advocacy, highlighting the importance of compassionate, non-stigmatizing care. This conversation challenges misconceptions, unpacks the complexity of language in healthcare, and emphasizes the need to meet pregnant people where they are. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
Send us a textBrittany is originally from a small town in Washington State. She is a 34 year old mother of six children and lives in Los Angeles California. She tested positive for drugs at her birth because her mother was actively using. As a result, she was taken away from her and placed in custody with her uncle and aunt. When she was one and a half years old Brittany was taken away from them by Child Protective Services. It was found out that besides being abused physically by both, she had been sexually abused by her uncle. At age of 2, she was adopted by the chief of police of the town and his wife. Brittany calls his adoptive father “my rock” because of the support he has given to her during all her life, despite of differences in opinions at times. When she was 11, her adoptive parents divorced and as it happens, it was a very traumatic for Brittany. To make it worse, she was blamed by her adoptive mother as the cause of the divorce. She stayed with her adoptive father for some time. Brittany comments that she had the tendency to hurt herself. Due to the duties of his adoptive father as a chief of police, there was nobody to look after Brittany during his long shifts. Brittany had to be placed in different foster homes. She was a rebel, at 12 years, she was placed in a treatment facility for difficult children; but she always found the way to run away from them. She escaped the treatment facility and being still a minor, she went to live with an 18-year-old guy. She was using drugs, having sex and doing all sort of things that a 15-year-old should not do. She was found by the police, and she was placed in a foster system, Brittany went to live to a foster home with thepastor of a church and his wife where she did not have time to misbehave, she was always at church. For one year she was with them, her foster parents did everything they could possibly do for her wellbeing, she wrote poetry and a diary to deal with her emotions. Brittany was diagnosed with a mental disability and addiction to substances because she was born from a drug addict mother. Then she was placed in an adult foster home where she thought she finally had found the family she was looking for; however, it did not last long, one week after she ran away and met a guy whom she was using drugs and having sex. At 19, she gave birth go her first daughter. She was diagnosed with HIV when she was on the 8th month of her third pregnancy. She was put immediately on a very effective treatment and reach viral suppression very quickly, and she was able to deliver a healthy baby boy. Now she has a family of four children living together, her children are negative, healthy strong and beautiful babies.Brittany practically has gone to hell and come back. She says that she is adherent to her HIV treatment because it represents well being for her kids and herself. She is in recovery from substance use and sober for 8 years now. She receives medical care at UCLA with Dr. De Ville. She is going to community college; her goal is to complete higher education and help children and teenagers to overcome their traumas. She is accomplishing what once she was told she was not going to be able to accomplish. Brittany's story is very intense and rough. It includes drug addiction, survival sex work, violence, rape, and sex trafficking. It also includes successes and accomplishments. It's a story of survival, recovery, and motherhood.Funding provided by the Health Resources & Services Administration (HRSA) Ending the HIV Epidemic Grant and the County of Los Angeles, Department of Public Health, This podcast is brought to you by the Los Angeles Family AIDS Network
Health organizations can struggle to bridge the gap between intention and impact when creating resources for diverse communities. In this episode, host Spencer Brooks interviews Alicia Edwards, Jerico Cummings, and Jane Manthei from the Northwest Portland Area Indian Health Board (NPAIHB) about their approach to developing digital resources that respond directly to community needs. This conversation is perfect for nonprofit leaders and digital marketers looking to build trust, ensure cultural relevance, and make a meaningful difference through inclusive digital strategies. About the guests Alicia Edwards, MPH, CHES (she/her), is the Syndemics Communications Manager at the Northwest Portland Area Indian Health Board. She is dedicated to creating culturally relevant health materials for American Indians and Alaskan Natives, honoring her Okanogan Band of the Colville Tribe heritage and upbringing in Okanogan County, WA. Jerico Cummings (they/them) is a member of the Cheyenne River Sioux Tribe and serves as the 2SLGBTQ+ Training & Community Engagement Specialist for the Paths (Re)Membered Project at the Northwest Portland Area Indian Health Board. Personally and professionally, they feel called to spaces where they can exist and support community at the points where indigeneity, sexual orientation, and gender identity all intersect. Jane Manthei is the Text Messaging Communications Specialist at the Northwest Portland Area Indian Health Board. She focuses on projects within adolescent health and suicide prevention. Her work explores different forms of storytelling across multiple media formats and promoting cultural protective factors for Native youth. Resources Them: https://www.them.us/Erin in the Morning: https://www.erininthemorning.com/CDC: https://www.cdc.gov/index.htmlHIV.gov: https://www.hiv.gov/National Coalition of STD Directors: https://www.ncsddc.org/Illuminative: https://illuminative.org/NDN Collective: https://ndncollective.org/Native Health Resources: https://www.nativehealthresources.org/We R Native: www.wernative.orgPaths Remembered: https://www.pathsremembered.org/Text NATIVE to 94449 to sign up for We R Native text messagesText 2SLGBTQ to 94449 for Two Spirit & Indigiqueer Health Info & Resources Contact Alicia, Jane and Jerico www.npaihb.org @2slgbtq (Paths (Re)Membered account): https://www.instagram.com/2slgbtq/@wernative (adolescent health insta): https://www.instagram.com/wernative/@npaihb (Board's primary insta): https://www.instagram.com/npaihb/
Send us a textIn this deeply moving episode of Confessions: HIV+ Women, Lori shares her powerful journey of overcoming trauma, addiction, and HIV, ultimately finding healing and becoming the mother she always dreamed of. Born in Wichita, Kansas, Lori is a 43-year-old professional with a master's degree in counseling psychology and 18 years of experience as a therapist. But behind her academic success, Lori's life story is one of survival and resilience.Growing up in a tumultuous home with an alcoholic, verbally abusive father, Lori's parents divorced when she was just six. Her family moved to California, where Lori suffered years of sexual abuse by her stepfather, a secret she kept for many years. Despite these early hardships, Lori later built a career and became a mother. But six months after giving birth to her twins, Lori received an unexpected diagnosis—HIV. This news came after she had visited the doctor following a warning about Hepatitis C, but the diagnosis revealed something more life-changing.She was diagnosed with HIV six months after giving birth to the twins. As a mother, Lori was overwhelmed with concern about possibly passing HIV to her newborns, especially since she hadn't been tested during pregnancy since she was not considered to be “high-risk”. Shortly after she gave birth to her twins, Lori struggled with post-partum depression and relapsed. Lori and her partner at the time began using meth again. This led to her therapist filing a mandated report and removing her children from her. Her twins tested positive for HIV while in foster care. Lori worked hard to achieve sobriety and get her children back. Today, Lori is a mother to a 10-year-old son and two 4-year-old twins, a boy and a girl and her children are thriving. Her oldest son is in 5th grade and loves basketball, while her twins are excelling in kindergarten. Lori is a single mother determined to be the mother she never had, navigating life with love, dedication, and a commitment to spending quality time with her children.Lori's story is not just one of struggle but of strength. From childhood trauma to substance abuse, recovery, and the challenges of the COVID-19 pandemic, Lori has faced it all. With the support of her brother, who played a key role in her recovery, Lori found the strength to rebuild her life.Today, Lori is open about her HIV status with family and friends, helping to break the stigma and promote the importance of medication adherence and U=U (undetectable = untransmissible). As a therapist, she uses her own experiences to empower others, emphasizing the importance of self-care, healthy choices, and resilience.Lori's story serves as a powerful reminder that success in education or career doesn't shield us from life's toughest challenges. But with a willingness to change, dedication, and the support of others, we can overcome even the greatest obstacles. Join us for an inspiring conversation about healing, love, and the strength to transform our lives.Funding provided by the Health Resources & Services Administration (HRSA) Ending the HIV Epidemic Grant and the County of Los Angeles, Department of Public Health, Division of HIV and STD ProgramsThis podcast is brought to you by the Los Angeles Family AIDS Network
Today's podcast features an interview with Kristen Dillon, MD, Chief Medical Officer of the Federal Office for Rural Health Policy. In this special National Rural Health Day episode, we get an overview of the current state of rural maternal health, including access barriers and disparities in health outcomes, as well as exploring the ways that the Health Resources and Services Administration is working to improve outcomes for rural mothers. The transcript and a list of resources and organizations mentioned in the episode can be found at: https://www.ruralhealthinfo.org/podcast/maternal-health-nov-2024 Exploring Rural Health is an RHIhub podcast.
Send us a textMari is a Latina woman diagnosed with HIV in 2006 at 19 years of age when she was pregnant with her first child. Mari is now 37; she lives in Los Angeles and has been living with HIV for 18 years.Mari's story is about how she has learned to be a mother facing multiple challenges: domestic violence in the form of verbal abuse, drug use, HIV diagnosis, incarceration, substance abuse treatment, being unhoused, living on the streets, and raising five children. A very complex task to take on for anyone.When Mari was diagnosed with HIV, she had no methods for dealing with difficult emotions. She found a support system in Crystal, but it was not a person, she says it was crystal meth. She continued using substances for six weeks after conceiving. It was not until she was incarcerated that she started substance abuse recovery and became adherent to her HIV meds. She was released shortly after.She has been pregnant four times and has five children. In her second pregnancy she had a set of twins. Her immediate family is composed of her husband, four girls and a boy: “the king of the house” her youngest.Mari has worked so hard to have good control of her life and practice gentle parenting. Breaking the cycle of generational trauma is extremely hard, she comments.For Mari, the most challenging situation as a woman with HIV was disclosure. It prevented her from accessing many services for her children because of her own self-stigmatization; however, she came up with a way to resolve this matter. She recorded a podcast episode and since then has found relief. Now she can talk freely about HIV, sexual health and other topics historically considered taboo in the Latinx community.Breast feeding her children was something that was also robbed from her due to her HIV diagnosis. However, the guidelines have changed, and for many women with HIV, breastfeeding has become an option - after talking with their medial provider.Mari now works as a Peer Navigator in a prestigious public university in Los Angeles. She dedicates herself to helping women with HIV, drawing from her own experience. She helps them to be comfortable in their own skin and empowers them to be adherent to treatment and medication. Mari is currently attending school to obtain a bachelor's degree. Her goal is to become a Social Worker, and she is on her way.In this compelling episode, Mari shares how she has resolved challenges related to HIV, how she has become a good mother, and how to blossom and thrive despite an unhappy childhood all for the love of her 5 children.Funding provided by the Health Resources & Services Administration (HRSA) Ending the HIV Epidemic Grant and the County of Los Angeles, Department of Public Health, Division of HIV and STD ProgramsThis podcast is brought to you by the Los Angeles Family AIDS Network
For the first time in decades, the Health and Human Services department plans to shake up an obscure system. It's the one controlling human organs destined for transplant patients. The Organ Procurement and Transplantation Network serves some 100,000 patients and their families and officials say it's overdue for modernization. Here with the details, the administrator of the Health Resources and Services Administration, Carole Johnson. Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
For the first time in decades, the Health and Human Services department plans to shake up an obscure system. It's the one controlling human organs destined for transplant patients. The Organ Procurement and Transplantation Network serves some 100,000 patients and their families and officials say it's overdue for modernization. Here with the details, the administrator of the Health Resources and Services Administration, Carole Johnson. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Send us a textDana is a 28-year-old white woman, born in San Clemente California, and currently resides in Los Angeles. She was diagnosed with HIV in 2018. Her biological mother suffered from substance abuse disorder and was unable to care for her. Dana was adopted by her uncle and aunt. She grew up in Hollywood Hills, an upper middle-class neighborhood. When she was a little girl, she was enrolled into sports, arts, photography, piano lessons, swimming, etc. Her adoptive parents were able to give her the best life possible to have a good outcome; however, she was a rebel. On her 18th birthday she was thrown out from her home. Due to circumstances related to her adoption, she did not have any sort of identification documents which caused her problems later in her life. She moved to San Juan Capistrano, a small city 70 miles northwest of Los Angeles, with her biological father who was a recovering addict. They did not get along well and she was expelled from this living situation. Dana came back to Los Angeles and went to live with the family of a friend from high school who was using drugs. Her friend would take her to “trap houses”, where illegal substances are sold. She ended up using substances and because of it, was kicked out again by the parents of her friend. She met the father of her baby in the environment of drugs. He also had substance abuse problems. They developed a special bond being homeless and united by drugs. She had her fist baby girl when she was 20 years old, but the baby was removed by Child Protective Services at the time of birth. The irreversible fact of losing her baby gave Dana the strength to seek drug rehabilitation. Dana learned of her HIV status in a very unusual way - she began hearing rumors from other people. By this time, she was already experiencing symptoms of the infection. Dana tells us that the manner she got infected with HIV is as odd as the way she learned she had it. Nobody in her circle of friends had HIV. She was not uncareful and she practiced safer sex. After being diagnosed with HIV she continued abusing substances for a year and a half, and shortly after realized that she needed to change her life. Dana wanted a sober man, someone to emotionally support her, to have a baby and build a family. Finding sober friends was a part of her recovery.Dana eventually found the man she was looking for, someone who helped her to stay sober. She planned to get pregnant, and the magical moment occurred. From that time, she became very proactive in staying sober and finding the right place for her recovery. Dana has not used since. As a majority of women would agree, one of the most special and unique ways to feel connected to their baby is to breastfeed. Under proper medical advice, Dana was able to accomplish it and not pass HIV to her baby. However, disclosing her HIV status was still challenging. Dana's intricate story is full of experiences with homelessness, substance abuse, and cruel rumors; but it is also full of accomplishments and successes. Her story stresses that the components which surround her life are not exclusive to certain races nor socioeconomic statuses. Dana was born in the rain, and she has withstood multiple storms in her life. Thanks to the willingness to change and to have the courage to achieve her goals, the sun shines for her now and shares it in our podcast today.Funding provided by the Health Resources & Services Administration (HRSA) Ending the HIV Epidemic Grant and the County of Los Angeles, Department of Public Health, Division of HIV and STD ProgramsThis podcast is brought to you by the Los Angeles Family AIDS Network
Christie's talking with Audra Summers and Ashley Rainey about Indiana's innovative use of the AIM Patient Safety Bundles to drive sustainable change in maternal care. Audra and Ashley share their experiences implementing and maintaining quality improvements across Indiana's 75 delivery facilities. They discuss the importance of collaboration, the integration of safety measures into daily practices, and how sustainability is achieved through data-driven methods and cultural shifts. Tune in to learn how Indiana's approach to quality improvement can inspire and inform efforts nationwide. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
In this episode, we talk with Dr. Carey Eppes and her colleague, CheyAnne Harris, to explore Texas's experience with implementing the Maternal Early Warning Signs (MEWS) in maternal health care. Dr. Eppes shares her background and journey into the world of maternal health, detailing the personal motivations that drive her passion for this work. She and CheyAnne delve into the reasons behind adopting MEWS, how it was implemented, and the challenges faced along the way. This episode highlights the key levers that facilitate successful implementation and reveals the one thing for healthcare providers looking to adopt MEWS in their own practice. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
Within the past few weeks, drugmaker Johnson & Johnson went head-to-head with 340B hospitals and the federal government over the company's plan to stop paying upfront 340B discounts on two of its top-selling drugs. 340B Health Senior Counsel Amanda Nagrotsky joins us to explain how that conflict played out.HRSA Warns Johnson & Johnson of Strong Punitive ActionsIn letters to J&J, the Health Resources & Services Administration (HRSA) warned the drugmaker that replacing 340B rebates with discounts only would be allowed if approved by the Health and Human Services (HHS) secretary. HRSA gave the company until the end of September to announce that it was going to walk away from its plan or face both civil monetary penalties and the termination of its pharmaceutical pricing agreement (PPA). Nagrotsky said the threat to end the PPA was unprecedented, noting that it would cause the company to lose access to Medicaid and Medicare Part B coverage for all its drugs.Johnson & Johnson Backs Down Under PressureJ&J announced at the end of September that it would walk back its plan to implement rebates in mid-October, bowing to pressure from federal health officials and a bipartisan group of nearly 200 members of Congress who opposed the J&J strategy. The company maintained that it disagreed with HRSA's reasoning and noted that it was reserving all legal rights with respect to rebates. That stance indicates the company is likely to continue its push to implement rebates.The Battle Against Rebates ContinuesDespite the win for hospitals on the J&J rebate scheme, efforts from the drug industry to change the 340B discount structure continue. Drug industry consultant Kalderos is part of ongoing litigation in a federal court in Washington, D.C., over the right to impose rebates. HRSA's references to the concept of HHS approval of rebate proposals also leaves open the door for companies to seek federal consent for such a model.Resources340B Hospitals Prevail on J&J Rebate Plans, But Fight Is Not OverBipartisan U.S House Letter to HHS, Sept. 27 HRSA Letter to Johnson & Johnson, Sept. 27J&J Response to HRSA, Sept. 30
In this episode, Christie talks with renowned maternal health expert Dr. Elliott Main. A pioneering figure in maternal mortality review and quality care initiatives, Dr. Main discusses the history and evolution of the Alliance for Innovation on Maternal Health (AIM). Together, they explore the challenges and triumphs of addressing severe maternal morbidity and mortality in the U.S., the early groundwork that led to AIM, and the collaborative efforts that turned ideas into actionable tools, such as life-saving AIM bundles. Dr. Main also shares his thoughts on the future of maternal health and the "one thing" he believes is critical to driving change moving forward. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
Christie is talking with Amy Romano, founder and CEO of Primary Maternity Care. Amy, a nurse midwife with an MBA, shares her experience blending clinical expertise with system-level healthcare leadership to revolutionize maternity care in rural communities. They discuss the critical role of freestanding birth centers, their capacity to offer low-risk, community-based care, and how these centers could be a key part of the solution to the growing issue of maternity deserts. Amy also dives into the challenges of regulatory barriers, the importance of risk-appropriate care, and the unique quality improvement strategies needed for safe community births. From pandemic-driven innovations to rethinking the future of rural maternity care, this episode is packed with actionable insights for improving maternal health outcomes in underserved areas. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
The Health Resources and Services Administration threatens sanctions against Johnson & Johnson over the company's decision to change how hospitals are provided 340B discounts on some prescription drugs. And, a summer surge of COVID infections could be abating...We'll get that story—and more—coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.
Tune in to this episode to hear all about the Interactive map and dashboard for Transitions, Access, and Continuity of Care (ITACC). This resource provides an overview of reproductive healthcare and substance use treatment resources across the 18 westernmost counties of North Carolina. Use it to connect patients to providers or to find a service near you! Enjoy!Podcast Survey: https://redcap.mahec.net/redcap/surveys/?s=XTM8T3RPNKSocial MediaFacebook: Just Us: Before, Birth and Beyond Podcast Instagram: @justus.bbb.podcastResources https://mahec.net/regional-initiatives/itacc-resource-map https://mahec.net/regional-initiPlease provide feedback here:https://redcap.mahec.net/redcap/surveys/?s=XTM8T3RPNK
Dr. Emily Caffrey, a certified health physicist with the Health Physics Society, joins host Christ Stallman, CGC to talk about different types of radiation and their potential effects on a pregnancy. Links Mentioned in This Episode: Health Physics Society's Ask The Experts https://HPS.org Ep. 76 Transcript You're listening to the MotherToBaby podcast, medications and more during pregnancy and breastfeeding. Ask the experts with your host, genetic counselor and mom of four, Chris Stallman. This episode contains evidence based information that's current as of the day recorded and may change as more data becomes available. To get the very latest information about this topic or other topics in pregnancy and breastfeeding, please contact a mother to baby specialist at 866 626 6847 by text at 855 999 3525 or through our website at mothertobaby.org. Welcome to another episode of the mother to baby podcast. My name is Chris Stallman, and I'm a genetic counselor, a mom of four, and a teratogen information specialist. So what that means is that I talk to people, so patients, family members, healthcare providers, the general public, about exposures that can happen before pregnancy, during pregnancy, while breastfeeding, and in cases of adoption. Thank you And an exposure can be anything. So it could be a medication you take. It could be a vaccine. It could be a hair treatment. And in some cases it could be in the place where you work. Today we're going to talk about a very specific exposure, radiation. And we have a very special guest to talk with us today. Dr. Emily Caffrey is the program director and an assistant professor for the master's in health physics program at the University of Alabama at Birmingham. She is also a certified health physicist that specializes in calculating radiation doses from environmental sources of radiation. Dr. Caffrey, welcome to the show. Thanks for having me. Excited to be here. Great. So let's get started today. We're going to talk about radiation. Can you tell us a little bit about what radiation is and how people are exposed to it? Yeah, absolutely. Um, you know, radiation is just a form of energy. So there's two types of radiation. There's non ionizing radiation and ionizing radiation. So non ionizing radiation are lights, microwaves, your cell phone emits non ionizing radiation, things like that. There's also ionizing radiation, and that type of radiation is a little bit higher energy, um, that makes charged particles. Um, and that's the kind of radiation you get when you're talking about a CT scan or an x ray, something like that. Um, that's ionizing radiation. Uh, and I, and I just want to point out that radiation is all around us. It was present when life first evolved on Earth. It was present when dinosaurs lived. It's still present today. Uh, we live in a radioactive world, and I think a lot of people don't know that. So I'd like to start with, radiation's all around you, and it has been your whole life. Um, natural radiation comes from space, and it comes from living things that are in the Earth. The Earth's crust is radioactive. You may, if you live in a place that has high radon, um, you may have heard of radon coming from Earth up into your basement. That's a really common source of exposure. Um, and our human bodies and cells have adapted over time to respond to and repair the small amounts of damage you might get from these low levels of ionizing radiation. So some of the more common forms of radiation, like you described, light, microwaves, CTs, would that also include mammograms and would that increase risks to a pregnancy? Yeah, that doesn't include mammograms. The mammogram is again a low energy type of x ray that's used to image the breast tissue to look for cancer usually. Um, and You know, just like all other types of, of diagnostic imaging procedures, and I think we'll talk a little bit more about this as we get into it, um, you really aren't at risk when you have a low, a low, a diagnostic imaging procedure, those are very low doses, your, your pregnancy is not at risk, the unborn child, not at risk from those types of exposures. And I'm really glad that we can talk about that and hear about that again, because it is the kind of thing, you know, if. certainly if you need it in pregnancy, it's a good idea to get your cancer screenings. Absolutely. Dr. Caffrey, can you tell us a little bit about the Health Physics Society? Yeah. And I like to tell people like health physics is a profession you've never heard of, but the health physics society is the professional society for health, which are radiation protection professionals. So we are the profession that is devoted to the safe use of radiation. Um, so anywhere radiation is used, whether that's a hospital, a nuclear power plant, um, the government and military installations, um, there's gonna be a health physicist, a radiation safety officer, someone there making sure that the people and the environment are safe from that ionizing radiation. So you may not see us, but we are there making sure that we're following regulations and keeping people safe. When you mentioned earlier that radiation comes from space, I got to say, I love hearing that. I think that that's such a cool and exciting thing. So let's talk about cosmic ionizing radiation. So what is that specifically? And does that increase risks to a pregnancy? Yeah, it's space is always fun, right? And we're talking about sending astronauts to Mars and things, right? Radiation. So, you know, one component of your natural radiation dose that you get just by living here on Earth is from outer space, and that's called cosmic radiation. Um, so particles and electromagnetic magnetic waves from outer space, um, come and hit and impact Earth. So you may have heard of solar flares and things like that. And the sun flings off all these charged particles. So those come and hit Earth. Now, Earth is actually pretty well protected. We have this magnetic field that's around Earth that deflects a lot of those particles. Think of it as like a shield around Earth. And then our atmosphere, like a literal atmosphere above us, also protects us from a lot of that radiation, but not all of it. So some of that radiation is going to come in and actually get into Earth, like where you and I are sitting here right now. Um, and, and, and, There's more at the north and south poles and as you go higher in elevation because at the north and south pole the magnetic field that protects us is weaker and at higher altitudes you're just physically closer to the radiation coming from space. So if you're, um, your background radiation dose, if you're at the North Pole or if you're standing on top of a 14 year in Colorado is going to be higher than me sitting here in my office in Huntsville, Alabama, which is basically at sea level, right? So it's just a small difference, but it does change a little bit. Um, but you know, cosmic radiation contributes Um, about 5 percent of our average total background dose. So that's a very low, low number. You and I just living on Earth, which is radioactive, get about 3 millisieverts per year. And a millisievert is just a unit of radiation, uh, dose that we, that we use to count, you know, when we're talking about radiation doses, that's just a number we, a unit that we use. Um, so you and I get about 3 millisieverts per year, and about 5 percent of that 3 millisieverts is from cosmic space radiation. Um, and I, and I want to add to that background radiation doses are too low to increase your risk of pregnancy or cause any harm to your unborn child. We are not worried about background radiation doses or doses that are lower, um, in, in than, especially not background, but lower than three is definitely not a concern. And we'll talk a little bit more about what levels you might want to start thinking about, about, you know, where, at what levels you might want to be concerned, but definitely not at background levels. Great. Okay. So thinking about space occupation, what's out there? What about radiation exposure for someone who's working as a flight attendant? I got to tell you, I got this question for the very first time, maybe six or seven years ago. And until then, it never even occurred to me. I was like, yeah, of course, there's radiation in the atmosphere. So I'm going to stop talking and let you give us this answer. Yeah, and I'm really glad you asked that question because we hear this concern a lot, both from flight attendants, pregnant women that travel for work a lot, uh, pilots, right? We hear this question a lot. And I think people, uh, I certainly didn't before I got into this field, didn't think about flight attendants being, uh, people that are exposed to COVID. More than average, right? Um, but when you fly up high, especially people that fly transcontinental flights that go over those poles where you have a higher radiation dose, they get a higher radiation dose in the background. They actually, in some cases, get higher radiation doses than workers at nuclear power plants, but higher does not mean there's a problem. So let's back up for just a second. Um, so the amount of exposure that you get from flying is significantly lower than, um, The exposure needed to cause any harmful effects to your, to your unborn child or to you, the pregnant, pregnant person, rightly, that we're not concerned. Um, and just to give you some context, right, we talked about 3 millisieverts as our background radiation dose. Um, the radiation dose needed to cause harmful effects is roughly, and again, there's a lot of research on this that's ongoing all the time as we improve our models, but we're talking roughly 100 millisieverts. Um, and again, millisieverts just being a unit of radiation dose, so 3. Is your background radiation dose, and 100 is what we're talking about for harmful effects. Um, and then to talk a little bit more specifically about flight, so how much radiation do you get in a flight? Well, your radiation exposure during a commercial flight is about 0. 01 millisieverts per hour of flying time. So to get to 100 then right? That means you need if you do some quick division. That means you need about 10, 000 hours during your pregnancy to reach the amount of radiation that might be harmful. I don't think anyone is even flight attendants, right? You're not flying in 10, 000 hours. You really aren't quite safe from as a as a flight attendant or a pilot or even just someone that travels a lot while you're pregnant. That's it's not of concern. Excellent. And I'm so glad that you mentioned, you know, it could be higher than 100. wherever we start out. But that alone doesn't necessarily mean that there is a problem. We have to have more information. We have to have all the pieces and that's so important for all exposures. But again, certainly for one like this, where you may not have known or you may not have remembered, it's like, oh, there's radiation all around us. Oh, wait, it also depends on how much we're being exposed to. Now, for my favorite thing to ask all of the guests on the show, when I get the opportunity, what is the most interesting question about radiation and pregnancy that you or the Health Physics Society has received? Yeah. And I'm, and again, this is a great question. We get hundreds of questions from pregnant women and thousands of questions from the general public. Yeah. Um, and you know, it's kind of, I didn't pick something like when I was thinking about this, I didn't pick something light hearted because this, this particular question that I'm going to throw is one that has stuck with me and it's the one I that just reminds me of why talking to people and using my knowledge to explain why things are okay or not okay or what you need to be concerned about and what you shouldn't be concerned about is so important. Um, and so about, about a year ago, we had a woman right in, um, an Italian woman and she had had a diagnostic x ray of her pelvis before she knew she was pregnant. And her, her gynecologist told her the pregnancy was probably more risky because of the x ray. And she specifically asked us if she should terminate her pregnancy. And under Italian law, you know, that was very time sensitive because she only had a week to make such a like, insanely impactful life decision. Um, and so I was so glad that she found us because I just want to be really clear here. The answer to that question is absolutely not. A diagnostic x ray, even to the pelvis, um, is not going to cause any harm to your unborn child. And just the relief that we were able to provide, um, that, that soon to be first time mom was just like overwhelming. She wrote back to us, um, several times over the course of, you over the course of her pregnancy just to check in and she told us she sent us an email saying that her son was born happy and healthy and she was just so grateful and so relieved because she didn't know right and and so being able to offer that service and being able to help people understand and make massive decisions is just really amazing. Uh, it gives me the warmth, like, that is amazing. I am not only so glad that the society exists and that folks like yourself are out there giving this information. I'm so glad they found you. I'm so glad that, you know, it seemed like a good outcome for them. That's wonderful and so important. And it is one of those things where, you know, you don't know what you don't know. The good news is in a lot of cases, there are people, um, again, like you and the health physics society that are out there assisting with some of this information that isn't as commonly available. So thank you so much. What a great story. So Emily, if someone has a question specific for the health physics society, so radiation. Or even, you know, concerns in the pre pregnancy or after pregnancy planning stage. How did they get to your organization to find this information? Yeah, thanks for asking that. Um, so you can find us at hps. org, hps. org. That's the website of the Health Physics Society. And you'll see a little Ask the Experts button. And you just click that button and you'll see our webpage. Um, there's a webpage specifically for pregnancy and radiation. And on that web page are a couple of videos that the Health Society has produced. There are fact sheets about radiation and pregnancy. There are Q& A's from, uh, not only some, some basic Q& A's that we have written, but also, um, some stories that other people have, other questions that people have written in with. We, we anonymize them, of course, and we post some of those to our website. And we cover everything from, um, background radiation, to pregnancy and flying, to what if I need a medical procedure, to I'm a lactating mom that's breastfeeding, you know, and I have to have this nuclear medicine procedure, you know, if, am I okay, what should I do? Um, I think the medical industry does a good job of providing information, but I think people sometimes still want, you're still overwhelmed, right? When you, you have a child and you are doing something in the medical realm, like those are two very overwhelming things. In and of themselves. And so when you have another question that didn't get answered, please reach out to us and we're always happy to help. That's awesome. And we are going to put information for the Health Physics Society in the show notes. Something else, um, that I was just thinking of, I, you know, talk to people all day. That's my job. But if I forget to ask my doctor or healthcare provider something, or if I'm traveling or busy, I might not always have the opportunity to connect with them, and I will say that sometimes I turn to Google. So it's great to know where they can find this information. Providers are wonderful. They give good information. Sometimes I do not have it in me to wait 30 minutes on the phone. You know, life is busy. So it's great to know that we can find this information online as well. Dr. Caffrey, before I let you go for this episode, um, cause I would love to have you come back and talk more about radiation. Is there a final thought that you would like to leave our audience with? Yeah, I think, you know, I think the thing I want to emphasize is that radiation can be scary. You can't see it. You can't feel it. You don't know it's there. Like anything you can't see and you don't know is there. Can be scary, but I just I want to emphasize that our bodies evolved in this radioactive world. They have repair mechanisms for low doses. And we know from population studies from epidemiological studies. That the amount of radiation used in these diagnostic procedures, so x ray scans, mammograms. Um, even to the pelvis area are just not are way too small to cause harm to your unborn child. So you don't need to worry about those types of procedures. You know, and if you are concerned or you had a specific procedure or you had a nuclear medicine procedure, you know, those are things that experts can talk to you about and counsel you through, um, to make sure that you're getting up to date information. And it's so important to remember to ask those questions because diagnostic procedures can prevent a lot of issues that are harmful to your baby, right? And, or could be harmful to your, to your unborn child and, or yourself, right? As the pregnant woman, like, um, There are actual harms that can be done by not having a CT scan when it's clinically indicated, and the radiation dose should, should be something that you think about, um, and, and be aware of and educated about, but it should not stop you from getting a diagnostic procedure that could potentially save your life or your unborn child's life. So radiation's scary, but we, um, myself, the Health Physics Society, and all of my topic editors and experts are here to help. Hps. org or through the mother's baby website, there are links, um, and you can find us online and we are, please reach out. We are happy to help. Absolutely. And thank you. Thank you for the reminder that, you know, these procedures, MRIs, CTs, and so forth are not done lightly. They are done because someone needs it, especially during pregnancy and you, you probably do need it. So please feel free to contact. The health physics society or mother to baby with any questions that you have. Dr. Caffrey, it was my pleasure to speak with you today. Thank you so much for being on the show, giving us all this great information, and we hope to have you back in the future. Thank you so much for having me. It's been a pleasure. And that's going to do it for this episode of the mother to baby podcast. Be sure to hit that subscribe button. So that way you never miss a new episode and you can go back and listen or relisten to some of those older episodes as well. You can find us on iTunes, Spotify, Audible, or however you like to listen to podcasts. And if you want to be on the podcast, or if you have an idea for the show, we would love to hear from you. Please feel free to email us at contactusatmothertobaby. org. And Mother 2 Baby is here to answer your questions about exposures before and during pregnancy while breastfeeding, or if you have questions about exposures and adoption, you can reach us by phone at 866 626 6847. Buy text at 855 999 3525. You can visit us on our website, mothertobaby. org. And there you can chat with an information specialist. You can look at our many blogs, information pages, our hundreds of fact sheets that are available free in English and in Spanish. And you can also listen to our podcast. Or, find out how you can participate in our pregnancy studies. If you would like to support the MotherToBaby podcast, as well as all of the ways we get critical pregnancy and breastfeeding health information to you at home, we have a new way to do just that. Encircle is our new monthly giving society that helps ensure we can continue to provide our services at no cost. Join the community today and encircle parents and babies in health. Members will be recognized on the podcast and website. Visit mothertobaby.org/donate today. Until next time, remember, MotherToBaby is here for you. Take care. MotherToBaby is a service of the nonprofit organization of Teratology Information Specialists and supported by the Health Resources and Service Administration of the U.S. Department of Health and Human Services. It's made possible through generous donations from listeners like you. To learn more about MotherToBaby, please visit mothertobaby. org.
In this episode, Christie sits down with Dr. Andrea Greiner, a maternal-fetal medicine specialist at the University of Iowa, to discuss the unique challenges of rural maternity care. Dr. Greiner shares her experiences working at a perinatal regional center, offering insight into how larger facilities can support rural hospitals and providers. Together, they explore the importance of individualized care, the complexities of coordinating care across diverse healthcare settings, and the logistical hurdles rural patients face. Tune in for a discussion on improving access and quality of maternity care in rural America. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
In part two of our conversation with Dr. Tina Pattara-Lau, Maternal and Child Health Consultant at the Indian Health Service (IHS), Christie continues to explore the ongoing transformation of maternal health care within rural communities. Dr. Pattara-Lau delves deeper into the impact of culturally responsive care, the integration of traditional practices, and the expansion of telehealth services. They further discuss the strides being made in overcoming access barriers, fostering community trust, and implementing innovative care models tailored to the unique needs of American Indian/Alaska Native populations. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
This marks the time of year when 340B hospitals complete the recertification process to maintain their eligibility for 340B. But why is this recertification needed, and what do hospitals need to know before undergoing recertification? Steven Miller, the vice president of pharmacy services for 340B Health, describes what is at stake when it comes to hospitals completing recertification every year. Failure to do so could take a hospital months to correct and cost it millions of dollars – resources that the hospital could be using towards services for patients who need help the most.The key playersMiller says the hospital's authorizing official (AO) and primary contact (PC) are two of the most important figures for recertification. These individuals will be key to verifying and submitting information to the government during the process, and there are important rules governing their roles and responsibilities.Preparing for recertificationMiller says hospitals should have their “ducks in a row” and be ready to undergo recertification as soon as the period begins. This involves having the necessary staff involved, having required documentation on hand, and being prepared to respond quickly to any inquiries from the Health Resources & Services Administration (HRSA).Hospital best practicesMiller has tips for hospitals that want to navigate the recertification process efficiently and accurately. This includes advice on ensuring all the information in the HRSA Office of Pharmacy Affairs Information System is correct, fixing any discrepancies that could lead to future audit findings, and documenting needed changes to make sure they take effect.Resources:340B Health Registration and Recertification Resource340B Health Webinar Archive340B Health Equity Report 2023
Dr. Joel Warsh, also known as Dr. Gator, is a Board-Certified Pediatrician in Los Angeles specializing in Parenting, Wellness, and Integrative Medicine. Originally from Toronto, he earned degrees in Kinesiology, Psychology, and Epidemiology before completing his medical degree at Thomas Jefferson Medical College and his pediatric training at CHLA. He founded Integrative Pediatrics and Medicine Studio City in 2018. Dr. Warsh is a published researcher, media contributor, and founder of the Parenting Masterclass Platform, Raising Amazing. ___How Prepared is Your Team for the Next Big Disruption? Future-proof your team with Malosiminds.com Get your copy of Personal Socrates: Better Questions, Better Life Connect with Marc >>> Website | LinkedIn | Instagram | Twitter Drop a review and let me know what resonates with you about the show!Thanks as always for listening and have the best day yet!*A special thanks to MONOS, our official travel partner for Behind the Human! Use MONOSBTH10 at check-out for savings on your next purchase. ✈️*Special props
Christie is delving into the unique challenges and innovative solutions in rural and Indigenous maternal health care with Dr. Tina Pattara-Lau, Maternal and Child Health Consultant at the Indian Health Service (IHS). Dr. Pattara-Lau shares her experiences and insights on improving patient access to quality care through culturally safe practices, partnerships, and innovative models such as telehealth and community-based care. They discuss the systemic barriers, the importance of culturally safe practices, and the role of community partnerships in enhancing care for American Indian/Alaska Native populations, emphasizing the need for continuous quality improvement and sensitivity to cultural and traditional practices. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
Welcome to Supreme Court Opinions. In this episode, you'll hear the Court's opinion in United States ex rel. Polansky v Executive Health Resources, Inc. In this case, the court considered this issue: Does the government have the authority to dismiss a False Claims Act lawsuit brought by an individual on behalf of the government if it initially declined to take over the case, and if so, what standard applies? The case was decided on June 16, 2023. The Supreme Court held that in a qui tam action filed under the False Claims Act, the United States may move to dismiss under 31 U-S-C § 3730(c)(2)(A) whenever it has intervened—whether during the seal period or later on; in assessing a motion to dismiss an FCA action over a relator's objection, district courts should apply the rule generally governing voluntary dismissal of suits in ordinary civil litigation—Federal Rule of Civil Procedure 41(a). Justice Elena Kagan authored the 8-1 majority opinion of the Court. Section 3730(c)(2)(A) provides that “the Government may dismiss the action notwithstanding the objections of the relator,” so long as the relator received notice and an opportunity for a hearing. Contrary to the government's contention in this case, this does not mean that the government may dismiss the action without ever intervening in the case. Neither the text or subparagraph (2)(A) nor the broader context supports this understanding. But Polanksy's contention—that the government may dismiss only if it intervenes during the seal period—also fails. Under § 3730(c)(3), the government can intervene either during the seal period or “at a later date upon a showing of good cause.” If the government successfully intervenes, then it becomes a party to the litigation with the attendant rights, including the right to dismiss. The Federal Rules of Civil Procedure are the default rules in civil litigation, and nothing warrants a departure from those rules here. Thus, in assessing a motion to dismiss an FCA action over a relator's objection, district courts should apply the rule generally governing voluntary dismissal of suits in ordinary civil litigation—Rule 41(a). Justice Brett Kavanaugh authored a concurring opinion, in which Justice Amy Coney Barrett joined, calling upon the Court to consider, in an appropriate case, whether the qui tam device is inconsistent with Article II of the U-S Constitution. Justice Clarence Thomas authored a dissenting opinion, arguing that the FCA does not permit the government to dismiss a qui tam action after it has declined to take over the action from the relator at the outset. The opinion is presented here in its entirety, but with citations omitted. If you appreciate this episode, please subscribe. Thank you. --- Support this podcast: https://podcasters.spotify.com/pod/show/scotus-opinions/support
Special coverage — Right now the northeast side of the perimeter, near the Mill Creek area, is the main concern on the Park Fire as critical weather conditions are expected. Also, a local assistance center is being set up for Park Fire survivors. It opens Monday. And we hear from evacuees about their experience and what they returned home to in the wake of the fire.
Christie is joined by Dr. Kristen Dillon, Chief Medical Officer at the Federal Office of Rural Health Policy within the U.S. Department of Health and Human Services (HHS). With an extensive background in rural healthcare, public health, and health policy, Dr. Dillon shares her journey from an urban upbringing in the San Francisco Bay Area to a dedicated career in rural medicine, including her experience overseeing Oregon's Pandemic Response Unit and working on health policy in Speaker Nancy Pelosi's office. Dr. Dillon discusses the unique challenges and solutions in providing quality maternity care in rural areas, the importance of telehealth and collaborative networks, and the critical role of emergency care providers.Check out the Maternal Mental Health Hotline here. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
We dive into the evolving health care landscape with Jamie Babcock, a health care executive. We'll explore the growing demand for skilled providers and the critical clinician shortage projected by the Health Resources and Service Administration and the U.S. Chamber of Commerce. Jamie shares insights on innovative strategies that health care leaders can employ to address these challenges, emphasizing the importance of interdisciplinary care teams. Discover how home-based care, supported by field responders, advanced practice practitioners, and telehealth technology, can optimize patient outcomes and ensure high-quality care. Jamie Babcock is a health care executive. She discusses the KevinMD article, "Interdisciplinary care teams play a pivotal role in mitigating the clinician shortage." Our presenting sponsor is Nuance, a Microsoft company. Together, Microsoft and Nuance are leveraging their rich digital technology and advanced AI capabilities to tackle some of health care's biggest challenges. AI-driven technology promises to revolutionize patient and provider experiences with clinical documentation that writes itself. The Nuance Dragon Ambient eXperience, or DAX for short, is a voice-enabled solution that automatically captures patient encounters securely and accurately at the point of care. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows. Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 85 percent of patients say their physician is more personable and conversational. Discover AI-powered clinical documentation that writes itself. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo. VISIT SPONSOR → https://nuance.com/daxinaction SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus
Christie Allen, Senior Director of Quality Improvement and Programs at the American College of Obstetricians and Gynecologists (ACOG), and Dr. Veronica Gillispie-Bell are back to explore the complexities of sustaining momentum in maternal health quality. After reflecting on last season, they discuss the concept of "health equity tourism" and the importance of true community integration. Dr. Gillispie-Bell shares her insights on embedding sustainable, equitable practices in healthcare beyond initial surges of interest. This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
In the upcoming season, maternal health champions discuss quality improvement, sustainability, patient engagement, and more. Following the Season 2 kick-off episode, listen along to "You Can't Get There From Here," a four-part rural perinatal care miniseries – where our host Christie Allen and a variety of guests highlight the unique considerations and innovative solutions in providing quality maternity care in rural areas. Each week this season, guests will share “The One Thing” that they would like the audience to take away from each episode.Stay tuned for AIM for Safer Birth Season 2 coming July 15! This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.
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Today, Theresa is thrilled to welcome a very special guest and an old friend, Natalie Solomon Bramage. Natalie is an extraordinary individual—a true entrepreneur, leader, visionary, & public health analyst. She's done incredible work in the public health sector, particularly with the Ryan White AIDS program. In this episode, we will explore Natalie's path, from her early days in healthcare aspirations, navigating the academic world, to making pivotal shifts in her career. Natalie will also delve into the personal struggles she has overcome and the profound lessons she has learned along the way. Key points discussed: Natalie's passion for healthcare evolved from a pursuit of becoming a doctor to focus on a career in public health Learn about Natalie's significant contributions to the Ryan White AIDS/HIV Program, her work addressing health inequities & her fellowship with the Health Resources and Services Administration (HRSA) Theresa and Natalie discuss the importance of family support, positive affirmations, and how Natalie's personal health struggles have informed her professional endeavors No matter where you are on your journey… Keep pushing forward, stay inspired, and keep making an impact. Get Connected with Natalie HERE! https://natalieasolomon-brimage.me/ READY TO UNCOVER THE BLIND SPOT HURTING YOUR SMALL BUSINESS? Take this quiz to uncover what's holding your business back from success: https://theresacantley.lpages.co/quiz/
My next guest is a prolific researcher, writer, and renowned clinician. Dr. Joel Kahn, trained in conventional, interventional cardiology, is now regarded as one of the foremost integrative and preventive cardiology experts. He's written six books, including Your Whole Heart Solution, Dead Execs Don't Get Bonuses, The Plant Based Solution, and Lipoprotein(a): The Heart's Silent Killer. And has appeared on Dr. Phil, The Doctors Show, Dr. Oz, Larry King Now, and the Joe Rogan Experience. Key Takeaways To Tune In For: [02:32] - Plant-Based Nutrition and Integrative Medicine [08:10] - Early Screening for Heart Disease Benefits [15:45] - Heart Health Discrepancies in Marital Pair [23:08] - Plant-Based Diet for Heart Health [28:10] - Benefits of Mediterranean Diet [38:42] - Holistic Approach to Health Resources talked about in this episode Website: www.drjoelkahn.com Social media handles: Facebook Instagram
Dr. Leigh Richardson of the Brain Performance Center and host of In Your Head Podcast speaks with Sarah Lenz Lock, Senior Vice President for Policy & Brain Health at AARP, to talk about staying sharp through the pillars of brain health - social interaction, sleep, proper food, stress management, exercise and mental fitness. Cognitive decline is NOT inevitable, and AARP has free online resources on staying sharp and caregiving to empower everyone to support brain health and help people who have brain injuries and diseases. Leigh Richardson is also the author of Brain on Game On, available at Amazon and on http://www.thebrainperformancecenter.com and https://www.leigherichardson.com/. She also owns and operates The Brain Performance Center, a brain and mental health clinic located in Dallas, Texas that can be reached at 214-329-9017. This show is also on Apple Podcasts, iTunes, Google Play, Spotify, iHeart Radio, Audible and Stitcher.
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It's a Science Team Takeover! Senior Director of Product Innovation & Scientific Affairs Erin Barrett, Ph.D. welcomes Dr. Jamie McManus, Les Wong and Torrance Rogers for the first in a series of monthly calls we're calling "Office Hours." Office Hours will focus each month on health topics and product trainings aligned with our Wellness Communities and product promotions, with an opportunity for Q&A at the end of the call. This month, the team presents The Shaklee Difference, A Guided Tour of the Health Resources site, Stress, Mood & Emotional Wellness, & Cheer Up & Chill Out*. * These statements have not been evaluated by the U.S. Food and Drug Administration, This product is not intended to diagnose, treat, cure, or prevent any disease.
It's a Science Team Takeover! Senior Director of Product Innovation & Scientific Affairs Erin Barrett, Ph.D. welcomes Dr. Jamie McManus, Les Wong and Torrance Rogers for the first in a series of monthly calls we're calling "Office Hours." Office Hours will focus each month on health topics and product trainings aligned with our Wellness Communities and product promotions, with an opportunity for Q&A at the end of the call. This month, the team presents The Shaklee Difference, A Guided Tour of the Health Resources site, Stress, Mood & Emotional Wellness, & Cheer Up & Chill Out*. * These statements have not been evaluated by the U.S. Food and Drug Administration, This product is not intended to diagnose, treat, cure, or prevent any disease.
Even as Alabama scrambles to enact a law protecting in vitro fertilization in the state, the Biden-Harris Administration sees additional challenges that legislation may not be able to quickly fix. Carole Johnson leads the Health Resources and Services Administration, the part of the U.S. Health and Human Services Department tasked with strengthening the health workforce and connecting skilled professionals to rural, urban and tribal underserved communities. Johnson explains that some health care providers were already reluctant to work in states with restrictive reproductive legislation and the Alabama situation presents a new challenge. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
340B hospitals can register certain outpatient locations with the Health Resources & Services Administration (HRSA) as 340B child sites, which allows them to use 340B drugs. HRSA recently announced some changes to how it had been determining this eligibility during the COVID-19 public health emergency. How have these changes affected 340B hospitals, particularly those that had planned new child sites under the previous policy? For the answers to this question and more, we spoke to Chuck Stubbs, a 340B pharmacist with Intermountain Health based in Salt Lake City. How new hospital child sites gain 340B eligibilityChuck explains that 340B child sites are outpatient departments that are not on the main hospital campus but are fully integrated with the hospital parent site. To start using 340B drugs at a new child site, the location must appear on a filed Medicare cost report with associated costs and charges and then be registered with the HRSA Office of Pharmacy Affairs Information System (OPAIS).What changed during the pandemicPrior to the COVID-19 pandemic, the process to start using 340B drugs at a new child site could involve up to nearly two years. Chuck notes that during the pandemic, HRSA indicated that child sites that had not yet been registered could begin using 340B drugs right away if they were for eligible patients. Hospitals believed that shift in policy would be permanent.Where things stand nowThe COVID-era child site eligibility changes did not last. In October 2023, HRSA ended what it called a temporary flexibility, citing the termination of the public health emergency in May 2023. Although HRSA granted a grace period for hospitals to come into compliance, that did not provide protections for planned child sites that had not yet been using 340B drugs. Chuck explains how this affected one of Intermountain's planned sites, and he shares advice for hospitals that are in similar situations.Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you'd like us to cover in this podcast, email us at podcast@340bhealth.org.Resources:HRSA Announces Policy Restricting Use of 340B at New Child Sites After Transition Period
The Health Resources & Services Administration audits 200 covered entities each year for compliance with 340B rules. We speak with Mark Capuano, senior director of the corporate pharmacy 340B program at New York City Health and Hospitals, about what hospitals should expect when they find out they will be going through a 340B audit.How a hospital can prepare for a 340B auditAuditors typically will ask to schedule a pre-site visit call and will provide a data request list for the information the auditor is seeking. Mark says it is important to provide this information in a timely, accurate and concise way, and to make sure you inform key stakeholders at your organization so you can get the subject matter experts involved. He also recommends doing test runs of the audit ahead of time.What a hospital should expect on the day of an auditOn the day of an audit, the auditor will trace a sample to see how a 340B drug goes from drugmaker to pharmacy to patient. The auditor will assess whether the hospital is following its 340B policies and procedures to make sure the drug went to an eligible patient and does not involve a duplicate discount. Mark says the process can be very stressful but that it also provides an opportunity to reframe the audit to showcase the great work of your hospital.What hospitals should do if they receive audit findingsIf HRSA issues a finding, the hospital must draft and implement a corrective action plan. Mark recommends bringing in legal counsel and 340B consultants to review this document. After HRSA approves the CAP, the hospital will demonstrate to the agency that it is in place to ensure compliance going forward.Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you'd like us to cover in this podcast, email us at podcast@340bhealth.org.Resources:HRSA 340B Program Integrity Website
Rural communities in the U.S. are diverse, full of innovation, and each face their own unique health challenges. In this episode, we discuss some less commonly discussed rural health topics with Amy Elizondo, the Chief Strategy Officer for the National Rural Health Association (NRHA). In our conversation we discuss topics such as oral health, the scarcity of dentists in rural areas, behavioral health, substance abuse, and the health concerns of the rural indigenous population Amy highlights some of the amazing work being coordinated through the NRHA to address these health issues in rural communities, both through initiatives and health policy advocacy. Check out the NRHA's Faces of Rural video here: https://www.youtube.com/watch?v=pXpJ4fXRakU “Rural communities are far more diverse than anyone could ever imagine, truly that is where innovation can happen.” -Amy Elizondo Amy Elizondo serves as the Chief Strategy Officer for the National Rural Health Association (NRHA), a non-profit membership organization with the mission to provide leadership on rural health issues to improve access to care. Ms. Elizondo received a Bachelor of Science in Community Health Education from Texas A&M University in 2000 and a Master of Public Health in Social and Behavioral Health from the Texas A&M University System Health Science Center, School of Rural Public Health in 2002. She is currently pursuing her Doctorate in Public Health at the University of Illinois Chicago. Before joining the NRHA, Ms. Elizondo served as the primary analyst for rural health care and post-acute care issues at the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services. This position afforded her the opportunity to work as a liaison with Congress during the landmark passing of the Medicare Modernization Act of 2003, also known as the Medicare Prescription Drug Benefit. She also completed a fellowship at the Health Resources and Services Administration's Federal Office of Rural Health Policy where she took part in implementing a rural leadership program.