Tag: States

KFF Health News’ ‘What the Health?’: Harris in the Spotlight

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As Vice President Kamala Harris appears poised to become the Democratic Party’s presidential nominee, health policy in general and reproductive health issues in particular are likely to have a higher profile. Harris has long been the Biden administration’s point person on abortion rights and reproductive health and was active on other health issues while serving as California’s attorney general.

Meanwhile, Congress is back for a brief session between presidential conventions, but efforts in the GOP-led House to pass the annual spending bills, due by Oct. 1, have run into the usual roadblocks over abortion-related issues.

This week’s panelists are Julie Rovner of KFF Health News, Stephanie Armour of KFF Health News, Rachel Cohrs Zhang of Stat, and Alice Miranda Ollstein of Politico.

Among the takeaways from this week’s episode:

  • President Joe Biden’s decision to drop out of the presidential race has turned attention to his likely successor on the Democratic ticket, Vice President Kamala Harris. At this late hour in the campaign, she is expected to adopt Biden’s health policies, though many anticipate she’ll take a firmer stance on restoring Roe v. Wade. And while abortion rights supporters are enthusiastic about Harris’ candidacy, opponents are eager to frame her views as extreme.
  • As he transitions from incumbent candidate to outgoing president, Biden is working to frame his legacy, including on health policy. The president has expressed pride that his signature domestic achievement, the Inflation Reduction Act, took on the pharmaceutical industry, including by forcing the makers of the most expensive drugs into negotiations with Medicare. Yet, as with the Affordable Care Act’s delayed implementation and results, most Americans have yet to see the IRA’s potential effect on drug prices.
  • Lawmakers continue to be hung up on federal government spending, leaving appropriations work undone as they prepare to leave for summer recess. Fights over abortion are, once again, gumming up the works.
  • In abortion news, Iowa’s six-week limit is scheduled to take effect next week, causing rippling problems of abortion access throughout the region. In Louisiana, which added the two drugs used in medication abortions to its list of controlled substances, doctors are having difficulty using the pills for other indications. And doctors who oppose abortion are pushing higher-risk procedures, like cesarean sections, in lieu of pregnancy termination when the mother’s life is in danger — as states with strict bans, like Texas and Louisiana, are reporting a rise in the use of surgeries, including hysterectomies, to end pregnancies.
  • The Government Accountability Office reports that many states incorrectly removed hundreds of thousands of eligible people from the Medicaid rolls during the “unwinding” of the covid-19 public health emergency’s coverage protections. The Biden administration has been reluctant to call out those states publicly in an attempt to keep the process as apolitical as possible.

Also this week, Rovner interviews Anthony Wright, the new executive director of the consumer health advocacy group Families USA. Wright spent the past two decades in California, working with, among others, now-Vice President Kamala Harris on various health issues.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too: 

Julie Rovner: NPR’s “A Study Finds That Dogs Can Smell Your Stress — And Make Decisions Accordingly,” by Rachel Treisman.  

Alice Miranda Ollstein: Stat’s “A Pricey Gilead HIV Drug Could Be Made for Dramatically Less Than the Company Charges,” by Ed Silverman, and Politico’s “Federal HIV Program Set To Wind Down,” by Alice Miranda Ollstein and David Lim. 

Stephanie Armour: Vox’s “Free Medical School Won’t Solve the Doctor Shortage,” by Dylan Scott.  

Rachel Cohrs Zhang: Stat’s “How UnitedHealth Harnesses Its Physician Empire To Squeeze Profits out of Patients,” by Bob Herman, Tara Bannow, Casey Ross, and Lizzy Lawrence. 

Also mentioned on this week’s podcast:

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Care Gaps Grow as OB/GYNs Flee Idaho

Not so long ago, Bonner General Health, the hospital in Sandpoint, Idaho, had four OB/GYNs on staff, who treated patients from multiple rural counties.

That was before Idaho’s near-total abortion ban went into effect almost two years ago, criminalizing most abortions. All four of Bonner’s OB/GYNs left by last summer, some citing fears that the state’s ban exposed them to legal peril for doing their jobs.

The exodus forced Bonner General to shutter its labor and delivery unit and sent patients scrambling to seek new providers more than 40 miles away in Coeur d’Alene or Post Falls, or across the state border to Spokane, Wash. It has made Sandpoint a “double desert,” meaning it lacks access to both maternity care and abortion services.

One patient, Jonell Anderson, was referred to an OB-GYN in Coeur d’Alene, roughly an hour’s drive from Sandpoint, after an ultrasound showed a mass growing in her uterus. Anderson made multiple trips to the out-of-town provider. Previously, she would have found that care close to home.

The experience isn’t limited to this small Idaho town.

A 2023 analysis by ABC News and Boston Children’s Hospital found that more than 1.7 million women of reproductive age in the United States live in a “double desert.” About 3.7 million women live in counties with no access to abortion and little to no maternity care.

Texas, Mississippi and Kentucky have the highest numbers of women of reproductive age living in double deserts, according to the analysis.

Amelia Huntsberger, one of the OB/GYNs who chose to leave Sandpoint — despite having practiced there for a decade — did so because she felt she couldn’t provide the care her patients needed under a law as strict as Idaho’s.

The growing provider shortages in rural states affect not only pregnant and postpartum women, but all women, said Usha Ranji, an associate director for Women’s Health Policy at KFF, a health information nonprofit that includes KFF Health News.

“Pregnancy is obviously a very intense period of focus, but people need access to this care before, during and after, and outside of pregnancy,” Ranji said.

The problem is expected to worsen.

In Idaho, the number of applicants to fill spots left by departing doctors has “absolutely plummeted,” said Susie Keller, CEO of the Idaho Medical Association.

“We are witnessing the dismantling of our health system,” she said.

This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org.

En medio de un verano abrasador, California acelera protecciones contra el calor extremo en interiores

Sacramento, California. — Los californianos que trabajan en espacios interiores están recibiendo protecciones inmediatas contra el calor extremo, cuando el estado enfrenta temperaturas de tres dígitos.

California ha tenido estándares para proteger a los trabajadores al aire libre del calor desde 2005, pero el estado anunció el miércoles 24 de julio que ya había acelerado la revisión de un conjunto de reglas para los trabajadores en interiores.

La Junta de Normas de Seguridad y Salud Ocupacional del estado aprobó la regulación en junio, pero necesitaba ser evaluada para su cumplimiento legal.

“Esta regulación proporciona protecciones para los trabajadores en todo California y ayuda a preparar a los empleadores para enfrentar los desafíos de las temperaturas en aumento en ambientes interiores”, dijo Debra Lee, jefa de la División de Seguridad y Salud Ocupacional estatal.

California es uno de los pocos estados que están actuando frente a los crecientes impactos del cambio climático y el calor extremo con estándares de seguridad para los trabajadores.

A principios de este mes, la administración Biden propuso reglas federales para proteger a los trabajadores en interiores y exteriores, ya que el calor extremo, el asesino número 1 relacionado con el clima número en el país, se vuelve aún más peligroso.

Los estándares de California requieren que los lugares de trabajo en interiores se mantengan por debajo de los 87 grados Fahrenheit cuando hay empleados presentes, y por debajo de 82 grados en lugares donde los trabajadores usan ropa protectora o están expuestos al calor radiante, como hornos.

Los sitios de trabajo que no tienen aire acondicionado pueden usar ventiladores, nebulizadores y otros métodos para bajar la temperatura.

Las reglas permiten alternativas para los negocios si no pueden enfriar sus espacios lo suficiente. En esos casos, los empleadores deben proporcionar a los trabajadores agua, descansos, áreas donde puedan refrescarse, chalecos refrigerantes u otros medios para evitar el sobrecalentamiento.

Pero incluso con alternativas, las empresas están preocupadas por el costo de cumplir con la regulación, especialmente las pequeñas empresas que no son dueñas de sus locales o están en edificios antiguos, dijo Robert Moutrie, defensor de políticas senior en la Cámara de Comercio de California.

“La respuesta más simple a esta regulación es el aire acondicionado, y eso es una inversión costosa”, dijo Moutrie. “Si eres una pequeña empresa y no eres dueño de tu estructura, no puedes hacer cambios como crear un nuevo espacio para refrescarte”.

Las reglas se han estado desarrollando desde 2016, retrasadas, en parte, por la pandemia de covid. La Junta de Seguridad Laboral pidió que las regulaciones se aceleraran. Una revisión estándar habría retrasado la entrada en vigencia de la regulación hasta el otoño, dejando a los trabajadores en gran medida desprotegidos del calor del verano.

La regulación se aplica a la mayoría de los lugares de trabajo en interiores, incluidas aulas e incluso vehículos de reparto. Pero los reguladores estatales dejaron fuera a las prisiones y las instalaciones correccionales locales después que la administración del gobernador Gavin Newsom proyectara que podría costar miles de millones de dólares al Departamento de Correcciones y Rehabilitación de California implementarlas.

La junta tiene la intención de redactar una regulación separada para los miles de trabajadores en las 33 prisiones estatales, campamentos de conservación y cárceles locales del estado. Eso podría llevar un año, si no más.

En 2021, el Departamento de Salud y Servicios Humanos (HHS) informó que ocurrieron 1,602 muertes relacionadas con el calor a nivel nacional, lo que probablemente sea un subregistro porque los proveedores de atención médica no están obligados a informarlas.

En 2023, el HHS informó 2,302 muertes relacionadas con el calor. No está claro cuántas de estas muertes estuvieron vinculadas al trabajo, ya sea en interiores o exteriores.

Mientras tanto, en junio, las temperaturas globales registraron récords históricos por decimotercer mes consecutivo.

“Este es realmente uno de los mayores problemas de seguridad que vemos que los trabajadores experimentan en California en muchas industrias”, dijo Tim Shadix, director legal del Warehouse Worker Resource Center, que abogó por las protecciones. “Y el problema solo está empeorando con el cambio climático y los veranos más calurosos”.

Esta historia fue producida por KFF Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.

Montana Looks To Become Latest State To Boost Nonprofit Hospital Oversight

Montana’s proposal to increase oversight is part of a national trend by states to ensure nonprofit hospitals act as charitable organizations as they claim tax-exempt status. LISTEN here:

Montana is poised to become the latest state to increase scrutiny of how its nonprofit hospitals deliver community benefits in exchange for their tax-exempt status.

Under proposed rules, the Montana Department of Public Health and Human Services plans to collect data on nonprofit hospitals’ charitable acts, such as discounting prices, providing health education, or conducting free screenings. Montana officials expect to adopt the new rules in August, but state officials have yet to set standards for exactly what constitutes acceptable giving or how much hospitals must do.

The proposal comes some four years after a state audit found shortcomings in the health department’s oversight. The rules largely mirror federal requirements that national health policy analysts said have yet to lead to any meaningful enforcement.

“What is being proposed in Montana doesn’t really move the needle,” said Kevin Barnett, a researcher with the California-based nonprofit Public Health Institute who has studied hospital community benefits for decades. “It kicks the can down the road to say ‘we’ll consider this another day.’”

State officials would now be paying more attention, he said, but the impact depends on what they do with the information.

Montana’s plan is part of a national trend by states to try to cover federal enforcement gaps. The state would join at least 10 others that require nonprofit hospitals to create a broad community benefit plan and 25 states that mandate the facilities publicly share their financial assistance policies, according to The Hilltop Institute, a think tank at the University of Maryland-Baltimore County.

Policymakers have focused on nonprofit hospitals as a growing number of people in the U.S. struggle to afford medical care and, altogether, owe at least $220 billion in medical debt. The debt disproportionately affects people in poverty and Black people, according to data analyzed by KFF, a health information nonprofit that includes KFF Health News.

States with set giving standards take different approaches. In recent years, California adopted new reporting requirements for hospitals to show how they serve vulnerable populations. Oregon created new rules for when and how hospitals must provide patients discounted care. And five states — Illinois, Nevada, Pennsylvania, Texas, and Utah — have set minimums that hospitals must spend toward community benefits.

Just over half of the hospitals in the U.S. are nonprofits. While each must report the “community benefits” they provide, federal law doesn’t specify which services qualify or how much to give. Inconsistent hospital reports make it difficult to distinguish between low and high givers.

Montana’s 2020 state audit found that hospitals report benefits vaguely and inconsistently. The following year, a KFF Health News investigation found that, even by hospitals’ own reports, some of Montana’s richest facilities fell behind the national average in community benefit spending.

A Montana law passed in 2023 requires the state health department to track hospitals’ giving and to define standards. The department’s proposed rules spell out some requirements, such as calling on hospitals to post financial assistance policies prominently online. But mostly, the list of requirements sets the stage for more to come.

Holly Matkin, a health department spokesperson, said the agency will establish standards that are “fair to all nonprofit hospitals.” The state plans to collect data over a three-year period to begin establishing standards in 2026.

The state’s proposed rules have some differences from federal requirements, such as mandating hospital-level reports as opposed to systemwide information that covers numerous hospital locations. They also leave room for the state to seek more details about how hospitals provide care at reduced prices, such as the number of people who receive financial aid or the average amount given per person.

But the Montana Hospital Association lobbied legislators against including too many reporting rules, arguing it would increase hospitals’ administrative burden. State lawmakers then narrowed the data the state can collect to largely the information hospitals already provide to the federal government. The association supports the state’s rules as proposed but has said any state standards need flexibility.

“The truth is that most communities have more health needs than they can effectively address,” said Bob Olsen, president and CEO of the Montana Hospital Association. “Models that apply a one-size-fits-all standard on communities take decision-making out of local communities, and have the potential to do more harm than good.”

Adam Zarrin, director of state government affairs with the Leukemia & Lymphoma Society, supported Montana’s proposal during a June 18 public hearing. But he testified that Montana could do more, such as mandating screening for financial assistance and requiring that hospitals provide it to patients at particular income levels.

“These rules could go even further to provide greater access and protections for Montanans who need and apply for financial assistance,” Zarrin said.

Health department officials said they plan to create numerical or narrative standards for judging how hospitals say they’ve responded to people’s needs — or a combination of the two. Officials are still vague on what either standard could entail. But they have said the benchmarks would be set each year based on each hospital’s size and patient revenue. Hospitals with operating losses wouldn’t have to meet the forthcoming rules.

Ge Bai, a health policy professor at Johns Hopkins University who has long studied hospitals’ community benefits, said such standards come with trade-offs. For example, standards that can be met through words rather than numbers might allow large hospitals to pay consultants to window-dress the story of their benefits while smaller systems struggle to show their worth. She said numerical rules, such as spending minimums, could cause some hospitals to slow efforts once they meet the state’s requirement.

“It’s not perfect,” Bai said. “But If we don’t do anything, well, that’s the status quo.”

In 2020, Oregon set minimums for the free or discounted care hospitals must provide, but even with those rules, the state’s overall charity care spending didn’t increase, Bai said. Last summer, lawmakers there added a new set of rules, including that hospitals must screen patients with large hospital bills to see if they qualify for financial assistance.

California also has implemented a combination of standards. In recent years, the state expanded reporting requirements, mandating that nonprofit hospitals explain the math behind their community benefits tally and detail how they’re serving vulnerable populations such as people who are homeless. The state also mandated that hospitals offer discounted care to uninsured patients or some people with costly medical bills.

Even in states like California, it can be hard to see how those policies affect patients who struggle to access care, said Barnett of the Public Health Institute. He said he’d like to see states require hospitals to reduce health disparities with specific outcomes, such as lowering preventable emergency room visits by people from especially poor neighborhoods.

In 2025, California will start requiring hospitals to submit annual reports that include an analysis of access to care and a plan to address disparities. The state is still defining those reporting rules.

Whatever standard states employ, health policy researchers said promoting transparency is key, such as by standardizing reporting rules to provide a clear picture across systems. Bai said Montana’s rules are a good first step.

Matkin, from the state health department, said whatever giving benchmarks Montana sets won’t be a copy-and-paste of what others have tried. The department plans to create standards unique to Montana.

California Speeds Up Indoor Heat Protections Amid Sweltering Summer Weather

SACRAMENTO, Calif. — Californians working indoors are getting immediate protections from extreme heat as much of the state bakes in triple-digit temperatures this week.

California has had heat standards on the books for outdoor workers since 2005, but the state announced Wednesday that a set of rules for indoor workers had been finalized following an expedited review. The state’s Occupational Safety and Health Standards Board approved the regulation last month, but it needed to be vetted for legal compliance.

“This regulation provides protections for workers across California and helps prepare employers to deal with the challenges of rising temperatures in indoor environments,” said Debra Lee, chief of California’s Division of Occupational Safety and Health.

California is among a few states responding to the growing impacts of climate change and extreme heat with worker safety standards. Earlier this month, the Biden administration proposed federal rules to protect indoor and outdoor workers from heat exposure as extreme heat, already the No. 1 weather-related killer in the U.S., becomes even more dangerous.

California’s standards require indoor workplaces to be cooled below 87 degrees Fahrenheit when employees are present and below 82 degrees in places where workers wear protective clothing or are exposed to radiant heat, such as furnaces. Worksites that don’t have air conditioning may use fans, misters, and other methods to bring the room temperature down.

The rules allow workarounds for businesses if they can’t cool their workplaces sufficiently. In those cases, employers must provide workers with water, breaks, areas where they can cool down, cooling vests, or other means to keep them from overheating.

But even with workarounds, businesses are concerned about the cost of complying with the regulation, especially small businesses that don’t own their storefronts or are in old buildings, said Robert Moutrie, a senior policy advocate at the California Chamber of Commerce.

“The simplest answer to this regulation is AC, and that’s a costly investment,” Moutrie said. “If you’re a small business and you don’t own your structure, you can’t make changes like creating a new space to cool down.”

The rules have been in development since 2016 — delayed, in part, because of the covid pandemic. The worker safety board requested the regulations be expedited. A standard review would have delayed the regulation taking effect until the fall, leaving workers largely unprotected from the summer heat.

The regulation applies to most indoor workplaces, including classrooms and even delivery vehicles. But state regulators exempted prisons and local correctional facilities after Gov. Gavin Newsom’s administration projected it could cost the California Department of Corrections and Rehabilitation billions of dollars to implement.

The board intends to draft a separate regulation for the tens of thousands of workers at the state’s 33 state prisons, conservation camps, and local jails. That could take a year, if not longer.

In 2021, the Department of Health and Human Services reported, 1,602 heat-related deaths occurred nationally, which is likely an undercount because health care providers are not required to report them. In 2023, HHS reported, 2,302 heat-related deaths occurred. It’s not clear how many of these deaths are related to work, either indoors or outdoors.

Meanwhile, global temperatures in June were a record high for the 13th straight month.

“This is really one of the biggest safety issues we see workers experiencing across California in many different industries,” said Tim Shadix, legal director at the Warehouse Worker Resource Center, which lobbied for the protections. “And the problem is only getting worse with climate change and hotter summers.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

Louisiana Reclassifies Drugs Used in Abortions as Controlled Dangerous Substances

Louisiana lawmakers have added two drugs commonly used in pregnancy and reproductive health care to the state’s list of controlled dangerous substances, a move that has alarmed doctors in the state.

Mifepristone and misoprostol have many clinical uses, and one use approved by the FDA is to take the pills to induce an abortion at up to 10 weeks of gestation.

The bill that moved through the Louisiana Legislature this spring lists both medications as Schedule IV drugs under the state’s Uniform Controlled Dangerous Substances Law, creating penalties of up to 10 years in prison for anyone caught with the drugs without a valid prescription. Gov. Jeff Landry, a Republican, signed the bill into law in May. It takes effect Oct. 1.

The new law is the latest move by anti-abortion advocates trying to control access to abortion medications in states with near-total abortion bans, such as Louisiana. The law is the first of its kind, opening a new front in the state-by-state battle over reproductive medicine.

Republican-controlled states have passed various laws regulating medication abortion in the past, said Daniel Grossman, an OB-GYN and a reproductive health researcher at the University of California-San Francisco.

But after the Dobbs v. Jackson Women’s Health Organization decision in 2022, in which the Supreme Court ruled there was no constitutional right to an abortion, scrutiny of medication abortions escalated as clinics in certain states shuttered completely or were required to stop offering in-clinic procedures.

“It’s not surprising that states are trying everything they can to try to restrict these drugs,” Grossman said. “But this is certainly a novel approach.”

Before the Louisiana bill passed, more than 250 OB-GYNs and emergency, internal medicine, and other physicians from across the state signed a letter to the bill’s sponsor, state Sen. Thomas Pressly, a Republican, arguing the move could threaten women’s health by delaying lifesaving care.

“It’s just really jaw-dropping,” said Nicole Freehill, a New Orleans OB-GYN who signed the letter. “Almost a day doesn’t go by that I don’t utilize one or both of these medications.”

Mifepristone and misoprostol are routinely used to treat miscarriages, stop obstetric hemorrhaging, induce labor, or prepare the cervix for a range of procedures inside the uterus, such as inserting an IUD or taking a biopsy of the uterine lining.

Bill Born From a Family’s Misfortune

The proposal to reschedule the drugs as controlled dangerous substances was introduced as amendments to Pressly’s original bill creating the crime of “coerced criminal abortion” — where someone “knowingly” gives abortion pills to a pregnant woman to cause or attempt to cause an abortion “without her knowledge or consent.”

Pressly’s sister, Catherine Pressly Herring, testified at the hearing on the bill that she had been given abortion drugs without her knowledge by her former husband. Pressly said his sister’s story prompted the legislation.

In a statement, Pressly said that he added the new amendments to “control the rampant illegal distribution of abortion-inducing drugs.” He did not respond to requests for comment.

“By placing these drugs on the controlled substance list, we will assist law enforcement in protecting vulnerable women and unborn babies,” Pressly wrote in this statement.

Louisiana Right to Life, the state’s most influential anti-abortion group, helped draft the bill. And the group’s communications director, Sarah Zagorski, said that claims that rescheduling the drugs as dangerous could harm women’s health are “fearmongering.”

The real problem, she said, is that mifepristone and misoprostol are too accessible in Louisiana and are being used to induce abortions despite the state’s ban.

“We’ve had pregnancy centers email us with many stories of minors getting access to this medication,” Zagorski said.

Studies have shown a surge in the ordering of abortion pills online in states that have severe restrictions on abortion.

In the Louisiana Legislature committee hearing on the bill, anti-abortion advocates said that physicians would still be allowed to dispense mifepristone and misoprostol for lawful medical care, and that women who give themselves abortions using the medications would be exempted from criminal liability.

“Under this law, or any abortion law, in Louisiana we see the woman as often the second victim,” testified Dorinda Plaisance, a lawyer who works with Louisiana Right to Life. “And so Louisiana has chosen to criminalize abortion providers” rather than women who use the medications for their own abortions.

Move ‘Not Scientifically Based,’ Doctors Say

The U.S. Drug Enforcement Administration and individual states have the power to list drugs as controlled dangerous substances.

State and federal regulations aim to control access to drugs, such as opioids, based on their medical benefit and their potential for abuse, according to Joseph Fontenot, executive director of the Louisiana Board of Pharmacy, the agency that monitors drugs listed as controlled dangerous substances.

Like other states, Louisiana tracks prescriptions in databases that include the name of the patient, the health provider who wrote the prescription, and the dispensing pharmacy.

Physicians need a special license to prescribe the drugs — in 2023, there were 18,587 physicians in Louisiana, 13,790 of whom had a license to prescribe controlled dangerous substances, according to data from the Louisiana State Board of Medical Examiners and the Board of Pharmacy.

“Every state has a prescription drug monitoring program. And they really are designed to identify prescription drug mills that are hawking fentanyl and opioid painkillers,” said Robert Mikos, a professor of law and a drug policy expert at Vanderbilt University.

What happened to Pressly’s sister — being tricked into taking mifepristone or misoprostol — is a form of drug abuse, said Zagorski of Louisiana Right to Life, which is why the drugs should be more strictly controlled.

But Fontenot, of the Louisiana Board of Pharmacy, said that under Louisiana’s law, abuse refers to addiction. Jennifer Avegno, a New Orleans emergency physician and the director of the New Orleans Health Department, agrees. “There is no risk of someone getting hooked on misoprostol,” Avegno said.

Under the new law, mifepristone and misoprostol will be added to a list comprised of opioids, depressants, and stimulants. “To classify these medications as a drug of abuse and dependence in the same vein as Xanax, Valium, Darvocet is not only scientifically incorrect, but [a] real concern for limiting access to these drugs,” Avegno said.

Doctors worry that the bill could set a dangerous precedent for state officials who want to restrict access to any drug they consider dangerous or objectionable, regardless of its addictive potential, Avegno said.

Fears Over Delays in Care

In their letter opposing the reclassification, doctors said the “false perception that these are dangerous drugs” could lead to “fear and confusion among patients, doctors, and pharmacists, which delays care and worsens outcomes” in a state with high rates of maternal injury and death.

The increased scrutiny could have a statewide chilling effect and make doctors, pharmacists, and even patients more reluctant to use these drugs, the doctors wrote.

The state database allows any doctor or pharmacist to look up the prescription history of his or her patient. The data is also accessible by the Louisiana State Board of Medical Examiners, which licenses physicians and other providers, and by law enforcement agencies with a warrant.

“Could I be investigated for my use of misoprostol? I don’t know,” said Freehill, the New Orleans OB-GYN.

Pharmacists could become more reluctant to dispense the medications, Freehill said, exacerbating a problem she and other OB-GYNs have been dealing with since Louisiana banned nearly all abortions. That reluctance could lead to patients miscarrying without timely treatment.

“They could be sitting there bleeding, increasing their risk that they would have a dangerous amount of blood loss” or risking infection, she said.

Before the bill passed, Freehill routinely phoned in every prescription for misoprostol when her patients were miscarrying so she could explain to the pharmacist why she was prescribing it. Once the bill goes into effect in the fall and the drug becomes a controlled dangerous substance, that will no longer be possible because those types of prescriptions must be written on a pad or sent electronically.

In hospitals, the drugs will also have to be locked away. That could potentially cause delays getting the drug when a patient is hemorrhaging after childbirth.

Doctors worry some patients might be afraid to take the medications once they’re listed as dangerous, Avegno said.

In a written response to the Louisiana physicians who signed the protest letter, Pressly said the doctors whom he’s spoken with feel the bill “will not harm health care for women.”

Criminalizing Support for Abortions

Louisiana’s abortion ban already makes it a crime to provide an abortion, including by giving someone medications used to induce abortion. And a 2022 law added up to 50 years in prison for mailing mifepristone or misoprostol.

Because the new law explicitly exempts pregnant women, opponents like Elizabeth Ling believe it is meant to isolate those women from others who would help them. Ling, a reproductive rights attorney at If/When/How, is particularly concerned about the prison penalties, which she believes are intended to frighten and disrupt underground networks of support for patients seeking the pills.

Pregnant patients might worry about ordering online or enlisting a friend to help obtain the pills: “Is my friend who is simply just providing me emotional support going to somehow, you know, be punished for doing that?” Ling said.

Ling added that there’s concern that the law could also be used to target people who aren’t pregnant but who want to order abortion pills online and stock them in case of a future pregnancy. That practice has become increasingly popular in states with abortion bans.

This article is from a partnership that includes WWNO, NPR, and KFF Health News.

World-Famous Wall Drug Isn’t Immune From Challenges Facing Rural Pharmacies

WALL, S.D. — Stacey Schulz parks in a rear lot to avoid the crowded Main Street entrances to her local pharmacy.

“During the summer, it’s kind of hectic,” she said after greeting the pharmacist and technician by name.

That’s because Schulz’s pharmacy is tucked inside Wall Drug, a tourist attraction that takes up almost an entire block and draws more than 2 million visitors a year to a community of fewer than 700 residents.

The business is named after the town of Wall, which is just off Interstate 90 near Badlands National Park. Colorful, hand-painted billboards dot the roadside for hundreds of miles, telling motorists how far they are from Wall Drug’s free ice water, 5-cent coffee, and homemade doughnuts. Visitors can pan for gold, listen to singing animatronic cowboys, try on Western wear, and shop for souvenirs, including plush jackalopes — mythical jackrabbits with antelope horns.

Despite being part of a booming tourist attraction, Wall Drug’s pharmacy faces challenges common to independent rural pharmacies.

It’s the lone pharmacy in Wall, serving locals year-round. Some, like Schulz, live in town, while others live on ranches as far as 60 miles away. The next-nearest pharmacy is a 30-minute drive northeast.

Wall Drug also serves tourists who forget their prescriptions at home, get sick while roaming the country in their RVs, or hurt themselves while hiking through the otherworldly rock formations of the scorching Badlands, said Cindy Dinger, its sole pharmacist.

A photo of a pharmacist seem behind a pane of glass with a round hole. The hole frames her head and shoulders.
Pharmacist Cindy Dinger says her corner of the store would struggle without the rest of Wall Drug. “All this stuff around us — the poster and print shop, the boot shop, the fudge shop, the café — they pay our bills,” she says.(Arielle Zionts/KFF Health News)

Wall has no hospital, but a clinic is open four days a week. Schulz, a medical assistant there, said she and her co-workers see a lot of summer tourists. They send them to Wall Drug to pick up prescriptions.

“And then we tell them to get fudge before they leave,” Schulz said.

Rural pharmacies, especially independent ones, closed at a higher rate from 2003 to 2021 than pharmacies in other areas, according to a study by the Rural Policy Research Institute. By 2021, the institute found, nearly 8% of rural counties were left with no pharmacy. The Wall Drug pharmacy has fewer customers than a typical city pharmacy, which can mean less profit, Dinger said.

She said some of its prices are higher because the store can’t negotiate discounts as steep as the deals suppliers grant chain pharmacies. Rural drugstores also lack leverage with insurers, and they face increasing competition from mail-order pharmacies.

Another challenge is staffing. When Dinger needs time off, she finds a fill-in from Rapid City, nearly an hour’s drive away.

“It’s a challenge getting relief if I want to go on vacation or if I need a cover so that I can go to a doctor’s appointment,” she said. “You take what you can get and try to schedule around it.”

Dinger said her pharmacy would struggle without the rest of Wall Drug.

“All this stuff around us — the poster and print shop, the boot shop, the fudge shop, the café — they pay our bills,” she said.

The pharmacy’s white facade, with stained-glass signs and windows, is modeled after that of the original drugstore, which was across the street. The window displays and top shelves inside the store are filled with vintage pharmacy supplies, including manuals, glass medicine bottles, and a suppository-making machine.

Tourists carrying shopping bags and sporting new cowboy hats stop to look at the displays. “It’s a real pharmacy,” a woman said, sounding surprised.

Dinger and Sylvia Smith, the store’s only pharmacy tech, ring customers up below a Tiffany-style light fixture and retrieve prescriptions stored behind a wooden desk and wall.

Wall Drug’s pharmacy, across from its chapel and sandwiched between the fudge and rockhound shops along “Cowboy Alley,” takes up less than 1% of the space within the 76,000-square-foot tourist attraction in South Dakota. (Arielle Zionts/KFF Health News)
A photo of a pharmacist scanning a tourist's items at a cash register.
Dinger checks out tourist Will Lovitt after giving him advice on treating a mysterious rash he developed while visiting the Black Hills of South Dakota. (Arielle Zionts/KFF Health News)
Sylvia Smith, the sole pharmacy tech at Wall Drug, works behind a wooden counter. Shelves display vintage equipment alongside modern medicine. (Arielle Zionts/KFF Health News)
Stacey Schulz has to navigate around tourists when she picks up medicine during the summer from her local pharmacy, Wall Drug. (Arielle Zionts/KFF Health News)

Customer Will Lovitt said a friend advised him and his wife to stop at Wall Drug during their drive from Indiana to the Black Hills in western South Dakota. Lovitt developed a rash on the trip and ended up using the visit to get Dinger’s advice on treating it.

He said it can be difficult for tourists to know where to find medical help, especially when driving through rural states like South Dakota.

“I think it’s time that America gets back to the grass roots of the small-town doctor and the small-town pharmacist,” Lovitt said.

Alex Davis and a friend decided to visit Wall Drug on their road trip from Kansas to Yellowstone National Park.

“Then, when I saw there was a little pharmacy, I thought I’d grab something that I needed,” she said.

Davis bought Dramamine to treat car sickness on the long drive.

Dinger said she occasionally sees unusual situations, like the time several years ago when a park ranger needed antibiotics after getting bitten by a prairie dog.

“You never know what kind of diseases they might be carrying,” she said of the animals, which recently were hit with an outbreak of plague.

Rick Hustead is the chairman of Wall Drug. The store was opened in 1931 by his grandfather, pharmacist Ted Hustead. Ted’s wife, Dorothy, had the idea to advertise its soda fountain and free ice water to tourists traveling along unpaved roads during the hot years of the Dust Bowl era. Rick’s father, pharmacist Bill Hustead, began expanding the store in the ’50s, turning it into the tourist magnet it is today.

A photo of an older man working behind a counter with a young woman.
Rick Hustead, chairman of Wall Drug, works the restaurant counter when things get busy. Hustead, whose grandfather opened the store in 1931, says he’d never close the pharmacy, even though it’s not the main attraction. “We can’t be Wall Drug without being a drugstore,” he says.(Arielle Zionts/KFF Health News)

Rick Hustead didn’t follow his father and grandfather’s path to pharmacy school, so he had to recruit pharmacists from elsewhere.

Hustead found Dinger in 2010 after writing a letter to each pharmacist in the state.

Dinger said she was living at the time in Sioux Falls, South Dakota’s most populous city. But she and her husband were interested in raising their kids in a small town, the way she grew up. Dinger was also attracted by the store’s limited hours: She’d be done working by 5 p.m. on weekdays and have the weekends off.

Hustead said his family has never considered closing the pharmacy, even though it’s not the main attraction for most visitors.

“We can’t be Wall Drug without being a drugstore,” he said.

California Forges Ahead With Social Media Rules Despite Legal Barriers

California lawmakers are pursuing legislation aimed at protecting children from the dangers of social media, one of many efforts around the country to confront what U.S. Surgeon General Vivek Murthy and other public health experts say is a mental health emergency among young people.

But California’s efforts, like those in other states, will likely face the same legal challenges that have thwarted previous legislative attempts to regulate social media. The tech industry has argued successfully that imposing rules regulating how social media operate and how people can use the online services violates the free speech rights of the companies and their customers.

A previous effort at confronting the issue, the California Age-Appropriate Design Code Act in 2022, now rests with the U.S. Court of Appeals for the 9th Circuit. A tech trade association sued to block the law and won an injunction from a lower court, largely on First Amendment grounds. The appeals court heard oral arguments in the case on July 17.

“At the end of the day, unconstitutional law protects zero children,” said Carl Szabo, vice president and general counsel for NetChoice, which argued for the tech giants before the federal appellate court.

Like the design code act, the two proposals now working their way through the California Legislature would reshape the way social media users under 18 interact with the services.

The first bill, by state Sen. Nancy Skinner (D-Berkeley), prohibits sending push notifications to children at night and during school hours. Skinner’s measure also requires parental permission before platforms can send social media offerings via algorithms, which are designed to offer feeds that children didn’t ask for but might keep them looking at their phones longer, rather than the traditional chronological feeds of those they follow on the app.

The second measure, by Assemblymember Buffy Wicks (D-Oakland), would amend California’s privacy laws to prohibit businesses from collecting, using, selling, or sharing data on minors without their informed consent — or, for those under 13, without their parents’ approval.

Both bills have bipartisan support and are backed by state Attorney General Rob Bonta. “We need to act now to protect our children,” Bonta said earlier this year, by “strengthening data privacy protections for minors and safeguarding youth against social media addiction.”

California Gov. Gavin Newsom, a Democrat, has been vocal about youth and social media, too, and recently called for a statewide ban on cellphones in schools. His positions on the two social media proposals are not yet known. “But I think the governor, like most every other Californian, is concerned about the harms of social media on kids,” Skinner said.

California’s efforts are especially significant because its influence as the most populous state often results in its setting standards that are then adopted by other states. Also, some of the big tech companies that would be most affected by the laws, including Meta, Apple, Snap, and Alphabet, the parent company of Google, are headquartered in the state.

“Parents are demanding this. That’s why you see Democrats and Republicans working together,” said Wicks, who with a Republican colleague co-authored the design code act that is tied up in litigation. “Regulation is coming, and we won’t stop until we can keep our kids safe online.”

The fate of the design code act stands as a cautionary tale. Passed without a dissenting vote, the law would set strict limits on data collection from minors and order privacy settings for children to default to their highest levels.

NetChoice, which immediately sued to block the law, has prevailed in similar cases in Ohio, Arkansas, and Mississippi. It is challenging legislation in Utah that was rewritten after NetChoice sued over the original version. And NetChoice’s lawyers argued before the U.S. Supreme Court that efforts in Texas and Florida to regulate social media content were unconstitutional. Those cases were remanded to lower courts for further review.

Though the particulars differ in each state, the bottom line is the same: Each of the laws has been stifled by an injunction, and none has taken effect.

“When you look at these sweeping laws like the California laws, they’re ambitious and I applaud them,” said Nancy Costello, a clinical law professor at Michigan State University and the director of the school’s First Amendment Clinic. “But the bigger and broader the law is, the greater chance that there will be a First Amendment violation found by the courts.”

The harmful effects of social media on children are well established. An advisory from Surgeon General Murthy last year warned of a “profound risk of harm” to young people, noting that a study of adolescents from ages 12 to 15 found that those who spent more than three hours a day on social media were at twice the risk of depression and anxiety as nonusers. A Gallup survey in 2023 found that U.S. teenagers spent nearly five hours a day on social media.

In June, Murthy called for warnings on social media platforms like those on tobacco products. Later that month came Newsom’s call to severely restrict the use of smartphones during the school day in California. Legislation to codify Newsom’s proposal is working its way through the state Assembly.

Federal legislation has been slow to materialize. A bipartisan bill to limit algorithm-derived feeds and keep children under 13 off social media was introduced in May, but Congress has done little to meaningfully rein in tech platforms — despite Meta’s chief executive, Mark Zuckerberg, apologizing in a U.S. Senate hearing for “the types of things that your families have had to suffer” because of social media harms.

It remains unclear what kinds of regulation the courts will permit. NetChoice has argued that many proposed social media regulations amount to the government dictating how privately owned firms set their editorial rules, in violation of the First Amendment. The industry also leans on Section 230 of the 1996 Communications Decency Act, which shields tech companies from liability for harmful content produced by a third party.

“We’re hoping lawmakers will realize that as much as you may want to, you can’t end-around the Constitution,” said Szabo, the NetChoice attorney. “The government is not a substitute for parents.”

Skinner tried and failed last year to pass legislation holding tech companies accountable for targeting children with harmful content. This year’s measure, which was overwhelmingly passed by the California Senate and is pending in the state Assembly, would bar tech companies from sending social media notifications to children between midnight and 6 a.m. every day, and 8 a.m. to 3 p.m. on school days. The bill also calls for platforms to require minors to obtain parental consent to use their core offerings, and would limit their use to an hour to 90 minutes a day by default.

“If the private sector is not willing to modify their product in a way that makes it safe for Californians, then we have to require them to,” Skinner said, adding that parts of her proposal are standard practice in the European Union.

“Social media has already accommodated users in many parts of the world, but not the U.S.,” she said. “They can do it. They’ve chosen not to.”

Wicks, meanwhile, said she considers her data bill to be about consumer protection, not speech. The proposal would close a loophole in the California Electronic Communications Privacy Act to prevent social media platforms from collecting and sharing information on anyone under 18 unless they opt in. The Assembly approved Wicks’ measure without dissent, sending it to the state Senate for consideration.

Costello suggested that focusing the proposals more narrowly might give them a better chance of surviving court challenges. She is part of an effort coordinated by Harvard’s T.H. Chan School of Public Health to write model legislation that would require third-party assessments of the risks posed by the algorithms used by social media apps.

“It means that we’re not restricting content, we’re measuring harms,” Costello said. Once the harms are documented, the results would be publicly available and could lead state attorneys general to take legal action. Government agencies adopted a similar approach against tobacco companies in the 1990s, suing for deceptive advertising or business practices.

Szabo said NetChoice has worked with states to enact what he called “constitutional and commonsense laws,” citing measures in Virginia and Florida that would mandate digital education in school. “There is a role for government,” Szabo said. (The Florida measure failed.)

But with little momentum on actual regulation at the national level, state legislators continue to try to fill the vacuum. New York recently passed legislation similar to Skinner’s, which the state senator said was an encouraging sign.

Will NetChoice race for an injunction in New York? “We are having lots of conversations about it,” Szabo said.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

Rescue From Above: How Drones May Narrow Emergency Response Times

The drones are coming.

Starting in September, if someone in Clemmons, North Carolina, calls 911 to report a cardiac arrest, the first responder on the scene may be a drone carrying an automated external defibrillator, or AED.

“The idea is for the drone to get there several minutes before first responders,” such as an emergency medical technician or an ambulance, said Daniel Crews, a spokesperson for the sheriff’s office in Forsyth County, where Clemmons is located. The sheriff’s office is partnering on the project with local emergency services, the Clinical Research Institute at Duke University, and the drone consulting firm Hovecon. “The ultimate goal is to save lives and improve life expectancy for someone experiencing a cardiac episode,” Crews said.

The Forsyth County program is one of a growing number of efforts by public safety and health care organizations across the country to use drones to speed up lifesaving treatment in situations in which every second counts.

More than 356,000 people have a cardiac arrest outside of a hospital setting every year in the United States, according to the American Heart Association. Most people are at home when it happens, and about 90% die because they don’t get immediate help from first responders or bystanders. Every minute that passes without medical intervention decreases the odds of survival by 10%.

“We’ve never been able to move the needle for cardiac arrest in private settings, and this technology could meet that need,” said Monique Anderson Starks, a cardiologist and associate professor of medicine at Duke University. Starks is leading pilot studies in Forsyth County and James City County, Virginia, to test whether drone AED delivery can improve treatment response times. The work is funded by a four-year grant from the American Heart Association.

A 2017 study found it takes an emergency medical services unit seven minutes, on average, to arrive on the scene following a 911 call, though response times vary considerably by region, and rural wait times can be much longer. Starks said she believes the drone-delivered AEDs in the pilot study could reduce the time to treatment by four minutes compared with first responders.

Unlike a heart attack, which occurs when blood flow to the heart is blocked, a cardiac arrest happens when a heart malfunction causes it to stop beating, typically because of an arrhythmia or an electrical problem. Eighty percent of cardiac arrests start as heart attacks. The only way to get the heart restarted is with CPR and a defibrillator.

In Forsyth County, a drone pilot from the sheriff’s department will listen in on 911 calls. If there’s a suspected cardiac arrest, the pilot can dispatch the drone even before emergency medical services are contacted. The drone, which weighs 22 pounds and can travel 60 mph, will fly to the location and hover 125 feet in the air before lowering an AED to the ground on a winch. The AED provides simple verbal instructions; the 911 dispatcher on the phone can also help a bystander use the AED.

Eventually there will be six drone bases in Forsyth and James City counties, Starks said.

While the technology is promising and research has often found that drones arrive faster than first responders, there’s little conclusive evidence that drones improve health outcomes.

A Swedish study published in The Lancet in 2023 compared the response times between drones and ambulances for suspected cardiac arrest in 58 deployments in an area of about 200,000 people. It found that drones beat the ambulance to the scene two-thirds of the time, by a median of three minutes and 14 seconds.

In the United States, most programs are just getting started, and they are exploring the use of drones to also provide remedies for drug overdoses and major trauma or potential drowning rescues.

In Florida, Tampa General Hospital, Manatee County, and Archer First Response Systems, or AFRS, began a program in May to deliver AEDs, a tourniquet, and Narcan, a nasal spray that can reverse an opioid overdose. The program initially covers a 7-square-mile area, and EMS dispatchers deploy the drones, which are monitored by drone pilots.

There were nearly 108,000 drug overdose deaths in the United States in 2022, according to the National Institute on Drug Abuse.

As of early July, the Tampa program hadn’t yet deployed any drones, said Gordon Folkes, the founder and chief executive of AFRS, which develops and deploys emergency drone logistics systems. One request in June to send a drone to an overdose couldn’t be fulfilled because of a violent thunderstorm, Folkes said. In the testing area, which covers about 7,000 residents, Folkes estimates that 10 to 15 drones might be deployed each year.

“The bread and butter for these systems is suburban areas” like Manatee County that are well-populated and where the drones have the advantage of being able to avoid traffic congestion, Folkes said.

There are other uses for drones in medical emergencies. The New York Police Department plans to drop emergency flotation devices to struggling swimmers at local beaches. In Chula Vista, California, a police drone was able to pinpoint the location of a burning car, and then officers pulled the driver out, said Sgt. Tony Molina.

Rescue personnel have used drones to locate people who wander away from nursing homes, said James Augustine, a spokesperson for the American College of Emergency Physicians who is the medical director for the International Association of Fire Chiefs.

In the United States, one hurdle for drone programs is that the Federal Aviation Administration typically requires that drones be operated within the operators’ visual line of sight. In May, when Congress passed the FAA reauthorization bill, it gave the FAA four months to issue a notice of proposed rulemaking on drone operations beyond the visual line of sight.

“The FAA is focused on developing standard rules to make [Beyond Visual Line of Sight] operations routine, scalable, and economically viable,” said Rick Breitenfeldt, an FAA spokesperson.

Some civil liberties groups are concerned that the FAA’s new rules may not provide enough protection from drone cameras for people on the ground.

Jay Stanley, a senior policy analyst at the American Civil Liberties Union, acknowledged the benefits of using drones in emergency situations but said there are issues that need to be addressed.

“The concern is that the FAA is going to significantly loosen the reins of drones without any significant privacy protections,” he said.

Rescate desde el cielo: cómo los drones pueden reducir el tiempo de respuesta a una emergencia

A partir de septiembre, si alguien en Clemmons, Carolina del Norte, llama al 911 para pedir ayuda porque una persona está sufriendo un paro cardíaco, el primero en intervenir en la escena podrá ser un dron que lleve un Desfibrilador Externo Automático, o DEA.

“La idea es que el dron llegue varios minutos antes que los primeros socorristas”, como un técnico en emergencias médicas o una ambulancia, dijo Daniel Crews, vocero de la oficina del sheriff en el condado de Forsyth, donde se encuentra Clemmons.

La oficina del sheriff está llevando adelante este proyecto en alianza con los servicios de emergencia locales, con el Instituto de Investigación Clínica de la Universidad de Duke y con Hovecon, una empresa de consultoría en drones. “El objetivo final es evitar muertes y aumentar la esperanza de vida de quienes sufren un episodio cardíaco”, dijo Crews.

Cada vez con más frecuencia, en todo el país, las organizaciones de emergencias médicas y  las de seguridad pública están utilizando drones para acelerar la intervención en situaciones en las que cada segundo es importante para salvar vidas. El Programa del Condado de Forsyth es una de esas iniciativas.

En Estados Unidos cada año más de 356,000 personas sufren un paro cardíaco fuera de un hospital, según la Asociación Americana del Corazón (AHA). La mayoría se descompensa estando en su casa y alrededor del 90% muere porque no recibe ayuda inmediata del personal de emergencias médicas o de los transeúntes. Cada minuto que pasa sin intervención médica disminuye las probabilidades de supervivencia en un 10%.

“Nunca hemos podido alcanzar una mejora significativa en el tiempo de atención de los accidentes cardiológicos cuando se producen en entornos privados, y esta tecnología podría ayudarnos a lograr ese objetivo”, dijo Monique Anderson Starks, cardióloga y profesora asociada de Medicina en la Universidad de Duke.

Starks lidera estudios piloto en los condados de Forsyth y James City, en Virginia, que están midiendo si efectivamente la entrega de DEA con drones puede mejorar los tiempos de respuesta al tratamiento. El trabajo está financiado por una subvención de cuatro años de la AHA.

Según un trabajo de 2017, después de una llamada al 911 una unidad de servicios médicos de emergencia necesita un promedio de siete minutos para llegar al lugar. Sin embargo, los tiempos de respuesta varían considerablemente según la región. Y en el caso de las áreas rurales pueden ser muchísimo más largos.

Starks dijo que cree que los DEA entregados por drones podrían reducir el tiempo de intervención en cuatro minutos respecto de lo que tardan los primeros socorristas.

A diferencia de un ataque cardíaco, que ocurre cuando está bloqueado el flujo sanguíneo al corazón, un paro cardíaco sucede cuando este órgano deja de latir, generalmente debido a una arritmia o a un problema eléctrico. El 80% de los paros cardíacos comienzan como ataques cardíacos. La única manera de reiniciar el corazón es con resucitación cardiopulmonar (RCP) y un desfibrilador.

En el condado de Forsyth, un piloto de drones de la oficina del sheriff escuchará las llamadas al 911. Si sospecha que se está ante un paro cardíaco, el piloto puede despachar el dron incluso antes de que se contacten los servicios de emergencia médica.

El dron, que pesa 22 libras y puede viajar a 60 mph, volará hasta el lugar y se mantendrá a 125 pies de altura antes de bajar un DEA al suelo, ayudado por un dispositivo mecánico.

El DEA imparte instrucciones verbales simples y, desde su puesto, también el operador de la línea 911 podrá ayudar a usar el desfibrilador a cualquier persona sin experiencia que esté cerca. Con el tiempo se espera que haya seis bases de drones en los condados de Forsyth y James City, dijo Starks.

Sin embargo, aunque la tecnología es prometedora y la investigación a menudo ha comprobado que los drones llegan más rápido que los primeros equipos de emergencia, existe poca evidencia concluyente de que mejoren los resultados de los socorristas.

Un estudio realizado en Suecia y publicado en 2023 por The Lancet comparó los tiempos de respuesta entre drones y ambulancias para casos sospechosos de paros cardíacos en 58 intervenciones que abarcaron una población de alrededor de 200,000 personas.

El estudio llegó a la conclusión de que en el 66,67% de las ocasiones analizadas, los drones llegaron antes que las ambulancias y que esto significó que, en promedio, se anticiparon 3 minutos y 14 segundos.

En Estados Unidos, la mayoría de los programas recién están comenzando. Se está explorando el uso de drones para intervenir en casos de sobredosis de drogas, de traumas mayores y en los rescates a personas que estuvieron en riesgo de ahogarse.

En Florida, el Hospital General de Tampa, el condado de Manatee y los Sistemas de Respuesta Inmediata Archer o AFRS, iniciaron un programa en mayo para entregar DEA, torniquetes y Narcan, un spray nasal que puede revertir la sobredosis de opioides.

El programa inicialmente cubre un área de 7 millas cuadradas y los operadores de los servicios médicos de emergencia (EMS) despliegan los drones, que son monitoreados por pilotos especializados. En 2022, hubo casi 108,000 muertes por sobredosis de drogas en el país, según el Instituto Nacional sobre el Abuso de Drogas.

Hasta principios de julio, el programa de Tampa aún no había enviado ningún dron, explicó Gordon Folkes, fundador y director ejecutivo de AFRS, que desarrolla y despliega sistemas de logística de drones de emergencia.

Una solicitud recibida en junio para que enviaran un dron en un caso por sobredosis no pudo cumplirse por razones climáticas, lo impidió una tormenta violenta, dijo Folkes. En el área de prueba, que cubre aproximadamente a 7,000 residentes, Folkes estima que se podrían desplegar de 10 a 15 drones cada año.

“El punto fuerte de estos sistemas son las áreas suburbanas muy pobladas, como el condado de Manatee, porque los drones tienen la ventaja de poder evitar las congestiones de tráfico”, agregó Folkes.

Hay otros usos para los drones en emergencias médicas. El Departamento de Policía de Nueva York planea lanzar dispositivos de flotación de emergencia a los nadadores que se encuentren en problemas en las playas locales. Además, en Chula Vista, California, un dron de la policía pudo identificar la ubicación de un auto en llamas, y eso permitió que los oficiales sacaran al conductor, dijo el sargento Tony Molina.

El personal de rescate ha utilizado drones para localizar a personas que se alejan de los hogares de adultos mayores, dijo James Augustine, vocero del Colegio Americano de Médicos de Emergencia, quien es el director médico de la Asociación Internacional de Jefes de Bomberos.

En Estados Unidos, un obstáculo para los programas de drones es que la Administración Federal de Aviación (FAA) generalmente requiere que los drones sean manejados dentro de la línea de visión de los operadores. En mayo, cuando el Congreso aprobó la ley de reautorización de la FAA, se le otorgó un plazo de cuatro meses para emitir una propuesta de reglamentación sobre las operaciones de drones más allá de la línea de visión.

“La FAA se está concentrando en desarrollar reglas estándar para hacer que las operaciones (más allá del campo visual) sean rutinarias, y económicamente viables”, dijo Rick Breitenfeldt, vocero de la FAA.

Por otro lado, algunos grupos de libertades civiles están preocupados porque las nuevas reglas de la FAA no proporcionen suficiente protección contra las cámaras de los drones para las personas en tierra.

Jay Stanley, analista de políticas senior de la Unión Americana de Libertades Civiles, reconoció los beneficios de usar drones en situaciones de emergencia pero consideró que aún hay problemas que deben abordarse.

“La preocupación es que la FAA va a flexibilizar significativamente las restricciones a los drones sin ninguna protección significativa de la privacidad”, expresó.