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Aug. 16, 2021 -- Minnesota resident Sheletta Brundidge, 49, expected her son to ask for an Xbox or a pair of LeBron James shoes for his 15th birthday. Instead, he had one simple request. That his mother get vaccinated against erectile dysfunction treatment. €œWhat's going to happen to us if you get sick?.

Or if you die?. € asked now 15-year-old Andrew. €œThat touched my heart,” says Brundidge, the mother of four children, three of whom have special needs. €œI never thought about how my decision to not get the treatment would affect my kids. He made me realize it was not just a personal decision.

I had to get it for my kids and my community.” Less than 2 weeks after Andrew’s birthday, Brundidge gave him the gift he requested. On Friday, she went to a grocery store pharmacy in Maplewood, MN, and received the first of two Pfizer shots. Since the start of the levitra, Brundidge, a local media personality, has recognized the seriousness of erectile dysfunction treatment. But as a Black woman, she has little faith in a health care system that has often brushed aside communities of color. Researchers have found that people of color do not receive the same level of care as white patients.

According to various studies, pain is often undertreated in people of color, and Black women are three times more likely to die from a pregnancy-related cause than white women. Brundidge says she nearly died while giving birth because doctors ignored her symptoms and concerns. €œThe health care system has not been fair or provided equity when treating Black and Brown patients,” she says. €œAs a Black woman, we need to fight to get basic care.” “Now they’re coming to our communities, having town halls, trying to convince us to get vaccinated. They care about our health now because it affects white people.” Communities of color have also been hardest hit by the levitra.

Black people who contract erectile dysfunction treatment are twice as likely to die. Of those fully vaccinated in the U.S., about 10% are Black. Andrew’s birthday wish was a wake-up call for his mom -- especially now, with the highly transmissible Delta variant around, Brundidge says. She knew she needed to do her part to stop the spread. Andrew held her hand the whole time, he says.

€œHer friends and my dad tried to talk her into it, but she wouldn’t do it,” he says. €œI decided to use that special birthday wish.” Knowing she’s on her way to full protection means he can breathe a little easier, he says. €œI feel happy knowing everyone is a bit safer,” says Andrew, who already got his treatment. €œIt’ll help us get back to normal, which is where everyone wants to be.” Brundidge is now encouraging others to get the shot. Minnesota Gov.

Tim Walz joined her at the pharmacy to help amplify her message. Walz said Brundidge gave him homework. To read up on the reasons for hesitancy in the Black community. "This Delta variant is not your Alpha variant. This is more dangerous, it's more contagious, and you're exactly right.

It has a disproportionate impact on communities of color, especially Black communities,” he said. €œThank you,” he said to Brundidge. €œThis is really bold.” WebMD Health News Sources The Journal of Pain. €œRacial and ethnic disparities in pain. Causes and consequences of unequal care.” NIH.gov.

CDC. €œVital Signs. Pregnancy-Related Deaths, United States, 2011-2015, and Strategies for Prevention, 13 States, 2013-2017,” “Risk for erectile dysfunction treatment , Hospitalization, and Death By Race/Ethnicity,” “Demographic Characteristics of People Receiving erectile dysfunction treatment Vaccinations in the United States.” © 2021 WebMD, LLC. All rights reserved..

Aug. 16, 2021 -- Minnesota resident Sheletta Brundidge, 49, expected her son to ask for an Xbox or a pair of LeBron James shoes for his 15th birthday. Instead, he had one simple request.

That his mother get vaccinated against erectile dysfunction treatment. €œWhat's going to happen to us if you get sick?. Or if you die?.

€ asked now 15-year-old Andrew. €œThat touched my heart,” says Brundidge, the mother of four children, three of whom have special needs. €œI never thought about how my decision to not get the treatment would affect my kids.

He made me realize it was not just a personal decision. I had to get it for my kids and my community.” Less than 2 weeks after Andrew’s birthday, Brundidge gave him the gift he requested. On Friday, she went to a grocery store pharmacy in Maplewood, MN, and received the first of two Pfizer shots.

Since the start of the levitra, Brundidge, a local media personality, has recognized the seriousness of erectile dysfunction treatment. But as a Black woman, she has little faith in a health care system that has often brushed aside communities of color. Researchers have found that people of color do not receive the same level of care as white patients.

According to various studies, pain is often undertreated in people of color, and Black women are three times more likely to die from a pregnancy-related cause than white women. Brundidge says she nearly died while giving birth because doctors ignored her symptoms and concerns. €œThe health care system has not been fair or provided equity when treating Black and Brown patients,” she says.

€œAs a Black woman, we need to fight to get basic care.” “Now they’re coming to our communities, having town halls, trying to convince us to get vaccinated. They care about our health now because it affects white people.” Communities of color have also been hardest hit by the levitra. Black people who contract erectile dysfunction treatment are twice as likely to die.

Of those fully vaccinated in the U.S., about 10% are Black. Andrew’s birthday wish was a wake-up call for his mom -- especially now, with the highly transmissible Delta variant around, Brundidge says. She knew she needed to do her part to stop the spread.

Andrew held her hand the whole time, he says. €œHer friends and my dad tried to talk her into it, but she wouldn’t do it,” he says. €œI decided to use that special birthday wish.” Knowing she’s on her way to full protection means he can breathe a little easier, he says.

€œI feel happy knowing everyone is a bit safer,” says Andrew, who already got his treatment. €œIt’ll help us get back to normal, which is where everyone wants to be.” Brundidge is now encouraging others to get the shot. Minnesota Gov.

Tim Walz joined her at the pharmacy to help amplify her message. Walz said Brundidge gave him homework. To read up on the reasons for hesitancy in the Black community.

"This Delta variant is not your Alpha variant. This is more dangerous, it's more contagious, and you're exactly right. It has a disproportionate impact on communities of color, especially Black communities,” he said.

€œThank you,” he said to Brundidge. €œThis is really bold.” WebMD Health News Sources The Journal of Pain. €œRacial and ethnic disparities in pain.

Causes and consequences of unequal care.” NIH.gov. CDC. €œVital Signs.

Pregnancy-Related Deaths, United States, 2011-2015, and Strategies for Prevention, 13 States, 2013-2017,” “Risk for erectile dysfunction treatment , Hospitalization, and Death By Race/Ethnicity,” “Demographic Characteristics of People Receiving erectile dysfunction treatment Vaccinations in the United States.” © 2021 WebMD, LLC. All rights reserved..

What side effects may I notice from Levitra?

Side effects that you should report to your prescriber or health care professional as soon as possible.

• back pain
• changes in hearing such as loss of hearing or ringing in ears
• changes in vision such as loss of vision, blurred vision, eyes being more sensitive to light, or trouble telling the difference between blue and green objects or objects having a blue color tinge to them
• chest pain or palpitations
• difficulty breathing, shortness of breath
• dizziness
• eyelid swelling
• muscle aches
• prolonged erection (lasting longer than 4 hours)
• skin rash, itching
• seizures

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• flushing
• headache
• indigestion
• nausea
• stuffy nose

This list may not describe all possible side effects.

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Under the stewardship levitra price of the MidMichigan Health Foundation, this year, 23 area students will received scholarship awards from the Tolfree Scholarship, the Dr. George Schaiberger, levitra price Sr., Dr. Howard VanOosten and Dr.

Lloyd Wiegerink Medical levitra price Scholarship, and the Paul A. Poling Memorial Scholarship.Awardees receiving the Dr. George Schaiberger, Sr., levitra price Dr.

Howard VanOosten and Dr. Lloyd Wiegerink levitra price Medical Staff Memorial Scholarship are. Allie Morand, Camden Groff, Nicholas Morse, Anna Erickson, levitra price Emily Terry, Brooke Chenette, Tyler Walters, Austin Raymond, Jordan Williams, Andrew Waack, Rylie Alward, Nicholas Thomas and Madison Nachtrieb.

Those receiving the Tolfree Scholarship are. Allie Morand, Nicholas Morse, Anna Erickson, Emily Terry and levitra price Andrew Waack. Lastly, awardees receiving the Paul A.Poling Memorial Scholarship are Emily Terry, Anna Erickson, Nicholas Morse, Allie Morand and Andrew Waack.“The intent of our generous donors in creating these scholarships is to provide our rural counties, particularly those served by MidMichigan Medical Center – West Branch, with future generations of excellent health care professionals,” said Nicole Potter, director, MidMichigan Health Foundation.

€œWe congratulate all of this year’s recipients, as well as the parents and teachers who help them levitra price arrive at this major milestone in these students’ lives. We wish each one of them the best of success and hope to see them back again in a few years serving the people of their own hometown.”Examples of the health professions being pursued by these individuals include physical therapy, pre-medicine, nursing, health administration, sports medicine, neuroscience and human biology.Applications for the 2021-2022 school year will be accepted from Dec. 1, 2020, through March 1, 2021 levitra price.

Those interested in reviewing the eligibility guidelines, including a scholarship application, may levitra price visit www.midmichigan.org/scholarships or call (989) 343-3694.Growers donate produce to staff and patients at MidMichigan Health Park – Bay.Residents in the Bay area have an additional opportunity to embrace healthy lifestyles near MidMichigan Health Park – Bay. Produce by the Park, a community garden that began late last year with a donation from MidMichigan Health Foundation, is flourishing, allowing patients, friends and neighbors to literally enjoy the fruits of their labor.Brenda Turner, director, MidMichigan Physicians Group, has a farming background and dreamt of a garden for her community for years. When the Health Park was built with ample property behind and support from the Foundation, that dream was brought to life.“We are so pleased to be able to support this project as it represents very well MidMichigan Health’s purpose of building levitra price healthy communities – together,” said Denise O’Keefe, executive director, MidMichigan Health Foundation.Other local organizations came on board to offer help.

Tri-County Equipment of Saginaw donated dirt, and the Agriscience classes at John Glenn High School volunteered to get plots prepared for gardening. The Building Trades levitra price program at Bay Arenac ISD built and installed a tool shed. Woodchips from Weiler Tree Service were donated to cut down on weeding, and Nature’s Own Landscaping and Irrigation hooked up a spigot in a central location so that all gardeners could access it easily.“During our first season, we had just a few plots of our two-acre garden assigned and less than ten participants,” said Ashleigh Palmer, practice manager, MidMichigan Health Park – Bay.

€œThis year, levitra price we have all plots filled with more than 40 participants. We have couples, families and individuals who share their experience, produce and recipes with each levitra price other. It’s a lot of fun to see the friendships that have developed among our gardeners.

The ground is fertile, so produce levitra price is thriving, and excess vegetables are being donated to patients of the facility.”Jarod Morse, 21, saw the garden information on Facebook and is excited to be participating. €œMy whole family - brother, sister and her fiancé, mom, and Papa - are working on the garden together,” Morse stated. A few of the items they are growing are cabbage, cauliflower and a levitra price variety of peppers.

€œThe best part,” he added, “is getting to share knowledge and smiles with other members of the garden.”Rows of produce growing in the community garden, Produce by the Park.MidMichigan Health staffers Shelby Kuch and Kellie Picard do much of the organizing, serving as “garden ambassadors.” They are excited to see it thriving.“It has been fun to see how each person has their own unique approach to gardening and harvesting,” said Kuch. €œThere are so many things being grown levitra price. Cabbage, corn, levitra price potatoes, broccoli, tomatoes, and beautiful sunflowers.

You wouldn’t believe the variety and the willingness to share what is harvested with other gardeners, members of the community and patients.”Picard is pleased to see elderly residents becoming involved. €œMany don’t have the room to plant where levitra price they live,” she explained. €œThis place gives them a chance to be outside, grow their own food, socialize with others and get some exercise.

It’s inspiring to see their work pay off in so many levitra price ways.”Those who are interested in securing a plot must fill out an application and waiver, and agree to the terms set by Produce by the Park. All skill levels are welcome and there is no cost associated with securing a plot.“Our goal has evolved,” said Palmer. €œWe hope to build upon this year’s successes to increase food security by providing access to fresh, healthy foods while reinforcing ties to the environment and encouraging levitra price community members to work together.

I think we are well on our way.”Those interested in more information on the Produce by the Park or to request an application may visit www.midmichigan.org/bay/garden or contact Palmer at (989) 778-2888 or ashleigh.palmer@midmichigan.org..

Under the stewardship of the MidMichigan Health Foundation, this buy levitra professional year, 23 area students will received scholarship awards from the Tolfree how to get prescribed levitra Scholarship, the Dr. George Schaiberger, how to get prescribed levitra Sr., Dr. Howard VanOosten and Dr. Lloyd Wiegerink Medical Scholarship, how to get prescribed levitra and the Paul A.

Poling Memorial Scholarship.Awardees receiving the Dr. George Schaiberger, Sr., how to get prescribed levitra Dr. Howard VanOosten and Dr. Lloyd Wiegerink Medical Staff how to get prescribed levitra Memorial Scholarship are.

Allie Morand, how to get prescribed levitra Camden Groff, Nicholas Morse, Anna Erickson, Emily Terry, Brooke Chenette, Tyler Walters, Austin Raymond, Jordan Williams, Andrew Waack, Rylie Alward, Nicholas Thomas and Madison Nachtrieb. Those receiving the Tolfree Scholarship are. Allie Morand, Nicholas Morse, Anna Erickson, Emily Terry and Andrew how to get prescribed levitra Waack. Lastly, awardees receiving the Paul A.Poling Memorial Scholarship are Emily Terry, Anna Erickson, Nicholas Morse, Allie Morand and Andrew Waack.“The intent of our generous donors in creating these scholarships is to provide our rural counties, particularly those served by MidMichigan Medical Center – West Branch, with future generations of excellent health care professionals,” said Nicole Potter, director, MidMichigan Health Foundation.

€œWe congratulate all of this year’s recipients, as well as the parents and teachers how to get prescribed levitra who help them arrive at this major milestone in these students’ lives. We wish each one of them the best of success and hope to see them back again in a few years serving the people of their own hometown.”Examples of the health professions being pursued by these individuals include physical therapy, pre-medicine, nursing, health administration, sports medicine, neuroscience and human biology.Applications for the 2021-2022 school year will be accepted from Dec. 1, 2020, through how to get prescribed levitra March 1, 2021. Those interested in reviewing the eligibility guidelines, including a scholarship application, may visit www.midmichigan.org/scholarships or call (989) 343-3694.Growers donate produce to staff and patients at MidMichigan Health Park – Bay.Residents in the Bay area have an additional how to get prescribed levitra opportunity to embrace healthy lifestyles near MidMichigan Health Park – Bay.

Produce by the Park, a community garden that began late last year with a donation from MidMichigan Health Foundation, is flourishing, allowing patients, friends and neighbors to literally enjoy the fruits of their labor.Brenda Turner, director, MidMichigan Physicians Group, has a farming background and dreamt of a garden for her community for years. When the Health Park was built with ample property behind and support from the Foundation, that dream was brought to life.“We are so pleased to be able to support this project as it represents very well MidMichigan how to get prescribed levitra Health’s purpose of building healthy communities – together,” said Denise O’Keefe, executive director, MidMichigan Health Foundation.Other local organizations came on board to offer help. Tri-County Equipment of Saginaw donated dirt, and the Agriscience classes at John Glenn High School volunteered to get plots low cost levitra prepared for gardening. The Building Trades how to get prescribed levitra program at Bay Arenac ISD built and installed a tool shed.

Woodchips from Weiler Tree Service were donated to cut down on weeding, and Nature’s Own Landscaping and Irrigation hooked up a spigot in a central location so that all gardeners could access it easily.“During our first season, we had just a few plots of our two-acre garden assigned and less than ten participants,” said Ashleigh Palmer, practice manager, MidMichigan Health Park – Bay. €œThis year, we have all plots filled with more how to get prescribed levitra than 40 participants. We have couples, families and individuals who share their experience, produce and recipes how to get prescribed levitra with each other. It’s a lot of fun to see the friendships that have developed among our gardeners.

The ground is fertile, so produce is thriving, and excess vegetables are how to get prescribed levitra being donated to patients of the facility.”Jarod Morse, 21, saw the garden information on Facebook and is excited to be participating. €œMy whole family - brother, sister and her fiancé, mom, and Papa - are working on the garden together,” Morse stated. A few how to get prescribed levitra of the items they are growing are cabbage, cauliflower and a variety of peppers. €œThe best part,” he added, “is getting to share knowledge and smiles with other members of the garden.”Rows of produce growing in the community garden, Produce by the Park.MidMichigan Health staffers Shelby Kuch and Kellie Picard do much of the organizing, serving as “garden ambassadors.” They are excited to see it thriving.“It has been fun to see how each person has their own unique approach to gardening and harvesting,” said Kuch.

€œThere are so many things how to get prescribed levitra being grown. Cabbage, corn, potatoes, broccoli, tomatoes, how to get prescribed levitra and beautiful sunflowers. You wouldn’t believe the variety and the willingness to share what is harvested with other gardeners, members of the community and patients.”Picard is pleased to see elderly residents becoming involved. €œMany don’t have the room to how to get prescribed levitra plant where they live,” she explained.

€œThis place gives them a chance to be outside, grow their own food, socialize with others and get some exercise. It’s inspiring to see their work pay off in so many how to get prescribed levitra ways.”Those who are interested in securing a plot must fill out an application and waiver, and agree to the terms set by Produce by the Park. All skill levels are welcome and there is no cost associated with securing a plot.“Our goal has evolved,” said Palmer. €œWe hope to build upon this year’s successes to increase food security by providing access to fresh, healthy foods while reinforcing ties to how to get prescribed levitra the environment and encouraging community members to work together.

I think we are well on our way.”Those interested in more information on the Produce by the Park or to request an application may visit www.midmichigan.org/bay/garden or contact Palmer at (989) 778-2888 or ashleigh.palmer@midmichigan.org..

Buying levitra online safe

Marissa Castrigno was walking through downtown Wilmington, North Carolina, when she spotted the sign in the window http://www.luckjunky.com/where-to-get-viagra-pills/ of buying levitra online safe one of her favorite dance clubs. After months of being shuttered by the levitra, Ibiza Nightclub was reopening April 30, it announced. Thrilled, Castrigno immediately made plans with friends buying levitra online safe to be there. About 50 miles north in Jacksonville, Kennedy Swift learned of Ibiza’s reopening on social media.

He, too, decided to attend with friends. But on the night of April 30, the two groups were in for a surprise — buying levitra online safe one they would react to in starkly different ways. In addition to IDs, they learned, they’d need to show erectile dysfunction treatment vaccination cards for entry. The club was letting in only people who had had at least one shot.

€œI was buying levitra online safe shocked,” said Swift, 21. He learned of the policy a few hours before the reopening, when the club posted it on its Facebook page. He and his friends had to cancel their plans, since none of them was vaccinated. Marissa Castrigno (back center) and her friends, most of whom had been fully vaccinated since early buying levitra online safe April, felt the club’s treatment card policy made their return to nightlife even better.

(McKenzie Teter) “I’m not against [Ibiza] exercising their rights as a business,” Swift said. €œI just think it’s foolish. €¦ This will buying levitra online safe discourage a lot of former patrons from returning to the club.” On the other hand, Castrigno and her friends, most of whom had been fully vaccinated since early April, felt the policy made their return to nightlife even better. €œThere was raw excitement about going out to a place and feeling safe,” said Castrigno, 28.

Similar conversations are playing out across the country as vaccination rates increase and bars, clubs and other businesses navigate how to reopen. The concept of treatment passports — which allow people who have been inoculated against erectile dysfunction treatment and are at buying levitra online safe lower risk of contracting or spreading the disease to participate in certain activities — has been floated for clubs, cruise ships and other spaces where large groups gather in close quarters. The Centers for Disease Control and Prevention’s recent announcement that vaccinated people can safely gather indoors and outdoors without masks has reignited the idea. Yet these passports remain highly controversial and their implementation is largely piecemeal.

Many private businesses are making their own decisions, and governments in different parts of buying levitra online safe the country are adopting varying stances. In New York, for instance, Gov. Andrew Cuomo announced in early May that places where proof of vaccination or a negative erectile dysfunction treatment test are required can operate at a greater capacity. Some nightclubs there have implemented policies similar to Ibiza’s buying levitra online safe.

In Florida, however, Gov. Ron DeSantis recently signed a law prohibiting businesses, schools and government offices from requiring proof of vaccination, with fines of up to $5,000 per incident. For Ibiza Nightclub in southeastern North Carolina — buying levitra online safe a political battleground state — the treatment card requirement is proving to be a lightning rod. The club’s Facebook post announcing the policy had sparked 70 comments as of mid-May, and posts across other platforms echoed different sides of the issue.

€œI am thrilled to see a personal business putting the health and safety forward in order to keep their business running,” one comment read. Others took a markedly different tone buying levitra online safe. €œThis is pretty dumb!. € “Discrimination, expect lawsuits,” read another.

The Honor Code buying levitra online safe Last week, after the CDC said vaccinated adults could largely live their lives mask-free, Raleigh restaurant owner Hisine McNeill felt a troubling pang of déjà vu. He owns Alpha Dawgs, a sandwich shop in southeast Raleigh, and said small businesses like his carried the burden of mask enforcement for much of the levitra. Now, he said, they’re tasked with trusting adults who say they’ve been vaccinated. He isn’t ready to buying levitra online safe do that.

Hisine McNeill stands inside his Raleigh, North Carolina, restaurant, Alpha Dawgs, where he now requires customers who don’t wear a mask to instead show their treatment card. (Casey Toth/The News &. Observer) “I don’t have the luxury of buying levitra online safe taking chances on an honor code,” McNeill said. €œIf I have an outbreak because someone didn’t wear a mask and have to close down, who’s going to help keep me open?.

€ McNeill opened Alpha Dawgs in 2018 and, like most restaurateurs, he said, struggled through the levitra, professionally and personally. He said he has lost friends and family members and doesn’t believe buying levitra online safe the levitra is over. €œI know people personally in the ICU still recovering from [erectile dysfunction treatment],” McNeill said. €œI don’t need any more examples about how serious buying levitra online safe this is.” So McNeill posted a new requirement on the restaurant’s Facebook page.

He asked everyone to continue wearing masks unless they were prepared to show him a treatment card. €œTo whom it may concern,” McNeill wrote. €œIf you decide to come into my establishment claiming that you are fully vaccinated, I WILL ASK TO SEE buying levitra online safe YOUR CARD. If you don’t want to provide it then you will have to wear a mask in my store.

And if you still don’t want to comply with either then I have the right to deny service. Thank you for your cooperation.” The owner of Alpha Dawgs, Hisine McNeill, now requires customers who don’t wear a mask to buying levitra online safe instead show their treatment card. (Casey Toth/The News &. Observer) A sign requiring masks is displayed on the front door of the restaurant.

(Casey Toth/The buying levitra online safe News &. Observer) The day after he posted that statement, North Carolina Gov. Roy Cooper eased most erectile dysfunction treatment-related restrictions in the state, including its mask mandate. The Alpha Dawgs post stirred some online debate over masks and vaccinations and led to a few responses, including buying levitra online safe one from the Raleigh Republican Club.

€œShould you be in the area…,” it read. €œEat somewhere else….” McNeill felt the Raleigh Republican Club was calling for a boycott. Afterward, he noticed multiple one-star reviews pop buying levitra online safe up on Google, not from people who had been to the restaurant, but people accusing McNeill of discrimination. €œThis is not political for me, this is a personal belief,” McNeill said.

€œI have an 85-year-old grandmother I see every other week. I’m going to make sure she’s protected.” Raleigh Republican Club board member Guy Smith said the group’s post buying levitra online safe was written collectively, but he didn’t see it as a call for a boycott. €œOur philosophical position is it’s his business, the owner can choose to do what they choose to do within the confines of the individual business,” Smith said. €œOur philosophical position is, to demand someone to demonstrate they’re vaccinated with a card, we think that’s out of bounds.” Smith said the group also condemns writing bogus reviews of a business.

McNeill said Alpha Dawgs’ business has not buying levitra online safe suffered from the online dust-up. €œI haven’t had any problems,” McNeill said. €œOnly the online harassment.” The Nightclub Expected Opposition Charles Smith, general manager of the club, said he knew the policy would garner backlash, but “we’ve always put the health and safety of both staff and our patrons, and their families, first.” Since opening as a gay bar in 2001, Ibiza has been a pillar of the LGBTQ community in Wilmington. Although its clientele has expanded over time, it’s still known buying levitra online safe for drag shows on Friday nights.

Last year, the club shut down March 12, about a week before Gov. Cooper ordered all North Carolina bars and restaurants to stop dine-in service. Ibiza remained shuttered buying levitra online safe for 14 months, using the time to renovate, Smith said, and leaning on federal and state assistance for small businesses. When it came to reopening, he said, “the question was.

How do we provide the absolute safest experience alongside the nightlife experience we’ve been known for?. € It buying levitra online safe wouldn’t be easy. Nightclubs are a perfect cocktail of erectile dysfunction treatment risks. Lots of people socializing and dancing in close quarters.

Alcohol lowering buying levitra online safe inhibitions. Music forcing people to speak louder, releasing more droplets into the air. €œThe concept of social distancing in a nightclub is an oxymoron,” Smith said. And the club’s staff didn’t want to be “the police buying levitra online safe of nightlife,” trying to separate people on the dance floor, he added.

The safest option, it seemed, was to require people to be vaccinated. The club waited till all adults in the state were eligible for treatments before reopening. Now Ibiza requires patrons to present their treatment cards or photos of the cards for entry buying levitra online safe. On reopening night, the club asked customers to wear masks and limited its capacity to 50%, per an executive order from the governor.

But as of May 14, the state lifted its capacity restrictions and masking requirements. Castrigno, who’d been looking forward to that night for weeks since she saw the buying levitra online safe sign in the club’s window, said it was “the most jubilant I’d ever seen Ibiza.” Several performers put on a drag show. Customers took turns dancing on poles. Some people wore masks with rhinestones to match their outfits, she said.

She wasn’t surprised buying levitra online safe that many people took the treatment requirement in stride. €œQueer people are well versed in the risks of public health crisis and protecting the community,” she said, referring to the AIDS crisis, which devastated the community in the ’80s and ’90s. For James Colucci, who has been a customer since buying levitra online safe 2016, supporting Ibiza’s treatment policy is about protecting the club’s employees. Some of them have “spearheaded the [LGBTQ] movement, so we can get together and have events like this,” he said.

But others say the policy is discriminatory and injects the nightclub into people’s personal health care decisions. Joey Askew, a 37-year-old from buying levitra online safe Greenville, wrote on Ibiza’s Facebook page, “I’ll never go back to this club until they lift this mandate!. !. € In an interview with KHN, Askew said he’s not ready to get the treatment because there haven’t been lifetime studies of recipients to determine long-term side effects.

He’s willing to wear a mask and maintain buying levitra online safe physical distance, but a treatment requirement goes too far. €œA mask is something I can buy from anywhere and take off whenever I choose,” he said. €œBut I can’t take a treatment out. It’s a permanent choice that [the club] buying levitra online safe is involving themselves in, and it’s not their place.” In between the people condemning the club’s policy and those applauding it are many who are conflicted.

Mark Russell, 29, is a nurse in Washington, D.C., who cares for erectile dysfunction treatment patients and contracted erectile dysfunction treatment last year. He plans on visiting Ibiza Nightclub in late May while attending a small wedding in North Carolina where everyone will be vaccinated. The club’s policy makes him buying levitra online safe feel safer, Russell said. But he also worries about its effect on people of color, who in many places have faced barriers to vaccination.

€œIt’s a battle in my own brain, thinking those two things,” Russell said. For Heidi buying levitra online safe Martek, 55, the policy raised a personal question. €œWhat about those who can’t get the treatment?. € she wrote on Ibiza’s Facebook page.

She has an autoimmune disease, making her body hypersensitive to any buying levitra online safe treatment, Martek said, even the flu shot. But when commenters on Facebook suggested she sue the club, Martek pushed back. The club is facing difficult choices, she told KHN, and there’s no right answer. €œWhether I can go in or not, I support them,” said Martek, who’s been a patron at Ibiza for six years buying levitra online safe.

She wants the club to survive the levitra, unlike other establishments that have closed in the past year. €œIt’s not like Wilmington is overwhelmed with LGBTQ clubs,” Martek said. €œIbiza is really important.” News & buying levitra online safe. Observer reporter Drew Jackson contributed to this story.

Aneri Pattani. apattani@kff.org, @aneripattani Related Topics Contact buying levitra online safe Us Submit a Story TipColorado health officials so abhor the high costs associated with free-standing emergency rooms they’re offering to pay hospitals to shut the facilities down. The state wants hospitals to convert them to other purposes, such as providing primary care or mental health services. At least 500 free-standing ERs have set up in more than 20 states in the past decade.

Colorado has buying levitra online safe 44, 34 owned by hospitals. The trend began a decade ago with hopes these stand-alone facilities would fill a need for ER care when no hospital was nearby and reduce congestion at hospital ERs. But that rarely happened. Instead, these emergency rooms — not physically connected to hospitals — generally set up in affluent suburban communities, often buying levitra online safe near hospitals that compete with the free-standing ERs’ owners.

And they largely treated patients who did not need emergency care, but still billed them and their insurers at expensive ER rates, several studies have found. €œWe don’t want hospitals to have stand-alone ERs, so we are willing to pay to shut them down,” said Kim Bimestefer, executive director of Colorado’s Department of Health Care Policy &. Financing, which oversees the state’s Medicaid program buying levitra online safe. She said using these facilities to treat common injuries and illnesses leads to higher costs for Medicaid, which the state partly finances, and other insurers.

Colorado’s move is part of a new initiative that requires hospitals to improve their quality of care to qualify for millions of dollars in Medicaid payments. Hospitals can choose among goals provided buying levitra online safe by the state such as lowering readmission rates or screening patients for social needs such as housing. Converting free-standing ERs to meet other needs is one of those goals. €œMoney talks,” Bimestefer said in explaining why the state is offering the financial incentives.

Money has been a major driver of the buying levitra online safe boom in free-standing emergency centers. Hospitals used them to attract patients who could be referred to the main hospital for inpatient care. They are buying levitra online safe also seen as a way to compete with rivals. For instance, in Palm Beach County, Florida, for-profit hospital chain HCA Healthcare has opened free-standing ERs near competing hospitals in Palm Beach Gardens and Boynton Beach.

In addition, the massive amounts of private equity funds flowing into health care have further fueled the growth of independently owned stand-alone ERs. The Denver-based Center for Improving Value in Health Care found that most conditions treated in these facilities are more appropriate for lower-acuity, buying levitra online safe lower-cost urgent care centers. Patients can pay 10 times more in a free-standing ER than in an urgent care center for treatment of the same condition, the organization’s studies show. Adam Fox, deputy director of the Colorado Consumer Health Initiative, said free-standing ERs have not been placed where health care services are scarce.

Instead, they’ve opened in middle- and upper-income neighborhoods buying levitra online safe where most people have health insurance and access to care. €œThis push from the state will help” as hospitals rethink whether these facilities still make sense financially, he said. A free-standing emergency room in Arvada, Colorado, owned by UCHealth, part of the University of Colorado. (Markian Hawryluk buying levitra online safe / KHN) In the past few years, Colorado has moved to make owning these facilities less attractive with laws preventing them from sticking patients with surprise bills for high fees because the ER was out of their insurer networks.

It also has required that patients without true emergencies be told they can get treatment for a lower price at an urgent care facility. The law requires a free-standing ER to post a sign informing patients it is an emergency room that treats emergency conditions. It must also specify the buying levitra online safe prices of the 25 most common services it provides. Even before the new policy begins to roll out later this year, some Colorado hospitals started converting these facilities.

UCHealth has turned nine in the past two years into primary or urgent care centers and one into a specialty center. It still has nine others in buying levitra online safe operation across the state. The conversions were not prompted by state actions, according to Dan Weaver, a spokesperson for UCHealth, part of the University of Colorado. €œNeither surprise billing legislation nor price transparency played a role in these decisions — we converted them because we felt patients in these communities needed urgent care, primary care and/or specialty care services close to home,” Weaver said.

He added that the hospital system always stressed that people should use lower-cost services, buying levitra online safe including urgent care, primary care or virtual urgent care, in nonemergencies. Ryan Westrom, senior director of finance at the Colorado Hospital Association, said hospitals have converted some of these centers to services such as urgent care in response to changes in insurance reimbursement and other factors. He said he wasn’t sure whether many hospitals will accept the state payments to close their free-standing ERs. HealthONE, which has eight free-standing ERs in the Denver area, said buying levitra online safe it has no plans to close any despite the state incentive payment.

Vivian Ho, a health economist at Rice University in Houston who has tracked the growth of these stand-alone emergency rooms, applauded Colorado’s effort. But she worries hospitals may decide it’s not worth closing a free-standing emergency department and forfeiting the profits. €œYou have to attack free-standing EDs from buying levitra online safe multiple angles to get people to stop going to them and to get hospitals from using them as a way to generate extra revenues for care that can be delivered at lower-cost sites.” Ho said the erectile dysfunction treatment levitra, which dampened demand for emergency care, and recent federal surprise billing legislation may hurt the growth of free-standing ERs. They are already facing headwinds.

Adeptus Health, the Texas company that’s been leading the trend there and started dozens of the free-standing emergency rooms, often in conjunction with hospitals, filed for bankruptcy this year. And numerous stand-alone facilities closed at least temporarily during the levitra as buying levitra online safe demand for care fell dramatically. Advisers to Medicare are also pushing back on the growth. A recent proposal from the Medicare Payment Advisory Commission, which reports to Congress, would cut Medicare payment rates 30% on some services at stand-alone facilities within 6 miles of an emergency room in a hospital.

According to a MedPAC analysis of five markets — buying levitra online safe Charlotte, North Carolina. Cincinnati. Dallas. Denver.

And Jacksonville, Florida — 75% of free-standing facilities were within 6 miles of a hospital with an emergency department. The average drive time to the nearest such hospital was 10 minutes. Markian Hawryluk, KHN’s senior Colorado correspondent, contributed to this article. Phil Galewitz.

pgalewitz@kff.org, @philgalewitz Related Topics Contact Us Submit a Story TipRonald Lindquist, 87, has been active all his life. So, he wasn’t prepared for what happened when he stopped going out during the erectile dysfunction levitra and spent most of his time, inactive, at home. “I found it hard to get up and get out of bed,” said Lindquist, who lives with his wife of 67 years in Palm Springs, California. €œI just wanted to lay around.

I lost my desire to do things.” Physically, Lindquist noticed that getting up out of a chair was difficult, as was getting into and out of his car. €œI was praying ‘Lord, give me some strength.’ I kind of felt, I’m on my way out — I’m not going to make it,” he admitted. One little-discussed, long-term toll of the levitra. Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.

No large-scale studies have documented the extent of this phenomenon. But physicians, physical therapists and health plan leaders said the prospect of increased impairment and frailty in the older population is a growing concern. €œAnyone who cares for older adults has seen a significant decline in functioning as people have been less active,” said Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System.

Bean’s 90-year-old mother, who lives in an assisted living facility, is a case in point. Before the levitra, she could walk with a walker, engage in conversation and manage going to the bathroom. Now, she depends on a wheelchair and “her dementia has rapidly accelerated — she can’t really care for herself,” the doctor said. Bean said his mother is no longer able to benefit from rehabilitative therapies.

But many older adults might be able to realize improvements if given proper attention. €œImmobility and debility are outcomes to this horrific levitra that people aren’t even talking about yet,” said Linda Teodosio, a physical therapist and division rehabilitation manager in Bayada Home Health Care’s Towson, Maryland, office. €œWhat I’d love to see is a national effort, maybe by the CDC [U.S. Centers for Disease Control and Prevention], focused on helping older people overcome these kinds of impairments.” The extent of the need is substantial, by many accounts.

Teodosio said she and her staff have seen a “tremendous increase” in falls and in the exacerbation of chronic illnesses such as diabetes, congestive heart failure and chronic obstructive pulmonary disease. €œOlder adults got off schedule during the levitra,” she explained, and “they didn’t eat well, they didn’t hydrate properly, they didn’t move, they got weaker.” Dr. Lauren Jan Gleason, a geriatrician and assistant professor of medicine at the University of Chicago, said many older patients have lost muscle mass and strength this past year and are having difficulties with mobility and balance they didn’t have previously. €œI’m seeing weight gain and weight loss, and a lot more depression,” she noted.

Mary Louise Amilicia, 67, of East Meadow, New York, put on more than 100 pounds while staying at home round-the-clock and taking care of her husband Frank, 69, who was hospitalized with a severe case of erectile dysfunction treatment in early December. While Amilicia also tested positive for the levitra, she had a mild case. €œWe were in the house every day 24/7, except when we had to go to the doctor, and when he got sick I had to do all the stuff he used to do,” Amilicia told me. €œIt was a lot of stress.

I just began eating everything in sight and not taking care of myself.” The extra weight made it hard to move around, and Amilicia fell several times after Christmas, fortunately without sustaining serious injuries. After coming home from the hospital, Frank couldn’t get out of a chair, walk 10 feet to the bathroom or climb the stairs in his house. Instead, he spent most of the day in a recliner, relying on his wife for help. Now, the couple is getting physical therapy from Northwell Health, New York state’s largest health care system.

Just before the levitra, Northwell launched a “rehabilitation at home” program for patients who otherwise would have seen therapists in outpatient facilities. (Medicare Part B pays for the treatments.) Frank Amilicia was hospitalized with a severe case of erectile dysfunction treatment last December. When he returned home, he was confined to his recliner, relying on his wife, Mary Louise, for help. Mary Louise put on extra weight while taking care of Frank and fell several times after Christmas.

Now, the couple is getting physical therapy from Northwell Health, New York state’s largest health care system. (Saaba Mundia) The program is serving more than 100 patients on Long Island, in Westchester County and in parts of New York City. €œThe demand is very strong and we’re in the process of hiring another 20 therapists,” said Nina DePaola, Northwell’s vice president of post-acute services. Sabaa Mundia, a physical therapist working with the Amilicias, said Mary Louise can walk up to 400 feet without a walker, after doing strengthening exercises twice a week over the course of three weeks.

Frank had been using a wheelchair and is now regularly walking 150 feet with a walker after more than a month of therapy. €œOlder adults can lose about 20% of their muscle mass if they don’t walk for up to five days,” Mundia said. €œAnd their endurance decreases, their stamina decreases, and their range of motion decreases.” Recognizing that risk, some health plans have been reaching out to older members to assess how they’re faring. In Massachusetts, Commonwealth Care Alliance serves more than 10,000 older adults who are poor and eligible for both Medicare and Medicaid, the federal-state program for people with low incomes.

On average, they tend to have more medical needs than similarly aged seniors. Between March and September last year, the plan’s staffers conducted “wellness outreach assessments” by phone every two weeks, asking about ongoing medical care, new physical and emotional challenges, and the adequacy of available help, among other concerns. Today, calls are made monthly and staffers have resumed seeing members in person. An increase in physical deconditioning is one of the big issues that have emerged.

€œWe’ve had physical therapists digitally engage with members to coach them through strength and balance training,” said Dr. Robert MacArthur, a geriatrician and Commonwealth Care’s chief medical officer. €œAnd when that didn’t work, we sent therapists into people’s homes.” In California, SCAN Health Plan serves a similarly vulnerable population of nearly 15,000 older adults dually eligible for Medicare and Medicaid through its Medicare Advantage plans. Care navigators are calling these members frequently and telling them “now that you’re vaccinated, it’s safe to go see your doctor in person,” said Eve Gelb, SCAN’s senior vice president of health care services.

Doctors can then evaluate unmet health needs and make referrals to physical and occupational therapists, if necessary. Another SCAN program, Member2Member, pairs older adult “peer health advocates” with members who have noted physical or emotional difficulties on health risk assessments. That’s how Lindquist in Palm Springs connected with Jerry Payne, 79, a peer advocate who calls him regularly and helped him come up with a plan to emerge from his levitra-induced funk. €œFirst, he said, ‘Ron, you should try getting up every hour and taking a few steps’ — that was the start of it,” Lindquist told me.

€œThen, he’d suggest walking another block when I would take my dog out. It was painful. Walking was not pleasant. But he was very encouraging.” A month ago, Payne had a Fitbit sent to Lindquist.

At first, Lindquist walked about 1,500 steps a day. Now, he’s up to more than 5,000 steps a day and has a goal of reaching 10,000 steps. €œI’m sleeping better and I feel so much better all around,” Lindquist said. €œMy whole attitude and physicality has changed.

I tell you, this has been an answer to my prayers.” Coming Monday. Tips for Older Adults to Regain Their Game We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips. Judith Graham.

khn.navigatingaging@gmail.com, @judith_graham Related Topics Contact Us Submit a Story TipCan’t see the audio player?. Click here to listen on SoundCloud. The Supreme Court agreed to hear a case next term that could result in a significant modification or overturn of Roe v. Wade, the 1973 case that legalized abortion nationwide.

At issue is a Mississippi law that would ban the procedure after 15 weeks of gestation. That is well before a fetus is viable outside the womb and, under Roe, states may not ban abortion prior to viability. Meanwhile, the unexpected announcement by the Centers for Disease Control and Prevention that fully vaccinated people could stop wearing masks inside and outside has caused considerable confusion, as the U.S. Does not have a way for people to prove they are vaccinated.

And despite a successful voter referendum, Missouri Gov. Mike Parson, a Republican, has announced his state will not expand the Medicaid program after the Republican-led legislature failed to provide the state’s share of funding. This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet and Mary Ellen McIntire of CQ Roll Call. Among the takeaways from this week’s podcast.

Many states have passed restrictions on abortion that are at odds with the Supreme Court’s earlier decisions on the issue. If it were to uphold the Mississippi law, the court would have to discard or substantially change its standards from the Roe v Wade decision and subsequent cases.The decision by the justices is likely to come next summer, just months before the midterm elections, and it is likely to be used by both parties as part of their campaigns, no matter which way the court rules.The CDC has been heavily criticized for its abrupt announcement on masks last week. Although some officials, including Dr. Anthony Fauci, have sought to soften the message by saying it doesn’t mean people can’t wear masks or may not need them in some instances, public health authorities, states and some businesses were caught unaware by the announcement and are struggling with how to respond.The use of masks also has riled the House of Representatives.

Speaker Nancy Pelosi said she will remove the mask mandate on the floor only when 100% of members have been vaccinated. But some Republicans are refusing to take the shot or to say whether they have received a treatment, and they are subject to fines when they are maskless on the House floor.Biden administration officials announced the U.S. Will provide 20 million doses of treatment to other countries battling erectile dysfunction treatment, but the donation cannot meet the need. World health officials have complained that the U.S.

Is too worried about holding back treatment to give shots to children, who are at low risk, while millions of adults around the world are dying. Yet federal officials are still concerned that vaccination efforts here are not reaching enough Americans. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too. Julie Rovner.

CNN’s “’There’s No Way I Can Pay for This:’ One of America’s Largest Hospital Chains Has Been Suing Thousands of Patients During the levitra,” by Casey Tolan Alice Miranda Ollstein. The 19th’s “Women in Health Care Are at a Breaking Point — And They’re Leaving,” by Shefali Luthra and Chabeli Carrazana Sarah Karlin-Smith. KHN’s “Why Your Dentist Might Seem Pushy,” by Daryl Austin Mary Ellen McIntire. Stat’s “How the erectile dysfunction treatment levitra Ends.

Scientists Look to the Past to See the Future,” by Helen Branswell To hear all our podcasts, click here. And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Contact Us Submit a Story TipBlack Americans’ erectile dysfunction treatment vaccination rates are still lagging months into the nation’s campaign, while Hispanics are closing the gap and Native Americans show the highest rates overall, according to federal data obtained by KHN.

The data, provided by the Centers for Disease Control and Prevention in response to a public records request, gives a sweeping national look at the race and ethnicity of vaccinated people on a state-by-state basis. Yet nearly half of those vaccination records are missing race or ethnicity information. KHN’s analysis shows that only 22% of Black Americans have gotten a shot, and Black rates still trail those of whites in almost every state. Targeted efforts have raised vaccination rates among other minority groups.

Hispanics in eight states, the District of Columbia and Puerto Rico are now vaccinated at higher rates than non-Hispanic whites. Yet 29% of Hispanics are vaccinated nationally, compared with 33% of whites. While 45% of Native Americans have received at least one dose, stark differences exist depending on where they live. And Asian vaccination rates are high in most states, with 41% getting a shot.

The analysis underscores how treatment disparities have improved as availability has opened up and Biden administration officials have attempted to prioritize equitable distribution. Still, gaps persist even as minority groups have suffered much higher mortality rates from the levitra than whites and are at risk of as states move to reopen and lift mask mandates. Despite these lingering gaps, the CDC said last week that those who are fully vaccinated don’t need to wear masks in most indoor and outdoor settings or physically distance. Only 38% of Americans are fully vaccinated.

“Every day we do not reach a person or a community is a day in which there is a preventable erectile dysfunction treatment case that happens and a preventable erectile dysfunction treatment death in these communities,” said Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco. KHN requested race and ethnicity data from the CDC on people who have received at least one dose of a erectile dysfunction treatment since mid-December for all 50 states, the District of Columbia and Puerto Rico. The data covers shots as of May 14 given to 155 million people that were administered through federally run programs and federal agencies as well as by state and local authorities.

Eight states — Alabama, California, Michigan, Minnesota, South Dakota, Texas, Vermont and Wyoming — either refuse to provide race and ethnicity details to the CDC or are missing that information for more than 60% of people vaccinated. Those states are excluded from the KHN analysis, though the CDC includes all but Texas in its published national rates. Some states display race and ethnicity for treatment recipients separately, making it difficult to compare rates for Hispanics to non-Hispanic whites, for example. But the CDC data allows for direct comparisons.

It reports numbers for Hispanics, who can be of any race or combination of races, as well as numbers for non-Hispanic people of single-race or multiracial categories. The data for Native Hawaiians and other Pacific Islanders is unreliable, making it difficult to draw conclusions on the vaccination rate in that population. Dr. Georges Benjamin, executive director of the American Public Health Association, wasn’t surprised that Black Americans’ vaccination rates were still lagging, citing a complex combination of access issues, hesitancy and structural inequity.

Benjamin pointed to the early challenges in securing an appointment online and the initial placement of vaccination sites — which he noted the Biden administration had worked to improve. €œWe’re going to be judged whether or not we did it equitably at the end of the day,” he said. €œRight now, I still think we’re failing.” Dr. Utibe Essien, a health equity researcher and assistant professor of medicine at the University of Pittsburgh, stressed that targeted outreach must involve multiple institutions in a community.

€œIt’s not just the Black doctor, it’s not just the barber, it’s not just the pastor, kind of these traditional folks who have been the big messengers. We have to be broad,” he said. €œIt’s investing in folks who know the neighborhood, the small-store owner who gets to see all the 12- to 15-year-old kids come through the store getting snacks before they head off to school.” Why Native Americans Lead in Vaccinations Nationally, Native Americans and Alaska Natives have been vaccinated at significantly higher rates than other groups. Tribes administered doses quickly, prioritizing elders with culturally important knowledge, said Meredith Raimondi, director of congressional relations and public policy for the National Council of Urban Indian Health.

The rollout was imbued with urgency. Native Americans have died of erectile dysfunction treatment at more than double the rate of white Americans, according to the latest CDC data. Native vaccination rates are higher than white rates in 28 states, including New Mexico, Arizona and Alaska, where many receive care from tribal health centers and the Indian Health Service. In states such as South Carolina and Tennessee, where IHS access is more limited and Native residents are more likely to live in urban areas, vaccination rates are far lower than for white residents.

Groups in those areas reported problems finding health care providers to administer shots. Tribal organizations compiled lists of retired nurses to tap for clinics. At one point, staffers from an Oklahoma City clinic for Native Americans offered to fly to Washington, D.C., to help vaccinate Indigenous people living around the nation’s capital, Raimondi said. €œIt became an issue of, ‘Well, we could get you the treatment, but we don’t know who is going to administer them,’” Raimondi said.

The council and Native American Lifelines, a nonprofit providing health services, partnered with the University of Maryland-Baltimore for a vaccination site exclusively for Native Americans living in Maryland, Virginia and Washington, D.C. It launched in April. While the vaccination rates for Native Americans surpass those of whites in some states due in part to IHS, that infrastructure does not exist for Black Americans, said Rhonda BeLue, the department chair of health management policy at Saint Louis University. At the beginning of the levitra, people were shocked by how much more likely Black Americans were to die from erectile dysfunction treatment, she said.

€œHowever, the same structural inequities that caused that disproportionate mortality in erectile dysfunction treatment are the same structural inequities that predated erectile dysfunction treatment and caused disproportionate burdens of morbidity and mortality,” she said. €œThis isn’t new.” Easing Fears in Hispanic Communities Some states are reporting higher vaccination rates among Hispanics than white and Black residents, which Bibbins-Domingo said fits with surveys showing high enthusiasm for vaccination among Hispanics. It also indicates that some of the reported barriers may have been addressed more effectively in those states, she said. Paul Berry, chair of the Virginia Latino Advisory Board, partly attributes Virginia’s success to targeted outreach efforts.

The state and certain counties also increased Spanish-language resources to boost sign-ups. Connecting with every community cannot be an afterthought, said Diego Abente, president and CEO of St. Louis’ Casa de Salud, a health care provider focused on immigrant communities. Community buy-in, effective social media use and language programming from the start have been essential, he said.

Hispanics have a higher vaccination rate than whites in Missouri. But nationally, a dearth of transportation options, an inability to take off from work to get a treatment, and concerns about documentation and privacy have dampened uptake among Hispanics, according to experts. €œTo me it’s more about access to health care,” Berry said. €œIf you don’t live close to health care, you’re just going to shrug it off immediately.

€˜I can’t get that vaccination. I’m going to miss work.’” To reduce fear among Idaho agricultural workers that may be part of mixed-immigration status families, public health workers emphasized messaging that documentation wouldn’t be required, said Monica Schoch-Spana, a senior scholar at Johns Hopkins Center for Health Security. She has helped lead its CommuniVax project seeking to boost uptake among Black, Hispanic and Indigenous communities. It’s also important to engage trusted institutions to administer treatments, Schoch-Spana said.

€œIs it a familiar place, does it feel safe, and is it easy to get to?. € Federal efforts have placed sites in underserved neighborhoods. About 60% of shots at the Federal Emergency Management Agency’s vaccination sites and at community health centers were given to people of color, federal health officials said this week. Incomplete Data Collection Race or ethnicity information is still missing for nearly 69 million vaccinated people — or 44% — in the CDC data, despite vows by federal officials to improve outdated systems to better inform their response.

CDC spokesperson Kate Fowlie said their efforts, including sharing strategies for capturing demographic data and reducing data gaps with state and local governments, have resulted in improvements in data collection. Officials are also planning to allow agencies to update previously submitted treatment records. The true national rates by race or ethnicity group would each be higher with complete data. Unlike the federal government, North Carolina made it nearly impossible for providers to submit treatment data without recording race and ethnicity.

As a result, it has the most complete demographic data of any state. Adding that step was not an easy sell — providers and other vaccinators were initially resistant, said Kody Kinsley, the chief deputy secretary for health at the North Carolina health department. But it has paid off in the state’s ability to target its response to populations getting left behind, he said. Bibbins-Domingo said the federal government and states need to make collecting this vaccination data by race mandatory, because data drives the response to the levitra.

€œThe feds know how to do this. They do it every 10 years for the census,” she said. €œThat we somehow cannot figure it out in public health data is quite simply unacceptable.” KHN reporter Victoria Knight contributed to this report. Visit the Github repository to read more about and download the data.

Hannah Recht. hrecht@kff.org, @hannah_recht Rachana Pradhan. rpradhan@kff.org, @rachanadixit Lauren Weber. LaurenW@kff.org, @LaurenWeberHP Related Topics Contact Us Submit a Story Tip.

Marissa Castrigno was walking through downtown Wilmington, North Carolina, when she spotted the sign how to get prescribed levitra in the window of one of her favorite http://www.luckjunky.com/where-to-get-viagra-pills/ dance clubs. After months of being shuttered by the levitra, Ibiza Nightclub was reopening April 30, it announced. Thrilled, Castrigno immediately made plans with friends to be how to get prescribed levitra there.

About 50 miles north in Jacksonville, Kennedy Swift learned of Ibiza’s reopening on social media. He, too, decided to attend with friends. But on the night of April 30, the two groups how to get prescribed levitra were in for a surprise — one they would react to in starkly different ways.

In addition to IDs, they learned, they’d need to show erectile dysfunction treatment vaccination cards for entry. The club was letting in only people who had had at least one shot. €œI was how to get prescribed levitra shocked,” said Swift, 21.

He learned of the policy a few hours before the reopening, when the club posted it on its Facebook page. He and his friends had to cancel their plans, since none of them was vaccinated. Marissa Castrigno (back center) and her how to get prescribed levitra friends, most of whom had been fully vaccinated since early April, felt the club’s treatment card policy made their return to nightlife even better.

(McKenzie Teter) “I’m not against [Ibiza] exercising their rights as a business,” Swift said. €œI just think it’s foolish. €¦ This will discourage a lot of former patrons from returning to the club.” On the other hand, Castrigno and her friends, most of whom how to get prescribed levitra had been fully vaccinated since early April, felt the policy made their return to nightlife even better.

€œThere was raw excitement about going out to a place and feeling safe,” said Castrigno, 28. Similar conversations are playing out across the country as vaccination rates increase and bars, clubs and other businesses navigate how to reopen. The concept of treatment passports — which allow people who have been inoculated against erectile dysfunction treatment and are at lower risk of contracting or spreading the disease to participate in certain activities — has been floated for clubs, cruise ships and other spaces how to get prescribed levitra where large groups gather in close quarters.

The Centers for Disease Control and Prevention’s recent announcement that vaccinated people can safely gather indoors and outdoors without masks has reignited the idea. Yet these passports remain highly controversial and their implementation is largely piecemeal. Many private businesses are making their own decisions, and governments in different parts of the how to get prescribed levitra country are adopting varying stances.

In New York, for instance, Gov. Andrew Cuomo announced in early May that places where proof of vaccination or a negative erectile dysfunction treatment test are required can operate at a greater capacity. Some nightclubs how to get prescribed levitra there have implemented policies similar to Ibiza’s.

In Florida, however, Gov. Ron DeSantis recently signed a law prohibiting businesses, schools and government offices from requiring proof of vaccination, with fines of up to $5,000 per incident. For Ibiza Nightclub in southeastern North Carolina — a political battleground state — the treatment card requirement is proving to be a lightning rod how to get prescribed levitra.

The club’s Facebook post announcing the policy had sparked 70 comments as of mid-May, and posts across other platforms echoed different sides of the issue. €œI am thrilled to see a personal business putting the health and safety forward in order to keep their business running,” one comment read. Others took how to get prescribed levitra a markedly different tone.

€œThis is pretty dumb!. € “Discrimination, expect lawsuits,” read another. The Honor Code Last week, after the CDC said vaccinated adults could largely live their lives mask-free, Raleigh restaurant owner how to get prescribed levitra Hisine McNeill felt a troubling pang of déjà vu.

He owns Alpha Dawgs, a sandwich shop in southeast Raleigh, and said small businesses like his carried the burden of mask enforcement for much of the levitra. Now, he said, they’re tasked with trusting adults who say they’ve been vaccinated. He isn’t ready to do that how to get prescribed levitra.

Hisine McNeill stands inside his Raleigh, North Carolina, restaurant, Alpha Dawgs, where he now requires customers who don’t wear a mask to instead show their treatment card. (Casey Toth/The News &. Observer) “I don’t have the luxury of taking chances on an honor code,” McNeill how to get prescribed levitra said.

€œIf I have an outbreak because someone didn’t wear a mask and have to close down, who’s going to help keep me open?. € McNeill opened Alpha Dawgs in 2018 and, like most restaurateurs, he said, struggled through the levitra, professionally and personally. He said he how to get prescribed levitra has lost friends and family members and doesn’t believe the levitra is over.

€œI know people personally in the ICU still recovering from [erectile dysfunction treatment],” McNeill said. €œI don’t need any more examples about how serious this is.” So McNeill posted a new requirement on the how to get prescribed levitra restaurant’s Facebook page. He asked everyone to continue wearing masks unless they were prepared to show him a treatment card.

€œTo whom it may concern,” McNeill wrote. €œIf you how to get prescribed levitra decide to come into my establishment claiming that you are fully vaccinated, I WILL ASK TO SEE YOUR CARD. If you don’t want to provide it then you will have to wear a mask in my store.

And if you still don’t want to comply with either then I have the right to deny service. Thank you for your cooperation.” The owner of Alpha Dawgs, how to get prescribed levitra Hisine McNeill, now requires customers who don’t wear a mask to instead show their treatment card. (Casey Toth/The News &.

Observer) A sign requiring masks is displayed on the front door of the restaurant. (Casey Toth/The how to get prescribed levitra News &. Observer) The day after he posted that statement, North Carolina Gov.

Roy Cooper eased most erectile dysfunction treatment-related restrictions in the state, including its mask mandate. The Alpha how to get prescribed levitra Dawgs post stirred some online debate over masks and vaccinations and led to a few responses, including one from the Raleigh Republican Club. €œShould you be in the area…,” it read.

€œEat somewhere else….” McNeill felt the Raleigh Republican Club was calling for a boycott. Afterward, he noticed multiple how to get prescribed levitra one-star reviews pop up on Google, not from people who had been to the restaurant, but people accusing McNeill of discrimination. €œThis is not political for me, this is a personal belief,” McNeill said.

€œI have an 85-year-old grandmother I see every other week. I’m going to make sure she’s protected.” Raleigh Republican Club board member Guy Smith said the group’s post was written collectively, but he didn’t see it as a call how to get prescribed levitra for a boycott. €œOur philosophical position is it’s his business, the owner can choose to do what they choose to do within the confines of the individual business,” Smith said.

€œOur philosophical position is, to demand someone to demonstrate they’re vaccinated with a card, we think that’s out of bounds.” Smith said the group also condemns writing bogus reviews of a business. McNeill said Alpha Dawgs’ business has how to get prescribed levitra not suffered from the online dust-up. €œI haven’t had any problems,” McNeill said.

€œOnly the online harassment.” The Nightclub Expected Opposition Charles Smith, general manager of the club, said he knew the policy would garner backlash, but “we’ve always put the health and safety of both staff and our patrons, and their families, first.” Since opening as a gay bar in 2001, Ibiza has been a pillar of the LGBTQ community in Wilmington. Although its clientele has expanded over time, it’s still known for drag shows on Friday how to get prescribed levitra nights. Last year, the club shut down March 12, about a week before Gov.

Cooper ordered all North Carolina bars and restaurants to stop dine-in service. Ibiza remained shuttered for 14 months, using the time to renovate, Smith said, and leaning on federal how to get prescribed levitra and state assistance for small businesses. When it came to reopening, he said, “the question was.

How do we provide the absolute safest experience alongside the nightlife experience we’ve been known for?. € It wouldn’t how to get prescribed levitra be easy. Nightclubs are a perfect cocktail of erectile dysfunction treatment risks.

Lots of people socializing and dancing in close quarters. Alcohol lowering how to get prescribed levitra inhibitions. Music forcing people to speak louder, releasing more droplets into the air.

€œThe concept of social distancing in a nightclub is an oxymoron,” Smith said. And the club’s staff didn’t want to be “the police of nightlife,” trying to separate people on the dance floor, how to get prescribed levitra he added. The safest option, it seemed, was to require people to be vaccinated.

The club waited till all adults in the state were eligible for treatments before reopening. Now Ibiza requires patrons to present their treatment cards or photos of the cards for entry how to get prescribed levitra. On reopening night, the club asked customers to wear masks and limited its capacity to 50%, per an executive order from the governor.

But as of May 14, the state lifted its capacity restrictions and masking requirements. Castrigno, who’d been looking forward to that night for weeks since she saw the sign in the club’s window, said it how to get prescribed levitra was “the most jubilant I’d ever seen Ibiza.” Several performers put on a drag show. Customers took turns dancing on poles.

Some people wore masks with rhinestones to match their outfits, she said. She wasn’t surprised that many people took the treatment how to get prescribed levitra requirement in stride. €œQueer people are well versed in the risks of public health crisis and protecting the community,” she said, referring to the AIDS crisis, which devastated the community in the ’80s and ’90s.

For James how to get prescribed levitra Colucci, who has been a customer since 2016, supporting Ibiza’s treatment policy is about protecting the club’s employees. Some of them have “spearheaded the [LGBTQ] movement, so we can get together and have events like this,” he said. But others say the policy is discriminatory and injects the nightclub into people’s personal health care decisions.

Joey Askew, a 37-year-old from Greenville, wrote on Ibiza’s how to get prescribed levitra Facebook page, “I’ll never go back to this club until they lift this mandate!. !. € In an interview with KHN, Askew said he’s not ready to get the treatment because there haven’t been lifetime studies of recipients to determine long-term side effects.

He’s willing to wear a how to get prescribed levitra mask and maintain physical distance, but a treatment requirement goes too far. €œA mask is something I can buy from anywhere and take off whenever I choose,” he said. €œBut I can’t take a treatment out.

It’s a permanent choice that how to get prescribed levitra [the club] is involving themselves in, and it’s not their place.” In between the people condemning the club’s policy and those applauding it are many who are conflicted. Mark Russell, 29, is a nurse in Washington, D.C., who cares for erectile dysfunction treatment patients and contracted erectile dysfunction treatment last year. He plans on visiting Ibiza Nightclub in late May while attending a small wedding in North Carolina where everyone will be vaccinated.

The club’s policy how to get prescribed levitra makes him feel safer, Russell said. But he also worries about its effect on people of color, who in many places have faced barriers to vaccination. €œIt’s a battle in my own brain, thinking those two things,” Russell said.

For Heidi how to get prescribed levitra Martek, 55, the policy raised a personal question. €œWhat about those who can’t get the treatment?. € she wrote on Ibiza’s Facebook page.

She has an autoimmune disease, making how to get prescribed levitra her body hypersensitive to any treatment, Martek said, even the flu shot. But when commenters on Facebook suggested she sue the club, Martek pushed back. The club is facing difficult choices, she told KHN, and there’s no right answer.

€œWhether I can how to get prescribed levitra go in or not, I support them,” said Martek, who’s been a patron at Ibiza for six years. She wants the club to survive the levitra, unlike other establishments that have closed in the past year. €œIt’s not like Wilmington is overwhelmed with LGBTQ clubs,” Martek said.

€œIbiza is really how to get prescribed levitra important.” News &. Observer reporter Drew Jackson contributed to this story. Aneri Pattani.

apattani@kff.org, @aneripattani Related Topics Contact Us Submit how to get prescribed levitra a Story TipColorado health officials so abhor the high costs associated with free-standing emergency rooms they’re offering to pay hospitals to shut the facilities down. The state wants hospitals to convert them to other purposes, such as providing primary care or mental health services. At least 500 free-standing ERs have set up in more than 20 states in the past decade.

Colorado has 44, how to get prescribed levitra 34 owned by hospitals. The trend began a decade ago with hopes these stand-alone facilities would fill a need for ER care when no hospital was nearby and reduce congestion at hospital ERs. But that rarely happened.

Instead, these emergency rooms — not physically connected to hospitals — generally set up in affluent suburban communities, often how to get prescribed levitra near hospitals that compete with the free-standing ERs’ owners. And they largely treated patients who did not need emergency care, but still billed them and their insurers at expensive ER rates, several studies have found. €œWe don’t want hospitals to have stand-alone ERs, so we are willing to pay to shut them down,” said Kim Bimestefer, executive director of Colorado’s Department of Health Care Policy &.

Financing, which how to get prescribed levitra oversees the state’s Medicaid program. She said using these facilities to treat common injuries and illnesses leads to higher costs for Medicaid, which the state partly finances, and other insurers. Colorado’s move is part of a new initiative that requires hospitals to improve their quality of care to qualify for millions of dollars in Medicaid payments.

Hospitals can choose among goals how to get prescribed levitra provided by the state such as lowering readmission rates or screening patients for social needs such as housing. Converting free-standing ERs to meet other needs is one of those goals. €œMoney talks,” Bimestefer said in explaining why the state is offering the financial incentives.

Money has been a how to get prescribed levitra major driver of the boom in free-standing emergency centers. Hospitals used them to attract patients who could be referred to the main hospital for inpatient care. They are also seen as a way to compete with rivals how to get prescribed levitra.

For instance, in Palm Beach County, Florida, for-profit hospital chain HCA Healthcare has opened free-standing ERs near competing hospitals in Palm Beach Gardens and Boynton Beach. In addition, the massive amounts of private equity funds flowing into health care have further fueled the growth of independently owned stand-alone ERs. The Denver-based Center for Improving Value in Health Care found that most conditions treated in these facilities are more appropriate for lower-acuity, lower-cost urgent care centers how to get prescribed levitra.

Patients can pay 10 times more in a free-standing ER than in an urgent care center for treatment of the same condition, the organization’s studies show. Adam Fox, deputy director of the Colorado Consumer Health Initiative, said free-standing ERs have not been placed where health care services are scarce. Instead, they’ve how to get prescribed levitra opened in middle- and upper-income neighborhoods where most people have health insurance and access to care.

€œThis push from the state will help” as hospitals rethink whether these facilities still make sense financially, he said. A free-standing emergency room in Arvada, Colorado, owned by UCHealth, part of the University of Colorado. (Markian Hawryluk / KHN) In the past few years, Colorado has moved to make owning these facilities less attractive with laws how to get prescribed levitra preventing them from sticking patients with surprise bills for high fees because the ER was out of their insurer networks.

It also has required that patients without true emergencies be told they can get treatment for a lower price at an urgent care facility. The law requires a free-standing ER to post a sign informing patients it is an emergency room that treats emergency conditions. It must how to get prescribed levitra also specify the prices of the 25 most common services it provides.

Even before the new policy begins to roll out later this year, some Colorado hospitals started converting these facilities. UCHealth has turned nine in the past two years into primary or urgent care centers and one into a specialty center. It still has nine others in operation how to get prescribed levitra across the state.

The conversions were not prompted by state actions, according to Dan Weaver, a spokesperson for UCHealth, part of the University of Colorado. €œNeither surprise billing legislation nor price transparency played a role in these decisions — we converted them because we felt patients in these communities needed urgent care, primary care and/or specialty care services close to home,” Weaver said. He added that the hospital system always stressed that people should use lower-cost services, including urgent care, how to get prescribed levitra primary care or virtual urgent care, in nonemergencies.

Ryan Westrom, senior director of finance at the Colorado Hospital Association, said hospitals have converted some of these centers to services such as urgent care in response to changes in insurance reimbursement and other factors. He said he wasn’t sure whether many hospitals will accept the state payments to close their free-standing ERs. HealthONE, which has eight free-standing ERs in the Denver area, said it has no plans to close any despite the state incentive payment how to get prescribed levitra.

Vivian Ho, a health economist at Rice University in Houston who has tracked the growth of these stand-alone emergency rooms, applauded Colorado’s effort. But she worries hospitals may decide it’s not worth closing a free-standing emergency department and forfeiting the profits. €œYou have to attack free-standing EDs from multiple angles to get people to stop going to them and to get hospitals from using them as how to get prescribed levitra a way to generate extra revenues for care that can be delivered at lower-cost sites.” Ho said the erectile dysfunction treatment levitra, which dampened demand for emergency care, and recent federal surprise billing legislation may hurt the growth of free-standing ERs.

They are already facing headwinds. Adeptus Health, the Texas company that’s been leading the trend there and started dozens of the free-standing emergency rooms, often in conjunction with hospitals, filed for bankruptcy this year. And numerous stand-alone facilities closed at least temporarily during the levitra as demand for care fell how to get prescribed levitra dramatically.

Advisers to Medicare are also pushing back on the growth. A recent proposal from the Medicare Payment Advisory Commission, which reports to Congress, would cut Medicare payment rates 30% on some services at stand-alone facilities within 6 miles of an emergency room in a hospital. According to a MedPAC analysis of five markets — Charlotte, North Carolina how to get prescribed levitra.

And Jacksonville, Florida — 75% of free-standing facilities were within 6 miles of a hospital with an emergency department. The average drive time to the nearest such hospital was 10 minutes. Markian Hawryluk, KHN’s senior Colorado correspondent, contributed to this article.

Phil Galewitz. pgalewitz@kff.org, @philgalewitz Related Topics Contact Us Submit a Story TipRonald Lindquist, 87, has been active all his life. So, he wasn’t prepared for what happened when he stopped going out during the erectile dysfunction levitra and spent most of his time, inactive, at home.

“I found it hard to get up and get out of bed,” said Lindquist, who lives with his wife of 67 years in Palm Springs, California. €œI just wanted to lay around. I lost my desire to do things.” Physically, Lindquist noticed that getting up out of a chair was difficult, as was getting into and out of his car.

€œI was praying ‘Lord, give me some strength.’ I kind of felt, I’m on my way out — I’m not going to make it,” he admitted. One little-discussed, long-term toll of the levitra. Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.

No large-scale studies have documented the extent of this phenomenon. But physicians, physical therapists and health plan leaders said the prospect of increased impairment and frailty in the older population is a growing concern. €œAnyone who cares for older adults has seen a significant decline in functioning as people have been less active,” said Dr.

Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System. Bean’s 90-year-old mother, who lives in an assisted living facility, is a case in point. Before the levitra, she could walk with a walker, engage in conversation and manage going to the bathroom.

Now, she depends on a wheelchair and “her dementia has rapidly accelerated — she can’t really care for herself,” the doctor said. Bean said his mother is no longer able to benefit from rehabilitative therapies. But many older adults might be able to realize improvements if given proper attention.

€œImmobility and debility are outcomes to this horrific levitra that people aren’t even talking about yet,” said Linda Teodosio, a physical therapist and division rehabilitation manager in Bayada Home Health Care’s Towson, Maryland, office. €œWhat I’d love to see is a national effort, maybe by the CDC [U.S. Centers for Disease Control and Prevention], focused on helping older people overcome these kinds of impairments.” The extent of the need is substantial, by many accounts.

Teodosio said she and her staff have seen a “tremendous increase” in falls and in the exacerbation of chronic illnesses such as diabetes, congestive heart failure and chronic obstructive pulmonary disease. €œOlder adults got off schedule during the levitra,” she explained, and “they didn’t eat well, they didn’t hydrate properly, they didn’t move, they got weaker.” Dr. Lauren Jan Gleason, a geriatrician and assistant professor of medicine at the University of Chicago, said many older patients have lost muscle mass and strength this past year and are having difficulties with mobility and balance they didn’t have previously.

€œI’m seeing weight gain and weight loss, and a lot more depression,” she noted. Mary Louise Amilicia, 67, of East Meadow, New York, put on more than 100 pounds while staying at home round-the-clock and taking care of her husband Frank, 69, who was hospitalized with a severe case of erectile dysfunction treatment in early December. While Amilicia also tested positive for the levitra, she had a mild case.

€œWe were in the house every day 24/7, except when we had to go to the doctor, and when he got sick I had to do all the stuff he used to do,” Amilicia told me. €œIt was a lot of stress. I just began eating everything in sight and not taking care of myself.” The extra weight made it hard to move around, and Amilicia fell several times after Christmas, fortunately without sustaining serious injuries.

After coming home from the hospital, Frank couldn’t get out of a chair, walk 10 feet to the bathroom or climb the stairs in his house. Instead, he spent most of the day in a recliner, relying on his wife for help. Now, the couple is getting physical therapy from Northwell Health, New York state’s largest health care system.

Just before the levitra, Northwell launched a “rehabilitation at home” program for patients who otherwise would have seen therapists in outpatient facilities. (Medicare Part B pays for the treatments.) Frank Amilicia was hospitalized with a severe case of erectile dysfunction treatment last December. When he returned home, he was confined to his recliner, relying on his wife, Mary Louise, for help.

Mary Louise put on extra weight while taking care of Frank and fell several times after Christmas. Now, the couple is getting physical therapy from Northwell Health, New York state’s largest health care system. (Saaba Mundia) The program is serving more than 100 patients on Long Island, in Westchester County and in parts of New York City.

€œThe demand is very strong and we’re in the process of hiring another 20 therapists,” said Nina DePaola, Northwell’s vice president of post-acute services. Sabaa Mundia, a physical therapist working with the Amilicias, said Mary Louise can walk up to 400 feet without a walker, after doing strengthening exercises twice a week over the course of three weeks. Frank had been using a wheelchair and is now regularly walking 150 feet with a walker after more than a month of therapy.

€œOlder adults can lose about 20% of their muscle mass if they don’t walk for up to five days,” Mundia said. €œAnd their endurance decreases, their stamina decreases, and their range of motion decreases.” Recognizing that risk, some health plans have been reaching out to older members to assess how they’re faring. In Massachusetts, Commonwealth Care Alliance serves more than 10,000 older adults who are poor and eligible for both Medicare and Medicaid, the federal-state program for people with low incomes.

On average, they tend to have more medical needs than similarly aged seniors. Between March and September last year, the plan’s staffers conducted “wellness outreach assessments” by phone every two weeks, asking about ongoing medical care, new physical and emotional challenges, and the adequacy of available help, among other concerns. Today, calls are made monthly and staffers have resumed seeing members in person.

An increase in physical deconditioning is one of the big issues that have emerged. €œWe’ve had physical therapists digitally engage with members to coach them through strength and balance training,” said Dr. Robert MacArthur, a geriatrician and Commonwealth Care’s chief medical officer.

€œAnd when that didn’t work, we sent therapists into people’s homes.” In California, SCAN Health Plan serves a similarly vulnerable population of nearly 15,000 older adults dually eligible for Medicare and Medicaid through its Medicare Advantage plans. Care navigators are calling these members frequently and telling them “now that you’re vaccinated, it’s safe to go see your doctor in person,” said Eve Gelb, SCAN’s senior vice president of health care services. Doctors can then evaluate unmet health needs and make referrals to physical and occupational therapists, if necessary.

Another SCAN program, Member2Member, pairs older adult “peer health advocates” with members who have noted physical or emotional difficulties on health risk assessments. That’s how Lindquist in Palm Springs connected with Jerry Payne, 79, a peer advocate who calls him regularly and helped him come up with a plan to emerge from his levitra-induced funk. €œFirst, he said, ‘Ron, you should try getting up every hour and taking a few steps’ — that was the start of it,” Lindquist told me.

€œThen, he’d suggest walking another block when I would take my dog out. It was painful. Walking was not pleasant.

But he was very encouraging.” A month ago, Payne had a Fitbit sent to Lindquist. At first, Lindquist walked about 1,500 steps a day. Now, he’s up to more than 5,000 steps a day and has a goal of reaching 10,000 steps.

€œI’m sleeping better and I feel so much better all around,” Lindquist said. €œMy whole attitude and physicality has changed. I tell you, this has been an answer to my prayers.” Coming Monday.

Tips for Older Adults to Regain Their Game We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips. Judith Graham.

khn.navigatingaging@gmail.com, @judith_graham Related Topics Contact Us Submit a Story TipCan’t see the audio player?. Click here to listen on SoundCloud. The Supreme Court agreed to hear a case next term that could result in a significant modification or overturn of Roe v.

Wade, the 1973 case that legalized abortion nationwide. At issue is a Mississippi law that would ban the procedure after 15 weeks of gestation. That is well before a fetus is viable outside the womb and, under Roe, states may not ban abortion prior to viability.

Meanwhile, the unexpected announcement by the Centers for Disease Control and Prevention that fully vaccinated people could stop wearing masks inside and outside has caused considerable confusion, as the U.S. Does not have a way for people to prove they are vaccinated. And despite a successful voter referendum, Missouri Gov.

Mike Parson, a Republican, has announced his state will not expand the Medicaid program after the Republican-led legislature failed to provide the state’s share of funding. This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet and Mary Ellen McIntire of CQ Roll Call. Among the takeaways from this week’s podcast.

Many states have passed restrictions on abortion that are at odds with the Supreme Court’s earlier decisions on the issue. If it were to uphold the Mississippi law, the court would have to discard or substantially change its standards from the Roe v Wade decision and subsequent cases.The decision by the justices is likely to come next summer, just months before the midterm elections, and it is likely to be used by both parties as part of their campaigns, no matter which way the court rules.The CDC has been heavily criticized for its abrupt announcement on masks last week. Although some officials, including Dr.

Anthony Fauci, have sought to soften the message by saying it doesn’t mean people can’t wear masks or may not need them in some instances, public health authorities, states and some businesses were caught unaware by the announcement and are struggling with how to respond.The use of masks also has riled the House of Representatives. Speaker Nancy Pelosi said she will remove the mask mandate on the floor only when 100% of members have been vaccinated. But some Republicans are refusing to take the shot or to say whether they have received a treatment, and they are subject to fines when they are maskless on the House floor.Biden administration officials announced the U.S.

Will provide 20 million doses of treatment to other countries battling erectile dysfunction treatment, but the donation cannot meet the need. World health officials have complained that the U.S. Is too worried about holding back treatment to give shots to children, who are at low risk, while millions of adults around the world are dying.

Yet federal officials are still concerned that vaccination efforts here are not reaching enough Americans. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too. Julie Rovner.

CNN’s “’There’s No Way I Can Pay for This:’ One of America’s Largest Hospital Chains Has Been Suing Thousands of Patients During the levitra,” by Casey Tolan Alice Miranda Ollstein. The 19th’s “Women in Health Care Are at a Breaking Point — And They’re Leaving,” by Shefali Luthra and Chabeli Carrazana Sarah Karlin-Smith. KHN’s “Why Your Dentist Might Seem Pushy,” by Daryl Austin Mary Ellen McIntire.

Stat’s “How the erectile dysfunction treatment levitra Ends. Scientists Look to the Past to See the Future,” by Helen Branswell To hear all our podcasts, click here. And subscribe to What the Health?.

on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Contact Us Submit a Story TipBlack Americans’ erectile dysfunction treatment vaccination rates are still lagging months into the nation’s campaign, while Hispanics are closing the gap and Native Americans show the highest rates overall, according to federal data obtained by KHN. The data, provided by the Centers for Disease Control and Prevention in response to a public records request, gives a sweeping national look at the race and ethnicity of vaccinated people on a state-by-state basis.

Yet nearly half of those vaccination records are missing race or ethnicity information. KHN’s analysis shows that only 22% of Black Americans have gotten a shot, and Black rates still trail those of whites in almost every state. Targeted efforts have raised vaccination rates among other minority groups.

Hispanics in eight states, the District of Columbia and Puerto Rico are now vaccinated at higher rates than non-Hispanic whites. Yet 29% of Hispanics are vaccinated nationally, compared with 33% of whites. While 45% of Native Americans have received at least one dose, stark differences exist depending on where they live.

And Asian vaccination rates are high in most states, with 41% getting a shot. The analysis underscores how treatment disparities have improved as availability has opened up and Biden administration officials have attempted to prioritize equitable distribution. Still, gaps persist even as minority groups have suffered much higher mortality rates from the levitra than whites and are at risk of as states move to reopen and lift mask mandates.

Despite these lingering gaps, the CDC said last week that those who are fully vaccinated don’t need to wear masks in most indoor and outdoor settings or physically distance. Only 38% of Americans are fully vaccinated. “Every day we do not reach a person or a community is a day in which there is a preventable erectile dysfunction treatment case that happens and a preventable erectile dysfunction treatment death in these communities,” said Dr.

Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco. KHN requested race and ethnicity data from the CDC on people who have received at least one dose of a erectile dysfunction treatment since mid-December for all 50 states, the District of Columbia and Puerto Rico. The data covers shots as of May 14 given to 155 million people that were administered through federally run programs and federal agencies as well as by state and local authorities.

Eight states — Alabama, California, Michigan, Minnesota, South Dakota, Texas, Vermont and Wyoming — either refuse to provide race and ethnicity details to the CDC or are missing that information for more than 60% of people vaccinated. Those states are excluded from the KHN analysis, though the CDC includes all but Texas in its published national rates. Some states display race and ethnicity for treatment recipients separately, making it difficult to compare rates for Hispanics to non-Hispanic whites, for example.

But the CDC data allows for direct comparisons. It reports numbers for Hispanics, who can be of any race or combination of races, as well as numbers for non-Hispanic people of single-race or multiracial categories. The data for Native Hawaiians and other Pacific Islanders is unreliable, making it difficult to draw conclusions on the vaccination rate in that population.

Dr. Georges Benjamin, executive director of the American Public Health Association, wasn’t surprised that Black Americans’ vaccination rates were still lagging, citing a complex combination of access issues, hesitancy and structural inequity. Benjamin pointed to the early challenges in securing an appointment online and the initial placement of vaccination sites — which he noted the Biden administration had worked to improve.

€œWe’re going to be judged whether or not we did it equitably at the end of the day,” he said. €œRight now, I still think we’re failing.” Dr. Utibe Essien, a health equity researcher and assistant professor of medicine at the University of Pittsburgh, stressed that targeted outreach must involve multiple institutions in a community.

€œIt’s not just the Black doctor, it’s not just the barber, it’s not just the pastor, kind of these traditional folks who have been the big messengers. We have to be broad,” he said. €œIt’s investing in folks who know the neighborhood, the small-store owner who gets to see all the 12- to 15-year-old kids come through the store getting snacks before they head off to school.” Why Native Americans Lead in Vaccinations Nationally, Native Americans and Alaska Natives have been vaccinated at significantly higher rates than other groups.

Tribes administered doses quickly, prioritizing elders with culturally important knowledge, said Meredith Raimondi, director of congressional relations and public policy for the National Council of Urban Indian Health. The rollout was imbued with urgency. Native Americans have died of erectile dysfunction treatment at more than double the rate of white Americans, according to the latest CDC data.

Native vaccination rates are higher than white rates in 28 states, including New Mexico, Arizona and Alaska, where many receive care from tribal health centers and the Indian Health Service. In states such as South Carolina and Tennessee, where IHS access is more limited and Native residents are more likely to live in urban areas, vaccination rates are far lower than for white residents. Groups in those areas reported problems finding health care providers to administer shots.

Tribal organizations compiled lists of retired nurses to tap for clinics. At one point, staffers from an Oklahoma City clinic for Native Americans offered to fly to Washington, D.C., to help vaccinate Indigenous people living around the nation’s capital, Raimondi said. €œIt became an issue of, ‘Well, we could get you the treatment, but we don’t know who is going to administer them,’” Raimondi said.

The council and Native American Lifelines, a nonprofit providing health services, partnered with the University of Maryland-Baltimore for a vaccination site exclusively for Native Americans living in Maryland, Virginia and Washington, D.C. It launched in April. While the vaccination rates for Native Americans surpass those of whites in some states due in part to IHS, that infrastructure does not exist for Black Americans, said Rhonda BeLue, the department chair of health management policy at Saint Louis University.

At the beginning of the levitra, people were shocked by how much more likely Black Americans were to die from erectile dysfunction treatment, she said. €œHowever, the same structural inequities that caused that disproportionate mortality in erectile dysfunction treatment are the same structural inequities that predated erectile dysfunction treatment and caused disproportionate burdens of morbidity and mortality,” she said. €œThis isn’t new.” Easing Fears in Hispanic Communities Some states are reporting higher vaccination rates among Hispanics than white and Black residents, which Bibbins-Domingo said fits with surveys showing high enthusiasm for vaccination among Hispanics.

It also indicates that some of the reported barriers may have been addressed more effectively in those states, she said. Paul Berry, chair of the Virginia Latino Advisory Board, partly attributes Virginia’s success to targeted outreach efforts. The state and certain counties also increased Spanish-language resources to boost sign-ups.

Connecting with every community cannot be an afterthought, said Diego Abente, president and CEO of St. Louis’ Casa de Salud, a health care provider focused on immigrant communities. Community buy-in, effective social media use and language programming from the start have been essential, he said.

Hispanics have a higher vaccination rate than whites in Missouri. But nationally, a dearth of transportation options, an inability to take off from work to get a treatment, and concerns about documentation and privacy have dampened uptake among Hispanics, according to experts. €œTo me it’s more about access to health care,” Berry said.

€œIf you don’t live close to health care, you’re just going to shrug it off immediately. €˜I can’t get that vaccination. I’m going to miss work.’” To reduce fear among Idaho agricultural workers that may be part of mixed-immigration status families, public health workers emphasized messaging that documentation wouldn’t be required, said Monica Schoch-Spana, a senior scholar at Johns Hopkins Center for Health Security.

She has helped lead its CommuniVax project seeking to boost uptake among Black, Hispanic and Indigenous communities. It’s also important to engage trusted institutions to administer treatments, Schoch-Spana said. €œIs it a familiar place, does it feel safe, and is it easy to get to?.

€ Federal efforts have placed sites in underserved neighborhoods. About 60% of shots at the Federal Emergency Management Agency’s vaccination sites and at community health centers were given to people of color, federal health officials said this week. Incomplete Data Collection Race or ethnicity information is still missing for nearly 69 million vaccinated people — or 44% — in the CDC data, despite vows by federal officials to improve outdated systems to better inform their response.

CDC spokesperson Kate Fowlie said their efforts, including sharing strategies for capturing demographic data and reducing data gaps with state and local governments, have resulted in improvements in data collection. Officials are also planning to allow agencies to update previously submitted treatment records. The true national rates by race or ethnicity group would each be higher with complete data.

Unlike the federal government, North Carolina made it nearly impossible for providers to submit treatment data without recording race and ethnicity. As a result, it has the most complete demographic data of any state. Adding that step was not an easy sell — providers and other vaccinators were initially resistant, said Kody Kinsley, the chief deputy secretary for health at the North Carolina health department.

But it has paid off in the state’s ability to target its response to populations getting left behind, he said. Bibbins-Domingo said the federal government and states need to make collecting this vaccination data by race mandatory, because data drives the response to the levitra. €œThe feds know how to do this.

They do it every 10 years for the census,” she said. €œThat we somehow cannot figure it out in public health data is quite simply unacceptable.” KHN reporter Victoria Knight contributed to this report. Visit the Github repository to read more about and download the data.

Hannah Recht. hrecht@kff.org, @hannah_recht Rachana Pradhan. rpradhan@kff.org, @rachanadixit Lauren Weber.

LaurenW@kff.org, @LaurenWeberHP Related Topics Contact Us Submit a Story Tip.

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Granting and Withdrawal of Deeming Authority to Private Kamagra prices walmart Nonprofit Accreditation where can i get levitra Organizations and CLIA Exemption Under State Laboratory Programs. Use. The information required is necessary to determine whether a private accreditation organization/State licensure program standards and accreditation/licensure process is at least equal to or more stringent than those of the Clinical Laboratory Improvement Amendments of 1988 (CLIA). If an accreditation organization is where can i get levitra approved, the laboratories that it accredits are “deemed” to meet the Start Printed Page 26922CLIA requirements based on this accreditation. Similarly, if a State licensure program is determined to have requirements that are equal to or more stringent than those of CLIA, its laboratories are considered to be exempt from CLIA certification and requirements.

The information collected will be used by HHS to. Determine comparability/equivalency of the accreditation organization standards and policies or State where can i get levitra licensure program standards and policies to those of the CLIA program. To ensure the continued comparability/equivalency of the standards. And to fulfill certain statutory reporting requirements. Form Number where can i get levitra.

CMS-R-185 (OMB control number. 0938-0686). Frequency. Occasionally. Affected Public.

Private Sector—Business or other for-profits and Not-for-profit institutions. Number of Respondents. 9. Total Annual Responses. 9.

Total Annual Hours. 5,464. (For policy questions regarding this collection contact Arlene Lopez at 410-786-6782.) 2. Type of Information Collection Request. Reinstatement without change of a currently approved collection.

Title of Information Collection. Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children's Health Insurance Program. Use. The information collected from the selected States will be used by Federal contractors to conduct Medicaid and CHIP FFS data processing and medical record reviews on which State-specific improper payment rates will be calculated. The quarterly FFS claims and payments will provide the contractor with the actual claims to be sampled.

The systems manuals, provider policies, and other supporting documentation will be used by the federal contractor when conducting the FFS data processing and medical record reviews. Further, the FFS claims and payments sampled for data processing and medical record reviews will serve as the basis for the eligibility reviews. Individuals for whom the state made the FFS claim or payments will have their underlying eligibility reviewed. In addition to the Federal Review Contractor conducting a data processing and medical record review of the FFS claims and payments, the FFS sample selected from the state-submitted universe will also be leveraged to support the PERM eligibility reviews. The Federal Eligibility Review Contractor will review the underlying eligibility of individuals whose FFS claims and payments were sampled as part of the PERM FFS sample.

Form Number. CMS-10166 (OMB control number. 0938-0974). Frequency. Quarterly.

Affected Public. State, Local, or Tribal Governments. Number of Respondents. 17. Total Annual Responses.

34. Total Annual Hours. 56,100. (For policy questions regarding this collection contact Daniel Weimer at 410-786-5240.) 3. Type of Information Collection Request.

Reinstatement without change of a currently approved collection. Title of Information Collection. Medicaid and Children's Health Insurance (CHIP) Managed Care Payments and Related Information. Use. The information collected from the selected States will be used by Federal contractors to conduct Medicaid and CHIP managed care data processing reviews on which State-specific improper payment rates will be calculated.

The quarterly capitation payments will provide the contractor with the actual claims to be sampled. The managed care contracts, rate schedules, and updates to both, will be used by the federal contractor when conducting the managed care claims reviews. Further, the managed care capitation payments sampled for data processing reviews will serve as the basis for the eligibility reviews. Individuals for whom the state made the managed care capitation will have their underlying eligibility reviewed. Section 2(b)(1) of IPERA clarified that, when meeting IPIA and IPERA requirements, agencies must produce a statistically valid estimate, or an estimate that is otherwise appropriate using a methodology approved by the Director of the OMB.

IPERIA further clarified requirements for agency reporting on actions to reduce improper payments and recover improper payments. The collection of information is necessary for CMS to produce national improper payment rates for Medicaid and CHIP as required by Public Law 107-300. Form Number. CMS-10178 (OMB control number. 0938-0994).

Frequency. Quarterly. Affected Public. State, Local, or Tribal Governments. Number of Respondents.

17. Total Annual Responses. 34. Total Annual Hours. 19,550.

(For policy questions regarding this collection contact Daniel Weimer at 410-786-5240.) 4. Type of Information Collection Request. Reinstatement with change of a previously approved collection. Title of Information Collection. Payment Error Rate Measurement—State Medicaid and CHIP Eligibility.

Use. The Payment Error Rate Measurement (PERM) program was developed to implement the requirements of the Improper Payments Information Act (IPIA) of 2002 (Pub. L. 107-300), which requires the head of federal agencies to annually review all programs and activities that it administers to determine and identify any programs that are susceptible to significant erroneous payments. If programs are found to be susceptible to significant improper payments, then the agency must estimate the annual amount of erroneous payments, report those estimates to the Congress, and submit a report on actions the agency is taking to reduce improper payments.

IPIA was amended by Improper Payments Elimination and Recovery Act of 2010 (IPERA) (Pub. L. 111-204), the Improper Payments Elimination and Recovery Improvement Act of 2012 (IPERIA) (Pub. L. 112-248), and the Payment Integrity Information Act of 2019 (PIIA) (Pub.

L. 116-117). The eligibility case documentation collected from the States, through submission of hard copy case files and through access to state eligibility systems, will be used by CMS and its federal contractors to conduct eligibility case reviews on individuals who had claims paid on their behalf in order to determine the improper payment rate associated with Medicaid and CHIP eligibility to comply with the IPIA of 2002. Prior to the July 2017 Final Rule being published in response to the Affordable Care Act, states provided CMS only with information about their sampling and review process as well as the final review findings, which CMS has used in each PERM cycle to calculate IPIA-compliant state and federal improper payment rate for Medicaid and CHIP. Given changes brought forth in the July 2017 Final Rule, states will no longer be required to develop eligibility-specific universes, conduct case reviews, and report findings to CMS.

A federal contractor will utilize the claims (fee-for-service and managed care universes) to identify a sample of individuals and will be responsible for conducting case reviews to support the PERM measurement. Form Number. CMS-10184 (OMB control number. 0938-1012). Frequency.

1 Kamagra prices walmart how to get prescribed levitra. Electronically. You may send your comments electronically to http://www.regulations.gov. Follow the instructions for “Comment or Submission” or “More how to get prescribed levitra Search Options” to find the information collection document(s) that are accepting comments.

2. By regular mail. You may how to get prescribed levitra mail written comments to the following address. CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention.

Document Identifier/OMB Control Number. CMS-P-0015A, Room C4-26-05, 7500 Security Boulevard, Baltimore, how to get prescribed levitra Maryland 21244-1850. To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice, you may make your request using one of following. 1.

Access CMS' how to get prescribed levitra website address at https://www.cms.gov/​Regulations-and-Guidance/​Legislation/​PaperworkReductionActof1995/​PRA-Listing.html. Start Further Info William N. Parham at (410) 786-4669. End Further Info End Preamble how to get prescribed levitra Start Supplemental Information Contents This notice sets out a summary of the use and burden associated with the following information collections.

More detailed information can be found in each collection's supporting statement and associated materials (see ADDRESSES). CMS-R-185—Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and CLIA Exemption Under State Laboratory CMS-10166—Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children's Health Insurance Program CMS-10178—Medicaid and Children's Health Insurance (CHIP) Managed Care Payments and Related Information CMS-10184—Payment Error Rate Measurement—State Medicaid and CHIP Eligibility CMS-10417—Medicare Fee-for-Service Prepayment Review of Medical Records CMS-372(S)—Annual Report on Home and Community Based Services Waivers and Supporting Regulations Under the PRA (44 U.S.C. 3501-3520), federal agencies how to get prescribed levitra must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term “collection of information” is defined in 44 U.S.C.

3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA requires federal agencies to publish a 60-day how to get prescribed levitra notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice. Information Collection 1.

Type of Information how to get prescribed levitra Collection Request. Extension of currently approved collection. Title of Information Collection. Granting and Withdrawal how to get prescribed levitra of Deeming Authority to Private Nonprofit Accreditation Organizations and CLIA Exemption Under State Laboratory Programs.

Use. The information required is necessary to determine whether a private accreditation organization/State licensure program standards and accreditation/licensure process is at least equal to or more stringent than those of the Clinical Laboratory Improvement Amendments of 1988 (CLIA). If an accreditation organization is approved, the laboratories that it accredits are “deemed” to meet the Start how to get prescribed levitra Printed Page 26922CLIA requirements based on this accreditation. Similarly, if a State licensure program is determined to have requirements that are equal to or more stringent than those of CLIA, its laboratories are considered to be exempt from CLIA certification and requirements.

The information collected will be used by HHS to. Determine comparability/equivalency of the accreditation organization standards and policies or State licensure how to get prescribed levitra program standards and policies to those of the CLIA program. To ensure the continued comparability/equivalency of the standards. And to fulfill certain statutory reporting requirements.

Form Number how to get prescribed levitra. CMS-R-185 (OMB control number. 0938-0686). Frequency.

Occasionally. Affected Public. Private Sector—Business or other for-profits and Not-for-profit institutions. Number of Respondents.

9. Total Annual Responses. 9. Total Annual Hours.

5,464. (For policy questions regarding this collection contact Arlene Lopez at 410-786-6782.) 2. Type of Information Collection Request. Reinstatement without change of a currently approved collection.

Title of Information Collection. Fee-for-Service Improper Payment Rate Measurement in Medicaid and the Children's Health Insurance Program. Use. The information collected from the selected States will be used by Federal contractors to conduct Medicaid and CHIP FFS data processing and medical record reviews on which State-specific improper payment rates will be calculated.

The quarterly FFS claims and payments will provide the contractor with the actual claims to be sampled. The systems manuals, provider policies, and other supporting documentation will be used by the federal contractor when conducting the FFS data processing and medical record reviews. Further, the FFS claims and payments sampled for data processing and medical record reviews will serve as the basis for the eligibility reviews. Individuals for whom the state made the FFS claim or payments will have their underlying eligibility reviewed.

In addition to the Federal Review Contractor conducting a data processing and medical record review of the FFS claims and payments, the FFS sample selected from the state-submitted universe will also be leveraged to support the PERM eligibility reviews. The Federal Eligibility Review Contractor will review the underlying eligibility of individuals whose FFS claims and payments were sampled as part of the PERM FFS sample. Form Number. CMS-10166 (OMB control number.

0938-0974). Frequency. Quarterly. Affected Public.

State, Local, or Tribal Governments. Number of Respondents. 17. Total Annual Responses.

34. Total Annual Hours. 56,100. (For policy questions regarding this collection contact Daniel Weimer at 410-786-5240.) 3.

Type of Information Collection Request. Reinstatement without change of a currently approved collection. Title of Information Collection. Medicaid and Children's Health Insurance (CHIP) Managed Care Payments and Related Information.

Use. The information collected from the selected States will be used by Federal contractors to conduct Medicaid and CHIP managed care data processing reviews on which State-specific improper payment rates will be calculated. The quarterly capitation payments will provide the contractor with the actual claims to be sampled. The managed care contracts, rate schedules, and updates to both, will be used by the federal contractor when conducting the managed care claims reviews.

Further, the managed care capitation payments sampled for data processing reviews will serve as the basis for the eligibility reviews. Individuals for whom the state made the managed care capitation will have their underlying eligibility reviewed. Section 2(b)(1) of IPERA clarified that, when meeting IPIA and IPERA requirements, agencies must produce a statistically valid estimate, or an estimate that is otherwise appropriate using a methodology approved by the Director of the OMB. IPERIA further clarified requirements for agency reporting on actions to reduce improper payments and recover improper payments.

The collection of information is necessary for CMS to produce national improper payment rates for Medicaid and CHIP as required by Public Law 107-300. Form Number. CMS-10178 (OMB control number. 0938-0994).

Frequency. Quarterly. Affected Public. State, Local, or Tribal Governments.

Number of Respondents. 17. Total Annual Responses. 34.

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