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- Written by: Elizabeth Larson
Without an extension by Dec. 31, seniors on Medicare would lose access to critical telehealth services.
“Since my days in the California State Senate, I’ve been a big believer in telehealth’s ability to save money, time, and lives,” said Rep. Thompson. “Telehealth allows patients — especially those with low mobility or who otherwise can’t make it to the doctor’s office — to access the care they need when they need it. Expanding Americans' access to vital telehealth services just makes sense.”
“Technology is critical in expanding access to care for not only Arizonans, but for citizens across the United States,” said Rep. Schweikert. “Even before the COVID-19 pandemic, telehealth provided effective, affordable, and accommodating means of care. Telehealth is by far the most moral and bipartisan method of providing access to care, and we owe it to our everyday health heroes, physicians, and patients to ensure this resource is always available.”
“The benefits are clear — telehealth makes it easier for patients to pick up the phone, follow through on their appointments, and seek care sooner. That’s why the expansion of telehealth services has been crucial for reaching our most vulnerable patients,” said Rep. Matsui. “Removing barriers to telehealth has expanded access and improved the quality of care for Medicare beneficiaries — and we cannot afford to take any steps back. We have a nation relying on these services. That’s why my colleagues and I are working hard to ensure that Americans continue to have access to convenient, quality health care that’s right for them, when and where they need it.”
“Telehealth services have proven to be essential for our rural communities,” said Rep. Balderson. “For many folks in rural and Appalachian Ohio, access to quality health care has long been a major challenge. With the technology we have today, we are able to improve health outcomes in our most underserved areas and finally close the urban-rural divide. It is critical for Congress to act and ensure federal support for telehealth services continues into 2025.”
The members of Congress who signed the letter include Representatives Mike Thompson, Troy Balderson, Nanette Barragán, Julia Brownley, Kathy Castor, Sheila Cherfilus-McCormick, Gerald Connolly, Angie Craig, Danny Davis, Donald Davis, Diana DeGette, Chris Deluzio, Debbie Dingell, Dwight Evans, Mike Ezell, Maxwell Frost, Jared Golden, Dan Goldman, Michael Guest, Eleanor Holmes Norton, Trent Kelly, Robin Kelly, Derek Kilmer, Doug LaMalfa, Teresa Leger Fernández, Mike Levin, Ted Lieu, Zoe Lofgren, Stephen Lynch, Seth Magaziner, Doris Matsui, Jennifer McClellan, Frank Mrvan, Kevin Mullin, Grace Napolitano, Troy Nehls, Scott Peters, Mark Pocan, Mike Quigley, Delia Ramirez, Andrea Salinas, Linda Sánchez, Jan Schakowsky, David Schweikert, Adrian Smith, Greg Stanton, Marilyn Strickland, Shri Thanedar, Paul Tonko, Lori Trahan, David Trone, Marc Veasey, Nydia Velázquez, and Nikema Williams.
Members of the U.S. Senate who signed the letter include Senators Richard Blumenthal, Cory A. Booker, John Boozman, Maria Cantwell, Shelley Moore Capito, Benjamin Cardin, Bill Cassidy, Susan M. Collins, Catherine Cortez Masto, Kevin Cramer, Steve Daines, Tammy Duckworth, John Fetterman, Deb Fischer, Kirsten Gillibrand, Lindsey O. Graham, Martin Heinrich, John Hoeven, Cindy Hyde-Smith, Tim Kaine, Mark Kelly, Angus S. King, Jr., Amy Klobuchar, Ben Ray Luján, Joe Manchin III, Jeffrey A. Merkley, Markwayne Mullin, Lisa Murkowski, Alex Padilla, Gary C. Peters, Jack Reed, James E. Risch, Jacky Rosen, Mike Rounds, Brian Schatz, Jeanne Shaheen, Kyrsten Sinema, Tina Smith, Dan Sullivan, Thom Tillis, Chris Van Hollen, Mark R. Warner, Raphael Warnock, Peter Welch, Sheldon Whitehouse, and Roger F. Wicker.
The text of the letter can be found below.
Dear Majority Leader Schumer, Minority Leader McConnell, Speaker Johnson, and Minority Leader Jeffries:
Expanded Medicare coverage for telehealth services is set to expire on December 31, 2024. As you work to advance a year-end appropriations package, we urge you to extend coverage as much as possible so that all Medicare beneficiaries retain access to these services.
Telehealth plays a critical role in health care delivery – a fact that Congress has recognized by expanding coverage during and after the COVID-19 public health emergency. Most recently, in the Consolidated Appropriations Act, 2023, Congress enacted a two-year extension of Medicare telehealth services coverage. Committees of jurisdiction in the House of Representatives have recently recognized the need to protect patients’ access to telehealth services by voting to advance an additional two-year extension on a bipartisan, unanimous basis.
We ask you to prioritize provisions that remove geographic restrictions on telehealth services and permit the home and other clinically appropriate settings as originating sites. Congress should also expand the authority for practitioners eligible to furnish telehealth services. Rural and underserved communities rely on telehealth services, and Congress should recognize federally qualified health centers and rural health clinics as telehealth distant site providers. Additionally, Congress should allow the use of telehealth in the recertification of hospice care. Finally, telehealth has transformed mental and behavioral health care, now accounting for 40 percent of telehealth services provided under the Medicare Physician Fee Schedule. Therefore, Congress should permanently repeal the six-month in-person visit requirement for telemental health services. It should also reject similar policies that create barriers to care.
Telehealth provides essential access to care and improves outcomes, including reduced emergency department utilization and improved medication adherence. Medicare beneficiaries have come to rely on expanded access to telehealth services and are satisfied with the care they receive. While there is overwhelming support for Congress to enact permanent telehealth legislation, we must provide patients and clinicians with long-term certainty to support continued investment in technology and clinical models to meet the evolving health care needs of Medicare beneficiaries. We appreciate your collaboration and leadership on this issue and look forward to working with you to ensure access to telehealth services is retained by the end of 2024.
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- Written by: Elizabeth Larson
At the state’s request, the company has issued a voluntary recall of the affected milk lot code number 20241119 with a Best By date of 12/07/2024 printed on the packaging.
No human bird flu cases associated with the product have been detected. As the state continues to investigate the link between bird flu detections in retail raw milk and the ongoing spread of bird flu in dairy cows, poultry, and sporadic human cases, consumers are strongly urged to not consume any of the affected raw milk. Customers should immediately return any remaining product to the retail point of purchase.
The California Department of Food and Agriculture was onsite at Raw Farm’s milk processing facility on Wednesday, Nov. 27, collecting additional samples of stored bulk tank milk and bottled products. Results from that additional testing are pending.
As with the testing that led to the November 24 voluntary recall notice, the Santa Clara County Public Health Laboratory tested raw milk products from retail stores in their county as a second line of consumer protection. The county identified bird flu in this second sample of raw milk purchased at a retail outlet.
Risks associated with raw milk
Public health experts have long warned consumers against consuming raw milk or raw milk products due to elevated risks of foodborne illness. Outbreaks due to Salmonella, Listeria monocytogenes, toxin producing E. coli, Brucella, Campylobacter, and many other bacteria have all been reported related to consuming raw dairy products.
Raw milk products are not pasteurized, a heating process that kills bacteria and viruses such as bird flu.
Pasteurized milk and milk products are safe to consume because the heating process kills pathogens, including bird flu, that can cause illness.
Drinking or accidentally inhaling raw milk containing bird flu virus may lead to illness. In addition, touching your eyes, nose, or mouth with unwashed hands after touching raw milk with bird flu virus may also lead to infection.
Symptoms of bird flu infection in humans include eye redness or discharge, cough, sore throat, runny or stuffy nose, diarrhea, vomiting, muscle or body aches, headaches, fatigue, trouble breathing and fever. Anyone who has consumed these specific products, and is experiencing these symptoms, should immediately contact their health care provider or local health department.
California regularly tests raw milk
As part of the state’s bird flu response, testing of raw milk from dairies has been increased to help prevent raw milk consumers from getting the virus.
Once bird flu was found in California dairy herds, the California Department of Food and Agriculture began regular testing of raw milk in bulk tanks. In response to these recent positive tests from two retail raw milk batches, CDFA followed up with immediate additional sampling and testing at Raw Farm.
Pasteurized milk is safe to drink
Pasteurized milk is safe to drink. Pasteurization, one of the most significant scientific food safety discoveries in human history, is the process of heating milk to specific temperatures for a certain length of time to kill many microorganisms and enzymes that lead to spoilage and illness.
Pasteurization kills the bird flu virus and other harmful germs that can be found in raw milk. CDPH advises consumers not to drink raw milk or eat raw milk products due to the risk of foodborne illnesses.
About bird flu
Since early October, California has reported 29 confirmed human cases of bird flu, 28 of whom had direct contact with infected dairy cows. No person-to-person spread of bird flu has been detected in California or the U.S.
To date, all cases have reported mild symptoms (primarily eye infections), and none have been hospitalized.
Because bird flu viruses can change and gain the ability to spread more easily between people, public health officials have provided preventive measures and are monitoring animal and human infections carefully.
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- Written by: California Department of Public Health
Deaths from rabies are rare in the United States, with fewer than 10 cases identified each year.
Nonetheless, each year, thousands of people receive preventive treatment for rabies following a bite or other direct contact with an animal with possible rabies.
The Fresno County Department of Public Health and the Merced County Department of Public Health worked with CDPH and the Centers for Disease Control and Prevention to investigate rabies as a possible cause of the patient’s illness in mid-November.
Samples collected at the hospital where the patient was being cared for were submitted to the state’s Viral and Rickettsial Disease Laboratory where evidence of rabies was confirmed.
The individual was hospitalized in a Fresno County hospital after experiencing symptoms and died late last week.
“Bites from bats can be incredibly small and difficult to see or to detect. It is important to wash your hands and look for any open wounds after touching a wild animal, and to seek immediate medical care if bitten,” said CDPH Director and State Public Health Officer Dr. Tomás J. Aragón. “It is always safest to leave wild animals alone. Do not approach, touch, or try to feed any animals that you don't know."
What should you do if you come in contact with a bat?
If a bat – dead or alive – is found, CDPH urges residents to take the following precautions:
• Bites from bats are often imperceptible, or very minor as occurred in this case, yet are one of the most common sources of human rabies in the US.
• Do not touch the bat; contact local animal control to remove or collect it. Keep pets and family members away from the area.
• If you touch a bat, wash the area with soap and water; if you are bitten, immediately contact your healthcare provider for additional guidance.
• Report the incident to your local health department.
• Even if you aren't sure whether you've been bitten, it is recommended to seek medical attention. For instance, persons who find a bat indoors, particularly in areas where people were sleeping, should discuss rabies treatment with their health care provider even if they are not aware of any bites or other contact with the bat. Additionally, if you find a bat near a person who can't report a bite, such as a small child or a person with a disability, assume that person has been bitten.
What is rabies?
Rabies is a viral disease that is deadly in people if medical care is not received before symptoms appear; symptoms usually appear about 3 to 8 weeks after exposure but can occur earlier or months later. Rabies is spread to humans and pets primarily through bites from an infected animal.
All mammals, including humans, can be infected with the rabies virus. In California, bats and skunks are the animals that most often get rabies. Each year, thousands of people in the United States receive medical care following a possible rabies exposure.
Fortunately, rabies control measures taken in the U.S., including widespread vaccination of pet dogs, have significantly reduced rabies as a public health threat.
Common signs that an animal has rabies
An animal with rabies will have strange or unnatural behavior because the rabies virus attacks the brain.
These behaviors can include:
• A bat that can’t fly or has been caught by a dog or a cat.
• A wild animal that seems unusually tame or unafraid to approach people.
• An animal out during the day that is usually active only at night.
• A pet that has trouble walking, eating, or drinking, or that has a change in personality or how it acts.
• A normally calm animal that acts in an agitated or aggressive manner.
How to prevent rabies
Because there is no treatment for rabies once symptoms begin, it is very important to prevent rabies exposures.
To prevent rabies, vaccinate pets against the rabies virus and keep them up to date on their shots. Don’t handle wild animals. Talk to a healthcare provider immediately if you think you may have been bitten by an animal, particularly a wild or sick-acting animal.
For more information see the CDPH web page on rabies.
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- Written by: California Department of Fish and Wildlife
State health agencies determined that Dungeness crab in portions of northern California have unhealthy levels of domoic acid and recommended delaying the opening of the recreational fishery in state waters from the California/Oregon state line (42° 0.00’ N latitude) south to the southern boundary of the Reading Rock State Marine Reserve (41° 17.6’ N latitude) in Humboldt County.
Following this recommendation, California Department of Fish and Wildlife (CDFW) Director Charlton H. Bonham ordered a delay of the opening of the recreational Dungeness crab fishery in this area of northern California. Recreational take and/or possession of Dungeness crab is prohibited in these closed waters. Please see the Directors Declaration regarding allowances for transiting and possessing Dungeness crab in the area. Other areas of the coast will open as scheduled.
Domoic acid is a potent neurotoxin produced by Pseudo-nitzschia, a naturally occurring single-celled, marine alga under certain ocean conditions. Domoic acid can accumulate in shellfish, other invertebrates and sometimes fish without the organism becoming ill themselves. At low levels, domoic acid exposure can cause nausea, diarrhea and dizziness in humans. At higher levels, it can cause persistent short-term memory loss, seizures and can in some cases be fatal.
This delay of season shall remain in effect until the Office of Environmental Health Hazard Assessment, in consultation with the State Public Health Officer of California Department of Public Health, or CDPH, determines that domoic acid no longer poses a significant risk to public health. Results of the sampling could change, or eliminate, the need for this delayed area.
If a determination is made that the delay should be changed or lifted, announcements will be made as soon as possible. Pursuant to Fish and Game Code, section 5523, the Director of CDFW will notify the California Fish and Game Commission of the delay and request that the Commission schedule a public discussion at its next scheduled meeting.
The latest information on current fishing season closures related to domoic acid will be updated on CDFW’s fishery closure information and health advisories website or by calling CDFW’s Domoic Acid Fishery Closure Information Line at 831-649-2883.
The latest domoic acid test results for Dungeness crab are posted on the CDPH’s Domoic Acid website (subsection Analytical Data – Crabs).
For the latest consumption warnings, please check for any Dungeness crab health advisory information on the CDPH's shellfish advisories page or by calling the CDPH’s Biotoxin information Line at 510-412-4643 or toll-free at (800) 553-4133.