www.thecentersquare.com – By Nolan McKendry | The Center Square – (The Center Square – ) 2025-05-05 14:45:00
(The Center Square) – Louisiana is looking to join several states in cracking down on access to mobile applications for underage individuals.
Under House Bill 570, teens would need parental permission to download apps like TikTok, Snapchat or Instagram.
The legislation, which passed without objection, aims to give parents greater control over the digital lives of their children by requiring app stores to verify the age of users and confirm parental consent for anyone under 18.
The bill passed the House Commerce Committee without objection.
“Our phones are now the white van,” said Michelle Johnson, a supporter of the bill who warned lawmakers about the link between social media and child exploitation. “We wouldn’t let a strange man lure our kids off the street, but we allow it online every day.”
The bill’s supporters, including Meta, the parent company of Facebook and Instagram, argue that placing the responsibility on app stores is both practical and protective of user privacy.
Nicole Lopez, Meta’s Director of Global Litigation Strategy for Youth, told lawmakers the company backs HB570 as a “privacy-protective solution” that streamlines parental control without overburdening app developers.
“Parents already verify age and grant permissions when they buy a phone for their teen,” Lopez said. “This bill would make that process apply to all app downloads, not just purchases, using the infrastructure Apple and Google already have.”
Lopez noted that Meta has already migrated over 25 million American teens into stricter “Teen Accounts” with limited messaging and default privacy settings. The company says 80% of U.S. parents support legislation requiring parental consent for app downloads by teens under 16, based on polling data.
The bill would also help ensure compliance with the federal Children’s Online Privacy Protection Act, which restricts the collection of data from users under 13.
Not everyone is on board. On Monday, critics argued the bill threatens user privacy, shifts liability unfairly to app stores, and may not stand up in court.
“HB570 would compromise the privacy of all users by requiring more data collection just to verify someone’s age,” said Aden Hizkias with the Chamber of Progress, a tech industry coalition. “This shifts responsibility away from social media companies and undermines First Amendment rights.”
Justin Hill, a policy analyst with NetChoice and a former Missouri lawmaker, warned that similar laws in Utah and Ohio have already been blocked by courts.
“This exact bill has been filed and hasn’t passed elsewhere. Courts have said forcing people to upload ID just to access digital content violates constitutional protections.”
In an interview, Carver said that the bill has been tailored so that it does not target specific content, such as social media platforms, thereby avoiding a constitutional challenge.
“This would apply to all 1.5 million apps on the stores, so we’re not limiting anyone’s access to speech,” Carver said.
Hill pointed out that the practical implications are enormous.
“On Day 1, you’d need to submit ID to the app store just to download or update apps. If you want your son to have access, you’d need to prove you’re their parent — how do you do that without a birth certificate?” Hill asked.
John Tamny of the Parkview Institute called the proposal “a trivialization of parenting,” saying Apple and Google already provide tools for parents to manage screen time and restrict access to apps.
“We’re pretending parents are powerless when, in reality, they’re already well-armed.”
HB570 would require major app stores like Apple and Google to collect minimal information about a user’s age and parental status before allowing teens to download apps. Once verified, parents would receive requests to approve or deny any attempted downloads by their child.
However, the bill does not address what happens if a child uses a parent’s already-approved device.
“That’s something that will have to be left to the parents,” said Rep. Kim Carver during the hearing. “We don’t want to get into the business of telling parents how to parent.”
Supporters emphasized that the legislation is narrowly tailored to avoid the constitutional pitfalls that have plagued other state efforts. Unlike earlier laws that singled out specific apps or websites, HB570 applies to all app stores equally.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article offers a neutral, fact-based account of Louisiana’s HB570 bill, presenting both the support and opposition surrounding it without overtly favoring one side. The article reports on the perspectives of various stakeholders, including supporters like Meta, and critics from organizations such as the Chamber of Progress. While it quotes both sides, including concerns over privacy and constitutional challenges, the tone remains largely informational rather than advocating for a particular ideological stance. The piece accurately reflects both the potential benefits and drawbacks of the bill, thus maintaining a centrist approach to reporting the legislative development.
lailluminator.com – Arielle Zionts, KFF Health News – 2025-08-09 05:00:00
In Ekalaka, Montana, Dahl Memorial Healthcare Association’s emergency room operates without on-site physicians, relying on physician assistants (PAs) and nurse practitioners (NPs) due to a nationwide doctor shortage. A 2022 study showed 7.4% of U.S. emergency departments, mostly rural and low-volume hospitals, lacked 24/7 attending physicians. This staffing raises debate: physician groups argue doctors provide superior care and advocate for laws requiring their constant presence, while others stress that experienced PAs and NPs, supported remotely, can safely manage rural ERs without causing hospital closures. Dahl Memorial staff emphasize rigorous training, oversight, and remote physician support to maintain quality care.
EKALAKA, Mont. — There was no doctor on-site when a patient arrived in early June at the emergency room in the small hospital at the intersection of two dirt roads in this town of 400 residents.
There never is.
Dahl Memorial’s three-bed emergency department — a two-hour drive from the closest hospital with more advanced services — instead depends on physician assistants and nurse practitioners.
Physician assistant Carla Dowdy realized the patient needed treatment beyond what the ER could provide, even if it had had a doctor. So, she made a call for a medical plane to fly the patient to treatment at Montana’s most advanced hospital. Dowdy also called out medications and doses needed to stabilize the patient as a paramedic and nurses administered the drugs, inserted IV lines, and measured vital signs.
Emergency medicine researchers and providers believe ERs, especially in rural areas, increasingly operate with few or no physicians amid a nationwide shortage of doctors.
A recent study found that in 2022, at least 7.4% of emergency departments across the U.S. did not have an attending physician on-site 24/7. Like Dahl Memorial, more than 90% were in low-volume or critical access hospitals — a federal designation for small, rural hospitals.
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The results come from the 82% of hospitals that responded to a survey sent to all emergency departments in the country, except those operated by the federal government. The study is the first of its kind so there isn’t proof that such staffing arrangements are increasing, said Carlos Camargo, the lead author and a professor of emergency medicine at Harvard Medical School. But Camargo and other experts suspect ERs running without doctors present are becoming more common.
Placing ERs in the hands of nondoctors isn’t without controversy. Some doctors and their professional associations say physicians’ extensive training leads to better care, and that some hospitals are just trying to save money by not employing them.
The American Medical Association, open to all medical students and physicians, and the American College of Emergency Physicians both support state and federal laws or regulations that would require ERs to staff a doctor around the clock. Indiana, Virginia, and South Carolina recently passed such legislation.
Rural ERs may see fewer patients, but they still treat serious cases, said Alison Haddock, president of ACEP.
“It’s important that folks in those areas have equal access to high-quality emergency care to the greatest extent possible,” Haddock said.
Other health care providers and organizations say advanced-practice providers with the right experience and support are capable of overseeing ERs. And they say mandating that a physician be on site could drive some rural hospitals to close because they can’t afford or recruit enough — or any — doctors.
“In an environment, especially a rural environment, if you have an experienced PA who knows what they know, and knows the boundaries of their knowledge and when to involve consultants, it works well,” said Paul Amiott, a board member of the Society of Emergency Medicine PAs.
“I’m not practicing independently” despite working 12-hour night shifts without physicians on-site at critical access hospitals in three states, he said.
Physician assistant Carla Dowdy, left, takes notes while treating a patient in the Ekalaka, Montana, hospital. (Arielle Zionts/KFF Health News)
Amiott said he calls specialists for consultation often and about once a month asks the physician covering the day shift at his hospital to come help him with more challenging cases such as emergency childbirth and complicated trauma. Amiott said this isn’t unique to PAs — ER doctors seek similar consultations and backup.
The proportion of ERs without an attending physician always on site varies wildly by state. The 2022 survey found that 15 states — including substantially rural ones, such as New Mexico, Nevada, and West Virginia — had no such emergency departments.
But in the Dakotas, more than half of emergency departments were running without 24/7 attending physician staffing. In Montana it was 46%, the third-highest rate.
None of those three states have a program to train physicians as ER specialists. Neither does Wyoming or Idaho.
But Sanford Health, which bills itself as “the largest rural health system in the United States,” is launching an emergency medicine residency in the region. The Sioux Falls, South Dakota-based program is intended to boost the ranks of rural emergency doctors in those states, the residency director said in a news release.
Leon Adelman is an emergency medicine physician in Gillette, Wyoming, which, at around 33,800 residents, is the largest city in the state’s northeast. Working in such a rural area has given him nuanced views on whether states should require 24/7 on-site physician coverage in ERs.
Adelman said he supports such laws only where it’s feasible, like in Virginia. He said the state’s emergency physicians’ organization pushed for the law only after doing research that made it confident that the requirement wouldn’t shutter any rural hospitals.
Camargo said some doctors say that if lawmakers are going to require 24/7 on-site physician coverage in ERs, they need to pay to help hospitals implement it.
Adelman said when instituting staffing requirements isn’t possible, states should create other regulations. For example, he said, lawmakers should make sure hospitals not hiring physicians aren’t refraining just to save money.
He pointed to Vermont, where a report recommended that several of the state’s hospitals cut physicians from their ERs. The report was part of a mandated process to improve the state’s troubled health care system.
Adelman said states should also require PAs and NPs without on-site physician supervision to have extensive emergency experience and the ability to consult with remote physicians.
Some doctors have pointed to a case in which a 19-year-old woman died after being misdiagnosed by an NP who was certified in family medicine, not emergency care, and working alone at an Oklahoma ER. Few NPs have emergency certification, an analysis found.
The Society of Emergency Medicine PAs outlines training and experience PAs should have before practicing in rural areas or without on-site doctors.
Haddock said emergency physicians have seen cases of hospitals hiring inexperienced advanced-practice providers. She said ACEP is asking the federal government to require critical access and rural emergency hospitals to have physicians on-site or on call day and night.
Haddock said ACEP wouldn’t want such a requirement to close any hospital and noted that the organization has various efforts to keep rural hospitals staffed and funded.
Dahl Memorial Hospital has strict hiring requirements and robust oversight, said Dowdy, who previously worked for 14 years in high-volume, urban emergency rooms.
She said ER staffers can call physicians when they have questions and that a doctor who lives on the other side of Montana reviews all their patient treatment notes. The ER is working on getting virtual reality glasses that will let remote physicians help by seeing what the providers in Ekalaka see, Dowdy said.
She said patient numbers in the Ekalaka ER vary but average one or two a day, which isn’t enough for staff to maintain their knowledge and skills. To supplement those real-life cases, providers visit simulation labs, do monthly mock scenarios, and review advanced skills, such as using an ultrasound to help guide breathing tubes into patient airways.
Dowdy said Dahl Memorial hasn’t had a physician in at least 30 years, but CEO Darrell Messersmith said he would hire one if a doctor lived in the area. Messersmith said there’s a benefit to having advanced-practice providers with connections to the region and who stay at the hospital for several years. Other rural hospitals, he noted, may have physicians either as permanent staff who leave after a few years or contract workers who fly in for a few weeks at a time.
People eating at Ekalaka’s sole breakfast spot and attending appointments at the hospital’s clinic all told KFF Health News that they’ve been happy with the care they have received from Dowdy and her co-workers.
Ben Bruski had to visit the ER after a cow on his family ranch kicked a gate, smashing it against his hand. And he knows other people who’ve been treated for more serious problems.
“We’ve got to have this facility here because this facility saves a lot of lives,” Bruski said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
This content presents a balanced view on the issue of rural emergency room staffing, highlighting perspectives from both physicians and advanced-practice providers. It acknowledges the challenges faced by rural hospitals, the shortage of doctors, and the potential consequences of staffing mandates without advocating strongly for one side. The article includes viewpoints from medical associations, rural healthcare workers, and patients, aiming to inform rather than persuade, which aligns with a centrist, fact-based approach.
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