US judge says layoffs at Department of Health and Human Services were likely unlawful and must be halted
US District Judge Melissa DuBose granted the preliminary injunction sought by a coalition of attorneys general from 19 states and the District of Columbia in a lawsuit filed in early May.
DuBose said the states had shown 'irreparable harm,' from the cuts and were likely to prevail in their claims that 'HHS's action was both arbitrary and capricious as well as contrary to law.'
'The executive branch does not have the authority to order, organize, or implement wholesale changes to the structure and function of the agencies created by Congress,' DuBose wrote in a 58-page order handed down in US District Court in Providence, Rhode Island, on Tuesday.
Her order blocks the Trump administration from finalizing layoffs announced in March or issuing any further firings. HHS is directed to file a status report by July 11.
The ruling applies to terminated employees in four divisions of HHS: the US Centers for Disease Control and Prevention; the Center for Tobacco Products within the Food and Drug Administration; the Office of Head Start within the Administration for Children and Families and employees of regional offices who work on Head Start matters; and the Office of the Assistant Secretary for Planning and Evaluation.
Health Secretary Robert F. Kennedy Jr. eliminated more than 10,000 employees in late March and consolidated 28 agencies to 15. Since then, agencies including the CDC have repeatedly rescinded layoffs affecting hundreds of employees, including in branches that monitor HIV, hepatitis and other diseases.
The attorneys general argued that the massive restructuring was arbitrary and outside of the scope of the agency's authority. The lawsuit also says that the action decimated essential programs and pushed burdensome costs onto states.
'The intended effect … was the wholesale elimination of many HHS programs that are critical to public health and safety,' the lawsuit argued.
The cuts are part of a federal 'Make America Healthy Again' directive to streamline costly agencies and reduce redundancies. Kennedy told senators at a May 14 hearing that there is 'so much chaos and disorganization' at HHS.
But the restructuring had eliminated key teams that regulate food safety and drugs, as well as support a wide range of programs for tobacco, HIV prevention and maternal and infant health. Kennedy has since said that because of mistakes, 20% of people fired might be reinstated.
The states who joined the lawsuit have Democratic governors, and many of the same states — plus a few others — also sued the Trump administration over $11 billion in cuts to public health funding. A preliminary injunction was granted in that case in mid-May.
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Forbes
30 minutes ago
- Forbes
Nevada Enacts New Law To Shut Down The Use Of AI For Mental Health But Sizzling Loopholes Might Exist
In today's column, I examine the recently enacted law by Nevada that seemingly aims to shut down the use of AI for mental health therapy in the glitzy Silver State. Here's the deal. Several states have been quickly pushing through new legislation to try and restrict or outrightly ban the use of AI to perform therapy. The idea is that only human therapists, psychologists, psychiatrists, and mental health professionals are allowed to perform mental health services. It is presumably an act reserved for human-to-human exclusivity. I recently analyzed the latest such AI-restricting law that was passed in Illinois, see the link here, which in many ways is akin to the Nevada law. I will discuss the mainstay similarities and differences herein. All in all, a looming spread of these laws, including potentially having federal enactments too, puts AI makers in potential trouble and will inexorably squash the use of AI as a mental health tool. Let's talk about it. This analysis of AI breakthroughs is part of my ongoing Forbes column coverage on the latest in AI, including identifying and explaining various impactful AI complexities (see the link here). AI And Mental Health Therapy As a quick background, I've been extensively covering and analyzing a myriad of facets regarding the advent of modern-era AI that produces mental health advice and performs AI-driven therapy. This rising use of AI has principally been spurred by the evolving advances and widespread adoption of generative AI. For a quick summary of some of my posted columns on this evolving topic, see the link here, which briefly recaps about forty of the over one hundred column postings that I've made on the subject. There is little doubt that this is a rapidly developing field and that there are tremendous upsides to be had, but at the same time, regrettably, hidden risks and outright gotchas come into these endeavors too. I frequently speak up about these pressing matters, including in an appearance last year on an episode of CBS's 60 Minutes, see the link here. Background On AI For Mental Health First, I'd like to set the stage on how generative AI and LLMs are typically used in an ad hoc way for mental health guidance. Millions upon millions of people are using generative AI as their ongoing advisor on mental health considerations. The top-ranked use of contemporary generative AI and LLMs is to consult with the AI on mental health facets, see my coverage at the link here. This popular usage makes abundant sense. You can access most of the major generative AI systems for nearly free or at a super low cost, doing so anywhere and at any time. Thus, if you have any mental health qualms that you want to chat about, all you need to do is log in to AI and proceed forthwith on a 24/7 basis. Compared to using a human therapist, the AI usage is a breeze and readily undertaken. When I say that I am referring to generative AI and LLMs, please know that there are generic versions versus non-generic versions of such AI. Generic AI is used for all kinds of everyday tasks, and just so happens to also encompass providing a semblance of mental health advice. On the other hand, there are customized AIs specifically for performing therapy; see my discussion at the link here. I'm going to primarily be discussing generic generative AI, though many of these points can involve the specialized marketplace, too. Therapists Adopting AI Therapists are realizing that they, too, must consider adopting the use of AI. The reason is straightforward. Potential clients and patients are walking in the door with claimed-to-be cognitive diagnoses that AI has generated for them. Some therapists tell their clients and patients to simply ignore the AI. But that doesn't usually do much good, since people will indubitably go behind the back of their therapist and access AI anyway. For more on the ins and outs of therapists using AI for mental health, see my analysis at the link here. An emerging strategy for therapists is to avidly adopt the use of AI into their practices. It's the proverbial if you can't beat them, join them refrain. The march toward AI is unstoppable. They generally do so in these two major ways: An administrative use of AI by a therapist is generally less concerning than when using AI for therapeutic purposes. Assuming that the administrative use of AI is done with proper security and rigor, most clients or patients won't especially care that the therapist is using AI in that manner. The assumption is that the AI streamlines the business side and hopefully reduces The controversial angle is the use of AI as an arm of the therapist. Some therapists say that choosing to use AI is a big mistake and that the cherished therapist-client dyad bond should remain untouched and unchanged. Others, such as my advocacy, assert that we are heading into an era of a new triad, consisting of a therapist-AI-client relationship. It is inevitable and unavoidable. See my coverage at the link here. The Law Gap Is Closing Fast Consider then that we have two potential overarching issues brewing: It would be possible to establish regulations that could be a means of dealing with one or both of those brewing concerns. Lawmakers could opt to formalize legal conditions associated with how therapists lean into AI. That could be a consideration all by itself. Likewise, a circumstance all by itself could be the matter of regulating AI makers about allowing their AI to wantonly provide mental health advice. A double whammy would be to tackle both tough topics in one fell swoop. The recently passed and signed Nevada law tries to tackle both topics at the same time. Indeed, the Nevada law goes further and has a veritable potpourri of other aspects. In contrast, the Illinois law tended to focus primarily on the two above-noted considerations. These state laws not only have to do with the respective states, but they are also a bellwether of how AI for mental health is possibly going to be regulated. Often, regulations of one kind or another start in one state and then are reused or recast when other states opt to do something similar. They might take the language used in the already passed law and use that as a draft for their own proposed law. Some language gets changed, new language is added, and so on. The first law to get approved often serves as a template or model. Besides the various states enacting their own laws, there is often a dynamic that gets the federal government to also pursue the same or similar regulation. Once again, the initial state law might be an illuminating example. Questions naturally arise on how to best reshape a state-specific law into a law that might be suitable across the board as a federal law. Impacts Are Plenty Let's go ahead and take a quick peek at the Nevada law and see what we can make of it. I will share just some mindfully chosen snippets and give you a taste of what the law contains. Please know that the law has numerous twists and turns. Also, my commentary is merely a layman's viewpoint. Make sure to consult with your attorney to garner the legal ramifications of whatever your own situation entails. The law that was passed is known as Assembly Bill 406, abbreviated as AB406, and was signed into law by the governor of Nevada on June 5, 2025. You will see the nomenclature of 'NRS' throughout the passages -- NRS means Nevada Revised Statutes, referring to the various codified laws of Nevada. Here is the official description of AB406 at a 30,000-foot level: A significant difference between the Nevada law versus the Illinois law is the added element of AI usage in schools. The background is that there is a lot of controversy these days about deploying AI in schools, and that AI could be used in undesirable ways. This law tries to provide conditions and restrictions on the educational use of AI in the public schools of Nevada. I am not going to address that topic in this discussion and will be covering the debate regarding school uses of AI in a future posting. Be on the watch for that coverage. AI Use By The Public I had mentioned earlier that the Nevada law and the Illinois law entail two major AI-powered mental health capacities. One aspect is the use of AI for mental health as undertaken by the general public of their own volition. The other capacity is the use of AI by mental health professionals via their services and professional practice. Let's start with the perhaps biggest kicker, the use of AI for mental health by the public at large. That portion is contained in Section 7 of AB406. In Section 7 of AB406, the legal indication amends an existing statute known as Chapter 433, and here is the core language (excerpt): There are three bulleted points labeled as 'a', 'b', and 'c'. Read those points carefully. You will keenly observe that the crux is that AI available for use in Nevada is not supposed to provide professional mental or behavioral health care. This includes that the AI is not to simulate human conversation in that same vein. Nor can the provider of the AI, nor the AI itself, appear to suggest or outrightly state that it is a kind of professional mental health specialist, such as a human therapist. I am paraphrasing the language shown, so realize that the actual language is paramount, not my paraphrasing. Emphasis On Professional And Of Programmed The next portion of that Section 7 adds a further twist to this: The language once again hammers away at the notion that the AI isn't supposed to be doing the job of a living-breathing mental health therapist. There are some key wording aspects in this Section 7 that are worth pondering. One aspect is the conspicuous use of the word 'professional'. A legal beagle that represents an AI maker would undoubtedly argue that if the AI isn't performing professional-caliber mental health guidance, the AI doesn't come under these provisions. Only AI that is acting in a seemingly professional manner, or that the AI maker claims is functioning professionally, ends up under this umbrella. In short, if the AI is, shall we say, feeble, in contrast to professional mental health guidance, the AI maker might insist they are off the hook. Hey, our AI is just playing around and perchance dips its toe into mental health therapy. It isn't the real thing. Period, end of story. In the portion above, you might also have noted that the phrase 'specifically programmed' was utilized. This provides perhaps another escape route. An AI maker might stridently claim that they didn't devise the AI to be professional. And, for sure, it isn't rising to any iota of a professional level or caliber. Voila, on both elements, we don't have to worry about this law and can proceed scot-free. It will be interesting to see how that plays out in reality and whether legal cases will be launched in Nevada that deal with the semantics or interpretation of this law. Due to space limitations here and wanting to be succinct, I'll note that there is a Section 7c that provides a definition of 'Professional mental or behavioral health care' that dovetails into the semantics considerations. I am not going to dive into that passage here but bring it to your attention for the sake of completeness. Self-Help Exclusion A provision in Section 6 brings forth another possible wiggle-room pathway: You might have caught the notable wording that if the AI is providing self-help in the mental health context, and assuming the AI and nor is the AI maker proclaiming that the AI is of professional quality, the AI maker might be given a free pass. Do you think that generative AI could be construed as providing a self-help style of interaction? If so, an additional avenue opens for AI makers who are trying to avoid getting ensnared in this new law. AI Provided Via Therapists Shifting gears, let's explore the side of things involving human therapists who opt to make use of AI in their services and practice. That comes up in Section 8: This smacks of a similar approach used in the Illinois law. The idea is that therapists can use AI for administrative purposes, such as scheduling and billing, but they dare not use AI for therapeutic purposes. I find this trend to be unfortunate, short-minded, and dismal. A therapist could legitimately have AI interacting with clients while the client is at home or elsewhere, doing some follow-up homework under the overall guidance of the therapist. These laws are an overreach, a clumsy catch-all. It will utterly chase therapists away from using AI in a manner that can be highly productive, merely because the wording is like a sword dangling over their heads. Society ought to want mental health professionals to use AI in sound ways, especially so on the therapy side of things. Thus, don't ban the AI. Instead, provide provisions associated with sensible and tangible guardrails and stipulations. Setting sensible boundaries would be useful. Squashing or heavily stifling innovation in mental health is not the way we should be headed. Thoughtful and guarded adoption of AI is warranted and saluted. I vote that any laws related to therapists' use of AI for therapy ought to be of a balanced nature. So far, they are lopsided, egregiously so. Key Takeaways For AI Makers For the AI makers, they should take this as a clarion call and closely scrutinize these laws and take immediate and mindful actions to protect themselves from undue legal vulnerabilities and reputational risks. Allow me to clarify that this does not imply they should dodge these laws. They should abide by these laws and figure out where their AI sits in the emerging wanton mosaic that is being formulated. In the case of Nevada law, it would seem likely that the legal counsel of an AI maker would urge their client to take overt action to refrain from suggesting or stating that their AI is performing professional mental health care. Don't say that your generic generative AI instantiates professional quality therapy, such as brazenly blabbing so in your marketing materials. The top executives should not be giving speeches proclaiming that their generic generative AI is an ace at mental health. The AI itself should not be telling users that it is professional quality. That could easily happen. Depending on how the LLM has been data-trained and subsequently tuned, there is a chance that on some occasions, it might emit that kind of claim. AI makers would be wise to institute specialized add-on filters and computational double-checks that catch the AI from making those emboldened assertions. Other considerations include aligning the online licensing agreement and terms of service so that there isn't any wording that leans toward professional-stating claims. Another angle is whether the AI maker has users perform some form of consent when using the AI in a mental health capacity. That would be a ripe spot to declare that the AI isn't of professional quality and make darned sure to remove any wording that suggests otherwise. Getting Over Our Skis A crucial distinction that some of these laws are astutely making, while others are not, consists of separating unregulated AI that does therapy from regulated AI. Think of it this way. Suppose a highly customized AI app for therapy is carefully devised, tested, and then fielded. It has gone through the gauntlet of getting certification or regulated approval. These laws that toss everything into the same kitchen sink are equating generic generative AI to those mindfully devised AIs. No distinction is acknowledged. It is one thing to go after generic generative AI, and yet an entirely different consideration involving AI that has been dutifully crafted with evidence-based rigor for mental health. Like the old saying goes, to some degree, we might be tossing out the baby with the bathwater. A final thought for now. The famous line that what happens in Vegas, stays in Vegas, provides ample fodder associated with this Nevada law. Any AI maker that has their AI available to anyone in Nevada has now gained a new high risk. Whether the AI maker knows it or not, and many AI makers seem not to be cognizant of these laws, what happens in Nevada doesn't per se stay in Nevada. An AI maker in New York, California, or wherever else is a high roller in Nevada, assuming their AI is accessible in that state. Your stake is sitting on the table, with both legal and financial penalties cozying up, so open your eyes, make sure you have a safe hand, else you could lose your shirt.
Yahoo
39 minutes ago
- Yahoo
Deep Core vs. Abs: Why You Should Tone the Muscles Below the Surface, Too
You've probably seen it all over your feeds: Fitness pros and physical therapists talking about 'training the deep core.' But unlike crunches or Russian twists, these exercises don't come with a pump or a burn. Sometimes they're straight up tedious. So what's the hype? The deep core is having a moment, and for good reason. Aesthetics is a side effect of efficient training; this type of training focuses on stability, longevity and functional strength. Yes, having visible abs can be a goal for some, but deep core strength is what helps keep injuries away, keeps your body aligned and gives you the ability to perform daily life (and workouts) without your back aching. Unlike the superficial ab muscles, the top layer of muscles you can see, the deep core muscles are hidden beneath the surface. They act like an internal corset, wrapping around your spine and pelvis to support movement and posture. But here's where it gets interesting: Some abdominal muscles, like the internal obliques, or the 'V-cut' above your hips, actually function in both the deep core and the superficial system, meaning they can help with performance and definition. Whether you're dealing with back pain or hip pain, want to feel more connected during workouts, or are postpartum and trying to 'feel like yourself' again, building deep core strength might be the smartest (and safest) place to start. Bonus? The results go beyond just visible or strong abs. You'll also have better balance, improved posture, confident movement, and yes, even a flatter tummy over time. Let's break it down. What Is the Deep Core? The deep core is a group of muscles that stabilize your spine, pelvis and ribcage. These include: Transverse abdominis (TVA): Your body's natural weight belt. These are the ab muscles that contribute to core health and back stability Multifidus: Tiny triangular muscles along your spine that stabilize and keep you upright Pelvic floor: Supports your organs and controls pressure, assists with bodily functions Diaphragm: Separates your chest from your abdomen and helps you breathe Together, these form a 360° pressure system — kind of like a soda can. When it's intact, you're strong. When there's a 'dent' (weakness), everything else collapses or other muscle groups compensate, putting you at risk for injuries. Is The Deep Core the Same As Abs? Not exactly. The superficial abs (think rectus abdominis and external obliques) are responsible for trunk movement like flexion and rotation. The deep core muscles are more about control and stability. Think crunches versus holding an extended plank while alternating lifting your legs. Superficial: Motion and aesthetics Deep core: Foundational support and functional strength That said, muscles like the internal obliques and transverse abdominis blur the line. They contribute to both core stability and waist definition — making them the MVPs in your midsection game. Can Deep Core Exercises Give You Abs? They can. Deep core training doesn't 'shred fat' the way high-intensity workouts or calorie deficits do. But it does improve your posture, alignment and muscle engagement, which can make your core appear flatter and tighter. Like the foundation of a home, if you build on a cracked foundation, you're going to have problems. When your deep core is strong, you're able to safely train your superficial abs more effectively, progressively, and without injury. So if you've been doing crunches forever with no real results, your deep core might be what you're missing. What's the Best Way to Tone Your Midsection? Here's a winning formula: Start with deep core activation: Try breath work, transverse abdominis engagement or these deep core exercises to fire up your midsection Add total-body strength training to your routine: Lifting weights builds muscle and muscle burns more calories at rest, which helps reduce overall body fat Mix in cardio you actually enjoy: Walking, intervals, dance, water sports, whatever keeps you most consistent Be mindful your posture and breath mechanics daily: Slouching and shallow breathing mess with core activation Fuel wisely: You don't need to avoid or restrict foods entirely, but sugar, alcohol and ultra-processed foods will absolutely fight your effort and progress Bottom Line: You don't have to choose between core strength and core aesthetics. Focus on the deep core first as your foundation; it's your body's power center. From there, everything else (including your abs) becomes more attainable, more sustainable and way more functional. This article was originally published on
Medscape
an hour ago
- Medscape
Hep B Transmitted by Shared Glucometers in Care Facility
Hepatitis B virus (HBV) was transmitted to a person in a long-term care facility via shared blood glucose monitors, the US Centers for Disease Control and Prevention (CDC) reported. 'Sharing glucometers presents a risk for HBV transmission that can be reduced by routine HBV vaccination of persons with diabetes and dedicating individual glucometers to a single resident,' the CDC said in the August 7 issue of the Morbidity and Mortality Weekly Report. During 2008-2019, the CDC reported 15 outbreaks of HBV and hepatitis C virus in US long-term care facilities due to the same practice. In the recent case, the patient was 69 years old with diabetes and no history of HBV or HBV vaccination when diagnosed with acute HBV in May 2024. Investigation revealed that the patient lived in a skilled nursing facility room close to another resident with diabetes who had a previously unreported chronic HBV infection. During March-April 2024, both received glucose monitoring from one of two devices stored on a single medical cart, and the recorded timing between tests suggested that disinfecting practices had not been followed. However, the CDC pointed out that even when disinfection protocols are followed, HBV transmission can still occur with sharing of equipment that is in contact with blood. For that reason, the agency recommends assigning each resident a dedicated glucometer and administering HBV vaccination to all people aged 60 years and older with diabetes. 'The findings of this investigation highlight [assisted monitoring of blood glucose] as a risk factor for HBV transmission and provide evidence that skilled nursing facilities might be an appropriate setting to offer hepatitis B vaccination,' the CDC concluded. Miriam E. Tucker is a freelance journalist based in the Washington DC area. She is a regular contributor to Medscape Medical News, with other work appearing in the Washington Post, NPR's Shots blog, and Diatribe. She is on X @MiriamETucker and BlueSky @
