Tagged Mental Health

State Highlights: Ga. Senate Panel Amends But OKs Surprise Medical Bill Measure; Conn. Non-Profit Hospitals Fight Bid To Make Them Pay Local Property Taxas

Outlets report on news from Georgia, Connecticut, Minnesota, Kansas, Texas, Massachusetts, Florida, Washington, Arizona, Wisconsin, Ohio and Louisiana.

Georgia Health News: After Tweak In Payment Formula, Senate Committee OKs Remedy For ‘Surprise’ Billing
A Georgia Senate panel Thursday passed legislation to halt ‘’surprise’’ medical billing – but not without a last-minute amendment that changed the contentious payment formula. The Health and Human Services Committee approved Senate Bill 8, which will address those situations in which patients get unexpected bills from providers who are not in their network, even though the hospital is a network facility. (Miller, 2/16)

The CT Mirror: CT Hospitals Launch TV Ad To Protest New Tax Proposal
Connecticut’s hospital industry launched a new television ad Thursday to protest Gov. Dannel P. Malloy’s proposal to end nonprofit hospitals’ exemption from local property taxation. The Connecticut Hospital Association announced the commercial will air starting today on network and cable television stations, and also can be seen at http://nomorehospitaltax.org. The commercial opens by listing a variety of occupations and one common thread among the people in all of them: they all pay a price when taxes rise on Connecticut hospitals. (Phaneuf, 2/16)

The CT Mirror: Budget Cuts Cost CT Medical Examiner’s Office Full Accreditation 
The Connecticut Office of the Chief Medical Examiner (OCME) has lost its full accreditation and was downgraded to provisional status because of staffing and facility shortcomings driven largely by budget cuts. The National Association of Medical Examiners (NAME), which ordered the downgrade, will reassess Connecticut’s status in September, the state office announced this week. (Phaneuf, 2/16)

The Star Tribune: Report On Minnesota Hospital Errors Sees Problems With Lost Tissue Samples 
The misplacing of irreplaceable biological specimens has proved to be a vexing problem for Minnesota hospitals, which reported 31 instances in the 12 months that ended last Oct. 6. The state’s 13th annual report on hospital “adverse events,” released Thursday, included 336 reportable mistakes, including operations on the wrong body parts and disabling medication errors. But few were as common as lost tissue samples, which also can have serious consequences. (Olson, 2/17)

KCUR: House Committee OKs Involuntary Hold Plan For Kansans In Mental Health Crisis 
A bill that would allow treatment centers to detain Kansans in mental health crisis for up to three days moved forward Thursday after months of work to develop a compromise. A similar bill proposed last year raised concerns that it would deprive Kansans with mental illnesses of their due process rights. A committee of law enforcement officers, treatment providers, mental health advocates and others met six times between legislative sessions to come up with a compromise bill that still fulfilled the original goal of providing short-term mental health care. (Wingerter, 2/17)

Stat: Texas Board Recommends Sanctions Against Stanislaw Burzynski
Along-running battle between the Texas Medical Board and controversial Houston doctor Stanislaw Burzynski could be coming to a head. The board said this week that it had proposed $380,000 in fines and a stiff set of sanctions for Burzynski’s failure to adhere to proper medical procedures in treating cancer patients. The decision is preliminary, and will be submitted and formally reviewed on March 3. (Tedeshci, 2/16)

Boston Globe: For This Hospital Chaplain, Work Is A Matter Of Life And Death 
As [Alyssa] Adreani, 41, likes to point out, [she] isn’t hanging out in the Newton hospital’s chapel and doesn’t wear a collar or a cross. She makes the rounds of the neonatal intensive care unit, oncology, ICU, orthopedics, and medical/surgical units, following her personal Golden Rule of chaplaincy: “Wear comfortable shoes.” The Globe spoke with Adreani about how hospital chaplains are considered part of the treatment team, sometimes even improving health outcomes. (Atoji Keene, 2/16)

Seattle Times: State Regulators Investigating Swedish’s Cherry Hill Hospital, Top Surgeon 
State health regulators have launched an investigation into the practices of Swedish Health Services’ Cherry Hill hospital, days after a Seattle Times report uncovered wide-ranging concerns about patient care at the facility. David Johnson, a spokesman with the state Department of Health, said Thursday a case-management team authorized the new investigation after reviewing The Seattle Times’ findings. Johnson added that the state Medical Commission, which handles issues involving specific doctors, was in the process of investigating complaints filed against Dr. Johnny Delashaw. (Baker, 2/16)

Arizona Republic: New Flu-Tracking App Uses Maricopa County As Beta Site
A California-based health diagnostics company has chosen Maricopa County as the pilot testing site for Communidy, a free web app that allows users to see the age and county of people who currently have the flu. The app, which displays real-time data from doctors’ offices, hospitals, clinics and labs, may encourage people to get vaccinated early, said Machrina Leach, nurse program manager at the Maricopa County Department of Public Health. (Bosch and Jha, 2/16)

Milwaukee Journal Sentinel: United Community Center Opens Third Residential Treatment Facility
This month, the United Community Center, commonly known as UCC, opened its third residential treatment facility for people working to overcome alcoholism and drug addictions. The $1.1 million residence, named Latinas Unidas II, will enable 16 more women to participate in UCC’s residential treatment program at any given time. The new residence, UCC’s second for women, also will treat women who are pregnant or who have infant children, and the program will include prenatal and post-partum care, child care coordination and parenting classes. (Boulton, 2/16)

Cleveland Plain Dealer: Summa Health Gift Establishes Traumatic Stress Chair 
Longtime philanthropists Jim and Vanita Oelschlager have donated more than $4 million to Summa Heath over the last three decades. This week, couple’s foundation provided another donation to Summa Health to establish a Chair in Traumatic Stress. Dr. Patrick Palmieri, director of the Traumatic Stress Center, will serve as the first Oelschlager Chair. As director of the Summa Health Traumatic Stress Center, Palmieri is responsible for the center’s clinical, training and research activities for patients experiencing post-traumatic stress disorder, anxiety and depression. (Becka, 2/16)

Health News Florida: Students Discover Lead In Tap Water May Be Common In Older Homes 
Last semester, the students in Laura Manke’s community cares class embarked on a project, collecting samples of tap water from their homes.  And testing provided by University of South Florida researchers revealed that all of the 46 samples contained lead.Fortunately, the amount of lead in the water in their homes fell below levels that would trigger action under Environmental Protection Agency standards. But experts, including the EPA, say any amount of lead is not good for the body, especially in children under six. Damage can be permanent. (Ochoa, 2/16)

Pioneer Press: Forest Lake Nurse Avoids Jail Time For Stealing Patient’s Medication
A Forest Lake nurse who pretended to check on a patient so he could steal the man’s medication evaded jail time for the offense. Gregory Thomas Welcher, 30, was sentenced in Ramsey County District Court Thursday to five years probation on one count of felony-level theft. He also was ordered to spend one day in jail, but was given credit for the day he already logged at the Ramsey County Correctional Facility. Welcher pleaded guilty to the charge this past December. (Horner, 2/16)

Shreveport Times: Workshop Lets Caregivers Take Care Of Themselves
Social workers seeking a moment of rest from careers steeped in others’ suffering participated in a free “Compassion Fatigue” workshop on Thursday. The workshop, presented by the Noel Memorial United Methodist Church’s arts program, aimed at offering those who take care of others a chance to center and to take care of themselves. (Talamo, 2/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

U.S. Urged China To Crack Down On Synthetic Opioids Killing Hundreds Here

China is believed to be a major source for bootleg opioids, including the potent carfentanil, that are brought into the U.S. and contribute to the painkiller epidemic. In related news on the crisis, Georgia lawmakers consider regulations for opioid treatment centers.

The Wall Street Journal: U.S. Authorities Pressed China For Action On Deadly Opioid
China’s crackdown on an extremely potent synthetic narcotic came amid pressure from U.S. authorities and evidence linking it to hundreds of U.S. overdose deaths since it first emerged in Ohio in July. The drug, carfentanil, has been connected to at least 700 fatalities in states including Ohio, Michigan and Florida, according to data compiled by The Wall Street Journal from county medical examiners and NMS Labs, a private laboratory outside Philadelphia that performs toxicology testing for counties around the U.S. (Kamp and Campo-Flores, 2/17)

WABE: Ga. Lawmakers Look To Tighten Regulations On Opioid Clinics 
Georgia lawmakers are considering a bill that would further regulate opioid treatment centers in the state. The bill, sponsored by state Sen. Jeff Mullis, R-Chickamauga, would put into place new requirements for those wanting to open up centers in Georgia. The centers offer medical-assisted treatment and counseling to help treat patients with addictions to heroin and other opioids. (Yu, 2/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Lawmakers Move To Ease Obama-Era E-Cigarette Regulations

A proposal by Republican Reps. Tom Cole of Oklahoma and Sanford Bishop of Georgia would get rid of a “grandfather” clause that requires companies selling cigars, pipe tobacco, and vapor products such as e-cigarettes after Feb. 15, 2007 to disclose their ingredients and prove that their products meet the applicable public health standards set by the law.

Stat: E-Cigarettes Would Be Excluded From Some Regulations Under New Proposal
Congressional supporters of the tobacco industry have wasted no time in proposing legislation to help e-cigarette companies escape rules adopted under President Barack Obama. In what Republican Reps. Tom Cole (Okla.) and Sanford Bishop (Ga.) described as a “clarification,” the two introduced a bill Thursday that would revise Food and Drug Administration rules governing the sale and advertising of e-cigarettes and cigars. (Kaplan, 2/16)

In other news from Capitol Hill —

CQ Roll Call: Senate Appropriators Signal Interest In Mental Health Funding
Senate appropriators signaled an interest in supporting mental health funding at a hearing Wednesday, appearing particularly interested in finding a way to address provider shortages in underserved areas. Witnesses at the hearing of the Appropriations Subcommittee on Labor-HHS-Education told lawmakers that attracting professionals to the field is the most pressing need. Some urged Republicans to consider the importance of the Medicaid expansion under the 2010 health care law (PL 111-148, PL 111-152) in expanding coverage of mental health services. (Siddons, 2/15)

Kaiser Health News: Right-To-Die Fight Hits National Stage
Melissa Bailey reports: “Opponents of aid-in-dying laws are claiming a small victory. They won the attention of Congress this week in their battle to stop a growing movement that allows terminally ill patients to get doctors’ prescriptions to end their lives. The Republican-led effort on Capitol Hill to overturn the District of Columbia’s aid-in-dying law could fail by Friday. But advocates worry the campaign will catalyze a broader effort to fully ban the practice, which is legal in six states and being considered in 22 more.” (Bailey, 2/16)

Kaiser Health News: Congressman’s Ties To Foreign Biotech Draw Criticism
When a small Australian biotechnology company, Innate Immunotherapeutics, needed a clinical trial for an experimental drug it hoped to turn into a huge moneymaker, the company landed a U.S. partner where it had high-level connections: Roswell Park Cancer Institute in Buffalo, N.Y. The company is partly owned by Rep. Chris Collins, a wealthy Republican entrepreneur from Buffalo, whose enthusiasm for Innate helped persuade others to invest. (Bluth and Kopp, 2/17)

The Baltimore Sun: Cummings Contradicts Trump Over Meeting On Drug Prices
President Donald Trump blamed Rep. Elijah E. Cummings on Thursday for failing to schedule a meeting about the cost of prescription drugs, suggesting the Baltimore Democrat didn’t want to come to the White House because it was “bad politics.” Cummings, the top Democrat on the House Oversight and Government Reform Committee, disputed that characterization, saying the president had made it up. The congressman said he has been waiting to schedule a meeting until he has crafted a prescription drug bill for the president to consider. (Fritze, 2/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

‘Tsunami’ Of Alzheimer’s Cases Among Latinos Raises Concerns Over Costs, Caregiving

SACRAMENTO, Calif. — Florence Marquez liked to describe herself as a cannery worker, even though she was best known in her heavily Latino East San Jose neighborhood as a community activist.

She strode alongside Cesar Chavez in the farmworker movement during the 1960s and 70s. She helped build affordable housing for poor families near her local church.

But eight years ago, Florence, now 86, couldn’t find her way to the house she had lived in for 50 years. “That’s when we knew she needed 24-hour care,” said her oldest daughter, Barbara Marquez, 61.

Florence was diagnosed with Alzheimer’s disease, which robbed her of her memory and her fierce independence. Across the United States, stories like hers are becoming more common, particularly among Latinos — the fastest growing minority in the country.

With no cure in sight, the number of U.S. Latinos with Alzheimer’s is expected rise by more than eight times by 2060, to 3.5 million, according to a report by the USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network.

Advanced age is the leading risk factor for Alzheimer’s disease and the likelihood of developing Alzheimer’s doubles about every five years after age 65. As a group, Latinos are at least 50 percent more likely than whites to have Alzheimer’s, in part because they tend to live longer, the report notes.

Barbara Marquez visits her mother Florence Marquez at her nursing home on Friday, December 16, 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

Barbara Marquez visits her mother Florence Marquez at her nursing home, Sagebrook Senior Living, in Carmichael, Calif., in December 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

“This is an incoming tsunami,” said Dr. William Vega, one of the report’s authors and the Roybal Institute’s executive director. “If we don’t find breakthrough medication, we are going to be facing a terrible financial crisis.”

That tidal wave of Alzheimer’s cases is prompting some tough conversations in Latino families, who often pride themselves on caring for elders at home, rather than placing them in nursing homes.

Those talks come with a lot of guilt, Barbara said. Until recently, Barbara was her mother’s primary caregiver. Her sister and brother helped out.

“But it was more than I could have anticipated,” Barbara said, recalling sleepless nights as she tried to make sure Florence didn’t get up and wander off. “It impacts your health, it impacts your marriage. So we looked for help.”

About 1.8 million Latino families nationwide care for someone with Alzheimer’s and other types of dementia. And while the Roybal report shows that Latino families are less likely than whites to use formal care services, such as nursing home care, institutionalized care is becoming more common among these families.

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Between 1999 and 2008, the number of elderly Latinos living in U.S. nursing homes grew by about 55 percent, a rate that outpaced the growth of the overall Latino population during that time, according to research published in July 2011 in Health Affairs.

That can be costly. Nationwide, the average cost for basic services in an assisted living facility is $43,200 per year, according to the Alzheimer’s Association. Yearly nursing home care now averages more than twice that, at slightly more than $92,000.

For many Latino families, getting outside help isn’t an option. It’s often too expensive for seniors who aren’t eligible for Medi-Cal, California’s version of the Medicaid program for low-income people, which generally pays for nursing home care. Immigrants who are in the country unlawfully do not qualify for it, nor do people whose incomes are too high.

Florence’s children decided to take their mother out of her house in San Jose, and they brought her to live with her daughter Barbara in Fair Oaks, just outside Sacramento. They sold the San Jose house, thinking it would help pay for institutionalized care should their mom need it down the road.

She did not qualify for Medi-Cal, so she lived with Barbara for about three years. But after trying out a senior day care program outside of the house at a cost of about $78 a day, Barbara and her family placed Florence in a senior home in the Sacramento suburb of Carmichael, where she has been living for the past year.

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Dwindling Resources

The decision to institutionalize Florence Marquez left her children feeling both guilty and overwhelmed by the steep expense. Her care now costs $3,000 to $4,000 per month, they said. They pay extra for specialized services.

They had the proceeds from the sale of Florence’s house, “but those resources are dwindling,” Barbara said. “What do we do when that money is gone?”

Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

Florence Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

The Roybal study estimates that the cumulative economic impact of Alzheimer’s among Latinos will hit $2.35 trillion by 2060. That figure includes the costs of medical and long-term care, as well as the lost earnings of family members who provide unpaid in-home care, and of the Alzheimer’s victims themselves, according to the study.

Gustavo Lopez of Chicago cares for his mother, Agustina Lopez, 76, who was diagnosed with Alzheimer’s disease seven years ago.

Gustavo, 48, and his four siblings looked into assisted living but couldn’t afford it. Agustina, after moving between her children’s homes, eventually landed with Gustavo, her youngest.

When Gustavo first took on the role of primary caregiver, his mother still did most things on her own, he said. But she now relies on him to help her eat, bathe, dress and take her medication.

So Gustavo needs a job with flexible hours. He’s worked mostly as a waiter. Other employment opportunities have come his way, some with better pay, but caring for his mother comes first, he said.

Asking For Help

Gustavo does get some help from family friends who check in on his mom while he is at work. He also found Casa Cultural in Chicago, a social service agency that offers a day program for seniors. He can drop his mom off at the center for a few hours, giving him a respite.

Free or low-cost programs like these are available in many communities, but families need to do research and ask for help, said Constantina Mizis, president of the Chicago-based Latino Alzheimer’s and Memory Disorders Alliance.

The alliance, formed in 2009, focuses on family members who are primary caregivers. Mizis said she has met many caregivers who are near their breaking point. The nonprofit offers training for them, helps find resources to boost their own well-being and puts on community events for families.

When seeking support, the best place to start is at a local community group or center — a church, a nonprofit, a United Way office, or the local Alzheimer’s Association chapter, for example, Mizis said. These groups will most likely refer caregivers to a county’s Agency on Aging or a state’s Department of Aging.

There, families are assigned a social worker who can discuss what benefits are available. If an Alzheimer’s patient qualifies for Medicaid, these benefits could include caregiver training and payment through programs such as California’s In-Home Supportive Services. But benefits and eligibility vary by state.

In 2010, the Social Security Administration recognized early-onset Alzheimer’s as a medical condition eligible for disability income. That could help people whose Alzheimer’s disease is diagnosed before the age of 65, but many Latino families aren’t aware the program exists, Mizis said.

A Push For Awareness

Because Latinos are more likely to use informal and more affordable care options, the Roybal report calls for improving training and resources for families in both English and Spanish.

Among the caregivers who opt to keep a parent with Alzheimer’s at home is Julia Garcia, of Houston, Texas. She rotates with her three daughters to watch her mother, Marcela Barberena, 85, who was diagnosed with the disease last year.

Julia, who had been unfamiliar with Alzheimer’s, initially thought her mother’s forgetfulness and childlike behavior was due to age.

“Too often people will see Alzheimer’s as a result of old age, but this brain-deteriorating disease is not natural,” said Vega, co-author of the report.

Julia Garcia said she realized it was something more serious when her mother took a shuttle bus from Houston’s international airport without knowing her destination.

“We had agreed I’d pick her up, but she left on her own,” Julia said. “She ended up downtown. It was the scariest moment of my life.”

As a new caregiver, Julia reached out to her local Alzheimer’s Association chapter for information. While some resources are available in Spanish in the Houston chapter, Julia noticed very few Latinos attending the informational workshops or classes.

Barbara Marquez takes her mother, Florence Marquez, on a walk on Friday, December 16, 2016. (Heidi de Marco/KHN)

Barbara Marquez takes her mother, Florence Marquez, on a walk. (Heidi de Marco/KHN)

Spanish-language media provided little information about the disease. “You rarely hear anything about it on TV or the radio,” she said.

In addition, many Latinos, including the Marquez, Lopez and Garcia families, are often unaware of clinical trials through which families can gain access to experimental therapies and medications at little or no cost.

Latinos are underrepresented in clinical trials sponsored by the National Institutes of Health: They account for 17 percent of the U.S. population but only 7.5 percent of participants at the 32 NIH-funded Alzheimer’s research centers across the country, according to the Roybal study.

Latino volunteers for these trials are important in helping researchers develop Alzheimer’s treatments that work for all ethnic groups, the report says.

“This is why it is so important to invest in the education of these communities,” Mizis said.

Her group helps train promotoras, or community health educators, in regions with large Latino communities — including San Francisco, Los Angeles, Baltimore and New York. Going door-to-door, promotoras educate families about the disease.

“I see firsthand everyday how much help our communities need,” Mizis said. “And this need keeps growing.”

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

Categories: Aging, California Healthline, Mental Health, Public Health, Syndicate

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El “tsunami” de casos de Alzheimer entre latinos plantea inquietudes sobre el cuidado y los costos

SACRAMENTO, Calif. — A Florence Márquez le gustaba describirse a ella misma como una trabajadora de fábrica de conservas, a pesar que era conocida en su latinísimo vecindario del este de San José como una activista comunitaria.

Ella caminó junto a César Chávez en el movimiento de trabajadores agrícolas durante los años 60 y 70. Ayudó a construir viviendas asequibles para familias pobres cerca de su iglesia local.

Pero hace ocho años, Florence, ahora de 86, no pudo encontrar su camino a la casa en la que había vivido durante 50 años. “Fue cuando supimos que necesitaba atención las 24 horas”, dijo su hija mayor, Barbara Márquez, de 61 años.

Florence fue diagnosticada con la enfermedad de Alzheimer, que le robó su memoria y su feroz independencia. A lo largo de los Estados Unidos, historias como Florence Márquez se están convirtiendo en más comunes, particularmente entre los latinos, la minoría de más rápido crecimiento en el país.

Sin una cura a la vista, se espera que el número de latinos con Alzheimer aumente más de ocho veces para 2060, a 3.5 millones, según un informe del Edward R. Roybal Institute on Aging de la Universidad del Sur de California (USC) y de la red Latinos Against Alzheimer.

La edad avanzada es el principal factor de riesgo para la enfermedad de Alzheimer y la posibilidad de desarrollar el mal se duplica cada cinco años después de los 65. Los latinos son al menos 50% más propensos que los blancos no hispanos a tener Alzheimer, en parte porque viven vidas más largas, destaca el informe.

Barbara Marquez visits her mother Florence Marquez at her nursing home on Friday, December 16, 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

Barbara Marquez, de 61 años, visita a su madre, Florence Marquez, de 85, en el hogar Sagebrook Senior Living, en Carmichael, Calif., el viernes 16 de diciembre de 2016. (Heidi de Marco/KHN)

“Este es un tsunami en marcha”, dijo el doctor William Vega, uno de los autores del informe y director ejecutivo del Roybal Institute. “Si no encontramos medicamentos innovadores, vamos a enfrentar una terrible crisis financiera”.

Esa marea de casos de Alzheimer está provocando algunas conversaciones difíciles en las familias latinas, que a menudo se enorgullecen de cuidar a sus ancianos en casa, en lugar de ponerlos en hogares para adultos mayores.

Esas charlas se presentan con mucha culpa, dijo Barbara Márquez. Hasta hace poco, Barbara era la principal cuidadora de su madre. Su hermana y su hermano ayudaban.

“Pero fue más de lo que yo podría haber previsto”, dijo Barbara, recordando las noches sin dormir mientras intentaba asegurarse de que Florence no se levantara y escapara. “Afecta tu salud, tu matrimonio. Así que buscamos ayuda”.

Alrededor de 1,8 millones de familias latinas en todo el país cuidan a alguien con Alzheimer y otros tipos de demencia, y mientras que el informe de la USC muestra que las familias latinas tienen menos probabilidades que los blancos no hispanos de usar servicios de atención formales, como un hogar, el cuidado institucionalizado se está convirtiendo en una opción más popular entre estas familias.

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Entre 1999 y 2008, el número de latinos seniors que vivían en hogares aumentó un 55%, una tasa que superó el crecimiento de la población latina en general durante ese período de tiempo, según una investigación publicada en julio de 2011 en Health Affairs.

A nivel nacional, el costo promedio de los servicios básicos en un centro de asistencia es de $43,200 al año, según la Asociación de Alzheimer. Los cuidados anuales en hogares de ancianos son, en promedio, unos $92,000, más del doble.

Para muchas familias latinas, obtener ayuda externa no es ni siquiera una opción. A menudo es demasiado costoso para las personas mayores que no son elegibles para el Medi-Cal, la versión de California del Medicaid para personas de bajos ingresos, que generalmente paga por el cuidado de enfermería en hogares de ancianos. Los inmigrantes que están en el país ilegalmente no califican, ni tampoco las personas cuyos ingresos son demasiado altos.

Después de probar un programa de cuidado de ancianos fuera de la casa a unos $78 al día, Barbara y su familia pusieron a Florence en una residencia para ancianos de la zona de Sacramento, donde ha estado viviendo durante el último año.

 Recursos en baja

La decisión de institucionalizar a Florence Márquez dejó a sus hijos no sólo sintiéndose culpables, sino también con una economía tambaleante por los elevados gastos. El cuidado de su mamá ahora cuesta de $3,000 a $4,000 por mes, dijeron. Pagan extra por servicios especializados.

Florence actualmente no califica para el Medi-Cal, por lo que la familia Márquez vendió la casa de su madre en San José para pagar por su atención. “Pero esos recursos están disminuyendo”, dijo Barbara. “¿Qué vamos a hacer cuando se acabe el dinero?”.

El informe de la USC estima que el impacto económico acumulado de la enfermedad de Alzheimer entre los latinos llegará a $ 2,35 mil billones en 2060. Esta cifra incluye los costos de atención médica y de largo plazo, así como la pérdida de ingresos de los miembros de la familia, y de las propias víctimas del Alzheimer, según el estudio.

Gustavo López, de Chicago, se preocupa por su madre, Agustina López, de 76 años, diagnosticada con la enfermedad de Alzheimer hace siete años.

Gustavo, de 48 años, y sus cuatro hermanos buscaron un centro de asistencia, pero no pudieron solventarlo. Agustina, después de vivir en las casas de todos sus hijos, eventualmente se quedó con Gustavo, el más joven.

Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

Florence Marquez, de 85, fue diagnosticada con Alzheimer hace 8 años. Marquez vivió en la misma casa por 50 años, pero un día no pudo encontrar el camino a su hogar. (Heidi de Marco/KHN)

Cuando Gustavo asumió por primera vez el papel de cuidador principal, su madre todavía hacía la mayoría de las cosas por su cuenta, dijo. Pero ahora depende de él para comer, bañarse, vestirse y tomar su medicación.

Así que Gustavo necesita un empleo con horario flexible. Ha estado trabajando principalmente como camarero. Han aparecido otras oportunidades de empleo, algunos con mejor salario, pero el cuidado de su madre está primero, dijo.

 Pidiendo ayuda

Gustavo recibe ayuda de amigos de la familia que vigilan a su madre mientras está en el trabajo. También encontró Casa Cultural en Chicago, una agencia de servicios sociales que ofrece un programa de día para personas mayores. Puede dejar a su mamá en el centro por unas horas, lo que le da un respiro.

Programas gratuitos o de bajo costo como éstos están disponibles en muchas comunidades, pero las familias necesitan investigar y pedir ayuda, dijo Constantina Mizis, presidenta de la Latino Alzheimer’s and Memory Disorders Alliance, con sede en Chicago.

La alianza, formada en 2009, se centra en los miembros de la familia que son los principales cuidadores. Mizis dijo que ha conocido a muchos cuidadores que están al borde de quebrarse. La organización sin fines de lucro les ofrece capacitación, ayuda para encontrar recursos para impulsar su propio bienestar, y participación en eventos comunitarios para las familias.

Al buscar apoyo, el mejor lugar para comenzar es en un grupo o centro comunitario local: una iglesia, una organización sin fines de lucro, una oficina de United Way o el capítulo local de la Asociación de Alzheimer, por ejemplo, dijo Mizis. Es probable que estos grupos refieran a los cuidadores a la Agencia de Envejecimiento del condado o al Departamento de Envejecimiento del estado.

Allí, se les asigna a las familias un trabajador social que puede discutir qué beneficios están disponibles. Si un paciente de Alzheimer califica para Medicaid [Medi-Cal en California], estos beneficios podrían incluir capacitación para cuidadores y pago a través de programas de “efectivo y consejería”. Los Servicios de Apoyo en el Hogar de California es uno de esos programas. Sin embargo, los beneficios y la elegibilidad varían según el estado.

En 2010, la Administración del Seguro Social reconoció al Alzheimer de inicio temprano como una condición médica elegible para los ingresos por discapacidad. Eso podría ayudar a las personas cuya enfermedad de Alzheimer se diagnostica antes de los 65 años, pero muchas familias latinas no son conscientes de esto, dijo Mizis.

Un impulso para la concientización

Debido a que los latinos son más propensos a usar opciones de atención informales y más asequibles, el informe de la USC pide mejorar la capacitación y los recursos para las familias, tanto en inglés como en español.

Entre los cuidadores que optan por mantener a un padre con Alzheimer en casa está Julia García, de Houston, Texas. Ella se rota con sus tres hijas adolescentes y adultas para cuidar a su madre, Marcela Barberena, de 85 años, quien fue diagnosticada con la enfermedad el año pasado.

Julia, que no estaba familiarizada con el Alzheimer, pensó que el olvido y el comportamiento infantil de su madre se debían a la edad.

“Demasiado a menudo la gente ve al Alzheimer como resultado de la vejez, pero la enfermedad que deteriora el cerebro no es natural”, dijo Vega, coautor del informe de la USC.

Barbara visits her mother almost every weekend. Her mother's care now costs $3,000 to $4,000 per month, says Barbara. (Heidi de Marco/KHN)

Barbara Marquez saca a pasear a su madre, Florence Marquez, el viernes 16 de diciembre de 2016. (Heidi de Marco/KHN)

Julia García dijo que se dio cuenta de que era algo más serio cuando su madre tomó un micro desde el aeropuerto internacional de Houston sin saber su destino.

“Habíamos acordado que la recogería, pero ella se fue por su cuenta”, dijo Julia. “Terminó en el centro de la ciudad. Fue el momento más espantoso de mi vida”.

Como nueva cuidadora, Julia se acercó a la sede local de la Asociación de Alzheimer para obtener información. Aunque algunos recursos están disponibles en español en el capítulo de Houston, Julia notó que muy pocos latinos asistían a los talleres informativos o a las clases.

Lo mismo ocurre con los medios en español, que proporcionan poca información sobre la enfermedad. “Rara vez se oye nada en la televisión o en la radio”, dijo.

Muchos latinos, incluyendo las familias de Márquez, López y García, no saben sobre los ensayos clínicos y cómo pueden ayudar a sus seres queridos.

Los latinos están subrepresentados en los ensayos clínicos patrocinados por los Institutos Nacionales de Salud: representan el 17 por ciento de la población de los Estados Unidos, pero sólo el 7,5 por ciento de los participantes en los 32 centros de investigación de Alzheimer financiados por los INS en todo el país, según el informe de Roybal.

Los voluntarios latinos son importantes para ayudar a los investigadores a desarrollar tratamientos para el Alzheimer que funcionen para todos los grupos étnicos, según el informe de USC.

“Por eso es tan importante invertir en la educación de estas comunidades”, dijo Mizis.

Su grupo ayuda a entrenar promotoras o educadores comunitarios de salud en regiones con grandes comunidades latinas, incluyendo San Francisco, Los Ángeles, Baltimore y Nueva York. Al ir de puerta en puerta, las promotoras educan a las familias sobre la enfermedad.

“Veo de primera mano cuánto necesitan ayuda nuestras comunidades”, dijo Mizis. “Y esta necesidad sigue creciendo”.

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

Categories: Aging, Mental Health, Noticias En Español, Public Health, Syndicate

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Veteran Teaches Therapists How To Talk About Gun Safety When Suicide’s A Risk

Jay Zimmerman got his first BB gun when he was 7, and his first shotgun when he was 10.

“Growing up in Appalachia, you look forward to getting your first firearm,” he said, “probably more so than your first car.”

His grandfather taught him to hunt squirrels and quail. Zimmerman, who lives in Elizabethton, Tenn., said pretty much everyone he knows has a gun. It’s just part of the culture.

“When I went into the military, that culture was reinforced,” he said. “Your weapon is almost another appendage. It’s part of who you are.”

Zimmerman served as a medic in the Army in the late 1990s and early 2000s, with stints in Bosnia, Africa and the Middle East. Since he came home, he’s struggled with PTSD and depression. It reached a crisis point a few years ago, when his best friend — the guy who had saved his life in a combat zone — killed himself. Zimmerman decided his time was up, too.

“I decided that I would have one more birthday with my daughter, one more Christmas with my daughter,” he said. “I had devised my own exit strategy for 16 February 2013.”

But then he bumped into a woman who used to ride the same school bus when they were kids. His exit date came and went. They’re married now.

Zimmerman still gets depressed, but now he’s a peer counselor at the Mountain Home VA Medical Center in Johnson City, Tenn. He also travels to conferences all over the country, sharing his story with therapists and with other vets, encouraging them to ask for help when they need it.

Even today, he explains at these conferences, if he’s not doing well, he disassembles his guns and stores them separately from ammunition, so he can’t make any rash decisions. And if things get really bad, Zimmerman has a special arrangement with a few friends.

“I call them and say, ‘Look, I’m feeling like it’s not safe for me to have firearms in my home. Can you store them for me for a couple days till I feel like I’m OK to have them back?’ ”

Suicide is often an impulsive act. Nearly half the people who survive an attempt say the time between their first thought of suicide and the attempt itself was less than 10 minutes. But the method can mean the difference between life and death: People who take pills have time to change their minds, or may still be alive when discovered. That’s not the case with guns.

Almost 70 percent of veterans who commit suicide do so with a gun, which prompted President Barack Obama to order the VA to talk to vets about gun safety and storage options like the ones Zimmerman uses.

But here’s the trouble: Most therapists aren’t gun people. They don’t know how to talk about guns and so they don’t.

“One obvious reason for that is that no one has taught them how,” explained Megan McCarthy, a psychologist and National Deputy Director in the Office for Suicide Prevention in the U.S. Department of Veterans Affairs.

McCarthy was invited to speak recently at a suicide prevention conference in San Francisco, aimed at therapists who work with vets.

“How many of you would say you feel really comfortable having a conversation with any of the people you work with about limiting access to all lethal means?” she asked the roomful of therapists.

Hardly anyone raised their hand.

“OK, so that’s why we’re here today,” she said.

Researchers recommend starting with a field trip to a shooting range. There, therapists can learn about different kinds of firearms, as well as gun locks, and get an introduction to gun culture.

When counseling vets, therapists have to ask more questions and be less directive, McCarthy said.

“We often conceive of ourselves as experts — as people who impart information to clients,” she said. But with vets, “it may take time to build trust. Telling them what to do the first time you’ve met them is probably not going to be a very effective approach.”

McCarthy presented a case study at the conference: A 28-year old, unmarried Army veteran who fought in Iraq told his VA psychiatrist that he had an argument with his girlfriend last week. He drove to an empty parking lot and sat with his loaded handgun in his lap, intending to kill himself.

He didn’t do it. A week later, the man told his psychiatrist things were still tense with his girlfriend. But he didn’t want to talk about suicide or storing his gun.

McCarthy asked the clinicians in the audience what they would do next, if they were this man’s psychiatrist.

“Why did he not do it? That would be my question,” one therapist said.

“I would want to see this individual again, within the same week,” said another. “I believe in strong intervention.”

Jay Zimmerman, the former army medic and peer counselor, stood up and explained his different perspective.

“Chances are the reason he’s not talking to you is because he’s afraid he’s going to lose his gun that he carries pretty much all the time,” Zimmerman said. “My buddies are the same way. We all carry — all the time.”

A lot of veterans would sometimes rather confide in a fellow vet than someone in a white coat, Zimmerman said. And that was an unusual takeaway for the professional counselors: Sometimes their role is not to intervene at all, but to be a facilitator. To make sure vets have someone to talk to outside the therapy office.

This story is part of a partnership that includes KQED, NPR and Kaiser Health News.

Categories: Mental Health, Public Health, Public Radio Partnership, Syndicate


Right-To-Die Fight Hits National Stage

Opponents of aid-in-dying laws are claiming a small victory. They won the attention of Congress this week in their battle to stop a growing movement that allows terminally ill patients to get doctors’ prescriptions to end their lives.

The Republican-led effort on Capitol Hill to overturn the District of Columbia’s aid-in-dying law could fail by Friday. But advocates worry the campaign will catalyze a broader effort to fully ban the practice, which is legal in six states and being considered in 22 more.

“The D.C. legislation has catapulted the issue of medical aid in dying onto the federal agenda at a time when Congress has the power to enact a ban on this end-of-life care option nationwide — even criminalizing the practice in the six states where this option is currently authorized,” warned Jessica Grennan, national director of political affairs and advocacy for Compassion & Choices, which supports right-to-die laws.

“If that happens, it will set the end-of-life care movement back to the last century,” Grennan said.

No matter how the effort plays out, both sides agree that the debate on Capitol Hill, featuring a Republican moral protest, could be only a taste of what’s to come.

In a vote that hewed closely to party lines, the Republican-controlled House Oversight Committee on Monday approved a bill that would knock down D.C.’s law, which won approval from the mayor and City Council in December. While D.C.’s law mirrors those passed in other states, Congress has unique power to intervene in D.C.’s affairs. Under the Home Rule Act of 1973, Congress has 30 legislative days to overturn any law D.C. passes.

“It’s of deep, personal moral conviction that I stand in opposition” to D.C.’s law, said Rep. Jason Chaffetz of Utah, who chairs the committee, in Monday’s hearing.

The clock is running out on his effort. Republicans in the House and Senate have introduced joint resolutions attempting to block D.C.’s law, but the bills would need to pass the full House and Senate and gain President Donald Trump’s signature. Trump has declined to take a public stance on the matter. If those steps don’t happen by Friday, D.C.’s law will take effect.

Dr. David Stevens, CEO of the Christian Medical & Dental Associations, which opposes medical aid in dying, said even if Republicans fail to overturn D.C.’s law, their efforts may have broader impact.

“As representatives and senators become more educated about the dangers of physician-assisted suicide,” Stevens said, “I wouldn’t be surprised” if members of Congress introduce laws to “prohibit or at least more closely regulate” the practice.

(Courtesy of Amazon.com)

(Courtesy of Amazon.com)

If Congress passes such a law, the only hope for advocates such as Grennan “would be for the Supreme Court to intervene,” she said. But she noted that Trump’s pick for the Supreme Court, Neil Gorsuch, a federal appellate judge on the U.S. Court of Appeals for the 10th Circuit, has published a book against aid-in-dying efforts. The book, she said, notes “the Supreme Court’s power to overturn the state medical aid-in-dying laws.”

Away from Capitol Hill, the aid-in-dying movement has gained steam: The practice is legal in Oregon, Washington, Vermont, Colorado, California and Montana.

Energized by victories in California and Colorado last year, aid-in-dying supporters are pushing ahead to battlegrounds nationwide. So far this year, 21 states have introduced aid-in-dying legislation, according to Compassion & Choices. And in South Dakota, proponents are trying to get the practice approved through a ballot initiative.

Hawaii, Maryland and Maine appear the most likely to pass new legislation this year, said Peg Sandeen, executive director of the Death With Dignity National Center, another national advocacy group.

But opponents have beaten back similar measures in many states in recent years. And in Alabama, South Dakota and New York, they have gone on the offensive, introducing bills to preemptively outlaw the practice or prohibit insurance from paying for the lethal drugs.

Chaffetz, who is leading the charge to overturn D.C.’s law, has enraged Democrats and D.C. officials, who accuse him of overreaching his power by meddling in local affairs. But Chaffetz and fellow House Republicans at Monday’s vote said moral concerns trump local autonomy.

“Only God gets to decide” when a person’s life ends, declared Rep. Paul Mitchell, a Michigan Republican, during the debate.

If Republicans fail this week, they could attack D.C.’s Death With Dignity law in April, when Congress approves D.C.’s proposed budget. D.C. has proposed to spend some local money to build a database tracking the assisted-dying program.

Republican Sen. James Lankford of Oklahoma, who introduced the Senate resolution blocking the bill, also made a legal argument, citing a 1997 law passed under President Clinton that bans the use of federal money for physician-assisted death. Because of that law, Medicare and the Department of Veterans Affairs do not pay for the lethal drugs, so patients must pay out-of-pocket or use private or state-funded insurance. Lankford challenged D.C. to show that its assisted-dying program wouldn’t conflict with that law.

Advocates dismissed that argument. Sandeen, of the Death With Dignity National Center, said D.C.’s program will not use any federal money to help people die. She called the legal argument a “red herring effort,” aimed at distracting attention from politicians’ true reasons for trying to strike down D.C.’s law.

“I’d rather that they said, ‘For religious purposes, I disapprove of this law,’” she said.

KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.

Categories: Aging, Mental Health, Syndicate

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Viewpoints: Will The IRS Do In Obamacare Or Is The Sweeping Health Law Here To Stay Despite Attack?

A selection of opinions on health care from around the country.

The Washington Post: Reality Dawns: Obamacare Might Be Here To Stay
The burgeoning crisis over President Trump’s and former national security adviser Michael Flynn’s connections to Russia makes the already difficult task of repealing and replacing the Affordable Care Act even more confounding for Republicans, who won the White House and both houses of Congress based on unrealistic expectations about an as-yet-unidentified replacement plan. (Jennifer Rubin, 2/15)

Bloomberg: A Rough 24 Hours For Obamacare
The last 24 hours have been one long string of bad news for Obamacare. Tuesday, the insurer Humana announced that it would be pulling out of the exchanges for next year. Then we found out that the IRS had responded to Trump’s executive order on Obamacare by quietly rolling back a new rule planned for this year, which would have required filers to indicate whether they had maintained coverage in 2016 or to pay a penalty. And on Wednesday, word came that Mark Bertolini, the CEO of Aetna, had told a Wall Street Journal conference that Obamacare was in a death spiral. This stands in pretty stark contrast to claims by Andy Slavitt, who ran the Center for Medicare and Medicaid Services under President Barack Obama, that things were shaping up splendidly for 2018, so long as Republicans didn’t screw anything up. (Megan McArdle, 2/15)

Los Angeles Times: Trump’s IRS Stages A Stealth Attack On Obamacare
The Internal Revenue Service has become the first agency to follow President Trump’s directive to start undermining the Affordable Care Act. In a quiet rule change, but an important one, the IRS has told tax preparers and software firms that it won’t automatically reject tax returns that fail to state whether the tax filer had health insurance during the year. That effectively loosens enforcement of the ACA’s individual mandate. It appears to be a direct response to Trump’s Jan. 20 executive order requiring federal agencies “minimize … the economic and regulatory burdens of the Act.” (Michael Hiltzik, 2/15)

The New York Times: Now You Can Do Your Taxes Without Filling Out The Insurance Question
If you want to keep your health insurance status a secret from the I.R.S., the Trump administration just made it a little easier. The policy change, confirmed by the I.R.S. on Wednesday after elements were reported by the libertarian magazine Reason, does not do away with the Affordable Care Act’s requirement that all Americans who can afford it obtain health insurance or pay a fine. But it might make it a little harder for the I.R.S. to figure out who is breaking the rules. (Margot Sanger-Katz, 2/15)

Forbes: 4 Ways GOP Medicare Reform Plan Will Hurt You
Now that Tom Price has been confirmed as Secretary of Health and Human Services, it’s time to examine what he has in store for Medicare. He backs “premium support,” which is the GOP’s backdoor plan to privatize the system. Although GOP leaders such as House Speaker Paul Ryan have said that privatization is the only way to save Medicare — it’s not — there are some dangerous drawbacks for retirees. (John Wasik, 2/15)

RealClear Health: High Risk Pools Solve The Problem Of Preexisting Conditions
One reason health insurance premiums exploded under the Affordable Care Act is the law’s requirement that health insurers accept anyone who applied for individual coverage, known as guaranteed issue. The provision destroys an insurance market because it allows people to wait until a medical incident has occurred to get coverage. (Merrill Matthews and Mark Litow, 2/16)

JAMA: Medical Liability Reform In A New Political Environment
The election of President Donald Trump and a Republican-controlled US Congress may once again thrust medical liability reform into the health care debate. One likely policy solution to be advocated for is to place a cap on noneconomic damages that plaintiffs can recover through lawsuits. This policy proposal is part of the GOP’s A Better Way health care platform and has been part of previous Republican proposals to limit medical malpractice torts despite concerns that federal medical liability reform, by preempting state laws, may potentially weaken successful state regulation in some cases. (Anand Parekh and G. William Hoagland, 2/15)

Bloomberg: The Big Abortion Question For Gorsuch
If the U.S. Supreme Court were to reverse Roe v. Wade, individual states could still permit abortion. But, in theory, the Supreme Court could go further, and rule that laws permitting abortion violate the equal protection rights of unborn fetuses. That may seem far-fetched — but in his book on assisted suicide and euthanasia, Judge Neil Gorsuch lays out an argument that could easily be used to this end. (Noah Feldman, 2/16)

JAMA: Should The Definition Of Health Include A Measure Of Tolerance?
In 1948 the World Health Organization officially defined health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The definition has remained unchanged for more than 60 years. When it was adopted, tools to measure health did not exist. Indeed, it was decades before a comprehensive set of tools to measure physical, mental, and social well-being were developed. (Robert H. Brook, 2/14)

The New York Times: Congress Says, Let The Mentally Ill Buy Guns
For all their dysfunction, the Republican Senate and House have managed to act with lightning speed in striking down a sensible Obama administration rule designed to stop people with severe mental problems from buying guns. President Trump, who championed the National Rifle Association agenda as a candidate, is expected to sign the regressive measure. This, despite the Republican mantra that tighter control of mentally troubled individuals — not stronger gun control — is the better way to deal with the mass shootings and gun carnage that regularly afflict the nation. (2/15)

The Wichita Eagle: Statewide Health Plan Could Cost Wichita Teachers
One promising idea in a state efficiency study was having school districts join a statewide health insurance plan. But as a new audit found, such a move is complicated and would not save as much money as previously suggested. What’s more, a big share of the potential savings would be cost shifts to schoolteachers, especially in Wichita. In fact, 40 percent of the projected savings would come from shifting costs to teachers and other district employees. And of the $25 million in net cost shifts statewide, nearly $24 million would come from Wichita school district employees. (2/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Public Health Roundup: Identifying Best Breast Cancer Treatment; Study Finds Wider Lead Exposure

Other news stories related to public health cover Zika, the status of a canceled climate change summit, the benefits of Vitamin D on the cold and flu, depression in new dads, cardiovascular disease, ADHD and more.

Stat: Mammograms Plus Genomic Testing Identify Best Breast Cancer Treatments
Critics of annual mammograms point to the issue of overtreatment. Just last month, for example, a report in the Annals of Internal Medicine showed that screening mammograms (those done for women without signs of breast cancer) often lead to unnecessary treatments. One in three women in the study whose breast cancer was identified by a screening mammogram had a potentially harmless disease that may not require treatment. That work has raised questions about the benefits of screening mammograms. The findings of screening studies, including mammography, can be influenced by certain biases in the study design. (Citrin, 2/16)

Modern Healthcare: Report Warns That Lead Contamination Could Be Greater Than Reported 
Current testing for lead contamination does not accurately measure exposure, according to a new report. That could mean providers are facing a whole generation of patients with long-term health effects. An analysis of lead levels in school water fountains across 16 states showed many schools had levels that exceeded the federal threshold of 15 parts per billion. Water from school drinking fountains has increasingly been tested for lead since the contamination crisis in Flint, Mich., sparked municipalities across the country to test their own water supplies. (Johnson, 2/15)

Stat: Zika Persists In Semen, But Shedding Typically Stops In Months
A new study suggests at least half of men who have been infected with Zika will emit traces of the virus in their semen, but in most cases that viral shedding stops after about three months. The research, conducted in Puerto Rico, found that 56 percent of men who had been infected had traces of virus in their semen but about half of them stopped emitting those viral traces by about a month after they first became ill. And by three months after the onset of symptoms, only 5 percent still had virus in their semen. (Branswell, 2/15)

Stat: CDC-Scrapped Climate Change Conference To Happen On Thursday
Remember how CDC officials abruptly cancelled their long-planned climate and health summit right before President Donald Trump took office? Well, an unofficial version featuring many of the same speakers will happen Thursday in Atlanta. After word spread last month of the summit’s cancellation, a group of advocates — led by former Vice President Al Gore — scrambled to put on an one-day version of the original three-day conference so experts in public health, public policy, and climate science could gather to talk about global warming and its impact on public health. (Blau, 2/15)

NPR: Vitamin D Can Reduce Colds And Flu, Study Finds
It’s long been known that Vitamin D helps protect our bones, but the question of whether taking Vitamin D supplements can help guard immunity has been more controversial. An analysis published online Wednesday in the British journal the BMJ suggests supplements of the sunshine vitamin can indeed help reduce the risk of respiratory infections — especially among people who don’t get enough of the vitamin from diet or exposure to sunlight. (Aubrey, 2/16)

Stat: Dads, Like Moms, Are At Risk Of Depression After A Child’s Birth
New dads are at risk of experiencing the same symptoms of postpartum depression as women who’ve just given birth — despite the fact that their bodies don’t go through the same sort of changes. A paper published Wednesday in JAMA Psychiatry finds that just over four percent of new fathers experience elevated symptoms of depression after their children are born. The idea of postpartum depression among new dads is a relatively new one, and the study’s authors say raising awareness about the issue is a critical first step. That, combined with screenings, could help catch symptoms of depression among new fathers and treat them early. (Thielking, 2/15)

The Washington Post: Survival Rate Improves For Extremely Premature Infants
Survival rates for very early preterm infants have improved slightly, according to a study published in the New England Journal of Medicine on Wednesday. Those who survive are also somewhat less likely to suffer from neurodevelopmental impairments, the study found. Researchers gathered survival and neurodevelopmental impairment data for 4,000 extremely premature infants by analyzing records from a National Institutes of Health research network. The infants were born between 22 and 24 weeks of gestation, rather than after a normal 40-week pregnancy. (Naqvi, 2/15)

The Philadelphia Inquirer: Progress In Saving Preemies On The Edge Of Viability
For premature babies born at the edge of viability, the chance of survival without serious health problems has gotten slightly better, at least at the nation’s top neonatal care centers — a small change with potential implications for the bitter abortion debate in  Pennsylvania and other states. Researchers from the 11 centers analyzed the records of more than 4,200 babies born at 22 to 24 weeks of pregnancy between 2000 and 2011. While the grim picture at 22 weeks did not change — 96 percent of newborns died — the outlook for the rest of the “periviable” infants improved over the 12-year period. (McCullough, 2/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Dementia Continues To Flummox Drugmakers As It Replaces AIDS As One Of World’s Top Killers

In 2015 the disease claimed double the amount of lives it did in 2000, but promising treatment after promising treatment fail in trials.

Bloomberg: Dementia Joins Ranks Of Top Global Killers With No Drug In Sight 
Dementia has unseated AIDS as one of the world’s top killers, new figures from the World Health Organization show, as drugmakers struggle to either curb or cure it. Alzheimer’s disease and other forms of dementia killed 1.54 million people in 2015, more than twice the number of deaths from the disease in 2000, according to documents posted on the WHO website last month. It replaced HIV/AIDS as No. 7 on the global health watchdog’s list of the 10 biggest causes of death worldwide. New therapies helped push fatalities from HIV/AIDS from 1.5 million down to 1.1 million over the same 15-year period. (Kresge, 2/15)

California Healthline: An Alzheimer’s ‘Tsunami’ Threatens Latinos
The number of Alzheimer’s cases is growing rapidly across the entire U.S. population, and could nearly triple by 2050 to 13.8 million, according to the Alzheimer’s Association. But the increase is particularly striking among Latinos, who as a group are at least 50 percent more likely than non-Hispanic whites to develop the disease, according to a report by the University of Southern California’s Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network. That’s in part because Latinos live longer, on average, than whites and also because they are more likely to suffer from certain chronic conditions that put them at greater risk for Alzheimer’s, the report says. Compounding the challenge, the report notes, is the fact that the elderly population is growing three times faster among Latinos. (de Marco and Ibarra, 2/16)

Meanwhile, former President Barack Obama’s Precision Medicine Initiative is likely to continue under the new administration —

Stat: Obama’s ‘Big Science’ Initiatives Will Keep Rolling Under Trump, AAAS Leaders Predict
The big research initiatives launched by President Barack Obama should have enough momentum to keep rolling in the coming years, even if President Donald Trump doesn’t prioritize them, leading advocates for science said Wednesday. Obama, a self-described “science geek,” announced the BRAIN Initiative, which aims to dive down to the cellular level to understand the workings of the human brain, in 2013. The Precision Medicine Initiative came two years later; it seeks to collect detailed health data from at least a million volunteers to fuel research on a variety of diseases. Both projects are housed in the National Institutes of Health. (Simon, 2/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Decades-Long Quest To Battle Alzheimer’s Dealt Latest Blow As Merck Pulls Plug On Anticipated Drug

Similar treatments from Eli Lilly, Pfizer, and Johnson & Johnson have all come up short in recent years. Meanwhile, treatments for mental illnesses have seen few advances despite increased understanding of the diseases.

Stat: The Next Big Alzheimer’s Trial Came Up A Dud
Merck pulled the plug on a closely watched trial in Alzheimer’s disease after finding out its in-development drug had no effect on patients with mild forms of the disorder. The drug, verubecestat, showed “virtually no chance” of meeting its goal in a 2,200-patient study, Merck said. The trial was meant to read out later this year, but Merck, on the advice of its independent data monitors, pulled the plug early. (Garde, 2/14)

Stat: Scouring The Brain For Clues To New Treatments For Mental Illness
While demand for mental health drugs has surged, big pharmaceutical companies have largely backed away from investing in the field; the number of psychopharmacological drug research programs has shrunk 70 percent in the last decade, according to NeuroPerspective…To advance the field, researchers say they need to find biomarkers — tangible biological clues that can help diagnose mental illness, just the way high blood glucose levels can signal diabetes. The hope is that those biomarkers could help pinpoint what’s gone wrong in the circuitry of a particular patient’s brain and offer clues for drug development — and, perhaps one day, even precision psychiatric therapies. (Keshavan, 2/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: In Va., Legislation Mandating Birth-Control Coverage Progresses; Colo. Gov. Appointee Aggressively Challenges Small Businesses On Disability Issues

Outlets report on news from Virginia, Colorado, Kansas, Tennessee, California, Pennsylvania, Ohio and Florida.

Denver Post: 64 Lawsuits In Two Months: Are Recent ADA Suits ‘Drive-By’ Litigation Or A Tool To Help The Disabled? 
A gubernatorial appointee who chairs the Colorado Developmental Disabilities Council has filed dozens of lawsuits against small businesses over the past two months claiming they violate federal disability laws. The 64 lawsuits filed so far by Mellisa Umphenour of Arvada are nearly identical in content and scope to scores of others filed in U.S. District Court last year in Colorado – and thousands of others filed in federal courts nationwide the past few years. Umphenour filed the suits on behalf of her 11-year-old son, who is disabled. Often called “drive-by lawsuits,” they rely on the Americans with Disabilities Act and are often filed by disabled people or their caretakers. (Migoya, 2/13)

KCUR: The High Cost Of Allowing Concealed Carry In KU Hospital 
The fight is raging on in Topeka over whether to roll back a law that would let almost anyone carry a concealed gun on a college campus, in a library or public hospital. The debate has mostly been around whether guns enhance or detract from people’s safety. Less talked about is just how much allowing guns on campuses could cost. For one Kansas City area institution it could run into the millions. Most Kansas Board of Regents institutions have said they have little choice but to let people carry concealed weapons on university or community college campuses. Any of the institutions could prohibit guns but they would have to buy metal detectors and post armed guards at each entrance of every area that they want to keep firearm-free. (Zeff, 2/13)

The Associated Press: Artificial Insemination Parenting Bill Draws LGBT Criticism
Two Tennessee lawmakers want to do away with a 40-year-old state law granting legitimacy to children conceived through artificial insemination. Critics say the bill is aimed at gay couples and their children. The bill would remove a single sentence applying to child custody when artificial insemination is involved, one that’s been interpreted to make no distinction between same-sex and heterosexual couples. But opponents warn that changing the law could prevent both same-sex parents from appearing on the children’s birth certificates, affecting their ability to make parenting decisions ranging from medical care to education. (Schelzig, 2/13)

Reuters: California Lawmaker Makes Push For Health Warning Labels On Soda
A California state senator is taking another stab at introducing a law that would require sugary drink manufacturers to put a warning label on their products, the latest effort in the “War on Sugar.” Officials and public health advocates have heightened their criticism of sugar as a key contributor to health epidemics like obesity and diabetes, and California has become a major battleground in the fight against what they say is excessive sugar consumption. (Prentice, 2/13)

The Philadelphia Inquirer: Bankrupt North Philadelphia Health System In Deal To Sell St. Joseph’s Hospital
Bankrupt North Philadelphia Health System has reached a deal to sell its shuttered St. Joseph’s Hospital at Sixteenth Street and Girard Avenue for $8.1 million to MMP Hospital Partners LLC., according to a bankruptcy-court motion Monday. The agreement of sale, dated Feb. 13, was signed by David Waxman, managing partner at MMPartners LLC., which has been building in Brewerytown since 2001. Waxman declined to comment on the pending purchase. The health system filed a motion Monday to be able to sell the property free and clear of liens, which would then attach to the net proceeds. (Brubaker, 2/13)

Los Angeles Times: South Gate Teacher Gets Meningitis And Dies, And Parents Worry About Health Risks
A teacher at Montara Avenue Elementary School in South Gate died last week after contracting meningitis, leading parents to worry about whether their children might have been exposed. The Los Angeles Unified School District issued a statement saying the Los Angeles County Public Health Department “is taking appropriate measures to identify and protect those who may have come in contact with our employee. They have provided preventative antibiotics, as well as information about meningococcal disease.” (Kohli, 2/13)

Denver Post: How Clear Creek County Is Spurring Economic Revival, One Patient At A Time 
The Jacob House — a century-old, single-story brick bungalow — is set to become the first primary care medical clinic the mountain community has had in years, an asset Clear Creek County leaders say is required to keep both residents and the local economy healthy. With no doctor’s office or hospital within many snow-packed, traffic-jammed miles of the county’s towns, Clear Creek County EMS is the only source of medical care for the community of about 9,000 people and the tens of thousands of motorists passing through each day. That dearth of options has led people to languish without care and proved a deal killer for highly sought employers considering a move to town. (Paul, 2/13)

Cincinnati Enquirer: Lawsuit: Lacking Mental Health Treatment In Warren County Jail Led To Suicide
A lawsuit filed in U.S. District Court last week claims that officials and employees at the Warren County Jail repeatedly failed to address the mental health issues of a man who eventually hanged himself with a sheet in his cell. Justin Cory Stewart was arrested April 19 for failing to comply with mental health treatment, a condition of his probation related to a previous conviction. He took his own life on Aug. 30. (Knight, 2/13)

Health News Florida: Doctor Wins $1.5M In Case Of Mistaken Identity 
When an individual goes up against a multibillion-dollar company, odds of prevailing are slim. But every now and then, justice smiles on the little guy. It’s smiling on Tampa internist Jose Ignacio Lopez, who won $1.5 million in a slander suit against a global health-finance powerhouse. Of the award, $1 million constitutes punitive damages for “gross negligence” by OptumRx Inc., a subsidiary of UnitedHealth Group Inc. OptumRx was negligent in two ways, the arbitrators said:  It said bad things about an innocent doctor and then failed to correct the mistake. (Gentry, 2/13)

WBUR: New Cleveland Police Training Accounts For Addiction, Mental Illness In Arrests 
Tanisha Anderson was 37 years old, suffering from mental illness, when she died in an encounter with Cleveland police in 2014. Her family recently settled a $2.25 million lawsuit against the city. Anderson’s death sparked a court-ordered agreement to reform Cleveland’s police department, which the U.S. Justice Department said showed a pattern of using excessive force on people with mental illness. Now, Cleveland police, in cooperation with the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County, are unveiling a new set of guidelines and training on how law enforcement treats suspects with mental illness and addiction. (Young, 2/13)

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Viewpoints: Drug Companies ‘Risky’ Idea; Scrapping Rule On Guns And Mental Illness Is ‘A Bad Move’

A selection of opinions on health care from around the country.

Chicago Tribune: Guns And Mental Illness: Don’t Scrap This Rule
If someone has a mental illness severe enough that he cannot work or manage his own money, should he be allowed to own a gun? In the waning weeks of his presidency, Barack Obama answered that question. Motivated by Adam Lanza’s bloody rampage at an elementary school in Newtown, Conn., that killed 20 children and six educators in 2012, Obama imposed a rule that barred gun ownership for people who qualify for Social Security disability insurance because their mental illness keeps them from working, and who cannot manage their benefits. That pool is small — just 75,000 Americans. (2/10)

The Wichita Eagle: Services For Disabled Also In Violation
Not only did federal officials determine last month that KanCare was “substantively out of compliance with federal statutes and regulations,” they determined the previous month that services for people with disabilities were also out of compliance. Yet state lawmakers had to learn about both decisions by reading about them in the newspaper. (2/12)

The Des Moines Register: Legislators Should Repay State For Cheap Health Care
Gov. Terry Branstad said in 2012 he would begin voluntarily paying 20 percent of his state-funded health insurance premiums. He encouraged other state workers, including lawmakers, to follow suit. The next year, the governor said some legislators, who had previously enjoyed premium-free health insurance, had started contributing 20 percent. But not a single lawmaker is paying that share, according to December 2016 data obtained by The Des Moines Register. And it appears they are violating state law. (2/11)

The Columbus Dispatch: More Needed To Fight Overdoses
Ohio lawmakers are asking good questions about the money that Gov. John Kasich’s proposed budget would devote to the state’s opioid epidemic and the collateral damage from it. Last week, Republican and Democrat legislators said they are concerned that the budget does not do enough. The concern is warranted. Ohio leads the nation in drug-overdose deaths, with 3,050 recorded in 2015, the most recent year with complete statistics. (2/13)

The New York Times: LSD To Cure Depression? Not So Fast
Psychedelics, the fabled enlightenment drugs of the ’60s, are making a comeback — this time as medical treatment. A recent study claimed that psilocybin, a mushroom-derived hallucinogenic, relieves anxiety and depression in people with life-threatening cancer. Anecdotal reports have said similar things about so-called microdoses of LSD. … I fear that in our desire to combat suffering, we will ignore the potential risks of these drugs, or be seduced by preliminary research that seems promising. (Richard A. Friedman, 2/13)

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State Highlights: Ga. Provider Fee Renewal Legislation Gains Final OK; In N.J., Religious Exemptions For Childhood Vaccinations On The Rise

Outlets report on news from Georgia, New Jersey, District of Columbia, California, Minnesota, Kansas, Florida, Ohio, Iowa, Texas and Connecticut.

Atlanta Journal Constitution: Hospital ‘Provider Fee’ Gains Final Legislative Approval
Legislation needed to renew a fee on Georgia hospitals to help close a more than $900 million gap in Medicaid funding is on its way to Gov. Nathan Deal’s desk. The state House on Friday voted 152-14 to give final approval to Senate Bill 70, which authorizes the Department of Community Health board to levy the fee for another three years. The board is expected to do so quickly if Deal signs the bill into law, as expected. (Gould Sheinin, 2/10)

The Associated Press: House Moving To Block DC ‘Death With Dignity’ Law
A House committee is taking up an unusual resolution that would invalidate a local law in the nation’s capital. The House Oversight Committee will vote Monday on whether to send a resolution to the House floor blocking the District of Columbia’s “Death with Dignity” law. Oversight chairman Jason Chaffetz, a Utah Republican, has vowed to stop the law, calling it “misguided” and immoral. (2/13)

Stat: California’s Criminal Penalties For HIV Transmission Could Be Rolled Back
The state legislature decided in 1988 that somebody who donated blood while knowingly HIV-positive could be punished with up to six years in prison. Ten years later, it became a felony to have unprotected sex with the intent of transmitting HIV to a partner. Now, in 2017, a group of Democratic state lawmakers say times have changed — not that those behaviors shouldn’t be illegal, but that HIV/AIDS shouldn’t be singled out. Under California’s newly introduced Senate Bill 239, intentionally transmitting any infectious or communicable disease, including HIV, would be a misdemeanor, not a felony. (Facher, 2/13)

The Star Tribune: Advocates For Disabled Send A Distress Signal To Legislators 
A group of individuals with disabilities, many in wheelchairs, testified at a state Senate hearing last week that Minnesota needs urgent measures to expand the supply of workers who care for tens of thousands of vulnerable adults and children in their homes. The state-funded personal care assistance program, they argue, has not kept pace with burgeoning demand and a more competitive labor market, thrusting many people with complex health needs into life-or-death situations. (Serres, 2/11)

KCUR: More Funding For Mental Health, Disability, Senior Services In Kansas: None Of The Above? 
A Kansas House committee overseeing budgets for social services offered appreciation to programs serving the elderly and people with disabilities or mental illnesses. Legislators may not be able to offer much more than that. Rep. Barbara Ballard, ranking minority member on the House Social Services Budget Committee, suggested members approve $250,000 to fund services for seniors, such as bathing and assistance with housework. The funds wouldn’t begin to make up for $2.1 million in cuts to Senior Care Act services last year, she said, but would help Area Agencies on Aging chip away at their waiting lists. (Wingerter, 2/10)

Orlando Sentinel: UCF Helps First Responders Fight PTSD, Pulse Flashbacks 
For some, it’s the scent of tequila or the sound of an iPhone ringing. Hearts race, breathing sharpens, palms sweat and suddenly, they’re back at the scene of the most traumatic event most are lucky enough never to have to see. Some Pulse nightclub terror attack first responders say post-traumatic stress disorder triggers can show up in everyday settings, but the University of Central Florida’s Dr. Deborah Beidel says they don’t have to stop sufferers from living their lives. (Doornbos, 2/10)

Columbus Dispatch: State Aid To Vastly Expand Ohio State Program For Victims Of Traumatic Stress
Crawford was seeing a counselor, but it wasn’t helping. Then her husband told her about the Stress, Trauma and Resilience program, or STAR, at Ohio State University’s Wexner Medical Center, where Crawford learned ways to cope with her anxiety so she could function again. “It absolutely changed my life,” said Crawford, now 30.The program, started eight years ago, offers psychological treatment to people affected by crime and other traumas. It’s on the verge of expanding with an $839,335 grant from the Ohio attorney general’s office that will more than quadruple the budget. (Viviano, 2/12)

Des Moines Register: Health Care Stripped From Collective Bargaining As Statewide Insurance Plan Takes Shape
Sweeping changes proposed to Iowa’s collective bargaining laws would block most public-sector unions from negotiating over health insurance, though they stop short of instituting a mandatory statewide health insurance system Gov. Terry Branstad has floated. Republican leaders say they considered including such a plan in the legislation, but felt it could be too restrictive. Instead, the bill leaves open the possibility for a voluntary statewide health insurance program that employers could opt into. (Pfannenstiel, 2/10)

California Healthline: California Regulator Slams Health Insurers Over Faulty Doctor Lists
California’s biggest health insurers reported inaccurate information to the state on which doctors are in their networks, offering conflicting lists that differed by several thousand physicians, according to a new state report. Shelley Rouillard, director of the California Department of Managed Health Care, said 36 of 40 health insurers she reviewed — including industry giants like Aetna and UnitedHealthcare — could face fines for failing to submit accurate data or comply with state rules. (Terhune, 2/10)

Cleveland Plain Dealer: Painesville’s Latino Community Rallies Around Neighbor After Brain Surgery
Juan [Horta] was diagnosed with xanthoastrocytoma, an uncommon and aggressive brain tumor. Stage three. A surgeon at University Hospitals removed the tumor, and Juan was sent to a nursing home to recover. Caesar, and his mother, Maria Guillen, visited daily. They noticed what Caesar called “a ball” on the back of Juan’s neck, and it was getting bigger by the day. On the fifth day, Juan was unresponsive. The “ball” was filled with cerebrospinal fluid, and Juan needed another surgery to insert a shunt… As an undocumented immigrant, he is not qualified for public benefits, including Medicaid. Government programs require proof of legal immigration. Once that proof is supplied, it is still five years before immigrants can apply for assistance. (Ischay, 2/11)

Texas Tribune: How Texas Pimps Recruit And Sell Underage Girls For Sex 
Texas Tribune reporters talked to three convicted traffickers to try to understand the power they wield over victims and the attraction of what they call “the lifestyle.” They explained how vulnerable kids end up in the sex trade and how the business works. The interviews also revealed a common thread between pimps and their victims: the poverty and violence in their backgrounds. (Walters, Satija and Smith, 2/13)

New Haven Independent: Cigarette Tax Hike: Promoting Health Or Penalizing The Poor?
The two New Haven state representatives offered those takes Wednesday after Gov. Dannel P. Malloy proposed proposed a $40.6 billion two-year budget that included raising the taxes on a pack of cigarettes by 45 cents, to bring the total cost to $4.35… The problem, argued Rep. Porter, whose district includes New Haven’s Newhallville neighborhood, is that it can also end up punishing poor people for their patterns of addiction without offering alternative treatment programs or therapies, like smoking cessation counseling. Lower-income people smoke at disproportionately higher rates. (Gellman, 2/13)

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As White America Comes Out Of Shadows On Opioid Abuse, People Of Color Remain Hidden

More and more, white Americans are putting faces to the opioid epidemic through explicit obituaries, interviews and letters to lawmakers. However, blacks, Latinos, Asians, and Native Americans are noticeably absent, which represents a larger trend with the crisis itself. Meanwhile, the Affordable Care Act helped expand treatment for substance abuse, and some worry what will happen if the law is dismantled.

Stat: ‘We Never Talked About It’: As Opioid Deaths Rise, Families Of Color Stay Silent
There’s a new honesty these days about drug abuse. In obituaries, media interviews, and letters to lawmakers, families that have lost loved ones to overdoses are naming the drugs that killed them. As more and more people emerge from the shadows to put a face on the nation’s opioid epidemic, however, faces of color are notably absent. In part that reflects the makeup of the epidemic itself: While deaths among white Americans have soared, those among blacks and Latinos have stayed relatively steady. (Samuel, 2/13)

The New York Times: Addiction Treatment Grew Under Health Law. Now What?
Chad Diaz began using heroin when he was 12. Now 36 and newly covered by Medicaid under the Affordable Care Act, he is on Suboxone, a substitute opioid that eases withdrawal symptoms and cravings, and he is slowly pulling himself together. “This is the best my life has gone in many, many years,” Mr. Diaz, a big man wearing camouflage, said as he sat in a community health center here. If Congress and President Trump succeed in dismantling the Affordable Care Act, he will have no insurance to pay for his medication or counseling, and he fears he will slide back to heroin. (Seelye and Goodnough, 2/10)

In other news on the epidemic —

Stat: Former Rep. Frank Guinta Seen As Possible Trump ‘Drug Czar’
Frank Guinta, a former New Hampshire lawmaker who helped create an opioid crisis task force in Congress, has discussed serving as President Donald Trump’s “drug czar” with Trump’s team, according to several individuals familiar with the discussions. Since the election, Guinta has spoken with top Trump aides about serving as director of the Office of National Drug Control Policy — a position colloquially known as the nation’s “drug czar”—  multiple individuals, speaking on condition of anonymity, told STAT this week. (Scott, 2/10)

The Wall Street Journal: New Jersey Finds Challenge To Combating Addiction Crisis
New Jersey Gov. Chris Christie has staked his final year as governor on tackling the state’s addiction crisis, but efforts under way in the state show how difficult that task is. Citing long waiting lists at many treatment centers, Mr. Christie wants to increase the availability of both inpatient and outpatient treatment programs. The governor has urged the state legislature to pass laws limiting the quantity of opioids doctors can prescribe and mandating insurance coverage for addiction treatment. (King, 2/11)

Boston Globe: Taunton Confronts Opioid Epidemic As Deaths Continue To Rise In City 
As the opioid epidemic escalated three years ago into a statewide public health emergency, Taunton boldly came forward and confronted the problem in a public way. A key moment came in February 2014, when Massachusetts Senator Edward J. Markey and the White House drug czar held a press conference about the crisis at a city fire station. As if to underscore the situation’s urgency, firefighters were dispatched to a reported overdose during the session. Despite the city’s direct approach, the number of people killed every year by opioids has grown over the past three years. (Crimaldi, 2/10)

Columbus Dispatch: State Task Force Recommends Schools Educate All Grade Levels On Substance Abuse
Teaching students of all ages social and emotional learning is a crucial step toward combating Ohio’s drug addiction crisis, Attorney General Mike DeWine suggests. The Ohio Joint Study Committee on Drug Use Prevention Education issued 15 recommendations Friday for schools across the state. These include requiring schools to report how they are teaching students to resist drug abuse. (Tenbarge, 2/10)

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State Highlights: Malloy’s Budget For Conn. Includes Deep Cuts In Health, Social Services; Wis. Legislators Skeptical Of Walker’s Health Plan For Public Employees

Outlets report on news from Connecticut, Wisconsin, Arizona, Ohio, Massachusetts, New Hampshire, Michigan, Pennsylvania, Maryland, Florida, Texas and California.

The CT Mirror: Malloy Budget Hinges On Big Labor Savings, New Revenues 
Gov. Dannel P. Malloy unveiled a $40.6 billion two-year budget Wednesday that seeks $1.5 billion in labor concessions, imposes $400 million of annual pension costs on municipalities and reorganizes the financial relationship between the state, communities and hospitals. The governor also would increase taxes by close to $200 million, scaling back income tax credits for the middle class and working poor and boosting the cigarette levy by 45 cents per pack. (Phaneuf, 2/8)

The CT Mirror: How Health Care And Medicaid Fare In Malloy’s Budget 
About 9,500 parents would lose Medicaid, fewer seniors would receive home care, mental health and substance abuse treatment providers would receive millions of dollars less from the state, and school-based health centers would see a 10 percent funding cut under the budget plan Gov. Dannel P. Malloy proposed Wednesday. The plan aims to close a budget deficit projected at nearly $1.7 billion, and many of the individual cuts drew concern from providers and advocates for health and social service programs. Still, some said the plan left them more optimistic than had previous proposals by Malloy. (Levin Becker, 2/8)

Milwaukee Journal Sentinel: Republicans Resist Walker’s Insurance Plan
Gov. Scott Walker is banking on saving $60 million in taxpayer funds over two years by changing the way public employees get health insurance, but legislators are deeply skeptical of the proposal. In the state budget he unveiled Wednesday, the governor detailed plans to shift the state to a self-insurance system to cover employee health care costs. But his fellow Republicans who control the Legislature questioned whether the state could generate the savings Walker is counting on and said the change could hurt the insurance market for individuals and small businesses. Republican legislators have resisted the proposal in the past. (Marley and Stein, 2/8)

The Wall Street Journal: Report Cites Deficiencies At Theranos Lab
Theranos Inc.’s lab in Arizona failed to ensure some patients who got potentially inaccurate diabetes test results were notified, according to a federal inspection report obtained through a public-records request. The embattled Silicon Valley company also performed patient blood-coagulation tests on a machine its staff configured improperly, according to the report and the company’s response to regulators. (Weaver, 2/8)

Milwaukee Journal Sentinel: Two More Cases Confirmed In Mumps Outbreak At Marquette University
Two more Marquette University students who live in a residence hall have been diagnosed with mumps, bringing to three the total number of cases confirmed on campus since winter break…. The newly diagnosed students are recovering at home, and the Milwaukee Health Department is following up with those known to have come into close contact with them, Smith said in the email. Mumps is a viral infection spread through coughing, sneezing, talking or occasionally through utensils and cups. It also can be spread by touching unwashed, contaminated surfaces. (Herzog, 2/8)

Arizona Republic: Gov. Doug Ducey Wants 86K Arizona Newborns A Year Tested For This Disease
Hospitals on the reservation include SCID in their newborn screenings. But outside of the Navajo Reservation, Arizona does not screen newborns for the disease, a practice Gov. Doug Ducey wants to change this year in the hopes of giving children like Ava, now 3, a chance at lifesaving treatment. Left undetected, SCID can lead to repeated infections and even death. The screening costs about $6, and Arizona is one of three states across the U.S. that do not screen for SCID. (Wingett Sanchez, 2/8)

Cleveland Plain Dealer: Toledo City Council Bans ‘Conversion Therapy’ 
City Council voted unanimously Tuesday to ban “conversion therapy,” the controversial psychological treatment that attempts to change a person’s sexual orientation or gender identity. The legislation, approved by a 12-0 vote, makes conversion therapy a fourth-degree misdemeanor with an attached fine for each offense, according to the Associated Press. (Pinckard, 2/9)

Boston Globe: OSHA Cites Brookline Psychiatric Hospital 
Workplace safety inspectors have cited Arbour-HRI, a Brookline psychiatric hospital, after discovering that front-line employees suffered broken bones and concussions during interactions with violently ill patients. The Occupational Safety and Health Administration said the hospital “has not developed and implemented adequate measures to protect employees’’ from aggressive patients. Nurses and mental health workers were punched, hit, scratched, bitten, and hit with objects including a soda bottle and wooden dresser drawer, the federal agency said. (Kowalczyk, 2/9)

NH Times Union: Hampton Nursing Facility Denies Role In Death Of Elderly Woman
A Hampton nursing facility denies that it played any role in the death of an elderly woman whose family claims died as a result of a bad hair perm.The lawyer for Oceanside Center and Oceanside Healthcare and Rehabilitation Center disputes some of the allegations made in a wrongful death suit filed late last year following the death of 89-year-old Betty Pettigrew in 2015. (Schreiber, 2/8)

Detroit Free Press: Detroit Hospitals See Hope For Heart Attacks With New Pump
Five health systems in southeastern Michigan have joined forces to save heart attack victims, using a new tiny heart pump. Since July, doctors from Henry Ford Health System, Beaumont, DMC Heart Hospital, St. Joseph Mercy Health System and St. John Providence Ascension have used Impella pumps, inserted in cardiac patients dealing with cardogenic shock, which has led to an 80% survival rate. When in cardogenic shock, patients’ heart function plummets, which leads to low blood pressure and not enough blood flowing to vital organs. (Meyer, 2/8)

The Philadelphia Inquirer/Philly.com: Money Fight Starts In North Philly Health System Bankruptcy
There is not much money to fight over in the bankruptcy of North Philadelphia Health System, which owed $24.8 million to its 30 largest unsecured creditors, according to its Dec. 30 filing. That explains the intense interest in the $692,000 that NPHS received from a New Jersey trust last Thursday. Before a hearing on the matter Wednesday in Center City, NPHS and three creditor groups reached a preliminary deal, which they detailed in U.S. Bankruptcy Judge Magdeline D. Coleman’s courtroom. (Brubaker, 2/8)

The Baltimore Sun: Center For Health Security At Hopkins Awarded $16 Million Grant
The Center for Health Security at the Johns Hopkins Bloomberg School of Public Health will study biosecurity and pandemics with the help of a $16 million grant announced Wednesday. The three-year grant from the Open Philanthropy Project will help the center study responses to serious biological risks and how technology could change those risks, improve biosafety practices, and increase awareness of biosecurity and pandemic challenges, according to the center. (Wells, 2/8)

Tampa Bay Times: Hernando Residents Tapped To Participate In National Health, Nutrition Survey 
The National Health and Nutrition Examination Survey, ongoing in Hernando County through March 8, will result in some answers to such questions and, likely, in revised national standards and recommendations regarding diet and physical and mental health. In the survey’s 55th year nationwide, this appears to be the first time Hernando County residents have been sampled, officials said. (Gray, 2/9)

Austin American Statesman: Critics Accuse UT Medical School Of Misspending Local Tax Dollars
The University of Texas Dell Medical School has spent millions of dollars on administrative and educational expenses using local tax dollars that are supposed to go only for indigent care, two activists and a former state senator charged Wednesday in remarks before UT’s governing board. The allegations echo previous complaints but were delivered with a stronger assertion of misspending and more detail. They were leveled by former state Sen. Gonzalo Barrientos of Austin and two local lawyers, Fred Lewis and Bob Ozer. (Haurwitz, 2/8)

Los Angeles Times: Southern California Gas To Pay $8.5 Million To Settle Lawsuit Over Aliso Canyon Leak
Southern California Gas Co. will pay $8.5 million to settle a lawsuit filed by air quality regulators over the Aliso Canyon gas leak and will fund a study of community health effects. The settlement with the South Coast Air Quality Management District, announced Wednesday, resolves a dispute over the months-long leak of methane from the gas company’s Aliso Canyon storage facility above the Porter Ranch neighborhood of Los Angeles. (Barboza, 2/8)

Orlando Sentinel: Orlando-Area Doctors, Patients, Growers Have Their Say On Medical Marijuana Rules
Dozens of people with ailments including cancer, chronic pain and multiple sclerosis implored the Florida Department of Health on Wednesday night to loosen the regulations for medical marijuana and allow them to get treatment faster. Voters in November approved a constitutional amendment that allows doctors to recommend full-strength marijuana for a wide variety of ailments including glaucoma, HIV, AIDS, ALS, Parkinson’s disease, Crohn’s disease and PTSD. Now the department’s Office of Compassionate Use is scrambling to figure out how to regulate the drug within the required six months of the effective date of the amendment, which was Jan. 3. (Jacobson, 2/8)

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Obama’s Drug Czar: The Opioid Crisis Must Continue To Be A Federal Priority

The GOP is working to repeal and replace the 2010 health law, known for insuring more than 20 million people. And the change could affect another health concern: the nation’s opioid abuse problem.

Just ask President Barack Obama’s former “drug czar,” Michael Botticelli.

Botticelli just finished running the White House’s Office of National Drug Policy, a post he assumed in early 2014 as the opioid epidemic began making national headlines. The drugs, which claimed more than 33,000 lives in 2015, include heroin and painkillers like OxyContin.

Fighting addiction — and opioids in particular — defined his tenure. But Botticelli was known for bringing a patient’s perspective. His background, after all, isn’t medicine or law enforcement. He previously headed Massachusetts’ Bureau of Substance Abuse. And he’s in recovery himself, having spent almost 30 years sober after battling alcoholism.

In office, Botticelli used a public health approach — helping people with addiction get medical treatment. That, he says, means getting them insurance and doctors. But now he worries this addiction crisis could fall from the priority status it received during the Obama administration. That would be noteworthy, he adds, since President Donald Trump won states hard hit by the opioid crisis — like Pennsylvania, Ohio and Michigan.

Trump’s promise to undo the health law could compromise anti-addiction efforts, Botticelli says. He points to Medicaid, the federal-state insurance for low-income people, which payed for about $60 billion worth of mental health services in 2014. It’s now expected to shrink.

Botticelli spoke with Kaiser Health News’ Shefali Luthra about how the new administration should fight opioid addiction. Below are excerpts of the conversation, edited for length and clarity.

Q: What do you think is needed to address the opioid epidemic?

We have not heard President Donald Trump talk about how he is going to deal with this. He heard [about] this issue on the campaign trail.

There is significant concern on the potential impact repealing the Affordable Care Act might have. We had a whole host of initiatives, but one of the main components was to ensure people had adequate access to treatment. Clearly, the Affordable Care Act had a major impact. When you look at data about why people are not able to get treatment, not having access to insurance is one of the major reasons people cite.

Q: What are the specific elements of repealing and replacing the law that you’re concerned about?

People with opioid addiction do not just need general access to substance abuse services. They often have a variety of comorbid mental health and medical conditions. We’ve seen a dramatic increase in people with hepatitis C among people with opioid addiction who are injecting drugs. We’ve seen in certain parts of the country outbreaks of HIV. Medicaid expansion has played a huge role in people’s ability to access treatment for both substance use disorder and other conditions.

One of the concerns is not just for people’s ability to access care — but what happens to those millions who are already receiving it? If there is a significant disruption in people’s ability to access treatment, it has a devastating impact.

Q: In addition to the repeal effort, the GOP has talked about revamping Medicaid so that it would be funded through block grants, which could give states more freedom to manage the program, but also could limit its budget. Could those affect the fight against opioid addiction?

In addition to requiring treatment for substance use disorders be considered an essential benefit, the Affordable Care Act imparted federal parity regulations to cover those. Without federal oversight, states might choose to not cover those services, and not cover them on par with other medical needs.

There are reasons we have federal parity laws. There’s a long history of both private and public insurance plans not adequately covering — or covering at all — substance use disorder services.

And so there’s a potential [to lose those protections by] moving to a block grant, where states have much more flexibility over who they cover and the kinds of services they pay for.

This goes back to the very long history of Medicaid, both private and public insurance, either not paying or not adequately covering these [services].

Q: Has the Trump administration been in touch with you — about opioid policy specifically, or drug policy generally?

No. And we had no contact with anyone on the Trump transition team before I left. It’s giving me and other people pause about to what extent this administration considers this a priority.

Q: Do you have a sense that the new administration has a sense of policy that might be effective? And what are the challenges they’ll face going forward?

Well, I think that we have seen not only in my time in the Obama administration, but in my time in Massachusetts — that this really requires a comprehensive response. And a dedicated response. And it needs to be well resourced, to be a priority across the federal government

I think if we were able to achieve anything, it was really understanding that this was an ‘all hands on deck’ approach, and we needed various elements of the administration focused on this issue if we’re going to make progress on this. We need it. And I think part of what was successful was this was a clearly articulated priority by President Obama. You know, I think that we were able — and whether it was getting the billion dollars for treatment through the [21st Century] Cures Act, I think it was a demonstrated priority on the part of the president.

We still have over 140 people dying every single day as a result of drug overdoses. And the entirety of the response can’t be, “We’re just going to build a wall to stop the flow of drugs coming in from across the border.”

This was an epidemic that was created by legally prescribed drugs, here in the United States, and so we need to make sure we’re doing everything in our power to make progress. Fundamental to that is making sure people have appropriate and timely access to treatment.

Q: Addiction science is a fairly new field. There’s a lot of unanswered questions. How does the administration’s interest in federally funded research fit in here?

Any drug policy that’s going to be effective has got to be based on science and research.

The research that the National Institute of Drug Abuse and National Institutes of Health funded to understand addiction as a brain disorder and not a moral failing made us pivot to a drug policy that was based on scientific principles. People have raised concerns to what extent those principles and that science are going to continue.

Q: Is this an area you plan to stay involved in?

This has been my life’s work, and I have every intent to continue that. I’m trying to decide now in what capacity. But I’m pretty certain I’m going to stay involved.

Q: Do you think policy makers will continue to focus on addiction — not just the administration, but Congress as well?

My hope is that we are not going to lose momentum, and that we’re not going to backslide on the focus on the opioid epidemic. We can’t. We are losing too many people on a daily basis.

Categories: Mental Health, Public Health, Repeal And Replace Watch, Syndicate, The Health Law


Viewpoints: Is It An Obamacare Replace, Repair Or Cleanup?; Rolling Back A ‘Sensible’ Gun Limit

A selection of opinions on health care from around the country.

The Wall Street Journal: The ObamaCare Cleanup Begins
All of a sudden the press is filled with stories about Republicans supposedly retreating from their promise to repeal and replace ObamaCare. Liberals are claiming vindication and conservatives are getting nervous, but the stampede to declare failure is premature. The orderly transition to a more stable and affordable health-care system is merely beginning. (2/6)

Los Angeles Times: In A Hopeful Sign, Republicans Are Finally Getting Around To ‘Repairing’ Obamacare — Six Years Late
Over the last few days, the Republicans’ campaign against the Affordable Care Act has undergone a subtle shift in branding. They’re no longer talking about a strategy of “repeal and replace’: The new buzzword is “repair.” Close followers of GOP efforts to gut the law, which has brought health insurance to some 20 million Americans and protected millions of others from being denied coverage because of medical conditions, are skeptical that this signals a real change in the Republican caucus’s approach. (Michael Hiltzik, 2/6)

Stat: I’ve Put My Family On A Health Insurance Experiment. It’s Been A Challenge
About one-third of American workers covered by health insurance are now in high-deductible health plans, in which the policy holder pays a substantial portion of the cost of health care services out of pocket before insurance coverage kicks in. Many economists and health policy experts believe that these plans are a promising way to reduce health care spending. So when a high-deductible plan became available through my employer, Harvard University, a couple years ago, I decided to enroll my family in it. If this is going to be a big national experiment, I thought that I, as a physician and a health policy scholar, ought to know what it’s like to live with this kind of health insurance. (Ashish Jha, 2/6)

The New York Times: Tom Price, Dr. Personal Enrichment
Each year, a publication called Medscape creates a portrait of the medical profession. It surveys thousands of doctors about their job satisfaction, salaries and the like and breaks down the results by specialty, allowing for comparisons between, say, dermatologists and oncologists. As I read the most recent survey, I was struck by the answers from orthopedic surgeons. They are the highest-paid doctors, with an average salary of $443,000 in 2015 — which, coincidentally, was almost the exact cutoff for the famed top 1 percent of the income distribution. (David Leonhardt, 2/7)

The New York Times: Congress Moves To Roll Back A Sensible Obama Gun Policy
Republican lawmakers and the National Rifle Association often attribute gun massacres to the country’s inadequate mental health system, rather than the easy availability of firearms. Now, those same people want to make it easier for those with schizophrenia, psychotic disorders and other mental health problems to buy guns. (2/7)

The Wall Street Journal: Don’t Repeal Obama’s Modest Gun Limit
The House last week voted to overrule an Obama administration regulation prohibiting gun ownership by a small group of people with severe psychiatric disorders. The Senate shouldn’t follow suit. The Obama rule is sensible, and to expend energy repealing it implies there should be no reasonable limits on firearms ownership. (Dinah Miller, 2/6)

Bloomberg: Obamacare, Abortion And The Ease Of Extremism
As Republicans struggle to find a way to repeal and replace Obamacare, and liberals and conservatives gear up for a battle over Supreme Court nominee Neil Gorsuch, it strikes me that the same lesson can be drawn from both phenomena: how much easier it is to hold radical opinions when you have no hope of passing legislation. (Megan McArdle, 2/6)

The Des Moines Register: Anti-Choice Lawmakers’ Fiscal Foolishness
Instead of tackling legitimate problems, some Republican state lawmakers are fixated on meddling in the reproductive lives of their constituents. It seems they will do anything to send a message they oppose abortion. That includes targeting health providers who offer the legal procedure. (2/6)

Louisville Courier-Journal: Abortion Bill Gags Clergy
In the current national political climate—which has understandably been preoccupied with questions around immigrants and refugees, around the electoral shenanigans committed by Russia, around charges of voter fraud and lying about crowd size—Kentuckians should not overlook a potentially sweeping bill submitted by the Republican controlled house. House Bill 149, which is being touted as yet another attempt to defund Planned Parenthood of Indiana and Kentucky (PPINK), will have much more broad-reaching effects than just taking aim at a favorite GOP target. (Derek L. Penwell, 2/6)

The Columbus Dispatch: Transition Center Could Save Lives
Not only do people wait in line to see doctors and counselors, there is a shortage of psychiatric beds for those needing in-patient care. And then, even those who receive care often are released with nowhere to go and no support system to help them remain stable. Even when families are willing to take in a troubled relative, they often lack the knowledge and the resources to help them sufficiently. Often, it is the patient’s family that is desperately appealing for help and finding little. (2/7)

San Jose Mercury News: Be Wary Of The Latest ‘Detox’ Plan
What do toxins have to do with detox? Nothing. In medicine, detoxification means managing withdrawal from alcohol or opioids, treating a medication overdose, or the medical management of poisoning. Exposure to actual toxins, like the ones described above, is treated with antidotes, antibiotics and often specialized supportive and intensive medical care. Because doctors have terrible handwriting along the way, detoxification was shortened to detox. (Jen Gunter, 2/6)

RealClear Health: Trump’s Radical Attack On Global Health
“I think the president, it’s no secret, has made it very clear that he’s a pro-life president,” White House Press Secretary Sean Spicer told reporters at his first briefing as he defended President Donald Trump’s decision to wildly expand what is known as the Global Gag Rule. But if Trump’s move was pro-life, it was pro-life only by name. The new and expanded Global Gag Rule is a radical policy, far beyond what any other Republican president has ever done before. And it will lead to an enormous loss of life. (John Norris and Jamila K. Taylor, 2/7)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Kan. Budget Could Fall Short In Providing Funds For Mental Health System; Despite Mass Shootings, Fla.’s Progress Slow On Curbing Access To Guns

Outlets report on news from Kansas, Florida, California, New Jersey and Minnesota.

KCUR: ‘Tough’ Budget Situation Makes New Funding Unlikely For Kansas Mental Health System 
A key Kansas lawmaker says the state doesn’t have the money to fix problems in its mental health system, which a new report says are getting steadily worse. The report, the second from a task force created in 2015 to advise the Kansas Department for Aging and Disability Services, says the system has continued to deteriorate. The task force’s first report, issued about 18 months ago, concluded the system was “stretched beyond its ability to provide the right care at the right time in the right place.” (Wingerter, 2/6)

Tampa Bay Times: After Mass Shootings, Little Changes In Florida On Mental Illness And Access To Guns 
As news spread that the suspected gunman told FBI agents in Alaska that he was hearing voices, Florida officials called for improvements to mental health care and tougher measures to keep guns away from people with severe psychological disorders. The Jan. 6 mass shooting was just the latest to be followed by hand-wringing from politicians, particularly gun-rights supporters, who blamed shortcomings in the mental health system for the tragedy. Despite years connecting mental illness and mass shootings, lawmakers in both parties have been reluctant to pass major legislation taking firearms out of the hands of people diagnosed with severe disorders. (Auslen and Clark, 2/6)

Los Angeles Times: Zika Virus Is Here To Stay. Here’s How California Is Preparing For That New Reality
Jason Farned set down a clear container in the middle of a table. The people gathered around leaned forward to peer at the tiny, zooming blurs trapped inside. “The deadliest creature in the world is the mosquito,” said Farned, who works for the San Gabriel Valley Mosquito and Vector Control District, a government agency that manages insect populations. By some estimates, mosquitoes transmit diseases that kill more people each year than any other creature. (Karlamangla, 2/6)

KCUR: Gonorrhea And Other STDs Rise In Kansas City, Preliminary Data Show 
Reported cases of sexually transmitted diseases in Kansas City, Missouri, rose last year, in some cases dramatically, in part due to increased testing and outreach by health authorities. Preliminary data from the Kansas City Health Department shows a nearly 27 percent increase in reported cases of gonorrhea, 8 percent in chlamydia and 7.6 percent in syphilis. The figures reflect national trends, with reported STDs reaching an unprecedented high in the United States in 2015. (Margolies, 2/6)

The Associated Press: 79-Year-Old Doctor On Trial In $200M Health Fraud Scheme
To prosecutors, Bernard Greenspan saw dollar signs when a blood-testing lab company came to his office seeking referrals several years ago, and he reaped a $200,000 windfall in illegal bribes. Greenspan’s attorney tells a different story, of an “old-school, solo family practitioner” still practicing while pushing 80 whose transactions were legitimate but who wound up in the wrong place at the wrong time — in the middle of an investigation into a $200 million health care fraud scheme. (2/7)

Miami Herald: UHealth And VitalMD Partner For Women’s Healthcare Network In Florida 
The University of Miami Health System and VitalMD — among South Florida’s largest physician providers — are teaming up to create a network of doctors focused on women’s health and cancer care, the two institutions announced this week. Under the alliance, patients who use VitalMD doctors will have access to UHealth’s broad range of specialty medical services and research, including cancer treatment at Sylvester Comprehensive Cancer Center. In return, UHealth will reach a broader segment of South Florida patients and their families, according to a press release announcing the partnership. (Chang, 2/6)

Minnesota Public Radio: Charges: Minn. Medical Marijuana Execs Illegally Distributed Oils
The Wright County Attorney’s office has brought felony charges against two former employees of Otsego-based Minnesota Medical Solutions, saying they smuggled concentrated marijuana oils out of state to aid their parent company. According to the complaint filed Monday, Ronald Owens, who worked as security director of Minnesota Medical Solutions, and Laura Bultman, the company’s former chief medical officer, conspired in December 2015 to transport 5.6 kilograms of concentrated marijuana oils from its Otsego, Minn. facility to New York because parent company Vireo Health was struggling to meet a production deadline for facilities licensed in New York state. (Scheck, 2/6)

Los Angeles Times: Santa Monica Middle School Reopens After Possible Norovirus Exposure
anta Monica middle school reopened Monday after being ordered closed late last week after a potential norovirus outbreak, officials said. John Adams Middle School officials on Friday canceled classes and closed the campus for cleaning after dozens of students came down with symptoms akin to norovirus, which typically include nausea, vomiting, diarrhea, aches and fever, after a recent science trip to Yosemite National Park. (Fry, 2/6)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Advocates, Officials Warn Repeal Would Undermine Progress Made Against Opioid Epidemic

Medicaid expansion and the law’s mandate that all insurers cover addiction treatment at the same level as medical and surgical procedures have helped states make strides in the battle against opioid addiction.

Stateline: ACA Repeal Seen Thwarting State Addiction Efforts
In the three years since the Affordable Care Act took effect, its federally funded expansion of Medicaid to low-income adults has become the states’ most powerful weapon in the battle against the nation’s worsening opioid epidemic. Now, as Congress and President Donald Trump debate potential replacements for the law, governors, health care professionals and advocates for the poor are cautioning that any cut in federal funding for addiction treatment could reverse much of the progress states have made. (Vestal, 2/6)

In other news on the crisis —

San Jose Mercury News: Heroin Use Fuels Surge Of ER Visits Among California Millennials
California’s millennials continue to flood hospital emergency departments because of heroin, a trend that has increased steadily statewide over the past five years, according to the latest figures. The state data released last week show that in the first three months of 2016, 412 adults age 20 to 29 went to emergency departments due to heroin. That’s double the number for the same time period in 2012. Overall, emergency department visits among heroin users of all ages increased, but the sharpest was among the state’s young adults. About 1,500 emergency department visits by California’s millennials poisoned by heroin were logged in 2015 compared with fewer than 1,000 in 2012. (Abram, 2/6)

The Philadelphia Inquirer: Genetic Test To Predict Opioid Risk Lacks Proof, Experts Say
It sounds like a godsend for America’s opioid epidemic: genetic tests that can predict how a patient will respond to narcotic painkillers, as well as an individual’s risk of misuse, addiction, and potentially deadly side effects. Proove Biosciences of Irvine, Calif., claims its “opioid response” and “opioid risk” tests are the only precision medicine tools on the market to do all that, giving doctors information “to guide opioid selection and dosage decisions as well as treat side effects.” (McCullough, 2/6)

New Hampshire Union Leader: Report Details Manchester’s Response To Opioid Crisis 
Nearly 4,000 grams of drugs seized. More than 570 needles collected, and 350 Narcan kits distributed. More than 19,000 visits to Hope For NH Recovery by individuals seeking help with addiction. These are just a few of the statistics included in a 24-page report detailing the city of Manchester’s response to the opioid crisis in 2016. (Feely, 2/7)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.