First Edition: August 19, 2019

Kaiser Health News: ER Redo: As Rural Hospital Closes, Emergency Care Is On The Blink With Fate Uncertain
For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide. (Tribble, 8/19)

Kaiser Health News: DIY Tech Gives People More Freedom In Managing Diabetes
When Sam Mazaheri was 9, he was diagnosed with Type 1 diabetes. That means Sam’s body makes little or no insulin, a hormone that turns food into energy. “All of a sudden I had to manage everything he was going to take, including the insulin,” said Sam’s mom, Nasim Mazaheri. It was frightening, she said, and it felt like bringing home a newborn all over again. (de Marco, 8/19)

The Associated Press: California Leads Latest Lawsuit Over Trump Immigration Rule
California and three other states on Friday filed the latest court challenge to new Trump administration rules blocking green cards for many immigrants who use public assistance including Medicaid, food stamps and housing vouchers. Nearly half of Americans would be considered a burden if the same standards were applied to U.S. citizens, said California Attorney General Xavier Becerra. (Thompson, 8/16)

The Washington Post: California, Other States Sue Over Trump Plan To Limit Poor Immigrants’ Access To Green Cards
The lawsuit is the fourth legal challenge filed this week since administration officials rolled out a new rule on Monday that seeks to redefine who will be eligible for permanent residency and a path to full U.S. citizenship. The rule, set to take effect in mid-October, will give preference to wealthier, educated immigrants who can support themselves, and it will make it more difficult for immigrants who rely on public help or are determined to be likely to need federal assistance. Opponents of the rule argue that punishing legal immigrants who need financial help endangers the health and safety of immigrant families — including U.S. citizen children — and will foist potentially millions of dollars in emergency health care and other costs onto local and state governments, businesses, hospitals and food banks. (Sacchetti, 8/16)

Los Angeles Times: California Sues Trump Over 'Public Charge' Rule Denying Green Cards To Immigrants
Legal experts say the case could turn on whether California can demonstrate the Trump administration adopted the policy with an intent to discriminate against certain immigrants, which is part of the state’s legal strategy. “This cruel policy would force working parents and families across the nation to forgo basic necessities like food, housing and healthcare out of fear. That is simply unacceptable,” Becerra said in a statement. (McGreevy, 8/16)

USA Today: California Is Seeking An Injunction To Block Public Charge Rule
California is not the first jurisdiction tochallenge the "public charge" rule. Maine, Pennsylvania, Oregon, and the District of Columbia joined the complaint, filed in U.S. District Court on Friday, seeking to stop enactment of the new rule. The complaint asserts that the rule unfairly targets "marginalized populations, such as children, students, individuals with disabilities, older adults, and low-wage working families." (Canon, 8/16)

The Associated Press: Doctors Say New Rule Will Mean Sicker Immigrants
Diabetics skipping regular checkups. Young asthmatics not getting preventive care. A surge in expensive emergency room visits. Doctors and public health experts warn of poor health and rising costs they say will come from sweeping Trump administration changes that would deny green cards to many immigrants who use Medicaid, as well as food stamps and other forms of public assistance. Some advocates say they're already seeing the fallout even before the complex 837-page rule takes effect in October. (8/17)

The Hill: Senate Dem Seeks Answers From DHS On Reports Of Pregnant Asylum Seekers Sent Back To Mexico
Sen. Jeff Merkley (D-Ore.) on Friday asked Department of Homeland Security (DHS) officials to clarify reports that pregnant asylum-seekers have been forced to wait out their immigration cases in Mexican border cities. Merkley wrote DHS Inspector General Joseph Cuffari, asking why six late-term pregnant women were included in the Migrant Protection Protocols (MPP) program in May. (Bernal, 8/16)

The Associated Press: 2 Shuttered Arizona Shelters For Immigrant Kids Could Reopen
The nation's largest provider of shelters for immigrant children is looking to reopen two facilities that the state of Arizona forced it to shutter last year because of issues with employee background checks and allegations of abuse. Southwest Key filed applications to reopen a downtown Phoenix facility that can house 420 children and one in the outer suburbs that can house 139. (8/18)

Politico: Court Rejects Planned Parenthood Bid To Freeze Trump's Family Planning Rule
A federal appeals court has rejected efforts to block the Trump administration from banning abortion referrals by federally funded family planning clinics, including affiliates of Planned Parenthood. The 9th U.S. Court of Appeals’ ruling Friday night will allow the policy to take effect while lawsuits from states, medical groups and reproductive rights advocates continue. (Ollstein, 8/17)

CNN: Planned Parenthood Faces Critical Decision After Abortion-Referral Restriction Upheld
Last month, an en banc panel of 11 judges on the 9th US Circuit Court of Appeals upheld the court's prior ruling to temporarily allow the Department of Health and Human Services rule to go into effect. The rule would prohibit taxpayer-funded family planning clinics from discussing abortion with patients or referring patients to abortion providers. The following week, HHS told Title X recipients that the new regulations would go into effect despite the pending legal challenges. Planned Parenthood then lobbied the court to reconsider its decision. (Kelly, 8/16)

The Daily Beast: Planned Parenthood Could Pull Out Of Title X Over Trump Gag Rule
For months, Planned Parenthood has been battling a new Trump administration rule that bars taxpayer-funded family planning clinics from talking with their patients about abortion, or referring them to abortion providers. Planned Parenthood deemed the measure a “gag rule” and said it would pull out of Title X—the program that administers the funds—rather than comply with the new regulations. (Shugerman, 8/17)

The Hill: Trump Abortion Rule Could Hit Rural Communities Hard 
Patients could face new challenges accessing birth control and other reproductive health care services, particularly in rural areas, under changes made by the Trump administration to a federal family planning program. Planned Parenthood, government agencies in blue states and other health providers are expected to tell the Department of Health and Human Services (HHS) on Monday that they will not comply with its new rules banning recipients of Title X family planning funds from referring women for abortions. (Hellmann, 8/18)

The Hill: Trump Donates Second Quarter Salary For 2019 To Surgeon General's Office 
President Trump donated his salary from the second quarter of 2019 to the Surgeon General's office, the White House announced Friday. The Surgeon General's office falls under the Department of Health and Human Services. The White House said the donation will help address the opioid epidemic and the growing use of e-cigarettes by teenagers and children. (Samuels, 8/16)

USA Today: President Trump To Fund Surgeon General Advisory With Salary Donation
It's his third salary donation to the Department of Health and Human Services. "The President recognizes the important mission of the Surgeon General to protect and improve the health of all Americans, including helping to tackle the opioid epidemic and raise awareness of the dangers of e-cigarette usage among teenagers and children," the White House said in a statement. (O'Donnell, 8/16)

CNN: Trump Donates 2nd-Quarter Salary To Surgeon General's Office
Since taking office, Trump has donated his salary to a variety of government agencies and efforts. He tweeted in March that he had donated a quarter of his annual salary to the Department of Homeland Security, posting a photo of a signed check for $100,000 made out to the department. Federal regulations prohibit agencies from accepting donated funds without congressional authorization. Unauthorized funds would instead be deposited into the Treasury Department's general fund. (Carvajal, Vazquez and Kelly, 8/16)

The Washington Post: As Mass Shootings Rise, Experts Say High-Capacity Magazines Should Be The Focus
It took a shooter all of 32 seconds to spray 41 rounds outside a popular bar in Dayton, Ohio, this month, an attack that killed nine people and injured 27. A lightning-fast response from nearby officers prevented a far higher toll: When police shot him dead, the killer still had dozens of bullets to go in his double-drum, 100-round magazine. The use of such high-capacity magazines was banned in Ohio up until 2015, when a little-noticed change in state law legalized the devices, part of an overall rollback in gun-control measures that has been mirrored in states nationwide. (Witte, 8/18)

The Associated Press: Suburban Voters Are Pressuring Republicans To Act On Guns
Following the news has grown stressful for Angela Tetschner, a 39-year-old nurse raising four children in this sprawling Phoenix suburb of tile roofs, desert yards, young families and voters who are increasingly up for grabs. “Sometimes I do think about the school shootings,” said Tetschner, who doesn’t pay much attention to politics but has been disappointed in President Donald Trump, days after sending her 5-year-old boy to kindergarten. She’d like to see Congress tighten gun laws, but her expectations for action are low. (Cooper, 8/19)

Politico: Beto O’Rourke Says El Paso Shooting Was A ‘Consequence’ Of Trump
Former Rep. Beto O'Rourke said Sunday the mass shooting in his hometown of El Paso was a "consequence and cost" of President Donald Trump. “It wasn't until that moment that I truly understood how critical this moment is and the real consequence and cost of Donald Trump,” O’Rourke said on NBC's “Meet the Press.“ (Kullgren, 8/18)

The Washington Post: Two Mass Killings A World Apart Share A Common Theme: ‘Ecofascism’
Before the slaughter of dozens of people in Christchurch, New Zealand, and El Paso this year, the accused gunmen took pains to explain their fury, including their hatred of immigrants. The statements that authorities think the men posted online share another obsession: overpopulation and environmental degradation. The alleged Christchurch shooter, who is charged with targeting Muslims and killing 51 people in March, declared himself an “eco-fascist” and railed about immigrants’ birthrates. The statement linked to the El Paso shooter, who is charged with killing 22 people in a shopping area this month, bemoans water pollution, plastic waste and an American consumer culture that is “creating a massive burden for future generations.” (Achenbach, 8/18)

The Washington Post: Virginia Commission Kicks Off Two Days Of Hearings On Gun Bills
Virginia’s Crime Commission will devote two days this week to mass shootings and other gun violence, issues vexing a state where 32 died in a university massacre a dozen years ago, where another 12 were cut down at a municipal complex in May and where an average of three more were lost to less sensational shootings every day in between. Over day-long hearings Monday and Tuesday, the commission will hear from law enforcement officials, academics and activists. State delegates and senators will be there, too, presenting about 60 bills proposed for a special legislative session on guns that Republicans ended abruptly in July. (Vozzella, 8/18)

Politico: Rival Gun Groups Look To Fill The NRA's Void
As the National Rifle Association flounders, some upstart pro-gun groups see an opportunity to become the nation’s most influential gun rights organization. The groups say they’re attracting new members and raking in donations. They’re hiring additional staff to work on grassroots advocacy and lobbying. One is going so far as to discuss at a conference in September how to fill the void left by the NRA, which has struggled to address internal squabbles and accusations of financial mismanagement. (Levine and Arkin, 8/18)

The Washington Post: The ‘Follow-Up Appointment’
The people being sued arrived at the courthouse carrying their hospital bills, and they followed signs upstairs to a small courtroom labeled “Debt and Collections.” A 68-year-old wheeled her portable oxygen tank toward the first row. A nurse’s aide came in wearing scrubs after working a night shift. A teenager with an injured leg stood near the back wall and leaned against crutches. By 9 a.m., more than two-dozen people were crowded into the room for what has become the busiest legal docket in rural Butler County. (Saslow, 8/17)

The New York Times: A Nun, A Doctor And A Lawyer — And Deep Regret Over The Nation’s Handling Of Opioids
Years before there was an opioid epidemic in America, Sister Beth Davies knew it was coming. In the late 1990s, patient after patient addicted to a new prescription painkiller called OxyContin began walking into the substance abuse clinic she ran in this worn Appalachian town. A local physician, Dr. Art Van Zee, sensed the gathering storm, too, as teenagers overdosed on the drug. His wife, Sue Ella Kobak, a lawyer, saw the danger signs in a growing wave of robberies and other crimes that all had links to OxyContin. (Meier, 8/18)

The Washington Post: Naloxone, A Drug That Reverses Overdoses, Can Save Lives. Here’s Why You Should Learn How To Use It.
Naloxone, a drug that reverses overdoses, can save lives. Also known as Narcan, it reverses the effects of opioids such as oxycodone, fentanyl, morphine and heroin. Naloxone prescriptions have risen dramatically in recent years — the most recent Centers for Disease Control and Prevention data shows a 106 percent increase in prescriptions dispensed from 2017 to 2018 — but the drug is still new to many. That should change, public health officials say. In a recent news conference, CDC officials encouraged naloxone use. And U.S. Surgeon General Jerome Adams emphasized the overdose reversal drug’s importance in an advisory last year. (Blakemore, 8/17)

Reuters: CDC Probes Lung Illnesses Linked To E-Cigarette Use
The U.S. Centers for Disease Control and Prevention is investigating a "cluster" of lung illnesses that it believes may be linked to e-cigarette use after such cases were reported in 14 states. The CDC said there was no evidence that an infectious disease was behind the illnesses and that more information was needed to determine whether they were in fact caused by e-cigarette use. (8/18)

The Washington Post: Vaping-Related Lung Illnesses Under Investigation In 14 States
Officials are warning clinicians and the public to be on alert for what they describe as a severe and potentially dangerous lung injury. Symptoms include difficulty breathing, shortness of breath or chest pain before hospitalization. Health officials said patients have also reported fever, cough, vomiting and diarrhea. (Sun and Bever, 8/16)

NPR: Vaping Is Linked To Dozens Of Hospitalizations, Cases Of Lung Damage In Midwest
When Dylan Nelson was admitted to the ICU in July with difficulty breathing, his mother, Kim Barnes. figured it was his asthma acting up. But when she got to the hospital in Burlington, Wis., he couldn't speak. He was intubated. His blood oxygen level was only 10%. He was put into a medically induced coma. Barnes told the nurse she worried she wouldn't see her 26-year-old son again. The nurse reassured her. (Sable-Smith, 8/16)

Stateline: Vaping Craze Prompts New State Taxes
Like the jump in vaping’s popularity, state taxes and regulations have ratcheted up recently. Of the 17 states and the District of Columbia that have specific taxes on vaping products, half implemented them in 2019, according to the Public Health Law Center at the Mitchell Hamline School of Law, which researches the links between public policy and health. The District of Columbia and 17 states (not all of the states are the ones that have raised taxes) have the 21-year-old vaping age limit. (Povich, 8/19)

NPR: Netflix Reduces Onscreen Smoking Of Tobacco But Not Cannabis
When is it wrong to show cigarette smoking on television, but OK to depict people smoking cannabis products, particularly in programming popular among young teenagers? Netflix recently announced it would curb depictions of cigarette smoking in original programming intended for general audiences, after a Truth Initiative study showed its monster summer hit, Stranger Things, featured more tobacco use than any other program on streaming, broadcast or cable. There's tobacco in every single episode. (Ulaby, 8/17)

Stat: Is Roche Starting A Price War In Cancer? Maybe Not 
On Thursday night, Roche (RHHBY) announced that it would price Rozlytrek, its newly approved pill to treat cancer related to specific, rare genetic alterations, at $17,050 a month, about half the cost of a competing drug, Vitrakvi, sold by Eli Lilly and Bayer (BAYRY). Umer Raffat, an analyst at ISI Evercore, sent a note to clients asking if this is a “pricing war in cancer.” He noted that there are safety and efficacy differences between the drugs. “But with all the caveats, this will be a very interesting competitive dynamic to track in coming weeks,” he wrote. (Herper, 8/16)

The Wall Street Journal: Novartis CEO Battles Fallout From Data Manipulation
Novartis AG Chief Executive Vas Narasimhan has spent part of his 18 months at the helm of the drug giant cleaning up issues that emerged before his watch. Now, he is facing a storm of his own making. Dr. Narasimhan said on a call with analysts earlier this month that the company kept a data-manipulation issue under wraps while the Food and Drug Administration completed its review of Novartis’s Zolgensma, the world’s most expensive drug. The Swiss company has said it wanted to finish its own review before alerting the FDA, which it eventually did. (Roland and Burton, 8/18)

The New York Times: How Job Retraining Can Yield Lasting Wage Gains (It Isn’t Cheap)
The economic odds facing Avigail Rodriguez a few years ago couldn’t have been much worse. An undocumented immigrant and a single mother, she lived in a cramped apartment in a tough neighborhood in San Antonio and earned just $9 an hour working as a nurse’s assistant. Today, Ms. Rodriguez, 26, owns her own home in a safer area, earns nearly three times as much as she did before and has secured legal residency. The key to her turnaround was a training program called Project Quest, whose own ability to beat the odds is no less striking than that of Ms. Rodriguez. (Schwartz, 8/19)

The New York Times: Spraying Antibiotics To Fight Citrus Scourge Doesn’t Help, Study Finds
When the Environmental Protection Agency approved the spraying of certain antibiotics three years ago to fight a deadly bacterial infection decimating Florida’s orange groves, growers thought they might have found a silver bullet. But public health advocates reacted with alarm, warning that the large-scale use of medically important drugs in agriculture could help fuel antibiotic resistance in humans. Now a new study by citrus researchers at the University of Florida suggests the spraying of one of the recommended drugs could be for naught. (Jacobs, 8/16)

The Associated Press: Backers Of Rural Dental Care Find Something To Smile About
It can be hard to keep smiles healthy in rural areas, where dentists are few and far between and residents often are poor and lack dental coverage. Efforts to remedy the problem have produced varying degrees of success. The biggest obstacle? Dentists. Dozens of countries, such as New Zealand, use "dental therapists" — a step below a dentist, similar to a physician's assistant or a nurse practitioner — to bring basic dental care to remote areas, often tribal reservations. (Villeneuve, 8/18)

The Washington Post: How Old Is Too Old To See A Pediatrician?
When Joann Alfonzo, a pediatrician in Freehold, N.J., walked into her office recently she mentally rolled her eyes when she saw her next patient: a 26-year-old car salesman in a suit and tie. “That’s no longer a kid. That’s a man,” she recalls thinking. Yet, Alfonzo wasn’t that surprised. In the past five years, she has seen the age of her patients rise, as more young adults remain at home and, thanks to the Affordable Care Act, on their parents’ health insurance until age 26. (Chesler, 8/18)

The Washington Post: Supplements For Kids Are On The Shelves But May Not Be Safe
Amy Martin’s 3-year-old twins were sick yet again — and the Anacortes, Wash., mom was fed up. “We were just getting cold after cold,” she says. Her solution: Dietary supplements. She searched online for ideas, then picked up a bottle of elderberry gummies. She wasn’t alone. Google logged over a half-million searches for “elderberry for colds” in the past year, and the market for elderberry products is growing. (Blakemore, 8/18)

The Wall Street Journal: The War On Sugar Hits The Juice Box
When the juice boxes are served at children’s birthday parties, Gabrielle Gard hands her son his own box—of flavored water. The 28-year-old accountant in Lakeland, Fla., doesn’t want her son Asa, almost 2, drinking real juice. To help limit sugar, she digs into her bag for a juice-box alternative: Hint brand “fruity water,” whose label promises it has “no juice, no sugar” but is “fun, delicious, parent approved.” (Chaker, 8/18)

NPR: Could The App Mahmee Save New Moms' Lives?
The U.S. has the worst rate of maternal deaths in the developed world. Thousands of women — especially black women — experience pregnancy-related complications just before or in the year after childbirth, and about 700 women die every year from them, according to the Centers for Disease Control and Prevention. Tech startup Mahmee wants to change that. Founded in 2014, the company works to help women during the weeks and months after they've given birth, via a mobile app that's designed to better connect new moms with health care and support, offering tools like surveys to assess their postpartum emotional and physical health. (Tobias and Neilson, 8/18)

NPR: Pain Eased By 'Virtual Reality' Explorations Of Nature
Virtual reality is not new. But, as people search for alternative ways to manage pain — and reduce reliance on pills — VR is attracting renewed attention. Imagine, for a moment you've been transported to a sunlit lagoon. And, suddenly, it's as if you're immersed in the warm water and swimming. That's what Tom Norris experiences when he straps on his VR headset. (Aubrey, 8/19)

Los Angeles Times: Here's Why It's Premature To Say That Ebola Has Been 'Cured'
Amid a year-long Ebola outbreak that has no end in sight, this week’s headlines were unusually upbeat: “Ebola is now curable,” one proclaimed. “Ebola has finally been cured, say scientists,” announced another. “Ebola ‘no longer incurable’ as Congo trial finds drugs boost survival,” a third promised. (Baumgaertner, 8/16)

The New York Times: Getting The Right Care For Painful Autoimmune Conditions
Beth Uffner, an avid tennis player, developed an aching pain first in her legs, then in her shoulders that got progressively worse until she lacked the strength to get out of a chair unaided, let alone play tennis. Faith Sullivan, a novelist, developed a headache so devastating that she could hardly read and had to take a fistful of aspirin to get through a scheduled talk about her books. Both women were in their mid-70s when they were seized by different but related inflammatory autoimmune conditions — polymyalgia rheumatica in Ms. Uffner, temporal arteritis in Ms. Sullivan. (Brody, 8/19)

The Washington Post: How D.C.’s Historic Columbia Hospital For Women Became A Trader Joe’s, Expensive Condos
Dwayne Lawson-Brown couldn’t find a home in his hometown. He spent over a year searching the District in 2016, but everything was too pricey. Frustrated and mourning the Washington he knew as a child, Lawson-Brown, 35, decided to list all the places he’d “lost.” The list became a poem — a poem centered on the Columbia Hospital for Women. (Natanson, 8/18)

The Washington Post: Arlington Finalizes Mental-Health Court Plan, But Advocates Say It Won’t Go Far Enough
After 15 years of failed efforts, Arlington is close to starting a specialized court program to address mental illness in the criminal justice system. But advocates say they were shut out of a plan that is now moving too quickly and would help too few people. “This is an issue of national importance,” said Naomi Verdugo, an advocate who helped organize a forum Thursday night to solicit comments on a plan expected to be sent to the Virginia Supreme Court for approval this fall. Most people in the criminal justice system, she noted, start in local jails. (Weiner, 8/16)

Los Angeles Times: Power Shutoffs Can Prevent Wildfires, But Put Vulnerable People At Risk
Cecilia Santillano faced a difficult decision last year before the power went out in her Simi Valley neighborhood: Ignore her monthly bills and buy a generator, or hope the batteries on her husband’s ventilators would outlast the next outage. “If I didn’t have the generator and there was no power and no sign of it getting turned on, George could start passing away,” said Santillano, whose husband suffers from a rare autoimmune disease and is bound to a wheelchair. “They are expensive and I didn’t want to buy it, but I’d rather be safe.” (Luna, 8/18)

NPR: Amid Homelessness Crisis, Los Angeles Restricts Living In Vehicles
Along a big, commercial street in L.A.'s North Hollywood area, near a row of empty storefronts, about a half dozen motor homes sat parked on a recent morning. Inside one of them, 67-year-old Edith Grays and her husband watched TV with the door open. Grays said they'd been there a few days, despite a two-hour parking limit. "Thank God they're not bothering us right now," she said. (Scott, 8/19)