First Edition: June 18, 2018

Kaiser Health News: Unwieldy Health Costs Often Stand Between Teachers And Fatter Paychecks
As teacher strikes flared this spring in more than half a dozen states, from West Virginia to Arizona, protesters bemoaned stagnant salaries, overcrowded classrooms and a lack of basic supplies like textbooks and computers.But often missing from hand-scrawled placards and fiery speeches was an issue that has contributed greatly to the financial woes of America’s schools: skyrocketing health care costs. Many teachers, like other public employees, have traditionally accepted a trade-off: In exchange for relatively low salaries, they could expect relatively generous benefits, including pensions and low- or no-cost health premiums. (Huetteman, 6/18)

Kaiser Health News: Postcard From D.C. Courthouse: Medicaid Work Requirements And Manafort
It’s probably safe to say that the scrum of reporters — noses and lenses pressed up to the glass doors of the E. Barrett Prettyman Federal Courthouse in Washington, D.C., — were not there to cover a hearing regarding Kentucky’s work requirements for some Medicaid recipients. No, the news satellite trucks parked outside and long queue of spectators stacked up against the building where there to catch a glimpse of Paul Manafort, President Donald Trump’s former campaign chairman, who was appearing that same morning before another judge in another federal courtroom. (Bluth, 6/15)

The Hill: Doctors Group Warns Of Health Risks For Migrant Children Separated From Parents 
Medical experts are cautioning that there are long-term health risks for migrant children who are separated from their parents, including "irreplaceable harm" to those children's lifelong development. “[It can] cause irreparable harm to lifelong development by disrupting a child’s brain architecture,” American Academy of Pediatrics (AAP) President Colleen Kraft told BuzzFeed News this week. “Immigration has become so politicized. We would really like people to sit back instead and think of the health of these children.” (Sanchez, 6/16)

The Wall Street Journal: Trump Policy Of Separating Migrant Families Threatens To Engulf Immigration Talks
The administration is facing increasing pressure on existing facilities, even without the possibility of new facilities to detain families together. The Department of Health and Human Services’ Office of Refugee Resettlement is adding bed space after eclipsing more than 11,000 children in its custody. A temporary, soft-sided structure has been erected in Tornillo, Texas, near El Paso, as part of that expansion. Eric Hargan, deputy secretary of HHS, said in a statement Sunday that the agency had welcomed lawmakers’ tours and that the semi-permanent structures—including at Tornillo—had ventilation and cooling “to ensure appropriate temperature” for the minors placed there, who, he said, were all teenagers. (Radnofsky, Hackman and Caldwell, 6/17)

Politico: 'Grim Sight': Migrants Await Uncertain Future At Strained Border Patrol Facility
The family separations that stem from the Trump policy add a new burden. On top of overseeing the welfare of people housed there, staff at the McAllen facility coordinate sending children to detention centers run by the Department of Health and Human Services’ Office of Refugee Resettlement while their parents head to court. There are only 10 permanently assigned agents at the facility, though officials would not say how many contract or other staff were on site. (Schor, 6/17)

Los Angeles Times: Texas Border Patrol Center Where Immigrant Families Are Separated Draws Lawmakers, Protest
The center costs about $12.1 million to operate annually, compared with the entire sector’s budget of $15 million. Built for 1,500 people, it has held more than 2,000 recently. It has a staff of 10 but due to the influx, Padilla added 300 more, about 10% of his workforce. There’s a medical unit with three paramedics, two medical staffers and space to quarantine those who have contracted chicken pox, scabies and other communicable diseases. There is no mental health staff, and agents have not received mental health training since the Trump administration “zero tolerance” policy was implemented May 6. (Hennessy-Fiske, 6/17)

Los Angeles Times: Was A Breastfeeding Infant Really Taken From An Immigrant Mother? The Answer To This And Other Questions About Families Separated At The Border
This week, Health and Human Services opened what it called a “soft-sided” and “semi-permanent” shelter for 360 unaccompanied minors outside El Paso in Tornillo, Texas. The tents, however, are air conditioned. Immigrant advocates decried the desert shelter as a “tent city.” Similar facilities were erected after an influx of Central American families arrived in the U.S. in 2014, but were later dismantled. Health and Human Services is also considering whether to open temporary shelters at military bases near the border, as it did in 2012. (Hennessy-Fiske, 6/16)

The New York Times: Theranos Founder Elizabeth Holmes Indicted On Fraud Charges
Elizabeth Holmes, the disgraced founder of Theranos, the lab testing company that promised to revolutionize health care, and its former president, Ramesh Balwani, were indicted on Friday on charges of defrauding investors out of hundreds of millions of dollars as well as deceiving hundreds of patients and doctors. The criminal charges were the culmination of a rarity in Silicon Valley — federal prosecution of a technology start-up. This one boasted a board stacked with prominent political figures and investors, and a startling valuation of $9 billion just a few years ago. (Abelson, 6/15)

The Wall Street Journal: U.S. Files Criminal Charges Against Theranos’s Elizabeth Holmes, Ramesh Balwani
The indictments of Ms. Holmes and Ramesh “Sunny” Balwani, Theranos’s former president and chief operating officer who was also Ms. Holmes’s boyfriend, are the culmination of a 2½-year investigation by the U.S. attorney’s office in San Francisco, sparked by articles in The Wall Street Journal that raised questions about the company’s technology and practices. (Carreyrou, 6/15)

The Associated Press: Theranos CEO Elizabeth Holmes Charged With Criminal Fraud
Holmes, who was once considered a wunderkind of Silicon Valley, and her former Chief Operating Officer Ramesh Balwani, are charged with two counts conspiracy to commit wire fraud and nine counts of wire fraud each, the U.S. Attorney's Office for the Northern District of California said late Friday. If convicted, they could face prison sentences that would keep them behind bars for the rest of their lives, and total fines of $2.75 million each. Prosecutors allege that Holmes and Balwani deliberately misled investors, policymakers and the public about the accuracy of Theranos' blood-testing technologies going back to at least 2013. Holmes, 34, founded Theranos in Palo Alto, California, in 2003, pitching its technology as a cheaper way to run dozens of blood tests. (6/15)

The New York Times: Major Study Of Drinking Will Be Shut Down
The extensive government trial was intended to settle an age-old question about alcohol and diet: Does a daily cocktail or beer really protect against heart attacks and stroke? To find out, the National Institutes of Health gave scientists $100 million to fund a global study comparing people who drink with those who don’t. Its conclusions could have enshrined alcohol as part of a healthy diet. (Rabin, 6/15)

The Associated Press: NIH Ends Alcohol Study, Citing Funding, Credibility Problems
The National Institutes of Health used money from the alcohol industry to help pay for a study that ultimately was expected to cost $100 million. It's legal for NIH to use industry money in addition to taxpayer dollars for research as long as certain rules are followed. The problem: An NIH investigation concluded Friday that a small number of its employees had close contact with industry officials that crossed those lines. Some of those interactions "appear to intentionally bias" the study so that it would have a better chance of showing a benefit from moderate alcohol consumption, said NIH Deputy Director Lawrence Tabak. (Neergaard, 6/15)

The Washington Post: NIH Cancels $100 Million Study Of Moderate Drinking As Inescapably Compromised
NIH Director Francis S. Collins said the results of the 10-year, $100 million study would not be trusted because of the secretive way in which staff at an institute under NIH met with major liquor companies, talked to them about the trial’s design and convinced them to pick up most of the tab for it. “Many people who have seen this working-group report were frankly shocked to see so many lines crossed,” he said, calling the staff interaction with the alcohol industry “far out of bounds.” (Wan and Bernstein, 6/15)

The Wall Street Journal: NIH Ends Study On Health Benefits Of Alcohol, Citing Improper Ties To Industry
In a meeting Friday of an advisory board to Dr. Collins, Lawrence A. Tabak, NIH principal deputy director, said an outside report on the study that was commissioned by the NIH concludes that NIAAA officials “appear to have intentionally biased the framing of the scientific premise” of the study in the direction of focusing on possible benefits of alcohol. The report said that email correspondence involving NIAAA staff, outside researchers and the alcohol industry “appear to be an attempt to persuade industry to provide funding” for the study. Also at the meeting, NIAAA director George Koob said, “I’m disappointed in what transpired. I think the trial is irrevocably damaged.” (Burton, 6/15)

Los Angeles Times: Ties Between Researchers And Alcohol Producers Prompt NIH To Shut Down Study Of Moderate Drinking
The plan was to enroll 7,800 people ages 50 and up who did not have diabetes. Some of them would be randomly assigned to consume about 15 grams of alcohol per day. The others would be asked to abstain from drinking. Researchers from Beth Israel Deaconess Medical Center in Boston, along with colleagues in the United States, Nigeria, Denmark and the Netherlands, would then follow these volunteers for about six years to see whether the moderate drinkers developed fewer cases of cardiovascular disease and diabetes compared to their teetotaling counterparts. (Kaplan, 6/15)

The Wall Street Journal: At Veterans Affairs, Trump To Try His Luck With A Washington Insider
The last two secretaries of the Department of Veterans Affairs were private-sector outsiders intent on bringing expertise from beyond Washington’s Capital Beltway into the VA. But Robert Wilkie, President Donald Trump’s presumptive nominee to head the department, is the opposite—a long-serving public official steeped in federal bureaucracy. Mr. Wilkie has decades of experience in government and familiarity with the companies and industries that rely on it, and now is expected to take over a sprawling department that has been on the verge of large-scale changes. (Kesling, 6/15)

Politico: Republicans Give Up On Medicare Overhaul
Republicans on Capitol Hill are giving up on what might be their last best chance to overhaul Medicare, just as they’re losing their leading champion on the issue, House Speaker Paul Ryan. The quiet surrender on a subject that’s energized GOP fiscal hawks for the better part of a decade comes as new projections show Medicare’s trust fund in its worst shape since the recession, partly because of Republicans’ other chief obsession: their sweeping tax cuts. (Cancryn and Ferris, 6/15)

The Hill: Key Takeaways From Lawsuit Against Kentucky's Medicaid Work Requirements
Attorneys for the Department of Health and Human Services (HHS), as well as Kentucky Gov. Matt Bevin (R), began their legal fight Friday against a group of activists from the state who are suing the Trump administration over the approval of Kentucky’s Medicaid waiver. Bevin has repeatedly said the state’s Medicaid expansion under ObamaCare is not fiscally sustainable, and that the waiver is needed to bring down the costs of covering so many new individuals. Kentucky was the first state in the country to win permission from the Trump administration to impose conservative Medicaid regulations. (Weixel, 6/15)

Stat: Drug Maker's Donations Of Overdose Antidote Were Close To Expiring
But STAT found that the auto-injectors donated to some police agencies through the Kaleo Cares program were just months away from expiration. One police department in Massachusetts threw away scores of expired injectors because it couldn’t use them fast enough. An agency in a medium-sized North Carolina city donated expired product to a local nonprofit willing to accept them. In interviews with officers at more than a dozen law enforcement agencies, nine said they had received naloxone anywhere from four to 11 months away from expiration. Fresh off the production line, naloxone typically has a shelf life of two years. Kaleo, for its part, says patients prescribed Evzio can expect to receive auto-injectors with a shelf life of over a year. (Blau, 6/18)

Stat: Exactly Who Is Coordinating The White House Drug Policy?
For at least six months, staffers in the Office of National Drug Control Policy — often political appointees in their 20s — have crossed 17th Street, entered the Eisenhower Executive Office Building, and sat through weekly meetings of an “opioids cabinet” chaired by Kellyanne Conway. Then they have returned to their desks and reported back to veteran career staff — who have listened, often with disappointment, to the ideas proposed by Conway and Katy Talento, a domestic policy adviser. (Facher, 6/18)

The Hill: Congress Tackles Mounting Opioid Epidemic 
House Republicans are beefing up their efforts to tackle the nation's deadly opioid crisis, but some experts question how effective their piecemeal approach will be. Congress is touting its recent flurry of action — the House is on track to pass more than 50 bills addressing the issue by the end of this week — on an issue that is hitting many constituents hard, and one that lawmakers are sure to hear about on the campaign trail this year. (Zanona and Roubein, 6/17)

The Associated Press: Overdose Death Toll Declines In County Hit Hard By Opioids
A hard-hit Ohio county that expanded availability of naloxone during the opioid epidemic has been seeing a decline in its overdose death toll. Hamilton County's program of increasing overdose antidote availability and quick response to requests for addiction treatment started last fall, the Cincinnati Enquirer reported. Public health officials increased distribution of the overdose-reversing Narcan nasal spray by 375 percent over a seven-month period. (6/17)

NPR: States Weigh Weed As An Opioid Alternative
A painkiller prescription could become a ticket for medical marijuana in Illinois. Lawmakers there passed a bill making anyone with a prescription for opioids eligible for its medical cannabis program. With this move, Illinois joins a growing number of states turning to legal cannabis in the fight against painkiller addiction. (Herman, 6/15)

The New York Times: A Family In Transition
Paetyn, an impish 1-year-old, has two fathers. One of them gave birth to her. As traditional notions of gender shift and blur, parents and children like these are redefining the concept of family. Paetyn’s father Tanner, 25, is a trans man: He was born female but began transitioning to male in his teens, and takes the male hormone testosterone. "I was born a man in a female body,” he said. (Grady, 6/16)

Modern Healthcare: Growing Recognition Of Gray Areas In Gender Identity Leads To Changes In EHRs 
A new field is beginning to pop up on patient registration forms: preferred pronouns. The healthcare industry, notoriously slow to change culturally and technologically, is beginning to speed up in both areas when it comes to gender identity. To do that, electronic health record vendors and health systems alike are pushing to include gender identity alongside other patient information. As with any piece of data in an EHR, the question is where to put it, which options to include, and what to do with the information once it's there. (Arndt, 6/16)

Los Angeles Times: Scant Abortion-Related ER Visits Suggest There's No Medical Basis For Restrictive Laws, Study Says
Abortions send women to hospital emergency rooms at lower rates than such routine procedures as colonoscopies and surgeries to have wisdom teeth removed, new research has found. In fact, for every 100,000 abortions provided, about 108 women sought out emergency care for what they thought was a complication of the procedure. (Healy, 6/15)

USA Today: Millions Of U.S. Kids Are Growing Up Without A Father In Their Lives
Father’s Day is different when there’s no father around."What do these days mean to children like me who had to grow up without one parent in their lives?" asks Louis Steptoe, 18, who just graduated from high school here. Instead, he celebrates what he calls "Father Figure Day" and honors his godfather, William Ford, who "was always present." Kaylynn Tobin, 12, of Rockville, Maryland, met her father only once, years ago, and barely remembers him. Her sister Aras, 10, has a different father and sometimes gets gifts from him. But she doesn’t have a good relationship with her father. (O'Donnell and Lewter, 6/15)

NPR: Millennial Stay-At-Home Dads: Isolation And Stigma Still A Problem
The number of men in the United States who are full-time, stay-at-home parents has risen steadily in recent decades, from maybe a million or so in 1984, according to a Pew Research Center estimate, to roughly double that in 2014. That's still much smaller than the number of stay-at-home moms, of course, and many of the challenges these dads face are universal to parenting. "It's a tough job," says Ben Sanders, who's raising two young boys in Haymarket, Va. His kids are 3 ½ and 6 ½ years old. "There are no breaks. It's 24/7. There's no vacation. You can't get sick." (Beaubien, 6/17)

The New York Times: Video Game Addiction Tries To Move From Basement To Doctor’s Office
Video games work hard to hook players. Designers use predictive algorithms and principles of behavioral economics to keep fans engaged. When new games are reviewed, the most flattering accolade might be “I can’t put it down.” Now, the World Health Organization is saying players can actually become addicted. (Hsu, 6/17)

The Washington Post: Compulsive Video-Game Playing Now New Mental Health Problem
The U.N. health agency said classifying “Gaming Disorder” as a separate condition will “serve a public health purpose for countries to be better prepared to identify this issue.” Dr. Shekhar Saxena, director of WHO’s department for mental health, said WHO accepted the proposal that Gaming Disorder should be listed as a new problem based on scientific evidence, in addition to “the need and the demand for treatment in many parts of the world.” (Keaten and Cheng, 6/18)

The Washington Post: Rebel Developers Are Trying To Cure Our Smartphone Addiction — With An App
To understand why it’s so hard to pry yourself free from your phone, Facebook account and Twitter, you need to know about B.F. Skinner’s pigeons. In the 1950s, Skinner began putting the birds in a box and training them to peck on a piece of plastic whenever they wanted food. Then the Harvard psychology researcher rigged the system so that not every peck would yield a tasty treat. It became random — a reward every three pecks, then five pecks, then two pecks. (Wan, 6/17)

USA Today: Therapy Apps: As Suicide Rates Rise, Do Apps Damage Or Deliver?
Following the birth of her third child, Kristin Rulon took a birth-control shot that triggered a wave of depression and anxiety. The 32-year-old suburban Kansas City, Missouri, mother and writer explored natural remedies before joining the millions of Americans who’ve turned to mobile-device apps that offer therapy via text messages. A therapist from the BetterHelp app in early 2016 typically exchanged three to four daily texts with Rulon from morning to bedtime. The access was great, Rulon said, but the $28 weekly charge for unlimited texting not covered by health insurance became too expensive. And Rulon worried that texts could not convey everything she wanted to share. (Alltucker, Connor and O'Donnell, 6/15)

The New York Times: Are Genetic Testing Sites The New Social Networks?
Three years ago Dyan deNapoli, a 57-year-old author and TED speaker who specializes in penguins, was given a 23andMe genetic testing kit for her birthday. Intrigued, she spit in the tube and sent the results to a lab in Burlington, N.C. About two months later she received a pie chart breaking down where her ancestors lived (99.4 percent of them were from Europe). What she was most giddy about, however, was a 41-page list of all the people who had done the test and were genetically related to her: 1,200 in all. (Customers can choose whether their information is shared with others.) (6/16)

NPR: Home DNA Testing For Health Has Pros And Cons
Rita Adele Steyn's mother had a double mastectomy in her 40s because she had so many lumps in her breasts. Her first cousin died of breast cancer. And Steyn's sister is going through chemotherapy for the disease now. So Steyn worries she might be next. "Sometimes you feel like you beat the odds. And sometimes you feel like the odds are against you," said Steyn, 42, who lives in Tampa, Fla. "And right now I feel like the odds are against me." (Stein, 6/18)

The Wall Street Journal: Can Ultrasonic Noise Make You Sick?
Can what you don’t hear hurt you? Researchers are studying whether the largely inaudible interplay of ultrasound beams from sensors and other devices can trigger headaches and dizziness. Those were among symptoms reported by some U.S. diplomatic personnel stationed in China and Cuba who returned home in the past year after becoming incapacitated. Ultrasonic signals are almost everywhere but the side-effects from so many transmissions remain a mystery, several experts said. (Hotz, 6/16)

The New York Times: Salmonella Outbreaks Affect Kellogg’s Honey Smacks Cereal And Cut Fruit
As a salmonella outbreak that sickened dozens forced a recall of some cereal products this week, federal officials announced that a separate outbreak linked to cut fruit has expanded to almost two dozen states. The outbreak linked to Kellogg’s Honey Smacks cereal had sickened 73 people in 31 states as of Thursday, according to a statement from the Centers for Disease Control and Prevention; 24 of them had been hospitalized and no deaths had been reported. (Hauser, 6/15)

The Washington Post: Educational Toys May Not Buy More Brains
It’s easy to look down at your bundle of joy and imagine a glowing future. Surely your child will be the best and brightest — and if you care about their intellectual development, you might try to smooth their path with an educational toy that promises to develop baby’s skills. But are those toys a smart buy? Science writer Erik Vance takes on that question in the June edition of Scientific American. His article, “Sorry, Mom and Dad, Toys Cannot Supercharge Your Baby,” cuts down to size an industry that makes outsize promises and rakes in billions, and it may make you think twice before buying a toy that promises to make your baby a brainiac. (Blakemore, 6/17)

The Washington Post: Little By Little, Domestic Violence Shelters Become Pet-Friendly
Her boyfriend became abusive about six months after they met. He would drink himself into a stupor and tear the house apart while screaming and insulting her, once even threatening to snap her neck. She worried for herself, but also for her beloved golden retriever, Cody, whom she had rescued from an abusive former owner. “The biggest argument I had with him in the beginning was saying, ‘Do not raise your voice in front of the dog. Don’t scream and yell in front of her. Don’t throw things around her,’ ” recalled K., a steely 44-year-old who spent two decades in the military. “ ‘These things traumatize her.’ ” (Strauss and Brulliard, 6/15)

Stateline: Many Recommend Teaching Mental Health In Schools. Now Two States Will Require It.
Amid sharply rising rates of teen suicide and adolescent mental illness, two states have enacted laws that for the first time require public schools to include mental health education in their basic curriculum. Most states require health education in all public schools, and state laws have been enacted in many states to require health teachers to include lessons on tobacco, drugs and alcohol, cancer detection and safe sex. Two states are going further: New York’s new law adds mental health instruction to the list in kindergarten through 12th grade; Virginia requires it in ninth and 10th grades. (Vestal, 6/15)

The Associated Press: State Appeals Court Reinstates California's Right-To-Die Law
A state appeals court has reinstated — at least for now — California's law allowing terminally ill people to end their lives. The Fourth District Court of Appeals in Riverside issued an immediate stay Friday putting the End of Life Option back into effect. The court also gave opponents of its decision until July 2 to file objections. (6/15)

The Associated Press: Texas Heart Transplant Program Resumed After Suspension
A Houston hospital announced Friday that it has reactivated its renowned heart transplant program after a two-week suspension of all medical procedures following the deaths this year of several patients. Baylor St. Luke's Medical Center's decision to temporarily halt its program came after a series of joint reports by the Houston Chronicle and ProPublica revealing the departure of several top physicians and an unusually high number of patient deaths in recent years. (6/15)

The Associated Press: California Moves To Clear Coffee Of Cancer-Risk Stigma
California officials, having concluded coffee drinking is not a risky pastime, are proposing a regulation that will essentially tell consumers of America's favorite beverage they can drink up without fear. The unprecedented action Friday by the Office of Environmental Health Hazard Assessment to propose a regulation to clear coffee of the stigma that it could pose a toxic risk followed a review of more than 1,000 studies published this week by the World Health Organization that found inadequate evidence that coffee causes cancer. (6/16)

The Washington Post: Puerto Rico Struggles With Jump In Asthma Cases Post-Maria
Shortly after he turned 2, Yadriel Hernandez started struggling to breathe. His doctor prescribed an inhaler and an allergy pill for asthma, and his symptoms were mostly under control. Then Hurricane Maria devastated Puerto Rico, strewing mold-producing wreckage across the island and forcing many to use fume-spewing generators for power. The boy, now 8, started having twice-monthly attacks and needing nearly four times the amount of medicine he used to take. (Coto, 6/18)

The Associated Press: California ER Doctor Seen On Video Mocking Patient Suspended
A Northern California emergency room doctor has been suspended after cursing and mocking a man who said he had an anxiety attack. The San Jose Mercury News reports that Dr. Beth Keegstra, a contract doctor with El Camino Hospital in Los Gatos, was suspended after she was recorded on June 11 questioning whether 20-year-old Samuel Bardwell was sick or just looking for drugs. (6/17)