www.wvgazettemail.com Health http://www.wvgazettemail.com Gazette archive feed en-us Copyright 2016, Charleston Newspapers, Charleston, WV Newspapers WVU football great Huff at center of family dispute http://www.wvgazettemail.com/article/20160902/GZ0115/160909870 GZ0115 http://www.wvgazettemail.com/article/20160902/GZ0115/160909870 Fri, 2 Sep 2016 17:11:15 -0400 By Rick Maese and Julie Tate The Washington Post By By Rick Maese and Julie Tate The Washington Post On March 31, just four days after Easter, Catherine Huff visited Huff Farm, the sprawling Middleburg, Virginia, estate with fields fit for horses, rooms filled with football memorabilia and home to one of the most famous men to ever play for the Washington Redskins. She picked up her father, Sam Huff, the Hall of Fame linebacker, to take him to a dentist appointment. Nothing seemed amiss to Carol Holden, Huff's live-in domestic and business partner of nearly three decades.

"Ms. Holden had no idea that [Huff's daughter] had no plans of bringing Mr. Huff back to Middleburg or returning him to Huff Farm," according to court records.

Five months later, Huff -- perhaps the greatest football player ever at West Virginia University -- still has not returned. The 81-year-old member of the Pro Football Hall of Fame suffers from dementia, according to court papers, related to either Alzheimer's or chronic traumatic encephalopathy, a degenerative brain disease researchers link to playing football. He now finds himself caught in the middle of a family dispute over who should be making medical and financial decisions on his behalf.

Holden filed a petition in May for Huff to be returned to her care, asking the court to grant an emergency appeal and appoint her as Huff's guardian.

"It appears that [Huff's daughter] is not concerned at all with Mr. Huff's best interests," Holden alleged in one court filing, "but rather in advancing her own needs and interests over those of her father or exacting revenge against Ms. Holden."

There is a hearing on Holden's emergency motion scheduled for Sept. 16 in Loudoun County Circuit Court. Catherine Huff has recently changed lawyers, and her new attorney, Eric Schell, said he'll seek to postpone that date. He would not comment further on the case and said his client was unavailable to comment.

In Catherine Huff's filings, she said her father was evaluated in July and "is incapacitated and is unable to make his own medical and financial decisions." She alleged that under Holden's care, her father was "seen wearing the same clothes day to day," would walk outside in the winter without appropriate attire and was allowed to drive his car on the road, putting himself and others at risk.

Holden's attorney, Kimberley Murphy, declined to comment.

Huff was known as his generation's most bruising, hard-nosed player, personifying toughness in a hard-scrabble era of football. He was inducted into the Hall of Fame in 1982 after 13 seasons, eight with the New York Giants and his last five in Washington.

He began broadcasting Redskins' games in 1975 and stayed behind the mic until finally stepping away in 2013. For most of that time, he offered color commentary alongside his friend and former teammate Sonny Jurgensen, their folksy banter helping to draw together a region of football fans every fall.

When Huff left Middleburg in March, his daughter did not take any of his medications, clothing or belongings with her, according to Holden's petition. He apparently has been living in Alexandria, Virginia, with Catherine Huff and has had little contact with friends, neighbors and associates he'd known for years in Middleburg.

Holden and Huff never married. In court filings, Holden describes herself as Huff's "life partner "of nearly 29 years, a characterization that Huff's daughter calls inaccurate in her legal response.

The dispute does not appear to be a matter of money but rather a disagreement over who can make decisions on Huff's behalf. Both sides agree that the former football great is in no condition to do so on his own.

Holden explained that Huff first had a diagnosis of dementia in 2013 and is partially incapacitated. "While Mr. Huff can dress and undress himself and eat without assistance, he requires assistance with certain personal affairs and management of his financial affairs," Holden stated.

While Holden has requested an emergency change of guardianship, Huff's current condition is not clear. According to his daughter's filings, Huff is receiving care from a "geriatric care manager" and could soon relocate to West Virginia, where Huff was born, raised and became a college football star. The court appointed a guardian ad litem in May to represent Huff's interests.

His absence around the Redskins and Middleburg has not gone without notice. For several years, longtime friend Franklin Payne met Huff for breakfast at the Red Fox Inn in Middleburg. Eight o'clock, every single morning.

"I have not been in touch with Sam since he was kidnapped and taken away from Middleburg," Payne said. "I would like to see Sam back here. He has so many friends here, and everybody knew him. We just don't know how he's doing."

In her filings, Holden makes the argument that Huff didn't willingly leave his home of nearly three decades - "his comfort zone, routine, friends and everything he knows and loves," she said.

In 2011, Huff granted his daughter durable power of attorney, giving Catherine Huff control over his finances in the event he becomes incapacitated. That same day, he executed an Advance Medical Directive naming Holden his agent responsible for health care decisions, court filings show.

Five years later, on April 16, barely two weeks after Huff left Middleburg, he signed another Advance Medical Directive, this time appointing his daughter as chief agent in charge of medical decisions and naming his ex-wife as successor agent.

In a court response, Holden said that Huff was not of sound mind to make such a decision and said that Huff's divorce was "contentious." She said he'd never appoint his ex-wife to have any role in his affairs. Holden paints Huff's daughter as someone unfit to properly care for him, noting an April 21 incident in which she alleges that Catherine Huff arrived at Huff Farm unannounced.

"She told Ms. Holden to pick which magazines by the kitchen table she wanted because [Huff's daughter] was going to burn the rest," the petition asserts.

The document claims that Catherine Huff called Loudoun County Fire and Rescue herself to warn that she was "going to start a fire" and then did just that, setting aflame two of Huff's books, his slippers and some magazines and pictures. Photos of what Holden says are the burned items are included in the court filing as exhibits.

"During the entire incident [Huff's daughter] was screaming incessantly, acting belligerent and accused Ms. Holden of stealing from Mr. Huff," according to Holden's petition.

In her response to the court, Huff denied the incident but offered no other details. A spokesman for the Loudoun County Sheriff's Office confirmed deputies responded to a call over a civil matter at Huff's address on that date but because it was a civil matter, there was no criminal incident report.

There are no indications that either party is seeking to amend Huff's trust or will. Holden's petition says Huff's estate has a value of approximately $4 million. In addition Catherine Huff, the football great has two sons, neither of whom was reachable to comment. Along with Huff's three children, Holden stands to inherit a sizable portion of that. The former linebacker's will stipulates that Holden and Huff must be "living together at the time of my death," but later points out that if the two are living apart because he required health or custodial care, "we shall nevertheless, for purposes of this Restatement, be deemed to have been living together," according to his trust agreement.

After decades in the spotlight - first as a star with the New York Giants and later as the familiar face and voice of the Redskins - Huff has spent the past couple of years in quiet retirement in Middleburg. With his memory and observation skills slipping, Huff took on a lighter broadcasting schedule in 2012 before leaving the booth entirely a year later.

Even then, he and Holden still ran the West Virginia Breeders Classics, the October thoroughbred races in Charles Town, West Virginia, and broadcast their weekly horse racing radio show from the second-floor studio of their home. The two are both longtime horse connoisseurs and bought and sold many horses together over the years. They began the Trackside radio show in 1989 and broadcast their final show in January.

Gupta named new medical association president http://www.wvgazettemail.com/article/20160902/GZ0115/160909892 GZ0115 http://www.wvgazettemail.com/article/20160902/GZ0115/160909892 Fri, 2 Sep 2016 14:35:06 -0400 From staff reports By From staff reports Dr. Rahul Gupta, state health officer and commissioner of the West Virginia Bureau for Public Health, has been named president of West Virginia State Medical Association.

Gupta, the former health officer for the Kanawha-Charleston Health Department, will replace past president Dr. Hoyt Burdick. A practicing internist, Gupta serves as an adjunct professor in the Department of Health Policy, Management and Leadership at the West Virginia University School of Public Health and adjunct associate professor at the University of Charleston's School of Pharmacy.

Gupta has previously taught at both Meharry Medical School and Vanderbilt University, both in Nashville, Tennessee. He earned his medical degree from the University of Delhi, and completed his residency at St. Joseph's Hospital at Northwestern University. Gupta also holds a masters in public health from the University of Alabama - Birmingham and is pursuing a masters in business administration from the London School of Economics.

Suicide memorial exhibit to visit West Virginia University http://www.wvgazettemail.com/article/20160902/GZ0115/160909909 GZ0115 http://www.wvgazettemail.com/article/20160902/GZ0115/160909909 Fri, 2 Sep 2016 10:23:02 -0400 MORGANTOWN, W.Va. - West Virginia University will host a traveling exhibit of 1,100 empty backpacks to represent the number of college students who die of suicide each year.

A news release from the university said the free exhibit will be Tuesday in front of Woodburn Hall from 9:30 a.m. to 4:30 p.m.

Clinical director T. Anne Hawkins of the Carruth Center for Psychological and Psychiatric Services says it's hoped the exhibit will raise awareness of services available on campus and offer a place to reflect for people affected by suicide. Staff from the center will be available to provide support during the event.

The exhibit, called "Send Silence Packing," was first unveiled in 2008 on the National Mall in Washington.

- The Associated Press

Affordable Care Act, banking regulations part of discussion at WV Chamber conference http://www.wvgazettemail.com/article/20160831/GZ03/160839898 GZ03 http://www.wvgazettemail.com/article/20160831/GZ03/160839898 Wed, 31 Aug 2016 18:23:56 -0400 Andrew Brown By Andrew Brown WHITE SULPHUR SPRINGS - The Affordable Care Act needs to be changed. Wall Street banking regulations need to be repealed. Republicans need to stay in control of the West Virginia Legislature. And natural gas companies need to be able to drill for minerals in the Mountain State, even if some of the property owners are unwilling sign a new lease.

Those were some of the messages that were shared during the first day of the West Virginia Chamber of Commerce's annual conference, an event that allows business executives, lobbyists and the state's political elite to mingle in luxury.

The event, which is being held at the historic Greenbrier resort, will be at the center of West Virginia's business and political universe over the next three days.

It will include speeches by some of the state's biggest corporate leaders, a large number of mostly Republican state lawmakers, West Virginia's entire congressional delegation and the state's two major-party candidates for governor.

"This is where deep personal relationships are built," said Rob Engstrom, the U.S. Chamber of Commerce's senior vice president of political affairs, who presented as one of the keynote speakers. "This is where business relationships are built. This is what the Congress of the United States can take a real lesson from."

During a presidential election year and with the Governor's Mansion up for grabs, politics loomed large at the conference.

Andrew Jordon, the state chamber's chairman, started off the morning by telling members that the state's new Republican majority has offered the first pro-business leadership in West Virginia in 80 years - a remark aimed at the now-minority Democratic Party.

In morning meetings and panel discussions, the chamber's staff and Republican politicians celebrated the pro-business legal reforms they helped push through the West Virginia Legislature in the past two years. They held up two specific bills that were passed last session - right to work and the repeal of prevailing wage - as progress for the state.

And they highlighted the $2.1 million they collected from business members last year and said they didn't plan to "take their foot off the gas."

Del. Carol Miller, R-Cabell, told the crowd at her panel on economic growth and workforce needs that all of the largely Republican-backed laws were "making it more fair for the job creators."

But while policy leanings in the state were made clear, the chamber's political calculus on the national level was shown to be a bit more fuzzy.

Engstrom, U.S. Chamber's vice president and a former member of the Republican National Committee, took a more middle-of-the-road political stance than his West Virginia counterparts.

He disparaged Bernie Sanders as a "devout socialist," but at the same time, he criticized the tea party wing of the Republican Party for wanting to shut down government, saying "these are people who know how to say no in about 147 different languages."

He advocated, instead, for Republicans and Democrats who support corporate-backed policies.

"What I do know is that there has been a fundamental loss of a governing middle, particularly on economic issues," said Engstrom, who previously was a campaign staffer for former U.S. Speaker of the House Newt Gingrich.

He started off his keynote speech by noting that nobody ever would have thought that the race for the White House would be between Hillary Clinton and Donald Trump.

"If anyone had predicted this, I want to see you at the blackjack table later on this evening," he said.

Engstrom's remarks were reflective of the U.S. Chamber of Commerce's ambivalence toward Trump as a presidential candidate, especially when it comes to the Trans Pacific Trade Partnership, which the U.S. Chamber supports.

"Trade is getting demagogued from the left," he said. "It's also getting demagogued from the right."

Still, Engstrom hit on some of corporate America's biggest sticking points, including President Obama's Affordable Care Act, the Dodd-Frank financial-reform law and the Clean Power Plan, the carbon-emission rules that are working their way through the federal court system.

"We in the business community feel like we have been shut out," Engstrom said.

The U.S. Chamber has spent more than $20.3 million on federal elections this year, according to the Center for Responsive Politics, which tracks campaign financing.

One of the most prominent issues that was discussed during Wednesday's meetings was West Virginia's relatively new oil and gas industry, which has grown substantially with horizontal drilling and hydraulic fracturing.

Two executives from EQT Corp., one of the largest gas drillers in West Virginia, gave a presentation explaining the growth in the industry, and the need for lawmakers to give the industry more leeway.

Blue Jenkins and David Elkin, two of EQT's senior executives, said lawmakers need to rewrite laws to make it easier for gas drillers to gain minerals that are controlled by unwilling mineral owners.

Industry lobbyists have tried on multiple occasions over the past two to three years to change the state's leasing laws to meet their needs, even if that meant forcing unwilling mineral owners to sign.

The gas executives also reiterated the industry's push to build seven new large-diameter natural gas pipelines to pump gas out of the state.

Jenkins told the lawmakers and other business officials in attendance that the state only produces 8 million to 10 billion cubic feet per day, but if built, all of the proposed pipelines would be capable of pumping 14 billion cubic feet of gas per day out of the state, to places like Michigan and North Carolina.

Throughout EQT's presentation, the decline in coal and the growing use of natural gas was on display.

Jenkins made it clear to the audience that the increasing use of natural gas over coal is not isolated to West Virginia, although he said some people in the audience likely would argue otherwise.

Reach Andrew Brown at andrew.brown@wvgazettemail.com, 304-348-4814 or follow @Andy_Ed_Brown on Twitter.

Hepatitis A cases in Berkeley, Jefferson counties linked to national outbreak http://www.wvgazettemail.com/article/20160831/GZ0115/160839906 GZ0115 http://www.wvgazettemail.com/article/20160831/GZ0115/160839906 Wed, 31 Aug 2016 15:42:52 -0400 Staff reports By Staff reports State and local health officials are investigating seven cases of Hepatitis A in Berkeley and Jefferson counties linked to a national outbreak involving contaminated strawberries.

According to the West Virginia Bureau for Public Health, three of the seven reported cases have been linked to a national outbreak that has affected more than 50 people. The outbreak is associated with Egypt-sourced frozen strawberries used by restaurants in a variety of smoothies, according to Dr. Rahul Gupta, state health officer and commissioner for the Bureau for Public Health.

Hepatitis A is a liver infection caused by a highly contagious virus. It is usually transmitted by the fecal-oral route, either through person-to-person contact or consumption of contaminated food or water, but unlike Hepatitis B and C, does not result in chronic illness.

"Not everyone will experience symptoms from a hepatitis A virus infection," Gupta said. "Some people may experience mild flu-like symptoms. Other symptoms of hepatitis A virus infection include yellow eyes or skin, abdominal pain, pale stools or dark urine. "Fortunately, a vaccine to prevent against hepatitis A is available," he said.

Gupta said small children, those traveling to certain countries, drug users and those who are treated with clotting factor concentrates should seek a Hepatitis A vaccine. People who think they may have become ill as a result of the outbreak should contact their health care provider.

Huntington mayor calls on Congress to combat opioid epidemic http://www.wvgazettemail.com/article/20160831/GZ0115/160839939 GZ0115 http://www.wvgazettemail.com/article/20160831/GZ0115/160839939 Wed, 31 Aug 2016 00:01:00 -0400 Eric Eyre By Eric Eyre Huntington Mayor Steve Williams and federal health officials on Tuesday reinforced President Barack Obama's call on Congress to pump $1.1 billion more into substance abuse treatment to curb opioid addiction.

The renewed push comes two weeks after Huntington paramedics responded to 26 heroin overdoses within four hours on a single day. Two people died.

"This is an issue of saving lives," Williams said on a conference call with Obama administration officials. "We absolutely have no time to waste. This appropriation needs to be acted upon immediately by Congress."

Also Tuesday, U.S. Health and Human Services Secretary Sylvia Burwell announced more than $53 million in federal grants that will go to 44 states, including West Virginia, to combat the opioid problem. The grants target over-prescribing of painkillers, increasing access to treatment facilities and bolstering the use of naloxone, a life-saving drug that reverses opioid drug overdoses.

In February, President Obama requested $1.1 billion in new funding to address the nation's opioid crisis. West Virginia could receive more than $10 million under the proposal.

Obama's plan would create more drug treatment centers, train new psychologists, psychiatrists and doctors specializing in drug treatment, and evaluate the results. The bulk of the funding - $920 million - would go to states to expand access to medication-assisted treatment for opioid abusers. The medications are used to help manage an addict's addiction and ease withdrawal symptoms.

So far this year, Congress has approved an extra $181 million in funding for drug treatment programs.

"The legislation Congress passed earlier this summer does not provide the funding for treatment that is necessary to address this epidemic," said Burwell, a West Virginia native who joined Williams on the conference call with reporters Tuesday.

In West Virginia, there's typically a six-month wait for a bed at a substance abuse treatment center, Williams said. Cabell County has only eight "detox" beds available for addicts, the mayor said.

"When somebody is asking, begging for help, we don't have six months or six weeks or six days," Williams said. "We should be able to place someone at a treatment facility immediately."

More than 28,000 Americans died in 2014 from overdoses of opioids, including heroin and prescription painkillers - more than any year on record, according to the Centers for Disease Control and Prevention. At least half of all opioid overdose deaths involved a prescription drug. The CDC also found a sharp increase in heroin-involved deaths and a spike in deaths related to synthetic opioids, such as fentanyl.

West Virginia leads the nation in drug overdose deaths, with 35.5 per 100,000 people. Overdose deaths in West Virginia climbed last year.

In Huntington, 70 people died of drug overdoses in 2015, and 35 drug overdose deaths have been reported so far this year.

"Communities are aggressively fighting this from a law enforcement standpoint," Williams said. "But there's a funding gap in treatment. We can't arrest our way out of this."

Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.

Cole, Justice outline plans for drug problems http://www.wvgazettemail.com/article/20160830/GZ0101/160839945 GZ0101 http://www.wvgazettemail.com/article/20160830/GZ0101/160839945 Tue, 30 Aug 2016 19:50:50 -0400 Andrew Brown By Andrew Brown As a string of heroin overdoses in Huntington has grabbed national attention and West Virginia continues to struggle with the country's worst overdose rate, both major-party candidates for governor are talking tough when it comes to "drug kingpins," and calling for increased programs for those struggling with addiction.

But neither Republican Bill Cole nor Democrat Jim Justice has said he would increase state spending to help with those treatment efforts.

On Tuesday, after being endorsed by the state's chapter of the National Association of Social Workers, Justice talked about the state's drug epidemic, mental health programs and other related issues.

During the discussion, Justice tried to differentiate himself by criticizing Cole for one of his most recent political commercials that compares drug dealers in West Virginia to ISIS, the terrorist organization operating in Syria and Iraq.

"If ISIS was behind this, we would go bomb them back to the Stone Age," Cole says in the commercial, as a video of fighter jets flying over the desert plays behind him. "As governor I will treat heroin dealers who come here and kill our kids with their poison with that same attitude."

Justice tried to use that commercial to paint Cole as uncaring when it comes to helping drug addicts throughout the state. He said Cole was sending a message that suggests the state is going to "line you up and shoot you if you're addicted to drugs."

Cole, who said he would increase mandatory prison sentences for drug dealers and possibly build new jails at a time when the rest of country is trying to reduce its prison population, has also offered up a plan that calls for increasing drug treatment facilities throughout the state.

Spokesman Kent Gates said Cole has made it clear that the commercial and his comments were only referring big drug dealers - the "drug kingpins."

"It's not for those addicted to drugs," Gates said, adding that Cole would also like to pass laws that charge people with accessory to murder if they are found guilty of supplying drugs to an overdose victim.

Justice's policy plan doesn't address any need for stricter criminal sentencing. It simply says he will work with law enforcement to "use the most advanced policing tactics to put drug kingpins behind bars."

Libertarian David Moran, Mountain Party candidate Charlotte Pritt and Constitution Party candidate Phil Hudok are also on the ballot for governor.

Beyond Cole's criminal sentencing changes, the policy proposals from him and Justice don't appear very different.

Cole's seven-point action plan says he will create a "Office of Drug Action," call a special legislative session to deal with drug addiction, and use federal government money to expand drug treatment centers.

A press release from the Justice campaign said he would "establish a comprehensive roadmap," expand drug courts and treatment at regional jails and "secure private investments" for new treatment facilities in the state.

The need for more treatment centers in West Virginia was recognized by many of the people that participated in the National Association of Social Worker's round-table.

"It makes no sense for the state with the highest overdose rate to be sending people out of state for treatment," said Mary Aldred Crouch, a clinical social worker and president elect of the West Virginia of Alcoholism and Drug Abuse Counselors.

Justice's criticisms of his opponent largely focused on the limited efforts by the Legislature to combat drug problems in the past two years, when Cole was Senate president.

Though he is running for the state's highest office, Justice repeatedly said he was not a politician, and he cast off questions about how he would pay for his proposed drug treatment policies by instead talking about his business history.

"Look at my deeds. Look at what I have done," Justice said.

Reach Andrew Brown at andrew.brown@wvgazettemail.com, 304-348-4814 or follow @Andy_Ed_Brown on Twitter

Hospital computer hacks, like at ARH, becoming more common http://www.wvgazettemail.com/article/20160830/GZ0115/160839952 GZ0115 http://www.wvgazettemail.com/article/20160830/GZ0115/160839952 Tue, 30 Aug 2016 18:20:55 -0400 Lydia Nuzum By Lydia Nuzum A regional health care system that operates hospitals in West Virginia and Kentucky is in the midst of a cyberattack that has crippled its electronic systems, but officials aren't yet saying how or why the system was targeted.

Appalachian Regional Healthcare, which operates two hospitals in West Virginia and nine in Kentucky, reported over the weekend that its hospital system had been the target of a cyberattack that has left employees unable to access electronic patient records, email and other automated systems.

"ARH continues to work with authorities and computer experts to address the problems and restore our systems to operational capacity as quickly as possible," ARH spokeswoman Melissa Cornett said.

She emphasized that ARH doesn't have any reason to believe that patient information, medical or financial, has been stolen, and said ARH would "take prompt action" to notify patients and employees if that did happen.

Since Saturday, ARH employees had been tracking patients and performing their jobs without access to any of the hospitals' computerized systems, Cornett said Tuesday afternoon.

The ARH attack bears similarities to other cyberattacks perpetrated against hospitals in recent months - at Hollywood Presbyterian Medical Center in California in February, Kansas Heart Hospital in May and more than a dozen others, as hospitals become increasingly targeted in a hack that is growing in popularity - "ransomware."

Ransomware is a type of software installed covertly on a computer that spreads through internet and intranet systems, encrypting information so that it no longer is accessible to users. The people behind the ransomware then demand to be paid before they restore access.

According to James Foley, manager of training and curriculum development at the National White Collar Crime Center, ransomware attacks have become increasingly sophisticated, and many hospitals, unable to break the malware's encryption, have been forced to pay up.

Hollywood Presbyterian paid $17,000 in the digital currency bitcoin to have its system unlocked, and Kansas Heart paid an initial ransom, only to have hackers demand a second ransom to break the encryption.

"The way most ransomware works is that it encrypts all of the files with an extremely difficult encryption to crack, and what you're really paying for is the key to that encryption, and if you don't pay, you don't get your files back," Foley said. "With the degree of encryptions some ransomware is able to do, there's really not a lot of chance of getting them back. There are a few versions that people have figured out how to overcome, but those are not spreading as fast as new versions that are coming out."

Asked if the hack at ARH was a ransomware attack, Cornett said the hospital system is "not at liberty to provide further information," citing the investigation with federal authorities.

Ransomware attacks have quadrupled in the past year, averaging nearly 4,000 attacks per day, according to the U.S. Justice Department. Many hacks target individuals, but businesses, universities and hospitals have increasingly become targets.

Jeremy Taylor, director of information technology at Saint Francis Hospital, in Charleston, said one common method hackers use to infect computers with ransomware is to infect the "payload" of a website and providing a link to the website in an email. When the link is opened, the malware infects the computer.

"I don't believe anyone is immune to the cyberattacks, just as I don't believe anyone's home is immune to a break-in," Taylor said. "What you have to do is your due diligence, as far as security goes, and, hopefully, they'll move on to an easier target."

Foley said one of the best ways to safeguard against a ransomware attack is to backup entire information systems on a server that is unconnected to the entity's main system. For Taylor, education is key to ensuring that doctors, nurses and support staff within the hospital know how to recognize and avoid malware in emails and online - a task that grows more difficult as cyberattacks become more sophisticated.

"Our weakest link is the employee that opens an email or an attachment they shouldn't have, or goes to a website and clicks on a link they shouldn't," he said. "The No. 1 thing we have to educate our users on is email use, strong passwords, and cybersecurity in general."

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

Mylan to offer half-price generic EpiPen http://www.wvgazettemail.com/article/20160829/GZ01/160829508 GZ01 http://www.wvgazettemail.com/article/20160829/GZ01/160829508 Mon, 29 Aug 2016 17:54:02 -0400 By Carolyn Y. Johnson The Washington Post By By Carolyn Y. Johnson The Washington Post EpiPen maker Mylan Pharmaceuticals announced Monday morning that it would introduce a generic version of the life-saving allergy injection at half the price of the brand-name product, after politicians blasted the company for a drug coupon program seen as a public relations Band-aid.

The generic, which the company said will be launched "in several weeks," will carry a list price of $300 for a two-pack carton. That is half the list price for the branded product, which costs $608 for a two-pack, but it is still nearly $40 more than the price three years ago, according to data from Truven Health Analytics.

"We understand the deep frustration and concerns associated with the cost of EpiPen to the patient, and have always shared the public's desire to ensure that this important product be accessible to anyone who needs it," Mylan chief executive Heather Bresch said in a statement. "Our decision to launch a generic alternative to EpiPen is an extraordinary commercial response."

Joshua Sharfstein, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, called it a face-saving move by the company. The generic offers a way of dropping the price of one version of the drug, while also bringing the company some benefits. It will allow Mylan to segment the market, because some people will continue to buy the brand-name product.

Sharfstein said one important question will be whether the price stays the same over time.

The introduction of Mylan's generic also won't automatically open the window to true competition from other generic companies, according to Michael Carrier, a professor at Rutgers Law School. Companies can introduce generics of their brand-name drugs, called "authorized generics," but the effect on competition is ambiguous, he said.

"We have more competition than we did yesterday, but on the other hand, we don't have wide-open competition among the generics," Carrier said. "And maybe, by having this authorized generic, we're keeping at bay some of that true competition."

He noted that when the first generic drug enters the market, it usually gets a very shallow discount off the brand-name list price - maybe 5 or 10 percent. It is only when multiple generics enter that deeper discounts occur. The deep initial discount off the brand-name price could make the market less attractive to generics companies.

"I think that's what we've seen over the past week, where Mylan realizes it is in political hot water, and so it is doing a whole bunch of things to make it seem like it's lowering the price - and, for some consumers, it will help," Carrier said. "These are measures that Mylan is taking to lower the price, but notice it has not lowered the list price of the drug at all."

Sen. Richard Blumenthal raised the same question in a statement.

"Mylan may appear to be moving in the right direction, but its announcement raises as many questions as solutions - including why the price is still astronomically high, and whether its action is a preemptive strike against a competing generic," Blumenthal, D-Conn., said.

Teva Pharmaceutical Industries has been trying to launch a generic version of the drug, but it was rejected by regulators earlier this year for "certain major deficiencies," according to a spokeswoman, and product launch has been delayed until at least 2017.

Public Citizen, a patient-advocacy group, noted that not everyone will get access to the generic, making it an incomplete solution to the high price - similar to the critique leveled at the coupons and patient assistance.

"The weirdness of a generic drug company offering a generic version of its own branded but off-patent product is a signal that something is wrong," Public Citizen President Robert Weissman said in a statement. Mylan "aims to continue ripping off some segment of the marketplace - both consumers who do not trust or know about the generic, and perhaps some insurers and payers constrained from buying a generic."

He noted that the price in Canada is $200 for a two-pack of EpiPens and that the price in France is even lower.

Virus affects area hospitals' computer system http://www.wvgazettemail.com/article/20160828/GZ01/160829547 GZ01 http://www.wvgazettemail.com/article/20160828/GZ01/160829547 Sun, 28 Aug 2016 17:01:00 -0400 Staff reports By Staff reports

The Appalachian Regional Healthcare system in Kentucky and West Virginia is currently on an emergency operations plan after a computer virus infected all electronic services, according to a statement from ARH.

All ARH computers have been shutdown to prevent spread of the virus, the release said. It was unclear how the virus was contracted, or whether the computers were hacked from an outside source.

It was also unclear which West Virginia locations were affected, but the ARH operates hospitals in Beckley and Hinton.

All patient-care, registration, medication, imaging and laboratory services are being managed manually, the release said. Critical patients were being assessed to determine if they should be transferred to another facility for care, according to the release.

The emergency departments are continuing to accept patients.

ARH officials said the issue is being investigated by governmental authorities, and would not provide further information.

DHHR to roll out new three-tiered foster care system http://www.wvgazettemail.com/article/20160827/GZ01/160829577 GZ01 http://www.wvgazettemail.com/article/20160827/GZ01/160829577 Sat, 27 Aug 2016 18:57:07 -0400 Lydia Nuzum By Lydia Nuzum The West Virginia Department of Health and Human Resources has begun accepting applications from providers for a new tiered foster care system the agency hopes will allow it to train some foster families to better care for children with severe needs.

According to DHHR, its therapeutic foster care program will include three tiers that children will be placed in depending on their needs - tier 1 for "traditional foster care," which will include families with the same level of training, reimbursement and supports DHHR currently provides, and tiers 2 and 3, which will be considered "treatment foster care" and "intensive treatment foster care" and will include families with more advanced training to care for children with disabilities or severe behavioral issues.

"All of our children have individual, complex needs, so a lot of our agencies now are trying to match the foster home to the child based on their behaviors and clinical needs," said Linda Watts, deputy commissioner of the West Virginia Bureau for Children and Families. "This is going to allow us to have homes with foster parents who are trained more in-depth to meet those individualized needs. We currently have 'specialized foster care,' but in the new model it will be seen as traditional, and then we'll have two higher levels...by doing that, based on the child's needs, they'll still be able to live in a family-like setting, but get those services and supports that they need."

DHHR has already completed a two-year pilot of the program in partnership with Pressley Ridge, a youth behavioral health provider the agency currently contracts with. Since June of 2014, Pressley Ridge has enrolled 34 children in its pilot, and has discharged 20 of them. Of the 20 who have been discharged, 15 have reached or are in the final stages of reaching their "permanency goal," meaning they have been returned to their biological families, returned to an existing adoptive family or have been adopted, according to Angie Hamilton, executive director of Pressley Ridge.

Watts said the DHHR is hopeful that if it can build enough capacity in the new foster care system, it can divert some children from residential treatment.

"It is a possibility that a child can be treated with the right services and supports in an intensive treatment foster home and not have to go into an out-of-home residential placement," she said. "It really depends on the child's individualized needs."

Watts also acknowledged the challenge the state faces with recruiting new foster families - it currently has 1,277 certified foster families, and although a foster family is usually licensed to care for up to six children at a time, that includes any biological children they may have. As of Thursday, the state had 115 available foster care beds, Watts said, adding that an available bed may not equal a placement, as a given foster family may not be able to meet the needs of a child in need of immediate placement.

"We are encouraging every specialized foster care agency to do this," she said. "This is a great opportunity for us to treat children in a family-like setting, and to provide them with the individualized services and supports that can maintain them in a community and their home setting."

The Bureau could not provide a number of exactly how many children in the state are in need of placement, but Hamilton said the number of children remanded to state care grows every year. There were nearly 5,000 children in out-of-home care in West Virginia in 2014, Hamilton said, and roughly half of those kids were in the foster care system. Out of the roughly 2,500 in the foster care system, close to 1,000 were being served by nearly a dozen private providers that contract with the state, while the rest were placed directly by DHHR, often in "kinship placements" with members of the child's extended family, she said.

"There are a lot of contributing factors at play - we have a higher level of poverty when compared to national norms, we have a huge drug epidemic that contributes to kids not being able to live in their biological homes. We have a lot of social determinants in West Virginia that drive the number of kids being removed from the home," she said.

Hamilton said the three-tiered system should prove to be a vast improvement over the current foster care system and will allow for more flexibility within the state's continuum of care.

"We will be able to recruit more families willing to care for children with more complex needs, we'll be able to reimburse at a higher rate for the intensive work they'll be doing with those kids, we'll be able to support the other components such as the family work and the movement toward permanency, the adoption work, the recruitment and retention work, the community support work ... it all provides a much better mechanism for providers," Hamilton said.

Reach Lydia Nuzum at

lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow

@lydianuzum on Twitter.

EPA proposes plan for long-awaited Kanawha dioxin cleanup http://www.wvgazettemail.com/article/20160827/GZ03/160829580 GZ03 http://www.wvgazettemail.com/article/20160827/GZ03/160829580 Sat, 27 Aug 2016 16:24:52 -0400 Ken Ward Jr. By Ken Ward Jr. More than a dozen years after they promised to more thoroughly investigate the problem, government regulators and Monsanto Co. are joining in a proposed plan to clean up dioxin contamination from the sediment in a 14-mile stretch of the Kanawha River west of Charleston.

The U.S. Environmental Protection Agency revealed late last week that the parties all prefer an alternative that would install stone caps over certain contaminated spots in the river sediment, rather than conducting a broader and more expensive dredging project to remove material contaminated with toxic dioxin pollution from Monsanto's former chemical plant in Nitro and from the company's waste dumps in the area.

The EPA published a short public notice about the proposal in the Gazette-Mail Thursday, and it made available a nearly 1,500-page report that describes the study of the contamination and the consideration of various alternatives for cleaning it up.

"This was done over several years and much, much discussion," said Joseph Gabriel, environmental remediation manager for Monsanto. "All of the options were evaluated, and the overall opinion was this was the best alternative."

Jake McDougal, a program manager with the Department of Environmental Protection Office of Environmental Remediation, said Friday that the proposal is "a consensus agreement" between federal and state officials and Monsanto.

The cleanup - covering an area of the Kanawha to the Winfield Lock and Dam - would address toxic contamination of the river that dates back many decades, to when Monsanto began in the late 1940s to make a powerful herbicide ingredient called 2,4,5-T.

In its best-known use, the federal government bought 2,4,5-T to make Agent Orange, the defoliant deployed widely in the Vietnam War. Monsanto's 2,4,5-T was contaminated with a highly toxic dioxin compound known as 2,3,7,8-TCDD.

Dioxin has been linked to cancer, birth defects, learning disabilities, endometriosis, infertility and suppressed immune functions. The chemical builds up in tissue over time, meaning that even small exposures can accumulate to dangerous levels.

For years, Monsanto disposed of wastes containing dioxin in dumps at Heizer and Manila creeks, north of the company's Nitro plant. A class-action lawsuit, later settled, also alleged that Monsanto's operations had sent dioxin-contaminated dust over the area, contaminating homes and businesses.

Repeatedly, Monsanto entered into agreements with the EPA to clean up at least some of its dioxin contamination, but the river remains contaminated to the point that anglers are warned against eating fish from that part of the Kanawha.

In 2004, the EPA and the state DEP announced that they had reached a deal to further investigate the dioxin in the river and come up with a plan to clean it up.

Then-DEP Secretary Stephanie Timmermeyer said at the time that the assessment of the contamination was "a positive step toward addressing ... a problem that has persisted far too long."

The new cleanup report, prepared by a contractor hired by Monsanto, says that the effort aims to address cancer risks that "exceed the target range" for anglers who eat contaminated fish.

In a "streamlined risk evaluation," the report says that, while fish consumption advisories are in place, "it is unknown" whether those advisories "reflect local consumption patterns," making the "resultant risk estimates" unclear.

The report said that current risks to wildlife from the contamination were "likely acceptable, or at worst, slight," and that while there "was some uncertainty," the proposed cleanup would address the issue.

"The most significant human health risks are associated with fish consumption from the river," the report says. "A reduction in fish tissue concentrations of approximately 60 percent would reduce all risks to within U.S. EPA acceptable ranges for cancer and non-cancer risks."

Under the alternative proposed in the report, stone caps would be placed on a more than 9-acre area adjacent and immediately downstream of the former Monsanto plant. The report says that the cap placement is entirely outside of the navigational channel for the Kanawha, either horizontally or below the depth of the navigation within the channel.

"Capping of the area of elevated 2,3,7,8-TCDD concentrations in the area adjacent to the former facility would provide an immediate and permanent reduction in the mobility of underlying impacted sediments," the report says.

The capping project would cost an estimated $8 million, according to the report.

Other alternatives examined included two different proposals for dredging to remove contaminated materials from the river. One of the dredging proposals was estimated to cost $26 million and the other $41 million, the report said. Dredging could result in short-term risk increases - as material is churned up in the river - but dredging "accelerates long-term recovery," the report said.

The report said the capping proposal would "have a faster anticipated recovery trend than the dredging alternatives" because it would not "result in sediment suspension." Also, the dredging would still leave some "residuals" that would require capping of some or all of the dredged areas, the report said.

The EPA public notice indicated that the agency is accepting public comments on its cleanup proposal through Sept. 24. A hard copy of the cleanup report is available at the Cross Lanes Library, and comments may be sent via email to EPA's Melissa Linden at linden.melissa@epa.gov or to U.S. EPA Region 3, 1650 Arch St., Mailcode 3HS32, Philadelphia, PA 19103.

No public hearings or public meetings have been scheduled on the proposal, but EPA officials said they would consider having such an event.

"It's always a possibility if it's requested," Linden said. "We want to address people's concerns and comments."

Reach Ken Ward Jr. at


304-348-1702 or follow

@kenwardjr on Twitter.

WV health officials urge vaccines for small children http://www.wvgazettemail.com/article/20160825/GZ0115/160829677 GZ0115 http://www.wvgazettemail.com/article/20160825/GZ0115/160829677 Thu, 25 Aug 2016 19:00:22 -0400 Lori Kersey By Lori Kersey While West Virginia is often praised for having high vaccination rates among school-age children, health officials say the state's rates for vaccinating younger children need to improve.

West Virginia has a 97.6 percent coverage rate for schoolchildren, but its rate for vaccinating younger children is much lower. The state has the lowest vaccination coverage rates for children under 3 years old in the nation, according to the 2015 National Immunization Survey.

"Vaccines are one of the most useful and cost-effective public health tools available for preventing disease, as well as preventing death," Dr. Sherri Young, immunization officer for the West Virginia Bureau for Public Health, said during a news conference Thursday outside Charleston Area Medical Center's Women and Children's Hospital. "They not only protect vaccinated individuals, but they also help protect entire communities, by preventing and reducing the spread of infectious disease."

Vaccines prevent illnesses such as whooping cough, measles, polio and rubella. Vaccines led to the eradication of small pox, Young said. While there are still cases of polio in other countries, there haven't been cases of polio in the United States for several decades because of vaccines, she said.

Young said that among U.S. children born between 1994 and 2013, vaccines will prevent an estimated 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes.

About one in three West Virginia children between the ages of 1½ years and 3 years are missing at least one vaccine, health officials say.

Low vaccination rates for young children mean that kids are not protected from vaccine-preventable illness when they are most vulnerable to them, officials say.

"I'd like to see that rate a lot higher," said Dr. Joseph Matusic, a pediatrician at ABC Pediatrics. "Thankfully, our legislators of our state have kind of mandated that you need your vaccines before school, you don't have any exemptions, and that protects our children. But as we learned, children under 3 years of age are much more susceptible to these illnesses."

West Virginia is one of the few states where religious exemptions to school vaccine requirements are not allowed. Medical exemptions are allowed.

West Virginia's children also are lacking well-child visits, officials said. About 16 percent of children ages 1 to 2 haven't had a well-child exam in the past year, officials said. Four well-child exams are recommended from 1 to 2 years. The exams are the best way to ensure that children stay up to date on vaccines, officials said.

The Vaccines for Children program provides free vaccines to children who are uninsured or under-insured. The state also provides free vaccines to local health departments, for children whose physician doesn't stock vaccines for children with insurance.

For more information on the program and to see a full vaccine schedule for children, visit the state Bureau for Public Health's website, at www.dhhr.wv.gov/oeps/immunization /Pages/default.aspx.

Reach Lori Kersey at lori.kersey@wvgazettemail.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.

Highmark WV president to retire in November http://www.wvgazettemail.com/article/20160825/GZ0115/160829714 GZ0115 http://www.wvgazettemail.com/article/20160825/GZ0115/160829714 Thu, 25 Aug 2016 10:57:57 -0400 Lydia Nuzum By Lydia Nuzum Highmark West Virginia, the state's largest health insurer, announced Thursday that its president, Fred Earley, will retire in November.

The company also announced Thursday that James Fawcett, a 27-year employee of Highmark, will become the next president of the company's West Virginia branch effective Nov. 1. Fawcett most recently served as senior vice president of Medicaid markets in West Virginia and Delaware, and has worked in provider contracting and network management for Highmark in West Virginia, Pennsylvania and Delaware.

"Fred's legacy is one of true commitment and dedication to not only the health and well-being of our members and employees, but also to the entire state of West Virginia, and he will be greatly missed," said Deborah Rice-Johnson, Highmark Health Plan president.

"Like Fred, Jim's extensive knowledge of the health care industry, combined with his experience in sales, provider contracting and the Medicaid market, make him an ideal fit and well-positioned to lead Highmark West Virginia as its president."

Earley, who was appointed president of Highmark West Virginia in 2009, served as general counsel for 20 years prior to becoming the company's president. Earley also serves as president of Highmark Senior Solutions Company and West Virginia Family Health and is a member of the board of directors for Highmark West Virginia. He became Highmark West Virginia's president seven years ago, just one year before the passage of the Patient Protection and Affordable Care Act, a sweeping healthcare reform law that Earley has been tasked with helping implement for the company for the majority of his tenure as president.

For Earley, the ACA has shaped much of his time as president of Highmark West Virginia - from enrolling nearly 30,000 West Virginians in individual coverage under the law's insurance mandate to creating a health maintenance organization, West Virginia Family Health, to participate in the state's switch to managed care organizations for covering its Medicaid expansion population.

"It obviously was a very uncertain time; there was such rancor over the law and how it was passed," he said.

Earley said that the company has experienced continued losses in its individual coverage, in part because the risk corridor payments promised by the federal government to insurers have yet to be paid. Despite that, Highmark West Virginia's overall standing is strong, and Earley said he still plans to continue to do some work with Highmark as he transitions into retirement.

"It's been very rewarding but very challenging," he said. "It just seemed like the right time for me to make this kind of move, and we're very fortunate to have Jim ready to succeed me."

Fawcett holds a bachelor's degree from Indiana University, was a commissioned officer in the United States Air Force and is a Certified Healthcare Consultant. Fawcett is a graduate of Leadership Pittsburgh and is on the board for the Greater Pittsburgh Arts Council.

For Fawcett, who has worked for Highmark as long as Earley has in a number of capacities, the opportunity to work with the current team at Highmark West Virginia is what drew him to the position.

"I give Fred full credit for the team of leaders there. I'm not walking into a startup or a turn around; the challenge here is to take what is already a very successful organization and keep up that trajectory," Fawcett said. "I'll be candid - when I caught wind of Fred's retirement, it was the experiences I've had working with his team that caused me to pursue this opportunity."

Fawcett said he hopes to continue to keep Highmark West Virginia a strong and viable insurer in the state, and will focus his efforts on making the insurer as desirable as possible for both consumers and employees.

"For me, to continue the financial stability and meet the mission of Highmark in West Virginia is paramount," he said. "I'm big into customer service - we all know it's far less expensive to keep a customer than to lose them and try to recover them, and ultimately, I also want to make this a great place to work...I want to keep (the leadership team) here and build a succession plan, and I'm really excited to officially join the team."

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

Heroin overdoses this week top 60 in Cincinnati http://www.wvgazettemail.com/article/20160825/GZ0115/160829718 GZ0115 http://www.wvgazettemail.com/article/20160825/GZ0115/160829718 Thu, 25 Aug 2016 09:26:32 -0400 The Associated Press By The Associated Press CINCINNATI (AP) - Police in the Cincinnati area say a surge in heroin overdoses has topped 60 cases this week.

WLWT-TV reports there was a death Tuesday of a man found in a parked car. First responders have been able to revive other overdosers with naloxone opioid antidote, sometimes requiring multiple doses.

Police are trying to find the source of the drug being circulated, which they suspect has a mixture of heroin and another strong substance such as an animal tranquilizer.

The head of the Hamilton County Heroin Coalition says that its task force is working with Cincinnati police. Newtown Police Chief Tom Synan warns dealers they have "the full and undivided attention" of the task force that includes state and federal agencies.

Cincinnati Officer Ryan Lay calls the overdose wave "complete madness."

Four senior living facilities in WV to be sold http://www.wvgazettemail.com/article/20160824/GZ0115/160829765 GZ0115 http://www.wvgazettemail.com/article/20160824/GZ0115/160829765 Wed, 24 Aug 2016 15:31:23 -0400 Lydia Nuzum By Lydia Nuzum Genesis HealthCare is selling four of its assisted living facilities in West Virginia for a total of nearly $22 million, according to filings from the West Virginia Healthcare Authority.

The authority issued exemptions to its certificate of need process for the purchase of the facilities earlier this month. The four facilities are Quarry Manor in Charleston, Regency Place in Scott Depot, The Seasons in Lewisburg and The Summit at Hidden Valley in Oak Hill.

Jeanne Moore, a spokeswoman for Genesis, said the company made the decision in June to divest itself of nine of its facilities in West Virginia, Delaware and Pennsylvania.

"Genesis made the business decision to sell some non-core assisted living assets," Moore said. "We expect the transaction to be finalized later this fall. We are committed to working closely with the residents, family members and staff to ensure a seamless transition."

Genesis' June decision coincides with the creation of eight new limited-liability companies listed as the purchasers of the four facilities - for The Seasons, its purchasers are listed as Lewisburg Aid II Propco LLC and Lewisburg Aid II Opco LLC. The other three facilities have similarly styled purchasers, named for the city the particular facility is based in.

All eight companies, and hundreds more around the country, are linked to Enlivant Healthcare, a national senior living company that, until its purchase by a private equity company two years ago, was Senior Living Concepts, LLC. The company has more than 200 assisted living residences comprising more than 9,000 resident units across 19 states.

A representative from Enlivant said the company will not make a statement on the acquisitions at this time.

Genesis operates five facilities classed as assisted living facilities in West Virginia. Once its deal with Enlivant goes through, its only remaining assisted living facility in West Virginia will be Wishing Well Assisted Living Community in Fairmont.

According to the Healthcare Authority, The Seasons, in Lewisburg, will sell for $3,500,000; The Summit at Hidden Valley, in Oak Hill, will sell for $1,500,000; Regency Place, in Scott Depot, will sell for $8,175,000; and Quarry Manor will sell for $8 million.

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

Senators cautious with colleague's daughter as Mylan CEO http://www.wvgazettemail.com/article/20160824/GZ0101/160829779 GZ0101 http://www.wvgazettemail.com/article/20160824/GZ0101/160829779 Wed, 24 Aug 2016 10:58:57 -0400 By Anna Edney and Billy House Bloomberg By By Anna Edney and Billy House Bloomberg Members of Congress are in an unusual position as they demand an explanation for Mylan's 400 percent price hike for the EpiPen and focus attention squarely on its CEO: Heather Bresch.

If lawmakers follow the usual script, Bresch could get called up to Capitol Hill next month to explain her company's justification for raising the price on the life-saving allergy shot. But that could be awkward, since she's the daughter of Democratic Sen. Joe Manchin of West Virginia.

While Bresch's family ties may mute the ire of some lawmakers, others are already asking the company about taxpayers having to foot the bill for these price increases - particularly after Bresch and the company successfully pushed legislation to encourage use of the EpiPen in schools nationwide.

Mylan is the latest drugmaker to provoke congressional ire for steep price hikes. Martin Shkreli and executives from the company he used to lead, Turing Pharmaceuticals, and executives from Valeant Pharmaceuticals International Inc. were called before congressional committees earlier this year to explain why they bought the rights to older drugs that lacked competition and raised the prices.

The Mylan controversy fits a similar pattern. Mylan has increased the price of its EpiPen from about $57 a shot when it took over sales of the product in 2007 to more than $600 for two auto-injectors. But the company's EpiPen is a more mainstream drug used to treat life-threatening allergic reactions from bee stings, food allergies or other triggers, which could give the issue a larger constituency.

Mylan declined to comment when asked to explain the price hike or Bresch's role in promoting legislation. Manchin's office also didn't respond to requests for comment.

Members in both chambers expressed outrage this week.

"I am deeply concerned by this significant price increase for a product that has been on the market for more than three decades, and by Mylan's failure to publicly explain the recent cost increase, which places a significant burden on parents, schools and other purchasers of the EpiPen," Sen. Mark Warner, a Virginia Democrat, said Tuesday in a statement, noting that he is a parent of a child with severe allergies.

Sen. Richard Blumenthal, a Connecticut Democrat who has asked the company to lower its prices, is holding an event on Wednesday where he will call for investigations by the Senate Judiciary Committee and the Federal Trade Commission into potential antitrust violations and deceptive and illegal trade practices.

Congressional anger may be fueled by the company's tactics in pushing legislation that helped boost the use of EpiPens.

Mylan spent about $4 million in 2012 and 2013 on lobbying for access to EpiPens generally and for legislation, including the 2013 School Access to Emergency Epinephrine Act, according to lobbying disclosure forms filed with the Office of the Clerk for the House of Representatives. Mylan also was the top corporate sponsor of a group called Food Allergy Research & Education that was the key lobbyist pushing for the bill encouraging schools to stock epinephrine auto-injectors, of which EpiPen is by far the leading product.

But Bresch's connections to Capitol Hill already have some lawmakers tiptoeing around the usual Washington blame game.

For example, Blumenthal, a member of the Senate Judiciary Committee and a co-sponsor of the 2013 schools bill, asked Bresch in a letter Monday to explain the "shocking price increases."

However, in an interview Tuesday, he was less eager to talk about Bresch herself or the prospect that she might soon be testifying to the committee.

He initially answered during one telephone call that he was unaware that she had any direct involvement in the pricing. Then, in a follow-up call, Blumenthal responded when asked again about the possibility of her coming before Congress by saying, "I am just not going to comment on that."

Bresch, 47, has been CEO of Mylan since 2012 and previously held other senior posts at the company, including as head of government relations. Last year, she had to defend the company after it moved its corporate address overseas to lower its U.S. taxes in a transaction known as an inversion. Now incorporated in the Netherlands, its principal executive office is in Canonsburg, Pennsylvania.

Ross Baker, a political scientist at Rutgers University in New Jersey, said Tuesday that he assumes Bresch's father, Manchin - who is not on the Judiciary Committee - would recuse himself "and put a lot of distance between himself and any investigation" into the matter.

"He'd be unwise to rise to the defense of Mylan," Baker said.

Senate Judiciary Chairman Chuck Grassley of Iowa, who is running for re-election, also wrote a letter to Mylan saying he was "concerned that the substantial price increase could limit access to a much-needed medication," asking for an explanation by Sept. 6, the day the Senate returns from its seven-week summer recess. Jill Gerber, Grassley's spokeswoman, said in an email that he wants to hear back from Mylan before considering holding a hearing.

Mylan has given away more than 700,000 free EpiPens to schools since 2012 under a program that allows them to receive four free auto-injectors, the company said in a statement. Yet schools have to use their own funds to purchase additional pens. Mylan declined to comment on the price increases coinciding with legislation to encourage EpiPen use.

Sen. Amy Klobuchar, a Minnesota Democrat, asked the Federal Trade Commission on Monday to look into whether Mylan had done anything to deny competitors access to the market in order to keep raising prices. She pointed to a competitor product, Adrenaclick, that she said is less expensive but has only minimal sales. Klobuchar was also a co-sponsor of the schools bill.

In the House on Tuesday, majority and minority staff members of the Oversight and Government Reform Committee held a meeting after receiving a letter from Representative Grace Meng, a New York Democrat, requesting the panel hold a hearing.

The majority staff scheduled a call with the company, though Democrats on the committee said they were waiting to hear back on whether a hearing will be scheduled.

A spokeswoman for committee Chairman Jason Chaffetz of Utah, said that as of Tuesday afternoon no hearing was scheduled. "And no comment beyond that," said the spokeswoman, M.J. Henshaw.

The top Democrat on the Oversight Committee, Elijah Cummings of Maryland, said Tuesday that he wants a hearing when lawmakers return from their summer break to Washington in September.

"The recent price increase for EpiPens places a financial burden on those who desperately need this drug to prevent life threatening allergic reactions, which is why we have expressed our desire for an investigation of this issue and for the Committee to hold a hearing in September," Cummings said Tuesday in a statement.

Senators question increased price of Mylan's EpiPen http://www.wvgazettemail.com/article/20160823/GZ01/160829803 GZ01 http://www.wvgazettemail.com/article/20160823/GZ01/160829803 Tue, 23 Aug 2016 18:07:28 -0400 Andrew Brown By Andrew Brown A bipartisan group of U.S. senators is raising questions about the increased price of Mylan Pharmaceuticals' EpiPens and calling for investigations into the inflated cost of the auto-injection drug that treats people with life-threatening allergic reactions.

Earlier this week, Sens. Chuck Grassley, R-Iowa, and Richard Blumenthal, D-Conn., sent letters to Heather Bresch, the CEO of Mylan, asking her to explain why the price of the epinephrine injections has increased by more than 400 percent since the Pennsylvania-based company bought the rights to the drug in 2007.

"I am concerned that the substantial price increase could limit access to a much-needed medication," Grassley wrote in his letter.

On the same day, Sen. Amy Klobuchar, D-Minn., sent a letter to the Federal Trade Commission, urging the federal agency to investigate the rising price of the drug and to look into whether Mylan is using "exclusionary practices" to keep similar products out of the marketplace.

Klobuchar, who serves on the Senate's antitrust subcommittee, also called for the Senate Judiciary Committee to hold a hearing on the company's pricing practices.

"Many Americans, including my own daughter, rely on this life-saving product to treat severe allergic reactions," Klobuchar wrote. "Although the antitrust laws do not prohibit price gouging, regardless of how unseemly it may be, they do prohibit the use of unreasonable restraints of trade to facilitate or protect a price increase."

The controversy over the commonly used drug has close ties to West Virginia.

Mylan has a manufacturing facility in Morgantown, and the company is the fifth-largest employer in the state, according to Workforce West Virginia.

Additionally, Bresch, who has led the company since 2011, is the daughter of Joe Manchin, a Democrat and West Virginia's senior U.S. senator.

Mylan's pricing for the EpiPen isn't the only thing that has rapidly inflated. According to federal financial reports, Bresch's executive compensation has skyrocketed in the past nine years.

In 2007, Bresch, who was then president of Mylan, made $2.4 million. Last year, as the CEO, Bresch received a total of $18.9 million through her salary, stock awards and other compensation packages.

Manchin's office did not respond to questions about whether he supports an investigation into Mylan's pricing practices for EpiPen.

Mylan's communication staff did not respond to a request for comment.

A statement posted Monday on the company's website, said Mylan has "worked tirelessly" over the past several years to advocate for increased anaphylaxis awareness, access to treatment and preparedness for those with severe allergies and that to ensure access to epinephrine is a "core part of our mission.

"With the current changes in the healthcare insurance landscape, an increasing number of people and families have enrolled in high deductible health plans, and deductible amounts continue to rise," the statement read. "This current and ongoing shift has presented new challenges for consumers, and now they are bearing more of the cost. This new change to the industry is not an easy challenge to address, but we recognize the need and are committed to working with customers and payors to find solutions to meet the needs of the patients and families we serve."

According to Klobuchar's letter, the price for two EpiPen injections has risen from about $100 in 2008 to more than $500 this year.

West Virginia Reps. Alex Mooney and David McKinley did not respond to questions about Mylan by the time this report was published.

"Families in West Virginia and across the nation rely on EpiPens, and I am concerned about the rapid increase in price for this life-saving medication," Rep. Evan Jenkins, R-W.Va., said in an emailed statement. "I believe Mylan needs to share with consumers the reasons for the price increase because this is impacting the availability of this medication for patients, families, schools and first responders."

Sen. Shelley Moore Capito, R-W.Va., said she agrees with the other senators who are putting pressure on Mylan. She said they are "raising valid questions about the pricing of this life-saving drug, which Congress and the American people deserve to have answered."

This isn't the first time that members of Congress have alleged price-gouging by companies in the pharmaceutical industry. Earlier this year, members of the U.S. House Committee on Oversight and Government Reform berated the former CEO of Turing Pharmaceuticals, Martin Shkreli, for buying a 62-year-old drug that treated parasitic infections and increasing the price from $13.50 to $750 per pill.

During the hearing, Shkreli - who has been nicknamed "Pharma Bro" - refused to answer questions from members of Congress and spent most of the hearing grinning.

But the dramatic price increases for EpiPen and Daraprim, the Turing-owned drug, are a small part of what many see as the larger problem: the rising cost of pharmaceutical drugs overall.

Earlier this year, a study by IMS Health showed that U.S. spending on drugs had increased by 8.5 percent in 2015 over the previous year. Total spending on medicine, according to the study, had reached $310 billion and is forecast to reach $370 billion to $400 billion by 2020.

That means increased spending for everyone, even those who are healthy.

The Centers for Medicare and Medicaid Services found that spending on drugs had increased by 12.2 percent in 2014, more than twice the growth rate of federal medical spending overall that year.

Reach Andrew Brown at andrew.brown@wvgazettemail.com, 304-348-4814 or follow @Andy_Ed_Brown on Twitter.

DHHR responds to commission report, calls juvenile reforms necessary http://www.wvgazettemail.com/article/20160823/GZ0115/160829806 GZ0115 http://www.wvgazettemail.com/article/20160823/GZ0115/160829806 Tue, 23 Aug 2016 17:44:15 -0400 Lydia Nuzum By Lydia Nuzum The West Virginia Department of Health and Human Resources has responded to accusations by a special commission that proposed changes to its juvenile residential treatment model were made "in secret," arguing that those changes are necessary to correct problems outlined in an earlier U.S. Department of Justice report.

The Juvenile Justice Commission, created by the state Supreme Court, released findings of fact and conclusions of law Monday about the pending reimbursement changes, which include a 180-day limit on juveniles' stays at the facilities.

The pending DHHR contract, which has been suspended, would replace bundled rates of $250 a day for residential placements to a standard rate of $178 a day for room, board and supervision, while requiring residential care facilities to bill separately for other services provided to each child on a fee-for-service basis.

That change, along with the elimination of three levels of classification of children based on treatment needs, could cause severe financial issues for residential centers that provide more intensive treatment options, according to the commission.

DHHR Secretary Karen Bowling said the proposed changes will align the state with a U.S. Department of Justice report from June 2015 that cites a lack of integrated services and a reliance on "unnecessary institutionalization" as part of the state's failure to comply with the Americans with Disabilities Act.

This refers specifically to the part that requires children and other people with disabilities to "receive supports and services in the most integrated setting appropriate to their needs."

"Given that West Virginia has one of the highest rates of residential placement of children per capita in the country, national experts, as well as the United States Department of Justice, through its investigation, urged immediate changes to our child welfare system," Bowling said.

"The change in the Bureau for Medical Services' state plan was necessary to ensure that all children in need of behavioral health services receive individualized, evidence-based therapy.

"Since October 2015, numerous meetings have been held where these discussions have taken place.

"The West Virginia Department of Health and Human Resources has been open and transparent throughout this entire process."

The commission also noted in its report that no one from the DHHR attended its day-long meeting to discuss the changes in July. According to Bowling, the DHHR declined to attend the meeting, which included more than 75 participants from several impacted agencies, because it was inappropriate for DHHR to argue its case publicly one day before a Kanawha County circuit court hearing on the changes.

But the commission also took issue with the DHHR's apparent refusal to consult with other involved agencies prior to trying to enact its proposed changes.

According to the commission's report, DHHR did not consult with the JJC, approach the Legislature, consult with the West Virginia Intergovernmental Task Force on Juvenile Justice or the Commission to Study the Residential Placement of Children, or alert the state Department of Education.

"The Juvenile Justice Commission is deeply troubled with the testimony provided at the public forum," the report states. "Furthermore, the Commission has taken note that the Department of Health and Human Resources has been provided many opportunities and invitations to explain the aforementioned changes and has refused to do so, seemingly taking the position that no explanation is warranted to the judiciary, providers, educators, and families, among others."

The Juvenile Justice Commission's report called the DHHR's proposals for its residential placement model a "unilateral attempt" to make changes that impact, and potentially violate, state law.

According to the report, Senate Bill 393, passed in 2015, may be impacted by the proposed changes, and that the proposed introduction of a computerized matrix for child placements could impact the role of the multidisciplinary treatment teams tasked by state statute with evaluating individual children's needs.

The matrix could also impact a provider's ability to accept and discharge children from their facilities, according to the report.

Nancy Exline, commissioner for the Bureau for Children and Families, said the matrix is not a new concept, but was developed in 2012 for the Commission to Study Residential Placement of Children as a means to provide information regarding residential providers.

"The matrix will be a tool to ensure workers will match the needs of the youth to the residential treatment provider," Exline said. "The information within the matrix includes location of the facility, number of beds, ages, gender, area of focus for treatment and services, and defines the evidence-based programming or programming used with evidence. This will allow the worker and [multidisciplinary treatment team] to ensure children are placed in the setting that will focus on the individualized needs of the youth."

The Supreme Court has placed a stay on the DHHR's proposed changes, and the agency has until Thursday to file a response.

"We respect the concerns of the judiciary and will continue to collaboratively work with them to improve the child welfare system in West Virginia," Bowling said. "The DHHR will honor the stay issued by the West Virginia Supreme Court of Appeals and is hopeful that the Supreme Court will ultimately rule in the Department's favor."

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

Charleston mother organizes awareness day for overdose victims http://www.wvgazettemail.com/article/20160822/GZ0115/160829855 GZ0115 http://www.wvgazettemail.com/article/20160822/GZ0115/160829855 Mon, 22 Aug 2016 16:28:20 -0400 Jake Jarvis By Jake Jarvis Every time she sees a drug overdose making headlines, Cece Brown said her heart feels heavy.

Most recently, it was when 27 people from Huntington overdosed. A friend of hers, another mother who had a child overdose, texted her about how awful some of the comments were she had seen circling around on Facebook. Brown usually kept herself away from those comments - every time she saw one, she'd tell herself to just keep scrolling.

But this time, she didn't

"They believe it's a decision, but it's not," Brown said. "It's a brain disease. They were saying things like 'they deserve it' or 'we should take them out and shoot them somewhere.'

"Really bad things - things that if you had cancer, no one would say."

Things she wouldn't want anyone to say about her son Ryan, who in April 2014 overdosed fatally. He had been struggling for years with a heroin addiction. He had gone in and out of recovery for a while, but he was doing pretty well before his last incident.

Brown isn't staying silent anymore, and she definitely won't just keep scrolling. In the two years following her son's death, she has waited for something to change, for someone in West Virginia to get the ball rolling and combat the state's high number of overdoses.

She's waited for someone to change the conversation about overdosing to be more compassionate and to separate a person from his or her addiction.

She had hoped that someone would try to organize an Overdose Awareness Day, a day recognized around the world that aims to end the stigma of drug overdoses. No one ever did, so she decided to organize one herself. All it took was a few phone calls and learning how to operate a Facebook page.

Brown is inviting everyone to commemorate West Virginia's Overdose Awareness Day Saturday on the steps of the state Capitol. In addition to a series of speakers and a naloxone training session, Brown is inviting people to bring a pair of shoes to the event to remember any family or friends lost to an overdose.

Attendees will pile the shoes high on the south side steps as a visual reminder of how many people are lost to overdoses every year in West Virginia. The event will run from 10 a.m. to noon.

Brown admits she has never done anything like this before, but her family says she was made for this sort of thing. In her day job, she deals with a lot of committees and subcommittees. She's used to working in a group to delegate responsibilities, define an objective and make measurable progress toward a goal.

"My one worry was getting a sound system," she said, laughing. "I had been saying that I needed to get a microphone and speaker, but apparently that's called a sound system. This is my first time doing an event like this, so I really didn't know a lot of what to do."

Brown and her husband Bobby never imagined their son would become a heroin addict. He was a smart kid, and funny, too. They remember how he could make everyone around him laugh.

The family still has plenty of pictures of Ryan sitting on the mantle in the living room. Of all the pictures the parents have kept, it's a photo of the side of Ryan's face they love the most. It was taken a few years ago, and you can't even get a good look at his face in the photo.

But you can see a warm smile stretching from ear to ear. That's the way Brown wants people to remember her son.

When it came time for Ryan to go to college, he decided to go to West Virginia University.

"I knew that WVU was a bigger school and everything, but I thought the right thing to do was cut the leash, as you would, and give him some independence," Brown said. "My older son went there and did fine, so I thought, 'well OK.'

"Boy, was I wrong."

He came back home to Charleston with a heroin addiction. Friends the family had known for a long time stayed away when they heard about Ryan's addiction.

When the Browns would walk through the supermarket, they would catch the eye of friends they had known for years. Those friends would quickly turn their heads away to look at anything else. For a while following their son's overdose, they felt invisible.

Brown said she thinks about her son every day. She runs through a list of things in her head of all the ways Ryan might still be with them. Maybe if he had gotten a Medicaid card sooner, maybe that would have allowed him to get into a program to keep him from relapsing. Maybe if they had paid closer attention to him when he went away to college, he would never have found heroin.

"The grieving never stops," Brown said.

So instead, she's created "Ryan's Hope." It's just a Facebook page right now, but she hopes to turn it into a nonprofit organization in the coming months. She hopes that the state's first Overdose Awareness Day tribute at the Capitol starts to break the stigma that so many families feel when someone they love overdoses.

Reach Jake Jarvis at



304-348-7939 or follow

@NewsroomJake on Twitter.