www.wvgazettemail.com Health http://www.wvgazettemail.com Gazette archive feed en-us Copyright 2015, Charleston Newspapers, Charleston, WV Newspapers Red Cross urges donations during holiday season http://www.wvgazettemail.com/article/20151125/GZ01/151129677 GZ01 http://www.wvgazettemail.com/article/20151125/GZ01/151129677 Wed, 25 Nov 2015 16:57:06 -0500 This holiday season, the American Red Cross is urging people to give a gift with meaning - a blood or platelet donation.

"During the winter months and especially around the holidays, blood donations tend to decline," said Natalie Haney, donor recruitment director of the Red Cross Greater Alleghenies Blood Services Region. "Long holiday weekends, like Thanksgiving, pose an extra challenge when many donors are traveling to be with family and friends."

Donations typically stay down until the new year - in addition to the holidays, seasonal illnesses and inclement weather can keep donors away, said Red Cross spokeswoman Kristen Hatfield.

"Up to 20 percent of our donor base is high school and college students," Hatfield said. "They're great donors; when they (are on) a break, we feel a loss."

Hatfield said the need for blood - of which there is no substitute - is constant, so any circumstances that pull regular donors away makes for difficult times for the agency.

Blood donors with all types, especially O negative (the universal blood type), B negative and A negative, are urged to give. Platelet donors and those with type AB blood are also continually needed.

To help speed up the process for busy donors this season, Red Cross has launched the new online feature RapidPass. Donors visit redcrossblood.org/RapidPass to complete their pre-donation reading and health history questionnaire online, on the day of their donation, from a computer or laptop.

Hatfield said RapidPass was made available in October, and can streamline the donation process. "It's easy, and I love that it saves time," she said.

While donors are the greatest need Red Cross has, businesses and organizations also can help by opening their doors to blood drive events.

This time of year, there are also fewer blood drives on the calendar as many sponsoring groups back off hosting while people are busy with holiday activities. It takes at least six weeks to schedule and confirm a blood drive, but anyone interested in hosting can reach out now to plan a drive for 2016.

"We're always looking for new sponsors," Hatfield said. "We need to keep collecting every single day to meet needs."

As a way to bring friends or colleagues together, regardless of geographical location, Hatfield said donors can visit redcrossblood.org/sleevesup to set up a virtual blood drive. There, visitors can set a donation goal, invite friends through social media, and tally results as participants donate in their own towns.

Those who come to give blood or platelets from Nov. 29 will receive a Red Cross mixing spoon with recipes from celebrity chefs, while supplies last. For more information, or to make an appointment, download the free Red Cross Blood Donor app, visit redcrossblood.org or call 1-800-RED CROSS (1-800-733-2767).

Indicted Raleigh County doctor wrote thousands of prescriptions http://www.wvgazettemail.com/article/20151125/GZ01/151129688 GZ01 http://www.wvgazettemail.com/article/20151125/GZ01/151129688 Wed, 25 Nov 2015 13:53:22 -0500 Joel Ebert By Joel Ebert A Beckley-based nephrologist indicted Tuesday on multiple drug charges by a federal grand jury had more than 9,000 Medicare Part D prescriptions filled in 2013.

Dr. Jose Jorge Abbud Gordinho, who was arrested Nov. 12, faces a 21-count indictment alleging he conspired to distribute prescription painkillers, such as oxycodone, for illegitimate purposes.

According to a news release from U.S. Attorney Booth Goodwin's office, Gordinho faces "multiple counts of distribution of oxycodone, oxymorphone, hydrocodone and morphine not for legitimate medical purposes in the usual course of medical practice and beyond the bounds of medical practice, as well as two counts of distributing controlled substances not within Gordinho's capacity as a medical doctor."

Among state nephrologists - doctors who specialize in kidney care - Gordinho wrote the sixth-most hydrocodone-acetaminophen Medicare Part D prescriptions, including refills, in 2013. That year, Gordinho handed out 1,577 hydrocodone prescriptions, according to ProPublica, a nonprofit investigative journalism organization that tracks doctors and drugs in the United States.

During the same year, West Virginia doctors wrote more than 426,000 prescriptions, including refills, for hydrocodone-acetaminophen, which is used to relieve moderate to severe pain, making it the most prescribed drug to the state's Medicare Part D patients.

Among nephrologists in West Virginia, the 9,071 prescriptions Gordinho wrote in 2013 was only topped by Vienna-based Mirza Hamirani, who penned 9,136 prescriptions, according to ProPublica's Prescriber Checkup database.

Gordinho also wrote almost 2,000 oxycodone prescriptions to Medicare patients in 2013.

According to the West Virginia Board of Medicine, Gordinho is a 1977 graduate of the Autonomous University of Guadalajara and did his post-graduate training at Mountainside Hospital in Montclair, New Jersey, in 1987.

Gordinho obtained his West Virginia license in 1989, and is also licensed to practice in Virginia and New Jersey.

In 2003, the West Virginia medical board reprimanded him for "certain answers given by Dr. Gordinho on his license renewal form for the period of July 1, 2000, to June 30, 2002." The board has taken no other actions against him.

In June 1999, the Virginia Board of Medicine issued a notice to Gordinho saying the board was looking into allegations that he may have violated several laws in the treatment of seven patients at a hospital in Low Moor, Virginia. Following a six-month review, the board exonerated Gordinho and dismissed the matter with no action taken against him. The issue was the only one on file in the Virginia Board of Medicine's records on Gordinho.

The New Jersey medical board has no history of discipline against the doctor.

The doctor has been held in the Southern Regional Jail since his arrest and could face up to 20 years in federal prison and a $1 million fine for each of the counts included in the indictment.

Gordinho is scheduled to be arraigned on Nov. 30 in federal court in Beckley.

Reach Joel Ebert at joel.ebert@wvgazettemail.com, 304-348-4843 or follow @joelebert29 on Twitter.

Raleigh County doctor ordered to close pain clinic http://www.wvgazettemail.com/article/20151123/GZ01/151129782 GZ01 http://www.wvgazettemail.com/article/20151123/GZ01/151129782 Mon, 23 Nov 2015 21:09:13 -0500 Eric Eyre By Eric Eyre A Raleigh County doctor must immediately stop operating his rural practice as a chronic pain clinic, a judge ruled Monday.

Raleigh Circuit Judge Robert A. Burnside granted a state agency's request for preliminary injunction against Dr. Michael Kostenko and Coal Country Clinic, which sees about 600 patients a month.

The state Department of Health and Human Resources has sought to shut down the pain-pill clinic in Daniels for the past four months - part of a crackdown on facilities that don't comply with new licensing requirements.

"We are thankful for Judge Burnside's decision," said DHHR Secretary Karen Bowling. "Our job is to protect the people of our state and ensure that safeguards are in place for appropriate prescribing of pain medications."

In recent months, DHHR inspectors cited Kostenko and Coal Country Clinic for failing to keep adequate medical records that documented patient assessments and diagnoses. Kostenko, an osteopathic physician, also lacked state-mandated education and training to operate a pain clinic in West Virginia, according to DHHR.

Agency officials twice directed Kostenko to close his clinic, located on C&O Dam Road in Daniels, but he refused, DHHR said.

All of Kostenko's patients were receiving prescriptions for narcotic painkillers, according to state Board of Pharmacy reports.

Kostenko has argued that his practice doesn't have to be licensed as a pain clinic. He said Coal Country Clinic is exempt from state pain clinic rules because the majority of his patients suffer from a "progressive disease that is expected to shorten life," according to a letter sent to DHHR's Office of Health Facility Licensure.

"We are in legal compliance with the pain clinic law," Kostenko said. "Our practice is for community and public health and the treatment of disease. I believe the order, and how it's processed is a little abusive."

The law requires clinics to be licensed, provided more than half of patients are being treated for chronic pain unrelated to cancer or another terminal disease.

Tim Bailey, a patient at the Raleigh County clinic for the past 15 years, said Kostenko is a "good doctor" who never prescribes more pain medication than his patients need. Kostenko has treated Bailey for back and neck pain, Bailey said.

"Someone's got to help people like me," Bailey said. "We can't just go around living in agony. I don't know what I'm going to do."

DHHR inspections have forced 13 pain clinics to close over the past year, after the agency started enforcing new laws that aim to curb prescription drug abuse in West Virginia.

For years, West Virginia's pain clinics essential went unchecked unless a patient filed a complaint against a doctor or nurse through a medical licensing board. State officials have estimated that nearly 60 pain clinics could be operating in West Virginia.

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

Higher deductibles meant to discourage county employees from ER visits http://www.wvgazettemail.com/article/20151122/GZ01/151129834 GZ01 http://www.wvgazettemail.com/article/20151122/GZ01/151129834 Sun, 22 Nov 2015 18:13:51 -0500 Daniel Desrochers By Daniel Desrochers The emergency room at Saint Francis Hospital was dead quiet at 2:30 p.m. on a Friday. The rows of chairs were vacant, the only people inside were two security guards.

On Thursday, the Kanawha County Commission voted to raise county employees' insurance deductible on emergency room visits from $50 to $100 in attempts to help keep it that way.

Last year, the county spent $949,941 on emergency room expenses for its employees. The commission is hoping that with a higher deductible, some people who are going to the emergency room for things they probably shouldn't be, like the flu, will be deterred and will opt for an urgent care or primary care physician instead, both of which are cheaper than an emergency room visit.

While the insurance hike and re-education policy won't save the county that much money, it could help emergency rooms decrease wait times for their patients.

"There's only so many resources in an emergency room," said Mark Stephens, a physician at Charleston Area Medical Center's urgent care. "Only so many doctors and mid-level practitioners and nurses and the more things that they have to deal with, the longer the wait times are."

According to Highmark West Virginia, the insurance company of Kanawha County Employees, 13.9 percent of a company's employees will usually go to the ER for injuries that are minor, or low to moderate. Those are typically the injuries that can be taken care of by urgent care or a primary care physician.

Sometimes, there's a reason for that. The hours of operation for primary care aren't always conducive to family life. If a boy breaks his bone jumping on the bed at a sleepover at midnight, his parents won't be able to take him to the primary care doctor or urgent care. If there's a late-night problem, most patients have only one option - the emergency room.

But not all visits happen at night.

"There are people who go to the ER for non-emergent things because that's pretty much all that they know," said Kala Withrow, a nurse practitioner at the Thomas Memorial Hospital in-house urgent care clinic.

Thomas Memorial Hospital started a new technique to solve the problem in February after facing a rise in minor cases following the expansion of Medicaid - an in-house clinic.

Now, when patients show up to the ER with the flu, they can be sent to the clinic where there's a shorter wait.

"People usually wander in over to us first and basically they'll say they don't know if they should come to us or to the ER," Withrow said.

Thomas has more resources than the average urgent care clinic. They're attached to a major hospital, so they can send people out for X-rays and have an in-house pharmacy attached.

"I know some doctors and some people are kind of leery about what we do here," Withrow said. "They feel like we're taking some of their patients away from them."

But the biggest advantage for patients going to urgent care is that it will cost less on their insurance.

"If you go to the ER and you're not in emergency, for example you just have a cold, the expense is a heck of a lot more for the insurance company," Stephens said. "Because not only do you get charged for the doctors' services and whatever things they do to you, the insurance company gets charged a facility fee."

Cathy McAlister, a Highmark spokeswoman for West Virginia, stressed the advantages of a primary care physician over going to the emergency room or urgent care.

Not only is there a continuity of care when a person goes to a primary care physician, McAlister said, but it can cost less too.

If a person goes to an urgent care facility they risk being marked as a first-time patient, even if they've been there before, according to McAlister. First-time patients are charged more based on insurance codes.

Despite the higher costs, people are gravitating toward emergency rooms and urgent care clinics, according to McAlister.

Urgent care clinics have seen tremendous growth over the past few years and there are now 6,900 urgent care centers in America, according to the Urgent Care Association of America, including at least four in Charleston.

Of course, if there is a real emergency, there's still only one place to go: the emergency room.

"If you have a life threatening emergency and you go to urgent care first, then they send you to the emergency room," Stephens said.

Reach Daniel Desrochers at dan.desrochers@wvgazettemail.com, 304-348-4886 or follow @drdesrochers on Twitter.

WVU doctor among signatories of Johns Hopkins opioid report http://www.wvgazettemail.com/article/20151122/LIFESTYLE03/151129835 LIFESTYLE03 http://www.wvgazettemail.com/article/20151122/LIFESTYLE03/151129835 Sun, 22 Nov 2015 18:13:32 -0500 Lydia Nuzum By Lydia Nuzum A West Virginia University doctor is among 30 experts nationwide who issued a joint set of recommendations this week for combating the nation's opioid epidemic.

Dr. Jeffrey Coben, director of WVU's Injury Control Research Center, traveled to the Johns Hopkins Bloomberg School of Public Health last year to convene with other medical experts to determine the best practices for addressing opioid addiction and treatment in the U.S. The group issued a report Monday with nearly 40 recommendations that focus on addiction treatment, overdose education, community-based prevention, pharmacies, prescribing guidelines, engineering and prescription drug monitoring programs.

"My hope is that this report can actually prevent a lot of unnecessary duplication of effort," Coben said. "What I mean by that is that I think it serves as a really nice summary of the existing evidence and strategies that can be implemented. For example, here in West Virginia, we grapple with confronting this problem, and do work at the state and local level - I don't think we need to reinvent the wheel by doing a lot of additional research ... I think this report really summarizes what we can do, and we should be thinking more about how we can implement, and what can we implement, at the state and local level to move these recommendations forward."

Coben, whose experience is focused primarily on emergency medicine, said he has treated many overdosing addicts. The Injury Control Research Center he directs at WVU is one of 10 of its kind in the nation supported by the Centers for Disease Control and Prevention - another is at Johns Hopkins. The WVU Injury Control Research Center has worked extensively on projects linked to opioid abuse at the local level, Coben said, including helping train Monongalia County law enforcement to administer naloxone, a drug that reverses overdoses.

"I have been involved in several areas of research trying to better address this problem," he said. "[At the WVU ICRC] we've done some research looking at how to better inform providers about patients who are getting prescriptions from multiple places by using the Prescription Drug Monitoring Program; we've also been working ... in communities around West Virginia, looking at the feasibility of doing community education and take-home naloxone programs."

Some of the specific recommendations include expanding access to medicine-assisted treatment for drugs like buprenorphine and suboxone, as well as expanded access to overdose-reversing drugs like naloxone. It also outlines the need for improved monitoring for prescribers, pharmacies and beneficiaries; more training for opioid-prescribing providers; the repeal of lax laws and rules on prescriptions; and greater support for take-back programs. According to Coben, the solutions for each of the recommendations will have to come from a mix of stakeholders at the local, state and national level.

"For example ... the number of patients an addiction specialist can treat with buprenorphine is currently limited by federal laws," he said. "Those things can and should be addressed at the federal level. There are issues that should be addressed at the state level - prescription drug monitoring programs, for example, are all managed at the state level. Prescriber guidelines can be most effectively addressed at the state level ... and then there are issues that are very local and that involve community programs."

The full report, called "The Prescription Opioid Epidemic: An Evidence-Based Approach," is available online.

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

Putnam YMCA open Thanksgiving morning http://www.wvgazettemail.com/article/20151121/GZ05/151129924 GZ05 http://www.wvgazettemail.com/article/20151121/GZ05/151129924 Sat, 21 Nov 2015 00:01:00 -0500 Elaina Sauber By Elaina Sauber The Tri-County YMCA is opening its doors to those looking to offset the inevitable extra calories that accompany Thanksgiving meals.

The Scott Depot-based center is providing a free Thanksgiving Day workout to anyone who wants to use its facility between 8 and 10 a.m.

Executive Director Cathy Stark said the Tri-County YMCA has been open on Thanksgiving for the past 20 years or so, an outreach effort made possible through a grant from Dow.

The wellness center, gym and racquetball courts will be open to members and nonmembers, and staff will be on site to help people through their workouts, she said. The aquatic center and the facility's child-care services will be closed that day. Those who participate are asked to bring a donation of two canned food items for The Church at The Depot's food pantry, according to a YMCA news release.

"On a day we would normally be closed, we do it so we can give back to the community for the food program," Stark said. "People know they are doing something good for their health and helping needy people at the same time."

A special group-fitness class will be held from 8:15 to 9:50 a.m. on Thanksgiving Day, Stark said, in which instructors will lead sessions of classes, including Zumba, step strength and boot camp.

Residents also are welcome to bring visiting family members from out of the area, Stark said, "to come in and experience everything we have."

West Virginia has the second-highest rate of obesity in the United States. Since 2000, the state's adult obesity rate increased from just under 24 percent to 35.7 percent in 2014, according to the 2014 State of Obesity report, which is a project of the Trust for America's Health and the Robert Wood Johnson Foundation. West Virginia closely trails Arkansas, with a 35.9-percent obesity rate.

In 2014, 14 percent of adult West Virginians were living with diabetes, while more than 40 percent had hypertension, according to the report.

"We all usually overindulge at Thanksgiving," Stark said. "If people come and at least work out for that time, maybe they'll counter some of those calories."

Reach Elaina Sauber at elaina.sauber@wvgazettemail.com, 304-348-3051 or follow @ElainaSauber on Twitter.

WV DHHR Medicaid lawsuit settlement means HMO contracts must be bid out http://www.wvgazettemail.com/article/20151120/GZ05/151129928 GZ05 http://www.wvgazettemail.com/article/20151120/GZ05/151129928 Fri, 20 Nov 2015 17:11:12 -0500 Lydia Nuzum By Lydia Nuzum A lawsuit brought against the West Virginia Department of Health and Human Resources by five West Virginia residents has been settled, and will force the agency to competitively bid its contracts with Health Maintenance Organizations that provide Medicaid managed care in the state.

Five people filed a petition in late April claiming that the DHHR violated state code by not competitively bidding HMO contracts, and that "the failure of [the Bureau for Medical Services] to comply with the laws governing the procurement of contracts under the . . . program places the state of West Virginia at risk of a significant negative impact to its budget and places a substantial burden upon West Virginia taxpayers."

The five plaintiffs also sent notice, as required by law, that they would sue the DHHR and the state Bureau for Medical Services over "the agencies' failure to follow state law."

"This is a clear victory for the citizens and taxpayers of West Virginia, and it will cause the state to engage in competitive bidding of these billion-dollar contracts and stop the hand-selecting of a few companies," plaintiffs' attorney Jesse Forbes said. "The Legislature spoke very clearly in making these contracts subject to bidding requirements. This case was always about making [the] DHHR follow the law, and this agreement does just that."

The petition and the lawsuit were resolved by an agreement entered in Kanawha County Circuit Court this week. The Bureau for Medical Services will submit all Medicaid managed care contracts to the West Virginia Department of Administration, Division of Purchasing, to be competitively bid and procured beginning in fiscal year 2017. The agreed settlement notes that the DHHR must comply with transparency laws, in regard to its Medicaid program, and must issue public performance summaries on the HMOs each year.

Jeremiah Samples, DHHR deputy secretary for public health and insurance, said the agency chose to enter into a settlement agreement to save taxpayers further litigation expenses and to eliminate the uncertainty the case had created for Medicaid patients, providers, and payers.

"[The] DHHR stands by the position that its contracting practices for Medicaid managed care have complied with federal and state law. These contracts were constructed to harness the innovation and efficiencies of the private sector to improve quality for our Medicaid members and to control the spending of taxpayer dollars," Samples said. "The Department is committed to [using] the procurement process in a manner which ensures quality service delivery and the protection of taxpayer interests."

The settlement requires that Medicaid managed care contracts not exceed 48 months and have a medical loss ratio of at least 85 percent, meaning that managed care companies must spend at least 85 percent of their Medicaid payments on services to recipients, leaving no more than 15 percent for the companies' profits and administrative costs. According to the settlement, any managed care company that fails to meet the 85 percent MLR requirement would have to rebate the difference.

"Because Medicaid was not bidding out these contracts, we were losing up to $100 million a year," said Patricia Rucker of Harpers Ferry, one of the plaintiffs. "With this settlement, I think, taxpayers are going to be gaining because we're going to be saving money, it's going to be a more transparent system, and we're going to be a lot more efficient."

In the past, the DHHR had argued that, because it currently pays the HMOs the lowest rates allowed by federal law, bidding out the contracts could result in higher payment rates for the state with no guarantee of improved care.

The agency has an MLR rebate model in its current HMO contract that would penalize the plans for not being able to maintain an MLR of 85 percent or more. The HMOs have not yet submitted their final raw data for this contract year, Samples said, but he added that, because the MLR requirement is in place, plans that fall short of the 85 percent MLR will have to rebate the state the difference.

Samples said the idea that competitive bidding would save the state money "isn't realistic" - plans would only submit capitation rates to the state and not a projected MLR, he said, and the state could likely pay a higher rate without a guarantee of improved care.

"If a plan comes in and their proposed rate is well below what an actuary will sign off on, an actuary wouldn't sign the letter we submit to [the Centers for Medicare & Medicaid Services], and conversely, if they come in at a level that is above the actuarial range, then the same situation would occur," Samples said. "The risk in this entire process, and it's something we've said several times, is that, because we've been at the actuarial floor, if the plans come in at a higher rate but are still within range, then we could see an increase in the cost of managed care.

"The notion that there is going to be money saved through this process is - I just don't understand how people can come to that conclusion," he said.

Local health care consultant Tom Susman said his group's latest evaluation of the HMO's medical loss ratios still put them below 85 percent, and that a court order to meet those requirements likely would have more weight than a DHHR rule.

"Had the plans been at 85 percent . . . if the plans cost a billion dollars, then it could get north of $100 million [in savings]," he said. "What we understand is that they're operating off the [Temporary Assistance for Needy Families] rates, because the new rates haven't been approved by [the] CMS, so when they put the new rates in, which may be higher, and there's no legislation that requires them to be at 85 percent - if the suit mandates they be at 85 percent, I would suspect that if they're at less than that, with a billion dollars, it wouldn't take long to get to $100 million."

Forbes said that because West Virginia has some of the lowest HMO MLR rates in the nation and some of the worst health statistics, the idea that low capitation rates alone will amount to the greatest savings is "short-sighted," and that more money spent by HMOs on health care could equal even more savings with improved health outcomes.

"The short-sighted argument that we had all the way through this was the argument from the other side that said 'our capitation rates are already at the floor.' If you open it up to competitive bidding, you can have someone who comes in and is willing to take a contract like that and agree to hit an even higher MLR rate," Forbes said. "It could save a lot of money - it seems like, every week, we have the DHHR with some sort of budget shortfall, so we're hopeful this will allow for more money to be saved by taxpayers and to be used toward other budget shortfalls."

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

School flu shots down due to nationwide manufacturing problem http://www.wvgazettemail.com/article/20151119/GZ01/151119415 GZ01 http://www.wvgazettemail.com/article/20151119/GZ01/151119415 Thu, 19 Nov 2015 20:12:20 -0500 Lydia Nuzum By Lydia Nuzum The Kanawha-Charleston Health Department missed out on administering nearly one-third of the influenza vaccinations it normally does for school children this year after a problem with the formulation of the nasal spray caused health-care providers nationwide to receive fewer doses of that form of vaccine.

Candace Nunley, office manager for clinical operations at the KCHD, told Kanawha-Charleston Board of Health members Thursday that the department was down 1,800 shots because the it didn't receive the shipment of intranasal vaccine it had expected. All providers this year were affected, so many doctors offices also did not have enough of the intranasal vaccine available, Nunley said.

"Many parents will opt for the nasal spray," said KCHD administrator Lolita Kirk. "Because we weren't able to provide it, we had fewer children getting the shots."

The nasal spray is a live vaccine approved for use in those between 2 and 49 years old. Roughly half of kindergartners opt for the nasal spray, Nunley said. The health department now has a few hundred doses of the nasal spray on hand, and will have more in December. Nunley encourages parents to bring their children to the KCHD to receive the intranasal vaccine.

"It was just a fluke with the manufacturer," Nunley said. "Since that happened, we just didn't have enough to go out to the schools."

It will be hard to tell whether the 1,800 missed shots will correlate to a higher instance of flu for school children this year, but Nunley stressed that the KCHD still has plenty of doses of the regular vaccine.

"It's just a matter of them getting the shot over getting the nasal - the parents need to tell them that, this year, it's time for the shot," Nunley said.

Dr. Michael Brumage, health officer for the Kanawha health department, said the agency still is gathering responses for its Adverse Childhood Experiences survey.

The 15-question, anonymous survey focuses on respondents' childhood experiences and their demographic information. The department hopes to take the results and determine if their is a correlation between negative experiences in childhood and poor health outcomes in adulthood for residents of the Kanawha Valley.

To take the survey, go to the Kanawha-Charleston Health Department's website at http://www.kchdwv.org/ and click on the green icon that says "The Adverse Childhood Experiences Survey."

The board also swore in Martha Yeager Walker for a full term on the board. Walker, a former state legislator and former cabinet secretary for the West Virginia Department of Health and Human Resources, joined the board in May to fill the unexpired term of Shannon Snodgrass, who resigned from the board in March.

The board held a moment of silence for Dr. Donald Rosenberg, a former health officer for the KCHD who died in October. Rosenberg served as the health officer for the department from 1986 to 1999, and again as the interim health director in 2003.

Reach Lydia Nuzum

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

@lydianuzum on Twitter.

Board dismisses complaint against pain clinic doctor http://www.wvgazettemail.com/article/20151118/GZ01/151119497 GZ01 http://www.wvgazettemail.com/article/20151118/GZ01/151119497 Wed, 18 Nov 2015 11:05:12 -0500 McMECHEN, W.Va. (AP) - The West Virginia Board of Osteopathic Medicine has dismissed a complaint against a doctor whose license was suspended amid allegations of unsafe injection practices.

The Intelligencer and Wheeling News-Register reports that the board recently determined there was no probable cause to believe Dr. Roland Chalifoux demonstrated a lack of professional competence to practice medicine, or acted unprofessionally.

Chalifoux told the newspaper that he and the Northern Panhandle are owed an apology.

The board had suspended Chalifoux's license in July 2014 after a state investigation found sanitation problems at Valley Pain Management in McMehen.

Kanawha County Circuit Court Judge Charles King later reinstated Chalifoux's license. King ruled that the board failed to show Chalifoux engaged in unsafe practices.

CAMC, Saint Francis hospitals earn national recognition http://www.wvgazettemail.com/article/20151117/GZ01/151119531 GZ01 http://www.wvgazettemail.com/article/20151117/GZ01/151119531 Tue, 17 Nov 2015 18:15:03 -0500 Lydia Nuzum By Lydia Nuzum The state's largest hospital system has become the first entity in West Virginia and the only health-care agency this year to receive the nation's highest Presidential honor for performance excellence.

U.S. Commerce Secretary Penny Pritzker announced Tuesday that Charleston Area Medical Center was one of four recipients of the 2015 Malcolm Baldrige National Quality Award. The award, which is given to businesses and organizations from six sectors, including manufacturing, service, small business, health care, education and nonprofits, is meant to recognize an organization's "outstanding commitment to sustainable excellence through innovation, improvement and visionary leadership."

"We have so many local measures of quality that we work diligently on, but the unique thing about Baldrige is that it looks at the entire organization; it looks at many categories - our customers, our vendors, our patients, our entire workforce, our communication processes, our leadership processes - it's a very complex amount of data," said Elizabeth Pellegrin, chief marketing director for CAMC. "I think it points to - because the Baldrige criteria is for all types of companies, how we're performing when compared to other companies all across the United States, including those in health care."

CAMC has ranked in the top 5 percent for quality inpatient service by Healthgrades, a national service that rates the performance of physicians, hospitals and health care providers, for the last two years, and has received the group's Distinguished Hospital Award.

An independent board of examiners recommended this year's Baldrige Award recipients from a field of 26 applicants after evaluating them in seven areas defined by the Baldrige Criteria: leadership; strategy, customers, measurement, analysis and knowledge management, workforce, operations and results.

"CAMC is leading the nation in quality care by providing second-to-none health services at its facilities around West Virginia," said U.S. Sen. Joe Manchin, D-W.Va. "Just last month, I had the opportunity to tour CAMC's new Cancer Center in Charleston, meet with the dedicated doctors and staff and see firsthand the great work they are doing to provide the highest level of comprehensive care to patients.

"This award is a testament to the superior care being offered at CAMC hospitals and facilities and the health system's deep commitment to quality care and to the communities it serves."

Saint Francis also announced Tuesday that it had been recognized as a 2015 "Top Performer on Key Quality Measures" by The Joint Commission, the foremost hospital accrediting body in the U.S.

The award recognizes hospitals for improving performance on evidence-based interventions that increase the chances of healthy outcomes for patients with certain conditions. The performance measures evaluated in the recognition program include heart attack, heart failure, pneumonia, surgical care, inpatient psychiatric services, stroke, venous thrombo-embolism, perinatal care, immunization, tobacco treatment and substance use.

"I think it validates all of the work that we've done on quality in ensuring that we're providing quality care; it's validation of the culture we're trying to promote," said Brian Lilly, the vice president for quality for Thomas Health System. "Putting the patient first, making sure they have great outcomes, and following evidence-based medicine that has a proven track record."

Saint Francis had a cumulative performance rating of 95 percent or above across all of its reported accountability measures. Saint Francis Hospital is one of only 1,043 hospitals out of more than 3,300 eligible hospitals in the United States to achieve the 2014 Top Performer distinction.

"We understand what matters most to patients at Saint Francis Hospital is the quality and safety of the care they receive. That is why we have made it a top priority to improve positive patient outcomes through evidence-based care processes," said Dan Lauffer, president and CEO of Thomas Health System. "Saint Francis Hospital is proud to be named a 'Top Performer' as it recognizes the knowledge, teamwork and dedication of our entire hospital staff."

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

@lydianuzum on Twitter.

DHHR to host health care job fair in Huntington http://www.wvgazettemail.com/article/20151117/GZ01/151119554 GZ01 http://www.wvgazettemail.com/article/20151117/GZ01/151119554 Tue, 17 Nov 2015 14:10:13 -0500 The West Virginia Department of Health and Human Resources' Bureau for Public Health will host a health professions recruitment fair on Thursday, National Rural Health Day, to allow health care providers from across the state the chance to recruit for a range of jobs in the field.

The event allows prospective job candidates to learn about employment opportunities that include practicing or resident physicians, interns, dentists, pharmacists, physician assistants, nurse practitioners, nurse midwives, nurses, licensed practical nurses, occupational and physical therapists and office staff.

"National Rural Health Day serves as a reminder of the importance of linking health care providers with health care facilities across the state to assist an aging population with a number of chronic conditions," said Dr. Rahul Gupta, state health officer and commissioner for the Bureau for Public Health. "I encourage anyone with an interest in the health field to attend this fair to explore the opportunities in West Virginia's rural communities."

The fair will be held from noon until 7 p.m. Thursday at the Marshall University Memorial Student Union in Huntington. To register, call 304-558-4382 or 888-442-3456. Walk-ins are welcome.

For more information, contact Karen.K.Pauley@wv.gov or Brandon.K.Carman@wv.gov.

Alternative heart cath method more comfortable for patients, doctors say http://www.wvgazettemail.com/article/20151116/GZ05/151119608 GZ05 http://www.wvgazettemail.com/article/20151116/GZ05/151119608 Mon, 16 Nov 2015 13:49:34 -0500 Lori Kersey By Lori Kersey The last time Edsil Prunty underwent a heart catheterization, he was surprised to be able to leave the hospital so soon after the procedure.

"I went in at 7 a.m. and was ready to go at noon. That's what's amazing," Prunty said. "I think this makes my third or fourth one."

Prunty, 60, of Charleston, is a diabetic and has had heart problems since 1998. While the procedure in August wasn't his first catheterization, it was the first transradial catheterization he'd had.

Catheterizations, a procedure to detect or unclog arteries, have traditionally been done using the femoral artery through an incision in the groin. But an alternative to that method - transradial catheterizations, a method that requires an incision in the radial vein in the wrist and to the heart - may have better outcomes for patient.

"It's more comfortable, less bleeding, fewer complications [for patients]," Dr. Donald Lilly, cardiologist and clinical director of Charleston Area Medical Center cardiovascular services, said.

Radial catheterizations have been less accepted in the United States than in Europe and other countries, where nearly 80 percent of caths are transradial. In the United States, 20 to 25 percent of the catheterizations are done through the radial vein. About 20 percent of catheterizations at CAMC are radial.

"It's a little harder to do," said Dr. Dan Foster, a surgeon and former state senator. "It's technically a little more demanding. It does take some time. For someone who has practiced [medicine] 20 to 25 years, changing the way you do something is not easy."

Foster knows about heart catheterizations first hand - 11 years ago he had a heart attack and underwent an emergency heart catheterization and bypass, he said. At the time, he wasn't aware that doctors could use the radial vein for the procedure, he said.

"If I had one again I'd do it this way," he said.

Heart catheterizations are the most commonly done procedures at CAMC; the hospital does 8,000 to 9,000 of them each year, Foster said. That's a reflection of the general health of Southern West Virginia, Lilly said.

"There are these things called cardiac risk factors that increase your chances of having blockages," Lilly said. "The worst of those is cigarette smoking then diabetes, high cholesterol, high blood pressure and you can go on down..."

Physicians have different perspectives about whether transradial catheterizations are the best things for patients. Physicians can use bigger tubes in the groin and certain devices can be used in the groin but not the wrist, Lilly said.

Dr. Shawn Groves, a cardiologist at CAMC, said he does catheterizations through the wrist about 50 percent of the time. The transradial procedure is more technically challenging, and some patients have issues that prevent them from having it done, he said. Groves said CAMC as an institution does transradial catheterizations about 20 percent of the time. Groves said the procedure likely will become more popular at CAMC and in the United States in general.

"If I think the patient is a candidate [for the procedure], I do recommend it," Groves said. "Not everyone is."

There are advantages to the new approach though, the doctors said.

When doctors use the femoral artery, a patient has to stay laying down in a hospital bed for hours after the procedure.

"So if you do [a diagnostic catheterization] from the groin you almost always have to watch them at least eight hours and if you do it late in the day you generally just watch them overnight, keep them, whereas with the wrist you can let them go a lot sooner than that," Lilly said.

Just how soon depends on the physician, he said. With the transfemoral catheterization, patients then have to wear a bandage on the groin which can be uncomfortable.

"With [transradial catheterizations] there's just a little band there," Lilly said. "With this, you can sit up and eat and do whatever you want to."

The bleeding rate from the femoral catheterization is higher than with the wrist, too, he said. Patients of the transradial procedure are less likely to need a blood transfusion, he said.

Foster said the transradial procedure may be better for heart attack patients, too.

"The data seems to show that if you're in the midst of a heart attack, the outcomes regarding survival or other complications of a heart attack are a bit improved," Foster said. "I guess the assumption is since you don't have to worry about bleeding, you can give more blood thinner than you can with the groin."

Evelyn Ellis, 81, of White Sulphur Springs, had a transradial catheterization in August. It was her fourth catheterization and the first time it was done through the radial artery, she said. Ellis said the recovery time after her latest procedure was much lower than it had been with the others. She also didn't develop hematoma, a swelling of clotted blood within tissue, this time like she had in the past.

"I always got hematoma really bad and I had to stay in the hospital," she said of her transfemoral catheterizations. "This time it was easy. I hope and pray if I have to have another one, it'll be the way I go."

Ellis had heard of the transradial catheterizations, and asked her doctor for it by name. Foster said other people may not be aware of the option.

"I think in fairness to the public, they need to be part of the discussion about what's being done and that involves knowing [their options]," Foster said.

Prunty said since his procedure, he has encouraged others to have transradial catheterizations the next time they need the procedure done.

"I've actually told several people about it," Prunty said, adding that when he told people at his church, some had heard about it and some hadn't. "I showed them where they stuck the needle in and it's barely see-able now, just like a little start, a needle puncher. It's healed up beautifully. What's really nice is you can take a shower the next day. Before, you had to wait two or three days."

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

Lung disease patients, caregivers invited to respiratory rally http://www.wvgazettemail.com/article/20151115/GZ05/151119750 GZ05 http://www.wvgazettemail.com/article/20151115/GZ05/151119750 Sun, 15 Nov 2015 00:01:00 -0500 Lori Kersey By Lori Kersey Until just before she was diagnosed with cancer, Nancy Tonkin thought she was perfectly healthy.

The 59-year-old Nitro resident had been on vacation and was living an active lifestyle, walking several miles a day.

"I walked Mount Vesuvius six weeks before I was diagnosed," she said.

But in November 2013, when she couldn't shake the cold she got on the plane ride after a cruise, she decided to get it checked out. After a 5 p.m. chest x-ray, her doctor called her at 7:30 p.m. and told her to get to a hospital emergency room immediately - there were blood clots on her lungs. She was in the hospital for 10 days and ultimately diagnosed with stage-4 lung cancer.

"It really does suck," Tonkin said of the cancer diagnosis. "I was already planning my next weekend. I was taking the dog here. I was going there.

"[When you're diagnosed with cancer] you have to stop and then your life gets taken over by medical people to cure you or to make your life easier to live," she said.

Lung disease, which includes lung cancer, asthma, COPD and other respiratory illnesses, is the third leading cause of death in the United States. While people typically associate lung cancer with smoking, not every lung cancer patient has a history of smoking.

"We have patients now that have never used any tobacco products," Jessica Randolph, a lung navigator at the Charleston Area Medical Center Cancer Center, said.

That stigma can sometimes make it difficult to raise money for the cause, said Chantal Fields, area director of the American Lung Association.

Tonkin has a family history of cancer and of second-hand smoke. Her mother was a smoker and died of lung cancer in 1993. Tonkin herself smoked socially during college.

"On Jan. 1, 1980, I gave up smoking cigarettes and I haven't really had a cigarette since then," she said.

Perhaps ironically, Tonkin was also a lobbyist and an advocate for increasing the tobacco tax in West Virginia and putting in place clean indoor air ordinances.

"Even before I had lung cancer, I was this rabid advocate - I can't breathe when I smell cigarette smoke," she said. "I can't enjoy a meal. I can't enjoy a glass of wine. I have to leave."

Now she's fearful the cigarette smoke will be detrimental to her cancer treatment, she said.

Tonkin also believes the environment where she has lived the past 30 years played a part in her cancer.

"I'm not blaming the chemical plants but there are an awful lot of days when it is pretty stinky in Nitro," she said. "Not so much recently, but 20 and 30 years ago it was and that's our community."

Two years into her cancer diagnosis, Tonkin is having chemotherapy treatments every two weeks, she said. Her hair thinned out for a while but has grown back, she said.

Tonkin tries to take care of herself. Part of that involves staying free of viruses. She doesn't hug and kiss people anymore. When she meets a new person she'll offer a fist bump instead of shaking their hands.

Her advice for people is to get any potential problems checked out by a physician.

"Don't hesitate," she said. "If you think you're having lung problems, get tested because it's not going away."

Even if a person doesn't have symptoms, they may still have lung cancer. Rarely is someone with stage 1 or 2 diagnosed with lung cancer because they don't show symptoms, Randolph said.

Low-dose CTs, which are used to screen for lung cancer in people who are not having symptom, are now covered by Medicare for eligible patients, Randolph said.

Lung disease patients and their caregivers as well as students are invited to tomorrow's Respiratory Rally, hosted by the American Lung Association.

The event, which is in its seventh year, will be held from 9 a.m. until 2 p.m. Tuesday at the CAMC Cancer Center. The one-day event is geared toward lung disease patients, caregivers and students enrolled in health care programs. Presentations will include relaxation methods, pulmonary rehabilitation, lung cancer and getting the most from your medications.

There will also be health screenings throughout the day.

Chantal Fields, area director of the American Lung Association, said the event is a chance for patients that have experienced similar things to meet each other. Many people feel isolated by their disease, she said. The event also introduces them to resources they may not have been familiar with, and the educational resources are helpful.

"It's just a neat day," Fields said. "It gets people out of their houses somewhere where they're around experts and they can ask people questions."

One of the health screenings offered by Baxalta will be a test for the genetic form of chronic obstructive pulmonary disease. Most cases of COPD are caused by smoking, but the Alpha-1 gene also causes it.

"That makes a huge difference - to know if you have that disease," Fields said. "Baxalta comes every year because they have such success with it. They have found a few Alpha-1 patients."

This is the first year the rally is being held at the Cancer Center, which opened earlier this year.

People are welcome to come and go from the rally as they please, Fields said.

The schedule of events for the day is as follows: 9 a.m. to 2 p.m. - vendor fair open and free health screenings;

10 a.m. until 10:30 a.m. - a program about relaxation techniques and essential oils by Debbie Elkins; 10:30 a.m. to 11:30 a.m. a session about pulmonary rehab by Len Picha; 11:30 a.m. to noon - lunch; noon to 1 p.m. a session on lung cancer by Dr. Steven Jubelirer and cancer navigator Jessica Randolph; 1 to 1:30 p.m. - a session about getting the most from your medications by pharmacist Anne Teichman.

For more information on the rally, contact Fields at 304-342-6600 ext. 312.

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

Kanawha health officials seek adverse childhood experience data http://www.wvgazettemail.com/article/20151112/GZ01/151119824 GZ01 http://www.wvgazettemail.com/article/20151112/GZ01/151119824 Thu, 12 Nov 2015 20:00:04 -0500 Lori Kersey By Lori Kersey Officials from the Kanawha-Charleston Health Department want to know how your childhood was - and they want you to know how that could affect your health now.

For the next two weeks, residents may take the Adverse Childhood Experiences Survey on the health department's website.

Bad childhood experiences can lead to poor health and public health consequences for adults, said Dr. Michael Brumage, executive director of the KCHD.

"Until we really begin to address the adverse childhood experiences, we're never going to get to the bottom of the major public health problems that we face here in Kanawha County, Putnam County or the state of West Virginia or anywhere else in the United States for that matter," he said.

The survey asks resident 15 questions about their childhood experiences and their demographic information. At the end, people are told their ACE score, a number from 1 to 10.

The higher a person's score, the higher their risk for smoking, obesity, suicide, depression and drug abuse, Brumage said.

"That doesn't mean that you will have those problems because there are resiliency factors that the ACE score doesn't measure, but it gives you a good indication of maybe not 'what's wrong with me' but 'what's happened to me,'" Brumage said.

The health department's survey is confidential. The survey does not ask a person's name, and health officials won't see results from individual surveys, just as aggregate data, Brumage said.

Dr. Joan Phillips, a child abuse and neglect pediatrician at Charleston Area Medical Center, said often when she sees children as young as kindergartners they already have had four adverse experiences, which can include abuse, living in a drug environment and having a parent incarcerated. Those experiences can cause toxic stress in children, she said.

"We now know that this toxic stress actually changes their body physiologically and actually changes the structure of the brain," Phillips said. "So this is not just about mental health, this is brain health. These are long-lasting effects."

The survey is open to residents anywhere, not just those in Kanawha and Putnam counties.

The survey is based on a similar study conducted as collaboration between the Centers for Disease Control and Prevention and the Kaiser Permanante's Health Appraisal Clinic in San Diego.

Dr. Vincent Felitti, of Kaiser Permanante, one of the investigators of the study, said that what happens in a person's childhood often has a big effect on a person as an adult. He used the analogy of a house fire - if a person sees smoke coming out of a house and brings in fans to disperse the smoke, they're only going to make the fire bigger. In the same way, obesity and other problems are often the symptoms of deeper issues, he said.

"In other words, we must treat the fire as well as the smoke," he said. Felitti spoke at the press conference by speaker phone from San Diego.

An ACE score of more than 6 increases a person's likelihood of intravenous drug use by 4,600 percent, Felitti said.

The survey will be up for two weeks. After that, health officials will analyze the data and then announce it at a later press conference, he said.

Brumage said he hopes people take the survey and read the information on the department's website to find out what the score means for their health. He also hopes to educate medical providers about what the score is and how it can be useful in clinical practice.

To take the survey, go to the Kanawha-Charleston Health Department's website at http://www.kchdwv.org/ and click on the green icon that says "The Adverse Childhood Experiences Survey."

Reach Lori Kersey at


304-348-1240 or follow

@LoriKerseyWV on Twitter.

Free health insurance enrollment session today http://www.wvgazettemail.com/article/20151112/GZ01/151119912 GZ01 http://www.wvgazettemail.com/article/20151112/GZ01/151119912 Thu, 12 Nov 2015 00:01:00 -0500 State residents who are interested in free, in-person help in learning how they might enroll or re-enroll in health insurance under the provisions of the Affordable Care Act are invited to attend an information and enrollment session from 3 to 7 p.m. today at the Charleston Town Center Mall, in the Bureau of Senior Services office, located across from the 3rd floor Food Court.

WV NaviCare, the Bureau of Senior Services, and the Appalachian Area Agency on Aging, working under a cooperative agreement with the federal Centers for Medicare and Medicaid Services, will provide information about how the new health insurance exchange operates under the ACA. They also will show people how they can sign up for low-cost health insurance plans. No appointment is necessary and there is no charge for this educational session or enrollment assistance.

Financial help is available when signing up for health insurance through the Marketplace. In 2015, 86 percent of West Virginians qualified for financial help in obtaining health care coverage.

For those that are already enrolled in Marketplace health insurance, new plans and prices are available. Those with current Marketplace coverage should pick a new plan or re-enroll in their existing plan by Dec. 15 to prevent a lapse in coverage.

More information is available at www.wvnavicare.com. That site includes resources for enrollment help, a calendar of enrollment events and an overview of facts and other information about health insurance, the Marketplace and the Affordable Care Act.

Ohio County board expands smoking ban to motels, other sites http://www.wvgazettemail.com/article/20151111/GZ01/151119911 GZ01 http://www.wvgazettemail.com/article/20151111/GZ01/151119911 Wed, 11 Nov 2015 09:55:38 -0500 WHEELING, W.Va. (AP) - Health officials are expanding Ohio County's smoking ban to hotels, motels and outdoor public places.

Media outlets report that the Wheeling-Ohio County Board of Health approved a revision to the county's clean air regulations on Tuesday.

The revised regulations also prohibit the use of electronic cigarettes and vaporizing devices in public. The changes go into effect March 1, 2016.

Smoking will still be allowed on the gambling floor at Wheeling Island Hotel-Casino-Racetrack and in other establishments' designated video lottery rooms.

The existing 2005 regulations ban smoking in restaurants, bars and other indoor public venues in the county.

Former Derakhshan patient touts neurologist's care at board meeting http://www.wvgazettemail.com/article/20151109/GZ01/151109461 GZ01 http://www.wvgazettemail.com/article/20151109/GZ01/151109461 Mon, 9 Nov 2015 19:09:50 -0500 Joel Ebert By Joel Ebert One week after the conclusion of Charleston neurologist Iraj Derakhshan's public hearing, a former patient of the embattled doctor delivered a message to the West Virginia Board of Medicine.

"I just want to ask that this board remember that part of your function is help protect the public's ability to receive good care," Patricia Falbo said on Monday.

Falbo, who began seeing Derakhshan in 2000, told the board that while those who have been receiving narcotic medication for long-term treatment are probably physically dependent on the drugs they imbibe, that does not make them an addict.

"A drug addict, in my opinion, is someone who is abusing medication with intent," she said. "They know they're abusing it and they're abusing it for a reason - to get high."

Falbo said patients who receive painkillers as part of a long-term treatment plan understand the risks associated with taking the powerful drugs. Overall, she said, the benefits of being able to function normally outweigh the risks.

The message is one that doesn't get heard too often because it can be seen as "politically incorrect," she said.

"Please in all your future decisions remember the other side of the narcotic drug story, the chronic pain sufferer," she said. "When they take a medical license or a DEA [U.S. Drug Enforcement Administration] license, maybe they need to consider putting some kind of emergency doctor into place because you have that problem of people being suddenly released and turning to street drugs and that has been happening recently, I know that for a fact."

Turning to the case of Derakhshan, who was named in a 15-count complaint by the medical board as a result of the doctor's history of writing prescriptions for Schedule II drugs, such as oxycodone, Falbo said it can be a months-long process for patients to find a new doctor.

Many of Derakhshan's patients, including Falbo, have been forced to find another doctor after he had to stop writing prescriptions for painkillers as a result of the DEA not providing him his federal registration number.

A resident of Fayette County, Falbo said under Derakhshan's care, she has been able to successfully operate her 200-acre farm by herself.

"I speak from personal knowledge and true conviction that Dr. Derakhshan does everything he does because of compassion and not for any nefarious reasons or excess financial gain," Falbo concluded.

The message came after the board had concluded the majority of its hour-long meeting.

The board took no action regarding the doctor. The agency is expected to have a final ruling on whether or not to impose any sanctions against Derakhshan during the board's next meeting, which is scheduled for January 11.

In addition to Falbo's comment, the board covered a variety of topics, including complaints, consent orders and potential legislation that will be introduced during the upcoming 2016 legislative session.

The board was given notice that several pieces of legislation that would affect the agency could be expected, including one related to telemedicine - the practice of using telecommunication technology to provide clinical care from a distance.

While a telemedicine bill was introduced during the 2015 session, it ultimately failed to make it to the governor's desk. Following the conclusion of Monday's meeting, Robert Knittle, the board's executive director, said this year things could be different.

"I think it will be a governor's bill," he said.

Dr. Rahul Gupta, state health officer and commissioner for the West Virginia Bureau for Public Health, who attended Monday's meeting, said having the ability to utilize technology can be beneficial from a public health standpoint.

To monitor tuberculosis, Gupta said public health officials have begun using iPads to watch patients take their medication.

"In the old days ... public health department nurses had to travel just about every day to people's homes that are being treated to observe them taking their medication," Gupta said. "And now we are working on getting that done through technology."

Reach Joel Ebert at joel.ebert@wvgazettemail.com, 304-348-4843 or follow @joelebert29 on Twitter.

Whooping cough cases spike in WV after a 2-year lull http://www.wvgazettemail.com/article/20151106/GZ01/151109605 GZ01 http://www.wvgazettemail.com/article/20151106/GZ01/151109605 Fri, 6 Nov 2015 21:36:26 -0500 Lydia Nuzum By Lydia Nuzum There have been 52 confirmed cases of pertussis so far in 2015 in West Virginia, up markedly from 2014, which saw only 18, and 2013, which had 19, according to the West Virginia Department of Health and Human Resources.

The DHHR has confirmed five outbreaks of pertussis, commonly known as whooping cough, so far this year, including one in October that still has active cases. The highly contagious respiratory disease, which causes intense coughing, fever, vomiting and exhaustion, tends to see outbreaks in three to five year cycles - there were 168 reported cases in 2010, 102 in 2011 and 85 cases in 2012, according to Dr. Rahul Gupta, state health officer and commissioner for the West Virginia Bureau for Public Health.

The majority of this year's 52 cases were among children under 14 years old, including about 15 in infants under the age of 1, Gupta said. Because the Tdap (Tetanus, Diphtheria and Pertussis) vaccine cannot be administered to babies under six months old, newborns are highly susceptible to the disease, Gupta said. While West Virginia has very high rates of vaccination among its school-aged children, more than 15 percent of West Virginia toddlers have not received their Measles, Mumps and Rubella shot, a good marker for how many of the state's toddlers are vaccinated. Gupta said those poor rates were the reasoning behind state Senate Bill 286, passed last session, which requires children entering a "state-regulated childcare center" to receive the same vaccines as children entering school.

"This goes back to legislation that was recently passed last session, the idea that we include day care centers in the vaccination requirement," Gupta said. "The idea was to work on the poor vaccination rates we have for toddlers."

Another 18 of the cases were in children between the ages of 1 and 14, Gupta said. The rest were distributed evenly among those older than 14, although older adults should consider receiving a new dose of Tdap in order to boost herd immunity and protect younger children they may interact with, Gupta said.

"It goes back to the fact that no vaccine is perfect, and our rates of vaccination aren't 100 percent," he said. "You will always have a gap; the important thing to remember is that good immunization policy is to ensure that you minimize the gap of unvaccinated children, because it impacts those vulnerable kids who cannot mount a response, or those who have special needs that prevent them from receiving vaccines."

Gupta said that recent studies have shown that, despite the idea that protection from the Tdap vaccination lasts a lifetime, the vaccine's efficacy lessens over time. The DHHR recommends that adults who are getting a tetanus shot, which are recommended every decade, ask their doctor to replace the shot with a Tdap vaccine to boost their immunity. Gupta declined to say where in the state the most recent outbreak had occurred. The DHHR sent out a health advisory to health-care providers across the state cautioning them to be aware and to look for symptoms of pertussis, and to coordinate with their local health department in testing for suspected cases of whooping cough.

"The reason this health alert has been distributed statewide is that, regardless of where these outbreaks are, it's important to be vigilant," he said.

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

Despite improvement, WV gets 'D' on premature birthrate http://www.wvgazettemail.com/article/20151105/GZ01/151109706 GZ01 http://www.wvgazettemail.com/article/20151105/GZ01/151109706 Thu, 5 Nov 2015 15:36:10 -0500 Lydia Nuzum By Lydia Nuzum Smoking, drug addiction and alcohol abuse, three of West Virginia's biggest health problems, are the biggest contributor to a fourth problem - the state's troubling rate of premature births.

This year's March of Dimes Premature Birth Report Card gives West Virginia a "D" for its premature birthrate, noting that 10.8 percent of infants born in the state arrived prior to 37 weeks gestation. The U.S. received a "C" for its preterm birthrate overall, and ranks among the worst when compared to other high-resource countries.

"Our state is not doing as well as we should in preventing premature births and too many of our babies must fight to overcome the health challenges of an early birth," said Beverly Kitchen, chair of the March of Dimes West Virginia Chapter's program services committee. "Premature birth is the number one killer of babies, and many of our families still face that fear. There are large gaps in the preterm birth rate between communities in our state, and racial and ethnic disparities persist."

Dan Lauer, chairman of the board for the March of Dimes West Virginia Chapter, said West Virginia has been slowly and steadily improving its rates. The state received a "C" on last year's report card, and its grade dropped this year due to a change in the organization's premature birthrate goal for 2020, and because of a change in the way the March of Dimes tracks premature birth - instead of measuring from two weeks before a missed menstrual cycle to determine conception, the group now tracks the length of a pregnancy based on sonograms and doctors' estimations.

"What they did this year, because they changed the statistical model, is to give the country a "C," and then gauge everyone else based on the country's grade," he said. "We actually improved."

For 2013, West Virginia's preterm birthrate was 12.5 percent, down from 14 percent in 2006, the year the national rate for premature births peaked, according to the March of Dimes. Last year's rate of 10.8 percent represents an improvement, but the state is still lagging behind the nation in improvement - the U.S. premature birthrate has dropped from 11.4 percent in 2013 to 9.6 percent in 2014, forcing the March of Dimes to set a new, lower national preterm birthrate goal of 8.1 percent for 2020.

According to Lauer, West Virginia's other health problems, including its high rates of smoking and drug abuse, have contributed to its premature birth rate. The state was one of only six to receive a "D" on the report, and only four states or territories, including Alabama, Mississippi, Louisiana and Puerto Rico, received an "F."

"Unfortunately, we're in a situation now, not just in talking about prematurity but with general health, that those are major issues for us," he said. "That's where we need to make our improvements; if we can improve on those statistics, it will help."

Three counties - Kanawha, Wood and Cabell - fared worse than the state and received an "F" on the report card, while two others, Monongalia and Berkeley, received a "B." The state also ranked 35th in race disparity among preterm births, and 13.8 percent of black babies are born prematurely in the state, compared to 10.7 percent of white babies.

Worldwide, 15 million babies are born preterm, and nearly one million die due to complications caused by premature birth. Babies born prematurely face potentially serious health problems, including breathing problems, jaundice, vision loss, cerebral palsy and intellectual delays, according to the March of Dimes. Other problems, including things as simple as regulating body temperature or recognizing hunger, can also make a huge impact on an infant's survival, Lauer said.

"I have a granddaughter who was born at 33 weeks, and one of her biggest problems was that, at that age, she doesn't even recognize that she's hungry," he said. "Sometimes these problems manifest themselves early on, and sometimes it's later in life."

The March of Dimes West Virginia Chapter is hosting "Babies, Business and the Bottom Line" events statewide throughout November designed to share with business leaders how March of Dimes helps decrease premature birth rates, and to share steps businesses can take to help continue lowering the state's premature birth rates. The events include a luncheon on Tuesday from noon to 1 p.m. at Global Science and Technology in Fairmont, a breakfast Wednesday from 8 a.m. to 9 a.m. at King's Daughters Medical Center in Ashland, Kentucky, and a breakfast on Friday from 7:30 to 8:30 a.m. at Raleigh General Hospital in Beckley.

For more information on the March of Dimes, visit marchofdimes.org.

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

DHHR lifts limits on EpiPen prescribing following Auvi-Q recall http://www.wvgazettemail.com/article/20151104/GZ01/151109708 GZ01 http://www.wvgazettemail.com/article/20151104/GZ01/151109708 Wed, 4 Nov 2015 00:01:00 -0500 Lydia Nuzum By Lydia Nuzum Despite making the Auvi-Q its preferred epinephrine injector for Medicaid recipients earlier this year, the West Virginia Department of Health and Human Resources has been forced to revert to offering the EpiPen after a nationwide Auvi-Q recall.

Mylan has manufactured the EpiPen, an epinephrine auto-injector used to treat anaphylaxis, a severe allergic reaction, since 1987. In 2012, the U.S. Food and Drug Administration approved the Auvi-Q, a more compact auto-injector that delivers the same dose of epinephrine.

Unlike the EpiPen, the Auvi-Q includes spoken instructions that guide the user through the injection once the device has been activated.

In January, the DHHR's Pharmaceutical and Therapeutics Committee, under the Bureau for Medical Services, voted to replace the EpiPen with the Auvi-Q on its preferred drug list, and to make the EpiPen available to patients only with prior authorization.

In late March, lawyers for Mylan filed for immediate injunctive relief, which Kanawha Circuit Judge Tod Kaufman denied, arguing that the Pharmaceutical and Therapeutics Committee had decided to replace the EpiPen with the Auvi-Q, a similar drug, outside of an open meeting.

The West Virginia Public Employees' Insurance Agency and the Children's Health Insurance Program had also both moved to make Auvi-Q the preferred drug for their enrollees. In April, Vicki Cunningham, director of pharmacy services for the Bureau for Medical Services, testified that the Auvi-Q would result in greater savings for the state's Medicaid program and would result in more consistency for children who transition between CHIP and Medicaid.

On Friday, Sanofi U.S., the makers of the Auvi-Q, issued a voluntary recall for all of its injectors currently on the market. In the company's release, it explained that the injectors had been potentially found to release an inadequate dose of epinephrine, the primary drug in both the Auvi-Q and the EpiPen. As of Oct. 26, Sanofi has received 26 reports of suspected device malfunctions in the U.S. and Canada. No deaths have been reported.

"We are doing this voluntary recall as a precaution, and we have temporarily stopped manufacturing," Dr. Paul Chew, chief medical officer for Sanofi, said in a statement. "We take seriously the quality of our products, as well as their safe and effective use. For that reason, we are working with the (Food and Drug Administration) to resolve this issue."

Allison Adler, spokeswoman for the DHHR, said that the prior authorization for the EpiPen and EpiPen Jr. has been removed for West Virginia Medicaid patients, and pharmacies across the state have been notified of the change.

All prescribers of Auvi-Q will receive a letter this week with a list of their patients for whom Auvi-Q has been prescribed in order to help those providers in writing replacement prescriptions, Adler said.

"As soon as more information is available from Sanofi, [the Bureau for Medical Services] will schedule an emergency meeting of the Pharmaceutical and Therapeutics Committee to re-evaluate the preferred product for next year," Adler said.

The independent Pharmaceutical and Therapeutics Committee is comprised of up to 15 actively practicing healthcare professionals and assists the Bureau for Medical Services in selecting drugs for the preferred drug list. The committee meets three times a year and as necessary to review the preferred drug list and new drugs as they become available.

Patients with questions regarding the recall can visit www.Auvi-Q.com or call 1-877-319-8963 or 1-866-726-6340 from 8 a.m. to 8 p.m. Monday through Friday for information about how to return their Auvi-Q devices.

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