www.wvgazettemail.com Health http://www.wvgazettemail.com Gazette archive feed en-us Copyright 2017, Charleston Newspapers, Charleston, WV Newspapers Free mobile dental clinic to visit 6 WV counties http://www.wvgazettemail.com/article/20170524/GZ0115/170529765 GZ0115 http://www.wvgazettemail.com/article/20170524/GZ0115/170529765 Wed, 24 May 2017 19:22:16 -0400 Erin Beck By Erin Beck West Virginia Health Right will set up a free mobile dental clinic for low-income adults in six West Virginia counties, the nonprofit announced Wednesday.

West Virginia has fewer dentists than most other states, and Mountain State adults are less likely to have visited a dentist in the past year, according to the American Dental Association.

Beginning July 17, a dentist from Marshall University, along with a dental hygienist, dental assistant and driver from Health Right, will bring the clinic to McDowell, Logan, Boone, Clay, Roane and Harrison counties, according to Angie Settle, chief executive officer of the Charleston-based free clinic.

The dental crew will visit each county twice a month to offer fillings, extractions and cleanings to uninsured and Medicaid-insured adults.

Volunteer dentists will conduct a few stops in June, before the official launch of the clinic on July 17, according to Settle.

"These are people who don't have anywhere else to go," she said, during a Wednesday morning news conference, noting that many low-income adults lack affordable childcare or can't leave work to travel.

Numerous state lawmakers attended the news conference, held in the waiting room of the clinic, although none of them were involved in establishing the clinic.

In an interview after the news conference, Settle said Health Right chose locations based on community support, distance and existing dental services.

"It was mainly calling around, and I actually had to approach the community, the different partners, and say 'Is this something you want?' " she said. "I didn't want to go to any community where we weren't wanted. I didn't want to go anywhere where the local dentist didn't want us, if they had one. I wanted to make sure the groundwork was laid in advance. The mission was to take care of people that couldn't afford it otherwise, and that we would be wanted."

"They give us a place to park, they give us internet access and they give us an electric plug," she added.

Dr. Jason Roush, West Virginia state dental director, noted that adults ages 21 and over are not covered for any preventative oral health services under Medicaid.

"It is going to increase access to care specifically for those adults," he added. "If you have a need for prevention or restorative care, there's not a payment system currently in place for that.

"We have a good workforce in the state, when it comes to our dental providers," he said. "Sometimes, there's a distribution problem, as far as certain counties, but again, when you're talking about adults, sometimes it's hard."

He said many providers do a significant amount of uncompensated care.

Dr. Michael Tupta, a volunteer dentist for Health Right who has a private practice in Charleston, said he regularly sees patients from other counties who travel hours to Charleston.

"This clinic has been a magnet for other places in the state," he said.

According to West Virginia's 2016-20 Oral Health State Plan, "Scientific reports have linked poor oral health to adverse general health outcomes."

"The role of chronic low-grade periodontal [gum] infections in increasing the risk for heart and lung diseases, stroke, low birth weight and premature births is being studied," the report stated. "A strong association between diabetes and periodontal infection has been observed."

"People kind of put it on the back burner but, really, if your mouth is not healthy, your body is not healthy," Tupta said. "It's a great petri dish for growing bacteria."

Dr. Raj Khanna, chairman of Marshall University's department of dentistry, oral and maxillofacial surgery, said oral health is "impacting pretty much every aspect of medicine" and "more and more, we realize there's a need to educate the people, educate the providers and, more than that, provide care to them."

"Once you educate them, you see the culture change," he said.

According to the 2016-20 oral health plan, in adults ages 55-64, about 43 percent have lost six or more teeth from dental decay or gum disease. In 2012, 22 percent of adults had not visited a dentist in more than five years and 40 percent of adults had some type of dental coverage, according to the report.

Nearly half of the counties had less than six practicing dentists, and two out of five dentists planned to retire within the next 10 years, according to the report.

The report states that low access to care is due "to a variety of complex factors, especially in rural areas; not enough providers willing to accept people on medical assistance due to low reimbursement rates; and a gap in affordable insurance options."

"West Virginia is one of the states where oral health care is neglected," Khanna said, "so there's a big need, partly because of the culture, partly also financially, and partly it's because of lack of access. People live out in these rural communities and nobody wants to go practice there, so they don't have dental practices. The nearest practice may be a hundred miles away."

According to an ADA fact sheet, in 2013, West Virginia had 48 dentists per 100,000 people in the population, compared to 60.5 dentists per 100,000 people in the population nationwide. Also in 2013, about 51 percent of West Virginia adults had visited a dentist in the previous 12 months, compared to 59 percent nationwide.

The Benedum Foundation, the Greater Kanawha Valley Foundation, the Logan Healthcare Foundation, the Bernard McDonough Foundation and Sisters Health Foundation are among the funders for the clinic. The first year will cost $524,000, according to a release.

For uninsured patients to qualify, income must be at or below 250 percent of the federal poverty level, according to a brochure. Patients must provide a copy of their tax return or proof that they don't have to file taxes before the appointment. For a single-person household, the maximum income is $29,700. For a four-person household, the maximum income is $60,750.

For more information, call the following people: Cindy at Community Care of West Virginia in Clay County, 304-587-7301; Trella at Health Access in Harrison County, 304-622-2708; Teresa, mobile dental coordinator for West Virginia Health Right in Roane and McDowell counties, 304-414-5944; Louis or Megan at Coalfield Health Center in Logan County, 304-855-1200; the referral clerk at Boone Memorial Hospital in Boone County, 304-369-1230.

Reach Erin Beck at erin.beck@wvgazettemail.com, 304-348-5163, Facebook.com/erinbeckwv or follow @erinbeckwv on Twitter.

CBO: Uninsured ranks will still grow under AHCA http://www.wvgazettemail.com/article/20170524/GZ0101/170529771 GZ0101 http://www.wvgazettemail.com/article/20170524/GZ0101/170529771 Wed, 24 May 2017 18:17:05 -0400 By Juliet Eilperin and Kelsey Snell The Washington Post By By Juliet Eilperin and Kelsey Snell The Washington Post Health care legislation adopted by House Republicans earlier this month would leave 23 million more Americans uninsured within a decade, the Congressional Budget Office projected Wednesday - only a million fewer than the projection for the House's earlier bill.

The finding, which is sure to draw fire from Democrats, patient advocates and many health industry officials, could complicate Republicans' push to pass a companion bill in the Senate.

The new estimate, which reflects a series of last-minute revisions Republicans made to win over several conservative lawmakers and a handful of moderates, calculates that the American Health Care Act would reduce the federal deficit by $119 billion between 2017 and 2026.

That represents a smaller reduction than the $150 billion the CBO estimated in late March, largely because House leaders provided more money in the final bill to offset costs for consumers with expensive medical conditions and included language that could translate to greater federal spending on insurance subsidies.

While House Republicans pressed ahead with a final vote without getting a precise cost estimate in advance, Wednesday's CBO score will now help shape what sort of measure can be crafted in the Senate.

To avoid a filibuster, Senate Republicans plan to take the bill up under budget-reconciliation rules, which only require a majority vote, but it means the legislation cannot increase the federal deficit within a 10-year window.

The bill the House narrowly passed on May 4 meets that test and would rewrite large portions of the Affordable Care Act, which Republicans have pledged to dismantle for more than seven years. But Senate Republicans have been working for weeks to craft their own health care bill and emphasize that they have no plans to simply take up the House's legislation.

"The CBO score on the Senate bill is going to be what counts," Senate Majority Whip John Cornyn, R-Texas, said earlier Wednesday.

Joseph Antos, a resident scholar at the libertarian American Enterprise Institute who specializes in health care, said the new estimate "is the same signal repeated," conveying that the changes congressional Republicans envision would cut the price of premiums and trim the deficit while leaving more Americans without insurance.

The AHCA's proposal to cut spending on Medicaid - a federal program that covers roughly 69 million Americans - by $880 billion over the next decade is the thorniest political issue facing the Senate, Antos said.

"They're going to have to do something on Medicaid," he said, "and that something is a real question."

In a statement, Sen. Joe Manchin, D-W.Va., said Wednesday that the House was "motivated by politics, not people" when it passed the health care bill.

"I have always said I'd be the first in line to repair the Affordable Care Act," Manchin said, but I cannot support a plan that results in 14 million people losing health care coverage next year, cuts $834 billion from Medicaid, significantly reduces the critical subsidies that tens of thousands of West Virginians rely on and ultimately reduces health care access for thousands more."

Bills to allow sale of Hopemont, Jackie Withrow hospitals return http://www.wvgazettemail.com/article/20170524/GZ0101/170529772 GZ0101 http://www.wvgazettemail.com/article/20170524/GZ0101/170529772 Wed, 24 May 2017 18:02:29 -0400 Jake Zuckerman By Jake Zuckerman Bills allowing the secretary of the Department of Health and Human Resources to sell two state-run hospitals that had died during the regular session reappeared on the governor's special session call.

On Wednesday, the state Senate voted to skip the requirement that a bill must be read three times over and approved the sale of Hopemont Hospital in Preston County by a 21-11 vote. Likewise, the House of Delegates received a bill to sell Jackie Withrow Hospital in Raleigh County and referred it to the committee on Health and Human Resources.

The Senate bill was met with resistance however, and had to survive a motion to reject the bill after its first reading.

Both bills appeared before the legislature during the regular session and almost went the distance, although the House and Senate could not reconcile differences between the amended versions, leading to a stall.

During the regular session, the House bills called for the state to divest from the hospitals outright, although the Senate amended in provisions requiring the state to build on-site replacement facilities at both locations.

Though the bill introduced to the Senate on Wednesday called for the state to build an on-site replacement facility, the Health and Human Resources Committee changed it to give the DHHR Secretary latitude to build or take up a new facility within five miles of Hopemont Hospital.

The House bill does not include any similar provision for construction of an on-site facility for Jackie Withrow Hospital.

A spokesman for the governor did not respond to a question regarding why the bills were included on the special session call.

Both bills require the DHHR secretary to ensure there is no lapse in care for the patients in either hospital during the transition and to work out a plan with the director of the Division of Personnel to minimize the sales' effects on state employees.

Hopemont and Jackie Withrow are two of seven hospitals run by the state. During committee meetings regarding the sale of Jackie Withrow, DHHR Secretary Bill Crouch said he'd like lawmakers to authorize the sale of more of the state's hospitals.

Reach Jake Zuckerman at jake.zuckerman@wvgazettemail.com, 304-348-4814 or follow @jake_zuckerman on Twitter.

Authorities talk boat safety as summer approaches http://www.wvgazettemail.com/article/20170524/GZ01/170529793 GZ01 http://www.wvgazettemail.com/article/20170524/GZ01/170529793 Wed, 24 May 2017 13:29:27 -0400 Giuseppe Sabella By Giuseppe Sabella Turkey hunting makes way for summer boating with the change of seasons, and West Virginia officials promote a different set of safety rules and recommendations.

With boating safety in mind, Kanawha County Homeland Security and Emergency Management joined forces with the state's Department of Natural Resources to address the media Wednesday morning.

The organizations met at Haddad Riverfront Park, where the 15-week Live on the Levee concert series will start Friday.

Brett Chandler, a natural resources officer, said boaters will surely anchor their boats along the Kanawha River during each concert. Officers have to step in, he said, when concert-goers block the flow of barges and other traffic.

Boaters should make sure their required fire extinguisher and lights are functional before leaving the dock. After disembarking, Chandler said, the most frequent mistake people make when cruising any West Virginia waterway is to simply not pay attention.

"When you're out here on the river, things happen fast. People just automatically assume 'I can drive a car, I can drive a boat.'" he said. "A boat operates totally different from a car."

Few accidents take place on the Kanawha River each year, Chandler said. When they do occur, the driver is usually intoxicated or absent-minded.

The legal limit of blood-alcohol level to be considered intoxicated for a boater is the same as it is for a driver on land: 0.08 percent. When drinking, boaters are urged to find a sober skipper.

Chandler said dehydration is doubled when drinking under the hot summer sun. The boat owner, regardless of who drives the boat, is responsible for any damages caused by reckless decisions.

"If you're out there, you're having fun, you're having a few beers, be sure you have somebody who can operate that boat," Chandler said.

Anyone who was born after 1986 and wants to operate a boat must first take a required boater safety certification class.

Sgt. Jerry Payne, a fellow natural resources officer, and Mike Oakley, of Kanawha County Emergency Management, joined the conversation Wednesday.

They said it's common to see life jackets that never left the original packaging, or life jackets that are worn to the point of being unusable.

Each mistake could change an otherwise enjoyable experience into a costly or tragic day on the water, Chandler said.

"It can be anywhere from property damage to loss of life," he said. "Boating, it's a fun activity, but you have to be mindful."

Free public lessons - ranging from safety talks to life jacket fittings - will take place throughout the weekend at New River Gorge National River.

The National Park Service and U.S. Army Corps of Engineers organize the Water Safety Weekend each year.

Water Safety Roundup is scheduled for 2 p.m. Saturday at the Canyon Rim Visitor Center, and River Ranger Rendezvous is scheduled for the same time at Sandstone Falls.

The Water Safety Festival will start at 1 p.m. Sunday at "The Pits" boat launch, according to an event announcement. More information can be found at nps.gov.

Reach Giuseppe Sabella

at giuseppe.sabella@wvgazettemail.com, 304-348-5189 or

@Gsabella on Twitter.

WV Attorney General reaches settlement with pharmacy company http://www.wvgazettemail.com/article/20170524/GZ0118/170529746 GZ0118 http://www.wvgazettemail.com/article/20170524/GZ0118/170529746 Wed, 24 May 2017 21:33:19 -0400 Staff reports By Staff reports The West Virginia Attorney General's Office, and offices of attorneys general in 42 other states, has reached a settlement with Johnson & Johnson subsidiary McNeil-PPC Inc.

The $33 million settlement will be split between the states, according to a news release from the West Virginia Attorney General's Office. West Virginia will receive more than $440,000 as part of the settlement.

The lawsuit alleges McNeil-PPC Inc. illegally promoted their over-the-counter drugs as meeting federal standards for manufacturing, when there were significant issues with the drugs' quality and effectiveness.

Certain batches of the drugs McNeil manufactured - including Tylenol, Motrin, Benadryl, St. Joseph Aspirin, Sudafed, Pepcid, Mylanta, Rolaids, Zyrtec and Zyrtec Eye Drops - were recalled three times between 2009 and 2010.

The settlement also bans McNeil from stating its facilities meet federal standards within 12 months of a recall, the release said. It also requires the subsidiary to follow standard operating procedures when manufacturing mishaps occur. The subsidiary will be required to quickly notify state attorneys general when recalled drugs are shipped into their state

"It's critical that companies meet good manufacturing practices and protect product quality," Attorney General Patrick Morrisey said in the release.

Attorneys general from Pennsylvania and Texas led the litigation.

Science Says: Medications prevent opioid addiction relapse http://www.wvgazettemail.com/article/20170522/GZ0115/170529891 GZ0115 http://www.wvgazettemail.com/article/20170522/GZ0115/170529891 Mon, 22 May 2017 15:01:54 -0400 By Carla K. Johnson The Associated Press By By Carla K. Johnson The Associated Press CHICAGO - Remarks by a top U.S. health official have reignited a quarrel in the world of addiction and recovery: Does treating opioid addiction with medication save lives? Or does it trade one addiction for another?

Health Secretary Tom Price's recent comments - one replying to a reporter's question, the other in a newspaper op-ed - waver between two strongly held views.

Medication-assisted treatment, known as MAT, is backed by doctors. Yet it still has skeptics, especially among supporters of 12-step programs like Narcotics Anonymous, because it involves opioid-based medications.

Price appeared to side with that camp when he said during a recent visit to Charleston, West Virginia: "If we just simply substitute buprenorphine or methadone or some other opioid-type medication for the opioid addiction, then we haven't moved the dial much."

But in an opinion piece published last week in the Charleston Gazette-Mail, he twice mentioned his agency's support for medication-assisted treatment.

Here's a closer look:

Because of how opioids act on the brain, people dependent on them get sick if they stop using. Withdrawal can feel like a bad flu, with cramping, sweating, anxiety and sleeplessness. Cravings for the drug can be so intense that relapse is common.

Medication-assisted treatment helps by moving a patient from powerful painkillers or an illicit opioid, like heroin, to a regular dose of a legal opioid-based medication, such as buprenorphine or methadone. The ideal dose is big enough to fend off withdrawal, but too small to produce a euphoric high. Patients can drive, rebuild relationships and get back to work.

"They're not walking around high," and it gives them the chance to practice new ways of coping with family and psychological issues, said Dr. Joseph Garbely of Pennsylvania-based Caron Treatment Centers.

With counseling and education about addiction, patients can get back on track. They eventually can taper off medications, but some take them for years.

Researchers studying these treatments use drug screening to see if patients are staying off illegal drugs. If someone uses heroin while in treatment, it shows up in their urine.

A 2014 review of 31 studies found that methadone and buprenorphine keep people in treatment and off illicit drugs.

The review, by the Cochrane Collaboration, an international group of scientists that evaluates research, found each drug worked better than a dummy medication. A side benefit worth noting: Methadone also helps prevent the spread of HIV, by reducing needle sharing, a different research review by Cochrane found.

Methadone and buprenorphine can be abused and both can cause overdoses, particularly methadone. But researchers have found that methadone prevents more overdose deaths than it causes.

For most patients, medication combined with counseling is superior to other strategies, according to the American Society of Addiction Medicine.

"What's right for one person isn't necessarily right for another person," Price said during his May 9 visit to West Virginia.

When asked if he and his team leaned toward medication or faith-based approaches to opioid addiction, his reply lined up with those who favor abstinence.

Abstinence-only philosophies "are not scientifically supported," according to the first surgeon general's report on addiction, published in November.

Yet people who describe themselves as in recovery consistently say abstinence is important. All told, remission from opioid addiction can take years and multiple tries at treatment.

"The public needs to know that there are proven, effective treatments for opioid addiction," former U.S. Surgeon General Vivek Murthy told The Associated Press. Murthy was fired by the Trump administration after he refused to resign.

Price also mentioned a non-opioid alternative - namely an injection of naltrexone called Vivitrol - as "exciting stuff." Vivitrol, a newer drug, can be used only with patients who have completely detoxed and has a limited track record when compared to buprenorphine and methadone. Early studies have shown promise, but relapse is a danger after injections stop.

Health and Human Services spokeswoman Alleigh Marre told the AP that Price's comments don't signal a policy change. Price "has argued that we should be open and supportive to the broadest range of options, from medication-assisted treatments - including methadone, buprenorphine or naltrexone - to faith-based recovery programs," Marre said.

Not informing patients about the effectiveness of treating addiction with medication is like a doctor not telling a cancer patient about chemotherapy, said Dr. Mark Willenbring, a former director of treatment research at the National Institute for Alcohol Abuse and Alcoholism. "Scientifically, this is a settled matter."

This Associated Press report was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Matulis asks to put lawsuit on hold http://www.wvgazettemail.com/article/20170521/GZ01/170529922 GZ01 http://www.wvgazettemail.com/article/20170521/GZ01/170529922 Sun, 21 May 2017 18:20:32 -0400 Kate White By Kate White A Charleston gastroenterologist is asking a judge to place a hold on one of the multiple lawsuits his former patients have filed against him to allow for the completion of both a criminal investigation and an investigation through the West Virginia Board of Medicine.

In a motion filed last week, attorneys for Dr. Steven Matulis asked to stay all discovery proceedings in the lawsuit, including a video deposition of Matulis, which was set to begin Tuesday.

"The Supreme Court of Appeals has acknowledged the constitutional dilemma faced by defendants who are compelled to engage in parallel litigation in the face of a pending criminal prosecution," Charleston lawyer Isaac Forman wrote. Forman, along with other lawyers from Bailey & Glasser, represent Matulis. "This occurs most frequently when the defendant must invoke his Fifth Amendment privilege against self-incrimination in the non-criminal proceeding, giving rise to 'the distinct possibility of unfairness.'"

Putnam County Prosecuting Attorney Mark Sorsaia, who was appointed to the case when the Kanawha County prosecutor's office stepped aside, intends to issue grand jury subpoenas for the discovery materials produced in both the lawsuit and in the Board of Medicine's investigation, the filing by Matulis' lawyers states. Matulis has also been made aware, according to the motion, that Sorsaia has met with several potential witnesses in the case.

"Dr. Matulis's fears of imminent prosecution are well-founded," the motion states.

Kanawha Circuit Judge Jennifer Bailey hasn't yet ruled on the motion, but a hearing is set in the case for Thursday. The deposition, which had been set for Tuesday, was automatically put on hold when the motion was filed.

The Board of Medicine is conducting its own investigation. Matulis, who has surrendered his medical license, expects to be summoned before the board in late June, his lawyers' motion states.

"Because of the looming criminal prosecution ... Dr. Matulis has moved the hearing examiner to continue the administrative proceedings until September," the motion states.

The lawsuit in which the motion was filed was the first to raise allegations of sexual misconduct against Matulis. The lawsuit was filed by a 25-year-old woman from Boone County. She is identified only through her initials "T. W." in the complaint.

About a week after Matulis performed a colonoscopy on the woman, Charleston police informed her that she had been the victim of a sexual assault by Matulis.

Charleston lawyer Ben Salango, who represents the woman, said last week he planned to argue against a stay in the case.

"Obviously we disagree that this important case should be put on hold for any reason, much less to accommodate the doctor," Salango said.

The lawsuit filed by T. W. is one of nearly 10 lawsuits filed against Matulis by former patients. Two lawsuits have asked judges to be given class-action status.

Some of the complaints allege, among other things, that they were sexually assaulted by Matulis during a medical procedure while under anesthesia. Some plaintiffs raise, among other claims, that they have been harmed by the stress from not knowing whether they are a victim of an assault because it would've been while they were under anesthesia.

Others claim Matulis rushed and incorrectly performed colonoscopies.

Reach Kate White at


304-348-1723 or follow

@KateLWhite on Twitter.

State leaders told representatives health care bill would devastate WV http://www.wvgazettemail.com/article/20170520/GZ0115/170529959 GZ0115 http://www.wvgazettemail.com/article/20170520/GZ0115/170529959 Sat, 20 May 2017 14:14:03 -0400 Erin Beck By Erin Beck About five months before the U.S. House of Representatives voted to repeal the Affordable Care Act, the state of West Virginia sent the House majority leader and West Virginia's representatives in Congress a letter.

The American Health Care Act, Republicans' plan to repeal and replace the Affordable Care Act, hadn't been introduced at the time. But then-Gov. Earl Ray Tomblin's letter warned of what any plan slashing federal funding, like the American Health Care Act would do, could mean for West Virginia.

In the Jan. 9 letter to House Majority Leader Kevin McCarthy, Tomblin warned any replacement to the Affordable Care Act that decreased federal funding "would immediately reverse all progress made for both our working population and those vulnerable citizens who we are morally obligated to serve."

"Federal funding must be maintained or West Virginia's health care infrastructure will collapse," he wrote.

"Our state faces many challenges in terms of being one of the most rural and oldest in the country," he added. "In addition, West Virginia's population health is similar to that in much of Appalachia, ranking among the worst in the nation."

The state went on to warn members of the Senate and House, at least two more times, that provisions of the American Health Care Act would have devastating economic effects and hurt the people of West Virginia.

The Congressional Budget Office estimated the original version of the bill would cut $880 billion from Medicaid over 10 years. It's unclear how many billions the newer version of the bill, which barely cleared the House, would cut.

The CBO also found an estimated 52 million people would be uninsured nationwide by 2026, compared with 28 million who would lack insurance that year under current law.

About a month after Tomblin's letter, and four months before the vote on the American Health Care Act, Gov. Jim Justice sent another letter to members of the U.S. Senate Finance Committee.

The letter, which was also sent to members of West Virginia's Congressional delegation, offered input on health care reform proposals and included potential effects of the repeal of Medicaid expansion.

A provision of the Affordable Care Act, Medicaid expansion would be eliminated in West Virginia by the American Health Care Act due to lack of federal matching funds.

"Repeal of Medicaid expansion would eliminate up to $900 million from West Virginia's healthcare economy, annually," the governor wrote.

Citing the Commonwealth Fund, Justice said the loss of federal funds could result in the loss of 16,000 jobs and $9.1 billion in state economic output in 2019.

"If healthcare providers close or decrease their practices, more citizens would be out of jobs, therefore putting more strain on the cities and counties," he wrote. "Also, since many individuals in the expansion population need behavioral health or substance abuse treatment, citizens who benefit from these services may end up in jail or psychiatric hospitals as opposed to receiving the treatment they need in their community."

Once again, the letter included the line, "Federal funding must be maintained or West Virginia's healthcare infrastructure will collapse."

According to the letter, the repeal of Medicaid expansion could lead to a $500 million annual increase in total uncompensated care sought by providers in 2019 and a more than $5.8 billion increase in total uncompensated care sought from providers from 2019 to 2028.

"West Virginia has the highest drug overdose death rate in the United States," Justice wrote. "The state also has the highest rate of severe mental illness and poor mental health days in the United States. If budget cuts take place reducing federal funding to the West Virginia Medicaid program, it would have a dramatic impact on substance abuse and mental health services.

"West Virginia would be unable to fund provider services required to treat the mental health and substance use disorder patients."

About three weeks before the House voted to pass the American Health Care Act, the state of West Virginia sent its representatives another letter.

In the letter, dated April 14, Department of Health and Human Resources Cabinet Secretary Bill Crouch warned West Virginia's three members of the U.S. House and two members of the U.S. Senate that Medicaid expansion would end by June 2021 if the bill became law.

The Affordable Care Act gave states the option to expand Medicaid coverage to people who made up to 138 percent of the poverty level. About 170,000 West Virginians, including 53,000 who accessed treatment for substance use disorders in 2016, gained coverage.

The federal government pays about 90 percent of costs for the Medicaid expansion population, compared to about 73 percent for other Medicaid patients. Under the American Health Care Act, the federal government would not provide the extra funds.

Crouch wrote that "any change" to the matching rate would "create an unsustainable financial obligation for our state."

"Through the expansion of Medicaid, many West Virginians now have access to health care services, including critical preventive and primary care," he wrote. "We project that in fiscal year 2018, expenditures for expansion members will be $941 million. In addition to the danger to the health of our Medicaid population, the financial impact associated with the loss of medical coverage would have a ripple effect creating crippling economic hardship and service burdens on public and private health care providers throughout the state. For many of our smaller, rural hospitals, the loss of covered patients could be devastating."

The letter also states that, in 2016, the DHHR's Bureau for Public Health received more than $13 million in federal funds tied to the Affordable Care Act, including money for in-home education and services for at-risk pregnant women, tobacco cessation services for underinsured and uninsured populations, diabetes prevention programs, teen pregnancy prevention, immunizations for children, and regional epidemiology investigations.

"We remain greatly concerned that as our state continues to wage war on addiction, any legislation repealing the ACA will negatively affect the ability of West Virginians with mental, behavioral health and substance use disorders to access needed services," Crouch continued. "In 2016, 53,000 West Virginians received treatment at a cost of $60 million. Approximately 20,000 Medicaid expansion members were treated for Substance Use Disorder at a cost of $48 million."

U.S. Rep. David McKinley, R-W.Va., voted for the bill earlier this month and said in a March statement the bill "offers new flexibility to the states and provides a transition period so no one currently on Medicaid has the rug pulled out from underneath them. States will also have the option to keep expanded eligibility in the future."

U.S. Rep. Evan Jenkins, R-W.Va., after he voted for the bill earlier this month, sent a statement saying, "I strongly support coverage for pre-existing conditions, mental health care, and substance abuse treatment."

U.S. Rep. Alex Mooney, R- W.Va., after he voted for the bill, sent a statement saying the bill would "increase access to care," as well as lower costs for West Virginians.

The Senate is still considering the bill.

Reach Erin Beck at 304-348-5163,


facebook.com/erinbeckwv or

follow @erinbeckwv on Twitter.

Drug giant McKesson selects law firm to probe opioid allegations http://www.wvgazettemail.com/article/20170520/GZ01/170529960 GZ01 http://www.wvgazettemail.com/article/20170520/GZ01/170529960 Sat, 20 May 2017 13:57:25 -0400 Eric Eyre By Eric Eyre Drug giant McKesson Corp. has hired an outside law firm to investigate allegations in a lawsuit filed last year by West Virginia Attorney General Patrick Morrisey that accuses the company of flooding the state with highly addictive prescription painkillers.

The investigation comes at the request of the Teamsters union, which has pension and benefit funds that invest in McKesson.

McKesson has appointed three of its board members to oversee the investigation. The special review committee hired Wilson Sonsini Goodrich & Rosati, a law firm based in Palo Alto, California.

"The board's decision to form an independent committee suggests that they are realizing the magnitude of the corporate crisis on their hands," said Ken Hall, general secretary-treasurer of the Teamsters and president of Local 175 in South Charleston. "McKesson's management should not be allowed to continue business as usual when it comes to addressing McKesson's role in the opioid crisis."

The law firm has agreed to meet with Teamsters officials and invited the union to turn over any information that should be investigated, according to a May 11 letter sent to Hall.

"McKesson has always been committed to maintaining - and continuously improving - strong programs and processes to prevent opioid diversion, while working closely with others to strengthen the integrity of the full pharmaceutical supply chain and advance meaningful solutions to stem opioid abuse," said McKesson spokeswoman Kristin Hunter. "Consistent with that, our board has appointed a committee to review issues raised by the Teamsters."

In January, Morrisey filed suit against McKesson, alleging the company awarded bonuses and commissions to sales managers while "West Virginia was drowning in millions of doses of highly addictive prescription painkillers."

Between 2007 and 2012, McKesson shipped 54.3 million oxycodone pills (typically sold under the brand name OxyContin) and 46.2 million hydrocodone tablets (Lortab, Vicodin) to West Virginia, according to the state's lawsuit.

Only two drug wholesalers shipped more prescription opioids to West Virginia during those years.

Earlier this year, U.S. District Judge John Copenhaver ordered that the state's lawsuit against McKesson be returned to Boone County Circuit Court, where it was initially filed in January 2016.

McKesson wanted the case to be heard in federal court, where the law is typically more favorable to corporations. Morrisey's office successfully argued that the lawsuit belongs back in Boone County.

The Teamsters also have asked McKesson's board to investigate whether the company's top executives should have their incentive pay taken back "given the serious injury to McKesson's reputation" amid the opioid epidemic and a "potentially precedent-setting civil suit by the state of West Virginia," according to a letter the union sent to the company in November.

In a second letter sent in February, the Teamsters urged McKesson to appoint an "independent chairman" of the board.

The Teamsters have argued that McKesson must take steps to show the company "is serious about accountability and getting ahead of this mounting corporate crisis."

"With America in the midst of an opioid crisis, the risk is that McKesson's board underreacts, not overreacts to the potential legal, regulatory and reputational risks facing the company," Hall wrote.

McKesson board member Donald Knauss, former CEO of Clorox Corp., serves as chairman of the special committee. The other members are Susan Salka, president and CEO of AMN Healthcare Services, and Dr.N. Anthony Coles, chairman and CEO of Yumanity Therapeutics.

After finishing the investigation, McKesson's special review committee plans to issue recommendations on how to respond to the Teamsters' demands. McKesson's full board will have the final say on the company's response.

The review committee also has the power to hire advisers.

In November, Hall predicted Morrisey's lawsuit might "trigger an avalanche of follow-on" suits against McKesson. During the past five months, about a dozen counties, cities and towns in West Virginia have filed suit against McKesson - or announced their intention to do so. The lawsuits also name other drug wholesalers as defendants.

McKesson is the fifth-highest revenue-generating company in the U.S., according to Forbes.

Earlier this month, a congressional committee directed McKesson and two other drug wholesalers to turn over records that show the companies' shipments of prescription pain pills to West Virginia. The U.S. House Energy and Commerce Committee gave McKesson until June 8 to disclose the number of oxycodone and hydrocodone pills sold in West Virginia from 2007 to 2016.

Reach Eric Eyre at


304-348-4869 or follow

@ericeyre on Twitter.

Buddhist monk to lead meditation, talks in Charleston, Huntington http://www.wvgazettemail.com/article/20170520/GZ0602/170529983 GZ0602 http://www.wvgazettemail.com/article/20170520/GZ0602/170529983 Sat, 20 May 2017 16:00:00 -0400 Bhante Jayasara, an American Buddhist monk from the Bhavana Society, in High View, will give several public talks during visits this week to Charleston and Huntington.

He will speak on "Mindfulness in Daily Living" from 6 to 7:30 p.m. Friday Unity of Kanawha Valley, 804 Myrtle Road.

He will lead a day-long retreat on meditation from 9:30 a.m. to 4 p.m. Saturday at the PeaceTree Center for Wellness, 5930 Mahood Drive, in Huntington. Space is limited. To register, visit themeditationcircle.com.

He will also lead a meditation and give a talk from 12:30 to 2 p.m. Sunday at Studio 8 Yoga and Wellness, 803 Eighth Ave., in Huntington. See themeditationcircle.com to register.

WV DHHR in early stages of medical marijuana planning http://www.wvgazettemail.com/article/20170519/GZ01/170519510 GZ01 http://www.wvgazettemail.com/article/20170519/GZ01/170519510 Fri, 19 May 2017 14:14:18 -0400 Erin Beck By Erin Beck The West Virginia Department of Health and Human Resources is "in the preliminary stage" of developing a plan for implementation of West Virginia's medical marijuana law, according to state officials, and has devoted a section of its website to frequently asked questions and more information.

Only one agency responsible for nominating a member to the West Virginia Medical Cannabis Advisory Board has publicly announced the nominee - Joe Hatton, deputy commissioner for the West Virginia Department of Agriculture.

Gov. Jim Justice signed Senate Bill 386 - permitting doctors to recommend marijuana for medicinal purposes and establishing a regulatory system in West Virginia - into law on April 19. The law states that no patient or caregiver ID cards will be issued until July 2019.

Lawmakers gave the DHHR's Bureau for Public Health oversight and tasked the bureau with creating an online source of public information.

The section of the website, found at www.dhhr.wv.gov/bph/Pages/Medical-Cannabis-Program.aspx, links to frequently asked questions for patients and caregivers, growers and processors, potential dispensary owners and physicians.

It also links to a 2013 announcement by the U.S. Department of Justice that was written in response to states' medical marijuana laws and lists enforcement priorities for the department. The memo states that "in jurisdictions that have enacted laws legalizing marijuana in some form and that have also implemented strong and effective regulatory and enforcement systems to control the cultivation, distribution, sale, and possession of marijuana, conduct in compliance with those laws and regulations" is less likely to threaten federal enforcement priorities. The memo also cites previous guidance, which stated "that it was likely not an efficient use of federal resources to focus enforcement resources on seriously ill individuals, or on their individual caregivers."

The website states that the Bureau for Public Health remains "in the early stages of the development of the program." DHHR is currently engaged in rule-making, which means the process of agencies writing the specific plans for implementing laws the Legislature passes.

Allison Adler, spokeswoman for the DHHR, said via email that the Bureau for Public Health's commissioner's office "is in the preliminary stage of developing an implementation plan, including a legal interpretation of what rules will be necessary to fully implement the Act."

"Those rules will begin with requirements for growers/processors so that those entities can come online and begin to produce products, then detailing requirements for dispensaries and physicians, followed closely by the requirements for the registration of caregivers and patients," she wrote.

"There are many considerations such as program operation, and how applications are to be submitted by growers/processors, dispensaries, patients and caregivers, and physicians," she added.

The law also established a Medical Cannabis Advisory Board within the Bureau for Public Health. The bill says that its members will include four physicians to be appointed by the State Medical Association; a pharmacist appointed by the Board of Pharmacy; a horticulturist appointed by the Agriculture commissioner; a person designated by the West Virginia Association of Alcoholism and Drug Counselors; and a prosecuting attorney appointed by the Prosecuting Attorney's Institute.

The governor is tasked with appointing a pharmacologist; an attorney knowledgeable about medical cannabis laws; and a person who is a patient, a family or household member of a patient or a patient advocate. The advisory board will also include the commissioner of the Bureau for Public Health and the superintendent of the State Police or a designee.

The Department of Agriculture is the only entity, so far, that has selected its representative on the board and responded to an email with the name of that person.

Crescent Gallagher, Agriculture spokesman, said that Commissioner Kent Leonhardt selected Hatton, a certified crop adviser and certified grassland professional.

"As a lifelong farmer, I think this is a great opportunity to show what we can do in agriculture," Hatton said, in a phone interview.

He noted that West Virginia will have to look to other states such as Colorado, since West Virginians have experience, "but not with the legal variety." He noted that "this can't be grown out in the middle of an open field."

He also has unanswered questions.

"It has to be profitable," he said. "We haven't talked about the structure ... who's going to own the crop? Who's going to own the marijuana? Will it be the farmers or the pharmaceutical companies or the state of West Virginia?"

House Judiciary Chairman John Shott, R-Mercer, whose committee made several amendments to the medical marijuana bill, has said that if the DHHR was ready sooner, the law could become effective before July 2019.

Asked about that, Adler would only say that "Under the Act, the Bureau may not issue patient and caregiver identification cards necessary to obtain medical cannabis until July 1, 2019 (passed by the Legislature.)"

It would take legislative action to change the bill.

Reach Erin Beck at erin.beck@wvgazettemail.com, 304-348-5163, Facebook.com/erinbeckwv, or follow @erinbeckwv on Twitter.

Kanawha health department cuts clerical positions in clinic http://www.wvgazettemail.com/article/20170518/GZ0115/170519535 GZ0115 http://www.wvgazettemail.com/article/20170518/GZ0115/170519535 Thu, 18 May 2017 19:27:08 -0400 Erin Beck By Erin Beck The Kanawha-Charleston Board of Health voted unanimously Thursday to cut the health department's full-time workforce by about 15 percent, eliminating all clerical positions in the clinic division.

The board voted to cut five jobs, bringing the number of full-time employees from 39 to 34. Health care providers at the health department will take over clerical work in the clinic division.

John Law, spokesman for the health department, attributed the layoffs to "declining funding sources, lessening patient load and automation of patient records."

Brenda Isaac, president of the board, noted that medical assistants are trained, while receiving their degrees, to perform administrative tasks.

She noted that the health department's electronic records system includes automated billing, and that they have a kiosk for patient check-ins.

"We no longer need to have a person doing that," she said, adding that the board made the decision "with a heavy heart."

Two of the employees losing their jobs attended the Thursday afternoon meeting. They said they had more than 20 years experience between them and had hoped to retire from their positions. The average tenure is about 14 years, Law said.

"I was really hoping to retire from here," said Juanita Whittaker, one of those losing her job. "I have a year and a half before I'm 55 ... but I know it's not about me. It's about the department and keeping things running. I don't see how you take out all the clerks. That leaves a medical assistant and a few nurses. I don't see how that small of a staff is going to be able to handle the clerical part and the nursing part, the billing part. I don't see how that staff is going to be able to keep a clinic running."

"It's definitely going to cause a lot of realignment," Isaac responded.

During the 2016-17 fiscal year, the health department saw a $410,000 reduction in state funding, Law said.

Income from off-site clinics for flu vaccinations declined by 23 percent, from $334,000 to $221,000, over the past four years, he said.

"You can get those at your neighborhood pharmacy," Isaac added.

Law also noted that the health department transitioned in February to an electronic records system, which "streamlined billing and greatly reduced the need for clerical support."

"The reduction in force allows KCHD to avoid a $232,000 deficit for the 2017-2018 fiscal year," he said in a statement. "The savings generated include $150,000 in salaries and $82,000 in benefits."

If the State Personnel Board approves the layoffs, the employees' last day would be June 30.

The health department will continue to provide clinical services, Law said. Those services include blood pressure checks, breast and cervical cancer screening, family planning, flu shots, immunizations, lice treatment, tuberculosis testing and sexually transmitted infection testing and treatment, according to the health department's website.

Law said the health department would cover the cost of insurance for laid-off employees for 90 days, and pay for all accumulated annual leave.

He said the State Personnel Board probably would consider whether to grant the request at its June meeting.

Reach Erin Beck at erin.beck@wvgazettemail.com, 304-348-5163, Facebook.com/erinbeckwv, or follow @erinbeckwv on Twitter.

Thomas hosts haircut event to support women with cancer http://www.wvgazettemail.com/article/20170518/GZ05/170519545 GZ05 http://www.wvgazettemail.com/article/20170518/GZ05/170519545 Thu, 18 May 2017 17:35:02 -0400 By Caity Coyne Staff Writer By By Caity Coyne Staff Writer In 2006, Lula Moffatt was told she only had four months to live due to uterine cancer.

On Thursday­ - 11 years, two surgeries and several treatments later - the 74-year-old Kenna woman sat with a lively smile on her face in the lobby of Thomas Memorial Surgery's waiting room, as she watched her granddaughter get eight inches chopped off her hair for donation.

"I'm out here to give hair to ladies that need it. I know how important image is," said 38-year-old Amy Good, Moffatt's granddaughter. "I'm a little nervous, not really though. I'm ready for it to go."

Good's hair will be donated to Pantene's Beautiful Lengths campaign, where - through a partnership with the American Cancer Society and HairUWear - it will be crafted into free, real-hair wigs for women who have lost their hair to cancer.

This is a mission close to Good's heart, as she watched Moffatt, a great-grandmother to 16, lose her hair shortly after her cancer diagnosis more than a decade ago.

"If I hadn't had a wig, I probably wouldn't have gone out in public as much," Moffatt said. "But I just put my wig on and went on like it was my normal hair.

"When it grew back, it was shorter and darker, and the texture was different, but everyone just thought I got my hair cut."

Good said she'd been growing her hair out since 2006, never cutting off anymore than necessary to keep it healthy and maintained. She had wanted to donate her hair for the past year, but said her hair stylist was unsure, so it kept getting pushed off. Thursday's event presented the perfect opportunity for her.

The event was part of Thomas Health's programming for National Women's Health week, which started on Monday, according to Anne Wheeler, the women's imaging technical leader for Thomas Health Systems. During a meeting last week, hospital staff members brainstormed ideas and events to honor the week, and this was one of the most favored, Wheeler said.

Wheeler has worked at the hospital since 1984, and in her three decades there she has been witness to many women who have lost their hair due to illness and treatment.

"It's funny how we women put so much emphasis on our hair, but we always do. So when you go through suddenly losing your hair, and you've taken such pride in it all your life, it's very difficult," she said. "I just heard it yesterday - one of our patients came in, and her hair had started coming back in. It was very short and curly, but she was so thrilled that she had her hair coming back. She was so thrilled."

And while the main goal of the event was to give back, it also provided the hospital and its staff with a little entertainment, especially as Wheeler took the scissors to her coworker Amanda Hill's hair.

"Amanda [Hill] and I have been working together for years, so she trusted me to cut it," Wheeler said. "This is really a lot of fun... It builds community at our hospital. It's a good way to do good things together."

Hill, 36 of Dunbar, said she'd been growing her hair out for the last year with the intention of cutting it off to donate, and while the professional hairdressers who were supposed to style the volunteers' hair after it was chopped canceled last minute, she still wore her new shoulder-length bob with confidence and a smile.

"If there is something that I can do that is minimal, that means so much to someone else, I'm going to do it," Hill said. "It feels tremendous, like there's something I can actually do to help."

Reach Caity Coyne at caitlin.coyne@wvgazettemail.com, 304-348-5100 or follow @caitycoyne on Twitter.

Manchin pens letter to Trump seeking preservation of drug office http://www.wvgazettemail.com/article/20170517/GZ0101/170519591 GZ0101 http://www.wvgazettemail.com/article/20170517/GZ0101/170519591 Wed, 17 May 2017 18:35:27 -0400 Eric Eyre By Eric Eyre Sen. Joe Manchin, D-W.Va., sent a letter Wednesday to President Donald Trump urging him not to gut the White House's Office of National Drug Control Policy, a federal agency responsible for curbing the nation's opioid epidemic.

Politico and other news outlets have reported that the Trump administration has proposed slashing the drug office's funding by 95 percent. The cuts would eliminate the High Intensity Drug Trafficking Area and Drug Free Communities programs that aim to curb the supply and demand for illicit drugs.

"While our country and state are fighting this opioid epidemic, we should not be cutting the White House Office of National Drug Control Policy," Manchin said. "In counties across West Virginia, drug abuse is tearing families apart, destroying our workforce and weakening our economy.

"Our communities rely on the [drug office's] leadership and funding to help rebuild the lives, families and communities that are being torn apart."

Also Wednesday, U.S. Rep. Evan Jenkins, R-W.Va., joined 70 House members who signed a letter, asking Office of Management and Budget Director Mick Mulvaney to keep the White House drug policy office intact.

"We are gravely concerned that any interruption would exacerbate the [drug] crises in our communities," Jenkins and fellow House members wrote.

U.S. Rep. David McKinley, R-W.Va., also signed the letter.

Jenkins recently announced plans to run for U.S. Senate in next year's election. If Jenkins wins the GOP primary, he would face Manchin in the general election.

West Virginia has the highest drug overdose death rate in the nation, and the deaths are rising. At last count, 864 West Virginians fatally overdosed in 2016 - a record number. Heroin, fentanyl and prescription painkillers caused the bulk of those deaths.

In his letter, Manchin wrote that White House drug office programs help coordinate federal and local law enforcement agencies, reducing illegal drug sales and production. The programs also work with community groups to address substance abuse, Manchin said.

"With an average of 91 people dying [nationwide] every day from an opioid overdose, now is not the time to be cutting funding to the critical federal programs that help us combat this epidemic," Manchin wrote in his letter to Trump.

The House letter says that the Office of National Drug Control Policy plays a critical role in ensuring that the nation's drug policies are "effective, accountable and evidence-based." The office was established nearly two decades ago. It serves as the White House's only repository of detailed information about national drug problems.

The office, which received $388 million in federal funding in fiscal 2017, would only get $24 million in fiscal 2018, according to a White House budget proposal first reported by Politico earlier this month. More than 30 employees would lose their jobs.

Trump recently set up a White House commission that's being asked to recommend ways to reduce opioid abuse. The president appointed New Jersey Gov. Chris Christie to lead the panel.

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

WVU assistant professor seeks to expand access to music therapy in WV http://www.wvgazettemail.com/article/20170517/GZ0115/170519617 GZ0115 http://www.wvgazettemail.com/article/20170517/GZ0115/170519617 Wed, 17 May 2017 14:08:59 -0400 By Caitlin Coyne Staff writer By By Caitlin Coyne Staff writer When Amy Rodgers Smith was 16, she thought she wanted to be a psychologist. She grew up loving music, finding herself through singing in the choir and playing piano.

Smith wanted to help people, but didn't want to leave music behind. Her piano teacher at the time gave her another idea.

"She said, 'You should give music therapy a try,' and I just looked at her like 'what is that!?' " Smith said. "After learning more about it, I decided it was perfect for me."

Smith, who is now an assistant professor at West Virginia University, learned music therapy was a way to combine the compassion of psychology with her love of music. Certified professionals in the field, like Smith, work with clients of all ages by creating and listening to music, which can help them tackle physical, mental, social and behavioral problems, among others.

These sessions are intimate, much like therapy sessions, and can help with an array of disabilities and cognitive functions (like autism, addiction and Alzheimer's) by activating the listener's entire brain at once. This allows broken connections to be fixed and the brain to produce chemicals, like dopamine, that can help with healing, among other things.

This month Smith became the first health care-focused music therapist at WVU.

"I wanted to bring music therapy to my neighbors, friends and family. No matter where I was, I'd check up on the music therapy opportunities in West Virginia," she said. "I could never leave it alone."

There were only three or four music therapists in the state in 2013, Smith said. Now there are 10, and that number is rising.

A year from now, eight more music therapists will be certified to serve the state upon graduation from WVU's music therapy program.

Smith hopes these graduates will bring the benefits of music therapy to communities across the state, making the services more accessible to West Virginians, and hopefully breaking down some stereotypes in the process.

"It seems like a lot of [mental health and therapy] services are not offered and are not accessible here," said Haley Crane, director of On A Better Note, Music Therapy LLC, a music therapy organization Smith founded in Morgantown a few years ago. "Part of the culture is acceptance of [these problems]. We're trying to break down those walls."

Currently, music therapy is not reimbursed through insurance in the state, and while there is a Medicaid waiver that can offset some fees, most patients pay out of pocket. Smith and Crane hope to see that change in the next few years as the industry grows and people in the area can see evidence of the effects and benefits of music therapy.

"Music immediately makes a human connection; it was a part of our culture long before language was," Smith said. "It almost leaves me speechless [to see how much the industry has grown]. I want nothing more than my friends, family and neighbors to have access to this in their communities."

Protesters rally against AHCA at WV Capitol http://www.wvgazettemail.com/article/20170512/GZ0115/170519837 GZ0115 http://www.wvgazettemail.com/article/20170512/GZ0115/170519837 Fri, 12 May 2017 19:04:12 -0400 Erin Beck By Erin Beck Sumer Cave's mother lost the ability to speak before she died.

Her mom was diagnosed with Stage 4 cancer of the mouth and esophagus when Cave was 14.

Cave, 21, spoke about her mother at an event held Friday afternoon in the lower rotunda of the state Capitol to protest the American Health Care Act.

About 30 people gathered in protest of the bill, currently being considered by the U.S. Senate. The original version of the American Health Care Act, proposed by Republican leaders, cuts an estimated $880 billion over 10 years from Medicaid, according to the Congressional Budget Office, and would end Medicaid expansion in West Virginia, which has brought health care to about 170,000 West Virginians. It also would eliminate the individual mandate to purchase health insurance, among numerous other controversial provisions. All three members of the U.S. House of Representatives from West Virginia already have voted in favor of the bill.

Organizers for the event included West Virginians for Affordable Health Care, the West Virginia Center on Budget and Policy, West Virginia Together for Medicaid Coalition and the Alliance for Health Care Security, according to a release.

Cave said her mother was sick for some time, but wasn't diagnosed until she became eligible for Medicaid through Medicaid expansion, a provision of the Affordable Care Act. About 64,000 women in West Virginia gained Medicaid coverage in the first year of the expansion, according to the National Women's Law Center.

It was too late.

"I believe if the Affordable Care Act had been active a year or two earlier she would be here," Cave said, "but here I am to tell her story, because even though she's not physically here, she still lives inside of me."

Cave, a student at Concord University, also became eligible for Medicaid after expansion. She uses it for counseling appointments, in which she talks about the loss of her mother. She also gets the yearly checkups her mom couldn't afford.

She also works three jobs, in service industries. About 50,000 West Virginians with Medicaid coverage in 2015 were working women ages 18-64, according to the National Women's Law Center.

Her mom would write her thoughts down in notebooks before she died. Cave and her brother later found some of her scribblings. Their mother had tried to erase them, because she didn't want them to see.

"She said she was scared and that she didn't understand why she was dying, but I know why she did," Cave said. Her voice was loud and clear.

"She didn't have affordable health care," she said. "This is important to every single American that lives in this country, whether you need it or not. Just because you don't need it doesn't meant the rest of us don't.

"So [Sen.] Shelley Capito, vote in favor of the Affordable Care Act. Don't let other people die because of your decision," she said, to applause.

"Money should not matter when it comes to saving lives," she said in an interview after. "They can't let millions of Americans die because of money."

Carey Jo Grace, an organizer with the West Virginia Healthy Kids and Families Coalition, was another speaker. She said that while Medicaid covered her prenatal care and care for her children, she suffered from teeth abscesses and untreated mental illness because she couldn't afford care.

"I put off getting my gallbladder removed until I couldn't walk across the room," she said.

"I am really, really tired of politicians in Washington and right here in West Virginia looking me in the eye and telling me that poor people are looking for a handout and that they're lazy, because that's not true," she said. "Most people are like me, they go through a tough time in their life, they need some help."

Grace suggested that she would have benefited from expanded Medicaid. She currently gets coverage through her husband's insurance provider, because her employer does not provide it.

"Health care is something the rest of world has accepted as being a human right and it's about time we do it here in the United States," she said.

Reach Erin Beck at erin.beck@wvgazettemail.com, 304-348-5163, Facebook.com/erinbeckwv, or follow @erinbeckwv on Twitter.

Judge orders alleged Raleigh pain clinic to close http://www.wvgazettemail.com/article/20170512/GZ01/170519838 GZ01 http://www.wvgazettemail.com/article/20170512/GZ01/170519838 Fri, 12 May 2017 18:28:57 -0400 Staff reports By Staff reports A Raleigh County judge on Friday entered a ruling to shut down an alleged pain clinic in Beckley, officials say.

Circuit Judge Andrew Dimlich ordered Dr. Yasar Aksoy to cease operating his practice as a pain clinic, according to a news release from state Attorney General Patrick Morrisey's office. The order also prohibits the doctor from prescribing any Schedule II and III narcotics, including addictive opioid painkillers.

A call late Friday afternoon to Aksoy's office at the Beckley Plaza Mall went unanswered.

Morrisey's office, on behalf of state Department of Health and Human Resources' Office of Office of Health Facility Licensure and Certification, filed a petition March 15 alleging Aksoy operated the practice as a pain clinic, in that he prescribed narcotics to more than 50 percent of the patients he saw, the release said.

State law and regulations allow pain clinics to exist, but facilities must meet increased educational requirements and more strict regulations, the release says.

"Pain clinic regulation ensures that patients are receiving quality care in a safe environment," DHHR Inspector General Kathy Lawson said in the release. "The decision today has affirmed the efforts of the OHFLAC pain clinic staff in achieving that goal for the citizens of West Virginia who seek care for chronic pain."

The March 15 petition alleges Aksoy repeatedly failed to comply with letters from DHHR and OHFLAC demanding that he cease operations. Dimlich entered Friday's ruling from the bench, the release says. A written order is expected in the days to come.

"This is a major victory in the fight to reduce opioid use," Morrisey said in the release. "This court order exemplifies our office's vigorous effort to ensure everyone in the pharmaceutical supply chain adheres to the law."

Sissonville clinic reopens after fire http://www.wvgazettemail.com/article/20170512/GZ0115/170519852 GZ0115 http://www.wvgazettemail.com/article/20170512/GZ0115/170519852 Fri, 12 May 2017 15:16:40 -0400 Lori Kersey By Lori Kersey A Kanawha County health clinic that was destroyed by fire has reopened.

Cabin Creek Health Systems reopened its Sissonville Health Center last month. The organization held an open house event Friday to celebrate the opening.

The original clinic, located on Sissonville Drive next to the Top Spot restaurant, was destroyed by fire in February 2015.

Amber Crist, director of education and program development for Cabin Creek, said the community rallied around the clinic after the building burned. The clinic staff continued to provide service, first at Aldersgate United Methodist Church and then at the former Bonham Elementary School.

"It's been busy two years for the staff at Sissonville, and for the community," Crist said Friday morning. "I think they're happy to be in their permanent space."

Construction on the new space, located on Sissonville Drive near Sissonville High School, started about a year ago, Crist said. The new $3 million building and equipment are being paid for in part by grant funding from the Affordable Care Act, she said. Cabin Creek also received a $2 million rural development loan from the United States Department of Agriculture.

At nearly 11,000 square feet, the new building is bigger than the old clinic, which was about 4,000 square feet, she said. The new clinic currently offers primary and acute care and behavioral health services. By the end of the summer, it plans to add a full-service pharmacy and dental services, something the old clinic didn't have.

"We've really upped our game but we needed to," she said. "We needed to, to add pharmacy and dental."

Craig Robinson, Cabin Creek's executive director, said the new building is an example of critical infrastructure for the community.

"What that means for us is that it's both a promise to the community and a challenge to us, to both address the day-to-day health needs of our patients and to address the emerging health problems the community will face over time.'

Cabin Creek has operated in Sissonville since 2007 and is the only health clinic in Sissonville, Crist said. Crist said Friday's open house is a celebration of the new construction and a thank you to the community and patients for sticking with the clinic, Crist said.

"They've stuck with us, so we're really appreciative of that," Crist said.

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

WV's payment from cigarette makers up last year http://www.wvgazettemail.com/article/20170511/GZ0101/170519898 GZ0101 http://www.wvgazettemail.com/article/20170511/GZ0101/170519898 Thu, 11 May 2017 15:55:36 -0400 Phil Kabler By Phil Kabler West Virginia's annual payment from cigarette manufacturers was $64 million for 2016, up 2.6 percent over the previous year.

"Being up is good news," because national cigarette consumption declined 3.9 percent last year, Citigroup financial adviser Paul Creedon told the state Tobacco Settlement Finance Authority at the group's annual meeting on Thursday.

Under then-Attorney General Darrell McGraw, West Virginia was one of the first states to sue cigarette manufacturers to cover future costs of medical expenses for smokers. In 1998, the state agreed to a $1.8 billion settlement.

The Tobacco Settlement Finance Authority was created in 2007 when the state sold its rights to national tobacco settlement payments to bondholders for 25 years, raising $911 million. Of that money, $807 million went to shore up the then-critically underfunded Teachers Retirement System pension fund.

West Virginia's 2016 payment increased despite a downturn in cigarette smoking because the state entered into an agreement with smaller cigarette manufacturers in 2012 to settle a legal dispute with those companies over whether they were obligated to honor the settlement agreement by major cigarette manufacturers, Creedon said.

Each year, the state has to make about a $62 million payment to bondholders, and to date, the annual tobacco settlement payments to the state have been sufficient to cover that bond debt.

The state also has, as part of the bond sale, a $73 million debt service reserve fund that could be used if annual payments from the manufacturers fall below $62 million a year - something Creedon said will happen eventually.

He said IHS Global Insight, an economic analysis firm, has projected 3.6 percent declines in cigarette consumption nationally for both 2017 and 2018. "Since 1999, it's not a straight line, but cigarettes have declined on average by 3 percent a year," Creedon said.

Overall, cigarette consumption has declined 41 percent since 1999, from 441 billion cigarettes that year to 260 billion cigarettes in 2016.

"We would expect that, if the trend continues ... there could be missed payments in the future, although I don't think there are any imminent," Creedon said.

Responding to a question from Administration Secretary John Myers, Creedon said e-cigarettes, or "vaping," do not appear to be having a significant impact on cigarette sales.

"It really is very small compared to the larger traditional cigarette market," he said.

He said growth in sales of e-cigarettes has slowed as many states have imposed taxes on e-cigarette devices and liquids, and as localities have included e-cigarettes in smoking bans.

Reach Phil Kabler at philk@wvgazettemail.com, 304-348-1220, or follow @PhilKabler on Twitter.

US Attorney General Sessions discusses opioid epidemic in WV http://www.wvgazettemail.com/article/20170511/GZ0101/170519912 GZ0101 http://www.wvgazettemail.com/article/20170511/GZ0101/170519912 Thu, 11 May 2017 12:36:03 -0400 Eric Eyre Jake ZuckermanJake Zuckerman By Eric Eyre Jake ZuckermanJake Zuckerman The chief law enforcement officer of the United States pushed for a tough-on-drugs criminal justice approach to combat the growing opioid epidemic at a speech in Charleston on Thursday, running counter to recent efforts in fighting the region's addiction problem.

Attorney General Jeff Sessions spoke at a Drug Enforcement Administration heroin and opioid response event at the University of Charleston, where he said the keys to curbing the rising tide of opioid abuse will be an emphasis on abuse prevention and criminal enforcement.

Parts of Sessions' speech sounded strikingly similar to the "Just Say No" anti-drug advertising campaign of the 1980s. First lady Nancy Reagan championed the slogan during her husband's presidency.

"Once again, we're sending a clear message: Illegal drugs are dangerous and deadly," Sessions said. "Say 'No.' It's not right to do it. It's wrong to do it."

Although there is a growing push to step away from intensifying criminal prosecution of drug criminals, Sessions said this misses the point.

"They would say, which is pretty much true, 'We can't arrest our way out of this problem,' and that is true, we can't," he said. "But it is a big political part of it, and people should not diminish the power and effectiveness of good law enforcement. But prevention, I truly believe, is the greatest part of our challenge and, over time, prevention will be the most effective."

Although he advocated for drug abuse prevention, the speech's context raised questions on the sentiment. Sessions spoke at an event co-hosted by the DEA and the Community Anti-Drug Coalition of America, the latter of which is funded by the Office of National Drug Control Policy.

A memo leaked last week from a White House budget proposal expected to come this month revealed that President Donald Trump's administration has planned to cut the drug policy office's funding by nearly 95 percent, from $388 million to $24 million.

The office oversees several governmental bodies that combat the drug epidemic from preventive, law enforcement and rehabilitative angles.

Although Sessions was originally scheduled to be available for questions from reporters after the speech, his staff issued a news release late Wednesday stating that he would not be available for questioning. Sessions canceled news media availability after Trump fired FBI Director James Comey, who was heading an investigation into possible collusion with the Trump campaign and the Russian government to influence the 2016 presidential election. Sessions recused himself from the investigation after it surfaced that he had met with Russian diplomats while serving as a surrogate for the Trump campaign.

Along with prevention, Sessions said ramping up criminal justice efforts to thwart drug flow into and around the country will be key. He said that although people might try to suggest otherwise, drugs and crime go hand in hand and law enforcement will need additional resources in the battle, as well.

"We are not going to allow gangs and international cartels to dominate our streets." Sessions said. "It's our streets."

He said he is working on plans to enhance border security and more aggressively prosecute criminals bringing drugs over the border.

Sessions also said the heroin problem has led to a steep increase in violent crime.

"The opioid and heroin epidemic is attributed to the recent surge we see on violent crime in our country, there's just no doubt about it," he said. "We are indeed seeing a big increase in violent crime."

According to an annual report by the FBI, preliminary data from 2016 shows violent crime increased by 5 percent during the year, with an 11 percent increase in the murder rate. However, the rate of violent crime fell 50 percent between 1993 and 2015, according to that same source.

Sessions said treatment is part of the solution to the opioid problem, but he seemed to put it behind prevention and a law enforcement crackdown.

"While treatment programs are crucial, they address the drug abuse crisis from the back end, after people have gotten addicted and communities and lives are devastated," Sessions said.

Sessions also put doctors on notice Thursday, saying pain pill prescribing has gotten out of hand.

"I think we're prescribing too much opioids today, and we're going to have to confront that," Sessions said. "Our doctors, our dentists, our drug companies, our pharmacies - all have got to be on board in this. The day that we can allow abused prescriptions to addict people ... leading them into heroin has got to end, and will end."

Sessions cited the federal prosecution of Dr. Michael Kostenko, who ran a pain clinic in Raleigh County. Kostenko agreed to plead guilty to federal charges last month, just two days after his criminal trial had started. Kostenko faces up to 20 years in prison.

"He admitted [that], in just one day, he was paid over $20,000 in cash to write 370 oxycodone prescriptions totalling over 22,000 pills ... even though he didn't see a single patient that day, he wrote those prescriptions," Sessions said.

The attorney general said prosecutors will target all levels of the prescription drug supply chain, including distributors that ship painkillers from manufacturers to pharmacies.

"We're going to keep that up," he said.

Sessions described the battle against opioid abuse as a "huge undertaking."

"We have too much complacency about drugs," Sessions said. "Too much talking about recreational drugs. We want to reverse this trend. We are not going to allow this abuse."

Also Thursday, law enforcement officials said 140 people have overdosed on drugs in Charleston so far this year, and 20 of those have died. Heroin and fentanyl have fueled most of those deaths.

"We're in the middle of the worst heroin epidemic we've ever encountered, and we know prescription pills has led us down that path," said Chad Napier, coordinator for the Appalachia High Intensity Drug Trafficking Area program in West Virginia and Virginia. "Eighty percent of all heroin users come from prescription pill abuse."

Reach Jake Zuckerman at jake.zuckerman@wvgazettemail.com, 304-348-4814 or follow @jake_zuckerman on Twitter.

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