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An attorney for the California college professor who has accused Supreme Court nominee Brett Kavanaugh of sexually assaulting her when they were teenagers said she would be willing to testify next week before the Senate Judiciary Committee, an offer that could break a partisan logjam over whether the FBI should investigate her allegations. Christine Blasey Ford isn’t willing, however, to go before the panel by Monday, when a hearing is now scheduled, her lawyer wrote in an email Thursday to committee staff members. “She wishes to testify, provided that we can agree on terms that are fair and which ensure her safety,” wrote the lawyer, Debra Katz, who added that Dr. Ford had been receiving death threats. (Peterson, Nicholas and Andrews, 9/20)

The chairman of the Judiciary Committee, Sen. Charles E. Grassley (R-Iowa), said through a spokesman late Thursday that he would be consulting with colleagues on how to proceed. Kavanaugh wrote to Grassley in a letter released by the White House that he looks forward to testifying. “I continue to want a hearing as soon as possible, so that I can clear my name,” Kavanaugh said in the letter. “Since the moment I first heard this allegation, I have categorically and unequivocally denied it. I remain committed to defending my integrity.” Amid the maneuvering, the nomination was roiled further late Thursday by incendiary tweets from a prominent Kavanaugh friend and supporter who publicly identified another high school classmate of Kavanaugh’s as Ford’s possible attacker. (Kim, Dawsey and Brown, 9/20)

Meantime, Gov. Bill Walker of Alaska, an independent, and his lieutenant governor, Byron Mallott, a Democrat, came out on Thursday against Judge Kavanaugh’s confirmation. They said they worry that Judge Kavanaugh would jeopardize Medicaid coverage under the Affordable Care Act, adding that his “record does not demonstrate a commitment to legal precedent that protects working families.” They also said that he has been hostile to laws that are favorable to Alaskan Natives. And, they added, “We believe a thorough review of past allegations against Mr. Kavanaugh is needed before a confirmation vote takes place.” The statement from the governor and his lieutenant governor increased the pressure on Senator Lisa Murkowski, Republican of Alaska and a key undecided vote in the narrowly divided Senate. (Stolberg, 9/20)

She says he sexually assaulted her; he denies it. Is somebody deliberately lying? Not necessarily. Experts say that because of how memory works, it's possible that both Supreme Court nominee Brett Kavanaugh and Christine Blasey Ford — the woman who says a drunken Kavanaugh pinned her to a bed and groped her at a party when they were teenagers in the early 1980s — believe what they say. And which one of them believes his or her version more strongly is no tipoff to what really happened. (Ritter, 9/21)

Midnight had passed, and Alex Azar was still in a coat and tie as he looked into a computer monitor inside the Department of Health and Human Services emergency-operations hub. It was a room built for managing responses to hurricanes and disease outbreaks, but the HHS secretary was, instead, scrambling to deal with a disaster instigated by his own boss — a “zero tolerance” immigration policy that led thousands of children to be separated from their parents. Azar was not consulted on the zero tolerance policy before it was announced in early May, according to people familiar with the events, even though his department is responsible for housing migrant children who are on their own. (Goldstein, 9/20)

A top White House health official on Thursday defended a decision to shift money from health efforts in order to help pay to house detained migrant children. Joe Grogan, director of health programs at the White House Office of Management and Budget, told reporters the administration will not divert money from anti-opioid efforts. (Weixel, 9/20)

Arizona officials have moved to revoke the licenses for a nonprofit that houses immigrant children after it missed a deadline to show that all its employees passed background checks. Texas-based Southwest Key demonstrated an "astonishingly flippant attitude" toward the state's concerns about delayed background checks for workers at its eight Arizona shelters, the state Department of Health said in a scathing letter Wednesday. (Galvan, 9/20)

Lawmakers are considering adding a provision easing costs on drug companies to an opioid package currently being negotiated. The powerful pharmaceutical industry has been pushing for months to roll back a provision from February’s budget deal that shifted more costs onto drug companies, and they sense they have a chance to attach the change to the bipartisan opioid package currently moving through Congress. (Sullivan, 9/20)

The provisions that made it into law in February leave drug makers on the hook for 70 percent of prescription costs for seniors who reach the so-called donut hole in 2019 — that is, after they’ve spent $3,750 a year on drugs. The figure was previously 50 percent. Republicans are negotiating the deal without Democrats, according to multiple lobbyists, who spoke on the condition of anonymity. But a good chunk of the Democratic Party is likely to support the change, particularly if it includes the CREATES Act to offset the cost. (Facher and Florko, 9/20)

Proposals on the table to offset some of the costs of the Part D policy change included watered-down version of the CREATES Act, pushed this year by Sens. Charles Grassley (R-Iowa) and Patrick Leahy (D-Vt.), to expedite approvals of new pharmaceutical alternatives to brand-name drugs as one way to off-set the cost. The bill being considered would save about $2.6 billion. Another potential proposal is to delay the Medicare Part D "cliff" that will increase the donut hole for seniors starting in 2020 by two years, rather than establishing a permanent fix, according to an aide. The measure in question would offload about $4 billion in financial liability that drugmakers are supposed to shoulder starting Jan. 1, 2019, under the Bipartisan Budget Act of 2018. (Luthi, 9/20)

The drug industry is seeking to reduce the percentage they pay to 63 percent, with health insurers paying the rest. House GOP leaders seemed to be leaning toward granting the drug industry's request. In a letter sent Tuesday, 155 Republican lawmakers thanked GOP leaders for their “extraordinary efforts” to address the Medicare issue and “attach a fix to an upcoming vehicle.” (McIntire and Siddons, 9/20)

The American Medical Association is opposing a change to patient privacy laws that would allow doctors to more freely share information about a patient’s history of substance use, a proposal that has divided the health care community and highlighted some of the challenges of addressing the opioid epidemic. In a letter to lawmakers obtained by STAT, the AMA said it believed there was a “fundamental misunderstanding” among groups working to incorporate the proposal into a sprawling opioids bill. Relaxing restrictions on patient privacy, the AMA wrote, could prevent individuals with addiction from seeking medical treatment in the first place. (Facher, 9/21)

An artificial intelligence start-up founded by three insiders at Memorial Sloan Kettering Cancer Center debuted with great fanfare in February, with $25 million in venture capital and the promise that it might one day transform how cancer is diagnosed. The company, Paige.AI, is one in a burgeoning field of start-ups that are applying artificial intelligence to health care, yet it has an advantage over many competitors: The company has an exclusive deal to use the cancer center’s vast archive of 25 million patient tissue slides, along with decades of work by its world-renowned pathologists. (Ornstein and Thomas, 9/20)

Health systems are debating how to ensure research and conflict of interest transparency in the wake of Dr. Jose Baselga's recent resignation from Memorial Sloan Kettering over undisclosed conflicts of interest. The New York City-based research institute's chief medical officer resigned last week, days after reports that he did not disclose several millions of dollars in payments he received from drug and healthcare companies in dozens of research articles. In fact, an investigation by the New York Times and ProPublica found Baselga failed to report industry ties in 87% of the papers he published or co-wrote last year. Baselga also sat on the board of Bristol-Myers Squibb since March, and radiation equipment supplier Varian Medical Systems since 2017, according to the report. (Johnson, 9/20)

A Cornell professor whose buzzy and accessible food studies made him a media darling has submitted his resignation, the school said Thursday, a dramatic fall for a scholar whose work increasingly came under question in recent years. The university said in a statement that a year-long review found that Brian Wansink “committed academic misconduct in his research and scholarship, including misreporting of research data, problematic statistical techniques, failure to properly document and preserve research results, and inappropriate authorship.” (Rosenberg and Wong, 9/20)

Leaders of one of the nation’s most prominent scientific groups are calling for the research community to “act with urgency” to address sexual and gender-based harassment in the field. “It’s time for systemic change,” three leaders of the American Association for the Advancement of Science wrote in an editorial published Thursday in Science. The editorial — penned by AAAS president Dr. Margaret Hamburg, chair of the board Susan Hockfield, and president-elect Steven Chu — follows on the heels of a new policy on harassment adopted by the organization last weekend. (Thielking, 9/20)

Americans have long construed drugs of abuse as choices. Poor choices that can cost users their lives, to be sure, but choices nonetheless. But what if drugs of abuse are more like predators atop a nationwide ecosystem of potential prey? Or like shape-shifting viruses that seek defenseless people to infect? If public health experts could detect a recognizable pattern, perhaps they could find ways to immunize the uninfected, or protect those most vulnerable to the whims of predators’ appetites. (Healy, 9/20)

It isn’t just opioids behind a surge in deaths from drug overdoses in the U.S.  Death rates from overdoses have been on an exponential-growth curve for nearly 40 years, involving methamphetamines, cocaine and other drugs in shifting patterns around the country and involving different age groups, a new analysis of federal data shows. When use of one drug has declined, another has moved in to fill the void, researchers at the University of Pittsburgh Graduate School of Public Health found in the analysis, published Thursday in the journal Science. (Ulick and McKay, 9/20)

Despite a raging drug overdose epidemic that is killing nearly 200 Americans every day and sending thousands more to emergency rooms, the vast majority of the nation’s more than 5,500 hospitals have so far avoided offering any form of addiction medicine to emergency patients. That’s starting to change. In [Dr. Zachary] Dezman’s ER at the University of Maryland Medical Center Midtown Campus in West Baltimore — and in 10 other Maryland hospitals — addiction services, including starting patients on the highly effective anti-addiction medication buprenorphine, is a new and growing emergency service. (Vestal, 9/21)

Health and Human Services Secretary Alex Azar on Thursday highlighted the administration’s efforts to combat the opioid crisis, as lawmakers seek to clear legislation on the issue soon. Azar noted in a roundtable with reporters that his agency announced this week that it would award more than $1 billion in previously appropriated funding to state, tribal and local governments to address addiction. Assistant Secretary for Health Brett Giroir also emphasized the importance of a new telemedecine guidance document that would expand access to medication-assisted treatment, or MAT, through telemedicine. (Raman, 9/20)

As Connecticut residents continue to die from opioid overdoses at an alarming rate, there is some consensus in the medical community that being able to share health records electronically across the entire state would help fight the epidemic. A system to accommodate that sharing remains elusive, however. (Rigg, 9/21)

Gov. John Kasich said Thursday he will vote against Issue 1, the proposed constitutional amendment that would lessen drug crime penalties if people participate in treatment.But Kasich's feelings about Issue 1 are more nuanced than other Republicans who oppose it. (Hancock, 9/20)

Scientists in Japan made progress recently in the quest to combat infertility, creating the precursor to a human egg cell in a dish from nothing but a woman’s blood cells. The research is an important step toward what scientists call a “game-changing” technology that has the potential to transform reproduction. The primitive reproductive cell the scientists created is not a mature egg, and it cannot be fertilized to create an embryo. But researchers have already created eggs out of mouse tail cells and fertilized them to produce viable pups, so outside scientists said the research is on track to one day achieve human “in vitro gametogenesis” — a method of creating eggs and sperm in a dish. (Johnson, 9/20)

"For the first time, scientists have been able to convincingly demonstrate that we are able to make eggs — very immature eggs," says Amanda Clark, a developmental biologist at UCLA who wasn't involved in the research. The technique might someday help millions of people suffering from infertility because of cancer treatments or other reasons, Clark says.But the prospect of being able to mass-produce human eggs in labs raises a host of societal and ethical issues. (Stein, 9/20)

If you give an octopus MDMA, it will get touchy and want to mingle. What sounds like the premise of a children’s book set at Burning Man is, in fact, the conclusion of a study published Thursday in the journal Current Biology. Neuroscientist Gül Dölen, who studies social behavior at the Johns Hopkins University School of Medicine, and octopus expert Eric Edsinger, a research fellow at Marine Biological Laboratory in Woods Hole, Mass., bathed octopuses in the psychedelic drug and observed the result. (Guarino, 9/20)

Octopuses are almost entirely antisocial, except when they're mating, and scientists who study them have to house them separately so they don't kill or eat each other. However, octopuses given the drug known as MDMA (or ecstasy, E, Molly or a number of other slang terms) wanted to spend more time close to other octopuses and even hugged them. "I was absolutely shocked that it had this effect," says Judit Pungor, a neuroscientist at the University of Oregon who studies octopuses but wasn't part of the research team. (Greenfieldboyce, 9/20)

Experiments with two gambling monkeys have revealed a small area in the brain that plays a big role in risky decisions. When researchers inactivated this region in the prefrontal cortex, the rhesus monkeys became less inclined to choose a long shot over a sure thing, the team reported Thursday in the journal Current Biology. (Hamilton, 9/20)

Antibiotic-resistant bacteria that have infected more than 100 people and that have been linked to pet store puppies appear to have spread at least in part because healthy dogs were given antibiotics — a decision that all but surely fostered antibiotic resistance. ... More than half of the puppies in a sample of roughly 150 dogs studied as part of the outbreak investigation were given antibiotics not because they were sick, but to keep them from becoming so, according to a new study published Thursday. The technique, called prophylaxis, has been widely used in food animal production and is blamed for fueling antibiotic resistance. (Branswell, 9/20)

Carmen Lugo has lived in Puerto Rico her whole life, and her whole life she has feared the water that comes out of her tap. "When I was a child, we used filters," she says, leaning on the doorjamb with her 11-year-old in front of her and two teenage sons sleepy-eyed behind her on a morning in July." The water here," she says, pausing as she purses her lips in a tight smile. She chooses her words carefully. "We want to be in good health," she finally says. "My husband, he buys water from the Supermax," referring to a local grocery store. (Hersher, 9/20)

Unsafe levels of lead or copper have been found in drinking water fountains and other fixtures at more than half of Detroit Public Schools Community District buildings. Tests show elevated levels in 57 schools. The 106-school district relies on federal protocols to determine water safety. Results are pending for 17 more. (9/20)

Three years after discovering that a military laboratory had shipped live anthrax to facilities around the world, the Department of Defense still has not developed a plan to evaluate its biological security practices, the federal Government Accountability Office reported on Thursday. The department has implemented about half of the procedural changes that had been recommended, the G.A.O. said. But the Pentagon still has not established a way to measure the effectiveness of these reforms, making it difficult for experts to determine whether safety has improved. (Baumgaertner, 9/20)

Not long after joining Aetna, the health insurance giant, Mark Bertolini almost died. A skiing accident in 2004 left his body broken and his prospects dimmed. He was in his late 40s and considered early retirement. When conventional Western medicine didn’t help him recover, Mr. Bertolini turned to Craniosacral therapy, yoga and meditation. Soon he was back at work, and was made chief executive of the company in 2010. (Gelles, 9/21)

A new study links daytime sleepiness with the accumulation of the plaques in the brain that are a hallmark of Alzheimer’s disease. The study, published in Sleep, included 124 mentally healthy men and women, average age 60, who reported on their own daytime sleepiness and napping habits. An average of 15 years later, researchers administered PET and M.R.I. scans to detect the presence of beta-amyloid, the protein that clumps together to form plaques. (Bakalar, 9/20)

You’ll never walk alone. Enveloping you is a vast menagerie of microbes and other minutia — counted and catalogued for the first time by scientists at the Stanford School of Medicine. The tally is startling: In just one week, the average person is exposed to about 800 different species of bacteria, viruses, chemicals, plant pollens, fungi and tiny microscopic animals, they report in the journal Cell. (Krieger, 9/20)

A federal judge in Connecticut has dismissed a lawsuit by 60 former professional wrestlers, many of them stars in the 1980s and 1990s, who claimed World Wrestling Entertainment failed to protect them from repeated head trauma including concussions that led to long-term brain damage. U.S. District Judge Vanessa Bryant in Hartford threw out the lawsuit Monday, saying many of the claims were frivolous or filed after the statute of limitations expired. Stamford-based WWE denied the lawsuit's allegations. (9/20)

Cargill Meat Solutions is recalling hundreds of thousands of pounds ground beef products following because of an E.coli outbreak after one death and 17 illnesses. According to the USDA, Cargill is recalling over 132,00 pounds of ground beef products that may be infected with E.coli following an epidemiological investigation that found the affected people purchased the meat from grocery stores supplied by Ft. Morgan, Colorado’s Cargill Meat Solution. (Haflich, 9/20)

California resident and former standout softball player Tiffany Thomas Lopez said she was elated Thursday morning after hearing Gov. Jerry Brown had signed Senate Bill 1448 requiring physicians, chiropractors and other practitioners notify patients if they are on probation for serious misconduct such as sexual abuse. Lopez, now 38, said she was just 17 and 18 years of age when Michigan State University team doctor Larry Nassar molested her. Nassar, who also treated many of the nation’s foremost gymnasts, was sentenced earlier this year to up to 175 years in prison for decades of sexual abuse. Lopez said she came to Sacramento twice to testify in support of SB 1448. (Anderson, 9/20)

If you want a straw with your drink or a soda with a kids' meal at a California restaurant, you'll need to ask for them starting next year. A law signed Thursday by Gov. Jerry Brown makes California the first state to bar full-service restaurants from automatically giving out single-use plastic straws. Another law he approved requires milk or water to be the default drink sold with kids' meals at fast-food and full-service restaurants. (Bollag, 9/20)

“Our state is in the midst of a public health crisis where rates of preventable health conditions like obesity and Type-2 Diabetes are skyrocketing, due in large part to increased consumption of sugary beverages,” state Sen. Bill Monning (D-Carmel), the law’s author, said in a written statement. “This bill is an important part of a statewide public health strategy that will better inform consumers about the unique impacts that sugary beverages have on their health and that of their children.” (Myers, 9/20)

Under Senate Bill 328, public and charter schools would have had to adhere to the start time rule by Jan. 1, 2021, a change researchers believe would have decreased students’ risk of depression, suicide and car accidents while increasing their attendance rates, grade-point averages and test scores. “This is a one-size-fits-all approach that is opposed by teachers and school boards,” Brown said in a veto message. “Several schools have already moved to later start times. Others prefer beginning the school day earlier. These are the types of decisions best handled in the local community.” (Racker, 9/20)

Set the alarm clock. Teens will not be sleeping in, after Gov. Jerry Brown vetoed a bill Thursday that would have barred middle schools and high schools from starting before 8:30 a.m. (Gutierrez and McBride, 9/20)

Complaints lodged by a dozen whistleblowers last year about the quality of care at the Manchester VA had consequences. At least four VA leaders lost their jobs and the government poured millions of dollars into improvements at the medical center. But in an internal draft VA report obtained by NHPR, investigators say nearly all of those complaints were unfounded. (Biello, 9/20)

The recent fatal shooting of a young, unarmed Broomfield man who had a mental breakdown hours before being killed by Westminster police highlights how cracks in the mental health care system combined with under-resourced law enforcement can have deadly outcomes, mental health advocates say. A lack of treatment oversight by state courts, difficult access to outpatient treatment and hurdles for family members getting their loved ones help make Colorado a “poster child” for failures in the mental health care system, according to a national organization dedicated to researching mental health care issues. (Barnett, 9/20)

Children registering for school in Florida this year were asked to reveal some history about their mental health. The new requirement is part of a law rushed through the state legislature after the February shooting at Marjory Stoneman Douglas High School in Parkland, Fla. The state's school districts now must ask whether a child has ever been referred for mental health services on registration forms for new students. (Ochoa, 9/21)

The state’s highest court decided Thursday to uphold a law that allows many hospitals to avoid paying property taxes — an issue that’s spurred debate in Illinois and across the country. The Illinois Supreme Court affirmed a lower court’s ruling that a 2012 law allowing not-for-profit hospitals to skip paying property taxes under certain conditions is constitutional. Many of the Chicago area’s biggest names in health care are not-for-profit, including Advocate Aurora Health, Northwestern Memorial Hospital, University of Chicago Medical Center and NorthShore University HealthSystem, among others. (Schencker, 9/20)

Three Boston teaching hospitals accused of compromising patient privacy by allowing television crews to film inside their facilities have settled their cases with the federal government. The Department of Health and Human Services’ civil rights office said Thursday that the hospitals will pay about $1 million total to settle the cases. Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Medical Center invited ABC crews to film a documentary series in 2014 and 2015, without first obtaining authorization from patients, the government said. (Kowalczyk, 9/20)

The number of people with sexually transmitted diseases in Maryland is growing rapidly and many might not even know they are infected, fueling the spread. The rise in STDs is happening across the state and not just in trouble spots such as Baltimore, which has a history of high rates. The spread of syphilis, gonorrhea and chlamydia are of particular concern to public health officials and doctors, who say they are treating many more cases. (McDaniels, 9/20)

The Nashville health care sector's impact on the local economy contributes $46.7 billion annually, up 20 percent from three years ago. The findings are based on a report from the Nashville Health Care Council conducted by the Nashville Area Chamber of Commerce. More than 500 health care companies operate in Nashville, along with nearly 380 professional services firms tied to the health care sector. The health care industry employs 273,000 local people from various sectors, including retail, trade, real estate and finance. The industry generates $92 billion in revenue. (McGee, 9/20)

On an average day in Louisiana, nearly 40 people pick up the phone and call 1-800-273-TALK, the number for the National Suicide Prevention Lifeline. For all but a handful of parishes, those calls are answered by the New Orleans-based nonprofit Via Link, where crisis intervention specialists have a singular goal: save the person on the end of the line. But as the demand grows with increased attention to the national hotline, Via Link leaders say they can no longer rely on private donations alone to cover the cost of answering those calls. If nothing changes, Via Link CEO LaVondra Dobbs said the agency will likely have to stop answering hotline calls in December – sending most of the roughly 1,100 monthly calls from Louisiana area codes currently routed to Via Link to a national backup center. (Bullington, 9/20)

For the better part of four years, David Ford has not had much in the way of teeth. When he first came to state prison, the Houston man had just enough molars to hold in place his partial dentures. But then he lost one tooth to a prison fight and the rest to a dentist. Now, five years into his stay, Ford has no teeth at all — and no dentures. And, despite his best efforts and insistent requests, he’s been repeatedly denied them and told that teeth are not a medical necessity. (Blakinger, 9/20)

Some Puget Sound residents spent the night at Seattle Center’s Fisher Pavilion to beat the crowds Thursday for free medical care at a makeshift clinic. The clinic, set up inside Key Arena, started admitting patients at 6:30 a.m. Forty-five minutes later, it had already issued hundreds of admission tickets. Volunteers and funding from 135 medical-services providers, businesses and nonprofits have made it possible for the four-day event to be held for a fifth year. (Pacheco-Flores, 9/20)

A company providing primary care to low-income seniors soon will open three health care centers in Cleveland. Chicago-based Oak Street Health plans to open three 9,000-square-foot community-based centers in the Glenville, West Boulevard and Lee-Harvard neighborhoods by the end of the year. The centers will serve those on Medicare. (Christ, 9/20)

A long-time director at Access Health CT was named the new chief executive officer of the state’s health insurance exchange on Thursday. The exchange’s board of directors voted to appoint James Michel as the permanent CEO at its meeting at the Legislative Office Building in Hartford. “I’m just very happy and proud to be leading this organization that’s doing very important work for the residents of Connecticut,” said Michel after the meeting. (Rigg, 9/20)

Amazon’s Sacramento fulfillment center hosted “Camp Amazon” on Wednesday, an event to raise awareness for childhood cancer. Six local children who have been diagnosed with cancer and are interested in science, math and technology were invited to tour the Amazon facility near Tahoe Park, according to a press release. (Darden, 9/19)

For every child who has squirmed and cried over a shot or a blood draw — and every parent who has stood by helplessly — doctors at Children’s Minnesota hospitals are reporting success in a campaign to eliminate needle pain. Strategies such as numbing cream, soothing blankets and visual distractions were rolled out in 2013 on the inpatient floors of Children’s hospitals in Minneapolis and St. Paul. They proved so effective that doctors extended them to the emergency room and, most recently, to all outpatient clinics. (Olson, 9/21)

It was police dispatcher Tiffany Holseberg’s first week back at work following a medical leave for cancer treatments when she answered the department’s non-emergency line and spoke with an 89-year-old artist desperate for help. Jim Campbell explained how on Sept. 7 he made the mistake of driving to a San Jose post office with a box of his original pen-and-ink drawings on the roof of his SUV. Campbell, who lives in Willow Glen, believes the box flew off the car somewhere on Hillsdale Avenue. (Gomez, 9/20)

Reporting a sex assault to police is unquestionably traumatic. Victims undergo an invasive medical exam. Police ask sensitive questions. Then, when victims get home, sometimes they have no sheets. That's because police take clothing and fabric from the scene of the crime for DNA analysis. And while a victim is likely to have multiple items of clothing, he or she may not have an extra set of bed sheets. So Kansas City Police Crime Scene Technician Marisa Smith had an idea: Why not leave a fresh set of sheets for victims to find when they get home? (Haxel, 9/20)

People experiencing homelessness in Miami now have access to a new bathroom after the city  opened on Wednesday its first permanent toilet in Downtown. The sleek restroom near the West Flagler street Metrorail station will be open 12 hours a day and features a sink and needle disposal area. Modelled off stand-alone toilets in Portland, Oregon, it runs on solar power and looks like a booth with steel panels. (Turken, 9/20)

Whole Foods Market will pay $1.64 million to settle claims by 21 cities and counties in California that its stores improperly handled and disposed of hazardous wastes. (Egelko, 9/20)

Recreational marijuana stores in Massachusetts are unlikely to open until the end of October or even later, after the state’s Cannabis Control Commission on Thursday failed to issue final licenses as hoped. Commission chairman Steve Hoffman told reporters two weeks ago that representatives of several pot firms with provisional licenses had indicated their facilities were ready to be inspected — a key step before opening for sales — and could be handed final licenses Thursday. That didn’t happen, Hoffman said, because the agency “just didn’t get peoples’ requests [for inspections] in time.” (Adams, 9/20)

Using a national sample of health care claims data from the Health Care Cost Institute, we found that total spending per capita (not including premiums) on health services for enrollees in employer-sponsored insurance plans increased by 44 percent from 2007 through 2016 (average annual growth of 4.1 percent). Spending increased across all major categories of health services, although the increases were not uniform across years or categories. Growth rates for total per capita spending generally slowed after 2009 but increased between 2014 and 2016. Spending on outpatient services grew more quickly (average annual growth of 5.7 percent) compared to spending on the other types of services. However, the overall distribution of spending across categories remained largely unchanged. In the context of the dramatic economic and policy events that have taken place since 2007—including the Great Recession, the Affordable Care Act, and numerous medical innovations—this assessment of ten-year spending trends provides insights into how the largest insured population in the US contributes to health care spending growth. (Frost et al, 9/19)

This observational study of data from the Medicare Current Beneficiary Survey and Area Health Resources File found that patient depression, dementia, limitations in activities of daily living, and residence in areas of mental health care shortage or high unemployment were associated with substantially higher TACC, after applying standard Medicare risk adjustment methods. In a model adding these factors to risk adjustment, the TACC performance of safety-net clinicians was improved. (Johnston et al, 9/17)

The uninsured rate among low-income Kansans ages 19 to 64 is 20 percent, significantly higher than rates in Ohio and Indiana. Low-income Kansans also reported comparatively more frequent delays in care because of cost, greater difficulty affording medical bills, and worse health care quality. Survey data show Medicaid expansion is favored by 77 percent of low-income Kansans, and state policymakers have expressed interest in using a Section 1115 waiver for expansion, which would include a work requirement. Our data suggest such a provision would likely have little impact on employment in Kansas, where most potential Medicaid enrollees are disabled or already employed. (Goldman and Sommers, 9/17)

In this crossover study of 18 primary care physicians, use of scribes was associated with significant reductions in electronic health record documentation time and significant improvements in productivity and job satisfaction. (Mishra et al, 9/17)

One year after hurricanes Maria and Irma struck Puerto Rico and the U.S. Virgin Islands (USVI), recovery has progressed but remains slow. This issue brief presents findings from the Geiger Gibson/Kaiser Family Foundation survey of community health centers in Puerto Rico and USVI one year after the hurricanes. It describes the current state of health center recovery and examines shifts in need and capacity, which have potential longer-term implications. (Sharac et al, 9/19)

Earlier this month, over a year after Republicans tried multiple times to repeal the Affordable Care Act, I asked people in the Twittersphere if their representatives in Congress had voted for repeal and, if so, if they held a town hall to explain their vote and put forward a better vision for health care. Within 24 hours, over 500 people had tweeted back their experiences. The responses reflected not just people who disagreed with their member of Congress, but people who felt ignored by them. The list of those who chose to vote and disappear in 2017 is long, including many who now find themselves in highly contested races — among them Republicans Barbara Comstock of Virginia, Dana Rohrabacher and Mimi Walters of California, Peter Roskam and Mike Bost of Illinois, Steve Chabot and Steve Stivers of Ohio, and Bruce Poliquin of Maine. (Andy Slavitt, 9/21)

The emergence of a new generation of people addicted to nicotine — many of them now in middle school — keeps me up at night. A few years ago, I and many of my colleagues who have cared for people with tobacco-related diseases breathed a sigh of relief as we watched smoking rates decline. That relief has dissipated as electronic cigarettes, or vaping, sweeps through middle and high schools. We won’t know the full extent of vaping’s health consequences until it’s too late, but we can expect to see a tsunami of related diseases in 20 or 30 years. (Richard Stumacher, 9/21)

Teenagers, particularly drunken teenagers, sometimes commit awful, cruel, even criminal acts — acts that can wound victims for decades. When possible, they should be held appropriately accountable. However, what provides more insight into a person’s moral rectitude is, arguably, not what he did as a minor but how he handles such sins once he has developed into a mature adult. Specifically, whether he takes responsibility and expresses contrition.And if Kavanaugh is continuing — today, as a 53-year-old man — to deny a crime he in fact did commit as a drunken teenager, that casts doubt not only upon his character as a teen but also on his trustworthiness in other high-stakes matters today. (Catherine Rampell, 9/20)

For me, it was OxyContin then heroin. It turns out that this is a common trajectory. In the United States, 72,000 people died from drug overdoses in 2017, nearly 50,000 of those from opioids. Imagine an entire football stadium full of people obliterated. I first abused opioids about the time I turned 18 years old. I grew up in Green Bay, Wisconsin, which, simply put, is the drunkest city in the nation, and I was pretty young when I started drinking alcohol and smoking marijuana. But when I first snorted Oxy, it was a high of another level. (Nicholas Bush, 9/21)

It was with great sadness that I read the guest column in The Tennessean by Meredith Lawrence, whose husband ended his life after his doctor dramatically reduced his pain prescription. I myself am a board certified pain specialist in the Middle Tennessee area and have practiced pain management for 22 years. I spend every day 'down in the trenches" taking care of all kinds of pain patients with the majority being injured workers in the worker's compensation system. I fight the battles every day trying to provide safe and cautious management with and without opioids. (Jeffrey Hazlewood, 9/20)

America faces an unprecedented opioid crisis, but we may be turning a corner. Due to a rapid surge of illegal synthetic opioids — such as fentanyl and carfentanil — the Centers for Disease Control and Prevention estimate deaths in 2017 increased by almost 10 percent, claiming the lives of more than 70,000 Americans. But today, Facing Addiction in America: The Surgeon General’s Spotlight on Opioids, shines a light on the latest data for prevalence of substance misuse, opioid misuse, opioid use disorder and overdoses.The Spotlight gives us reason for hope. For example, between 2016 and 2017, the nation saw a significant increase in the use of MAT, or Medication Assisted Treatment — the gold standard for treating opioid use disorders. In addition, we saw a national reduction in the rate of heroin initiation. Federal, state and local efforts are having an impact, but we must do more. (Derek Schmidt and Jerome Adams, 9/20)

FEMA may well have done its best in the aftermath of Hurricane Maria, but it was responding to a disaster that has its roots in the still-amorphous relationship between the island and the rest of the U.S. The storm was a stress test, and Puerto Rico and the rest of the nation failed together. More, and tougher, tests are undoubtedly on their way, as warming oceans make hurricane season more hazardous. (9/21)

Consider this stunning finding from analysis by Miami Herald parent McClatchy of public data for FEMA’s housing assistance program: As of June 1, Maria survivors in Puerto Rico received an average of $1,800 for repair assistance. In contrast, survivors of Hurricane Harvey in Texas last year got $9,127. Why the disparity? Yet, Kirstjen M. Nielsen Secretary of Homeland Security writes in an Opinion piece published today on these pages, that FEMA has done the best it can under difficult conditions and that $4.6 billion in assistance has been spent on the island’s’ recovery. (9/20)

At the California Department of Justice, our first priority is public safety. When it comes to keeping guns out of the hands of dangerous people, California has figured out what makes a difference, and we’re doing it. Earlier this month, a Government Accountability Office report suggested that the federal government and states like California that perform background checks on firearm purchases could do more to investigate and prosecute those who failed background checks and might have lied on their forms. In a world of unlimited resources, we certainly would. Instead, we prioritize our finite resources to go after dangerous criminals who already possess weapons illegally. (Calif. Attorney General Xavier Becerra, 9/19)

When Americans face a challenge, we adapt. We innovate. We step up and make the world better. As nurses, we take pride in the creative ways health care continues to improve and treat our patients’ most challenging illnesses.So we wonder, why is the Environmental Protection Agency proposing a rule that will be a gigantic step backward for public health? Rolling back vital clean air and climate protections will reverse progress toward cleaner air. ...As a nurse, I see patients, particularly children, elderly and pregnant women struggle with managing risks of heart problems and breathing trouble on poor air quality days. (Lynelle Phillips, 9/19)