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Health officials in New York State said on Thursday that they are investigating a possible cause of a recent surge in severe vaping-related illnesses: a compound called vitamin E acetate. The state Department of Health said in a news release that “very high levels” of the compound had been found in 13 samples from eight of 34 patients who have gotten ill in New York. The samples were analyzed as part of an investigation by the Wadsworth Center, a state laboratory. (Richtel, 9/5)

The chemical is an oil derived from vitamin E. Investigators at the U.S. Food and Drug Administration found the oil in cannabis products in samples collected from patients who fell ill across the United States. FDA officials shared that information with state health officials during a telephone briefing this week, according to several officials who took part in the call. That same chemical was also found in nearly all cannabis samples from patients who fell ill in New York in recent weeks, a state health department spokeswoman said. (Sun, 9/5)

Vitamin E acetate is a common dietary supplement and frequently used in skin creams. It isn’t known to be harmful when used in those ways, but the department and other experts believe that inhaling the oil could be a factor. Previous reports suggested that the patients could be suffering from lipoid pneumonia, a reaction to inhaling fats or oils, or a type of allergic reaction that causes inflammation. “When you inhale it, it gets deep into the lungs,” said Howard Zucker, the commissioner of the health department. “You get an inflammation, and the lungs cannot do their job.” (Abbott, 9/5)

But CDC Director Robert Redfield said it was "probably important for us to keep an open mind that it may be a cause or may be causes," of the vaping illness outbreak. "People need to realize that it is very probable that there are multiple causes." The FDA also stressed this point. "No one substance, including Vitamin E acetate, has been identified in all of the samples tested," the agency said in a news release. "Importantly, identifying any compounds that are present in the samples will be one piece of the puzzle but will not necessarily answer questions about causality." (Young and Owermohle, 9/5)

Vitamin E is not an approved additive for vape products approved by New York's medical marijuana program, and Zucker says the cartridges they tested appear to be "black-market" products purchased off the street — not in medical dispensaries. "This is a situation of people buying products that have been laced with markedly elevated amounts of vitamin E," Zucker says. (Neel and Aubrey, 9/5)

"The cases of pulmonary illnesses associated with vaping are continuing to rise across New York State and the country," New York Health Commissioner Dr. Howard Zucker said in a written statement on Thursday. "We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms. In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue," he said. (Howard and Gumbrecht, 9/5)

New York's 34 lung injuries are mostly in people aged 17 to 30, who started showing up at emergency rooms in July after vaping tetrahydrocannabinol, known as THC, the psychoactive element of marijuana. Some of them also were vaping nicotine, but the probe has narrowed in on cannabis use as the culprit, doctors and state health officials said. It’s part of at least 215 vaping injuries being investigated across the country, prompting federal officials to issue alerts against vaping nicotine or marijuana until a cause is determined. (O'Donnell and Robinson, 9/5)

Four other cases have been documented before the current spate of illnesses — all seemingly rare cases that concerned physicians enough to write about them in medical journals. “These cases may just be the tip of the iceberg,” Eissenberg said. “There could be many unreported cases that have passed below the clinical radar simply because the person treated themselves by abstaining from e-cigarettes and never went to the hospital.” (Edwards, 9/5)

CBS News spoke to one young man who nearly died from vaping. "I'm getting better now that I'm off oxygen. When I first got here it was like a baby bear was on my chest," said 18-year-old Adam Hergenreder. When he got to the Advocate Condell Medical Center in Libertyville, Illinois, on Saturday, Hergenreder was feverish, vomiting and gasping for breath. From what doctors know of his case, vaping nearly killed him. (9/5)

The lung illnesses are a threat to the e-cigarette industry, which has grown rapidly as a way for people to switch from traditional cigarettes, which are responsible for 480,000 deaths a year in the U.S. Some people use the devices to inhale cannabis and THC, and a variety of bootleg cartridges and pods are available for use with the devices. (Edney, 9/5)

State officials didn't identify one particular brand linked to the illness, noting that all patients have reported recent use of various products. (Hellmann, 9/5)

A House Democrat accused e-cigarette company Juul of making false and misleading advertising claims, and called on the Food and Drug Administration to investigate. Rep. Raja Krishnamoorthi (D-Ill.) said Juul has been marketing itself as a tool to help people quit smoking, claiming its pods are safer and healthier than traditional cigarettes. (Weixel, 9/5)

Krishnamoorthi's letter follows a two-day hearing in July, after which the committee concluded that "JUUL appears to be violating FDA regulations against making unapproved express and implied claims that its product helps users stop smoking cigarettes and is safer than cigarettes." At the subcommittee hearing in July, several people testified that the company was directly marketing to children in high school, to the Cheyenne River Sioux Tribe and to smoking cessation groups. (Christensen, 9/5)

Juul has become popular among underage vapers due in part to an early social-media campaign that appealed to kids and teens. Juul executives have said their e-cigarettes have always been intended to help adults quit cigarettes, though the FDA hasn’t approved any of the company’s products as smoking-cessation tools. (Edney, 9/5)

Texas oncologist Dr. Stephen Hahn met with President Trump Wednesday about a potential nomination to helm the Food and Drug Administration, according to two Republican policy experts and one without a party affiliation. Hahn is chief medical executive at the MD Anderson Cancer Center, but unlike many of the other men and women who have recently led the FDA, he has no Washington experience. (Florko, 9/5)

An administration official said that Trump has not made a decision on the FDA job, but that Hahn “is a strong candidate.” He has emerged as the chief rival to Norman E. “Ned” Sharpless, who was tapped as acting FDA chief after Commissioner Scott Gottlieb resigned in March. Sharpless previously was director of the National Cancer Institute and the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, N.C. He can serve as acting commissioner only until Nov. 1. (McGinley, 9/5)

Hahn, 59, has been at MD Anderson since 2015, when he was hired to head radiation oncology at the elite cancer center. Two years later, he became chief operating officer, then quickly made headlines when he told colleagues MD Anderson was on track to lose up to $450 million in the new fiscal year without swift and decisive action. The hospital eventually turned its finances around, but not before it laid off 778 employees and Dr. Ron DePinho was forced out as president. (Ackerman, 9/5)

Walgreens Boots Alliance Inc, CVS Health Corp and supermarket chain Wegmans Food Markets Inc said on Thursday they would start asking customers to not openly carry firearms in their stores, joining Walmart Inc and Kroger Co, in a change of gun policy following several deadly mass shootings in the United States. The retailers are among a growing number of U.S. companies, such as Delta Air Lines and Bank of America, that are responding to calls for action to help curtail the rash of gun violence that has plagued the nation, risking backlash from powerful gun owners' groups as politicians consider options. (Fares, 9/5)

“We join a growing chorus of businesses in requesting that our customers, other than authorized law-enforcement personnel, do not bring firearms into our stores,” CVS said. “The sight of someone with a gun can be alarming, and we don’t want anyone to feel that way at Wegmans,” the grocer’s corporate Twitter account said Thursday. The statements come two days after Walmart Inc., the country’s largest retailer, asked shoppers to stop carrying guns openly in stores and said the company will cease sales of ammunition that can be used in semiautomatic rifles and handguns. Last month, 22 people died in a mass shooting in an El Paso, Texas, Walmart, prompting company executives to rethink their policies around gun violence in the U.S. (Nassauer, 9/5)

President Donald Trump is finalizing his proposals designed to curb gun violence. But it's unclear whether anyone really wants what he’ll be offering. Most Democrats consider them too weak. Most Republicans, long resistant to triggering their base or the gun lobby, fear Trump won’t push them forcefully enough — leaving them hanging. (Kumar, 9/5)

President Trump met with Democratic Sen. Joe Manchin at the White House on Thursday to discuss a policy response to mass shootings that have killed dozens of people over the past several weeks, three people familiar with the matter said. The 30-minute private meeting, which included several White House staffers, touched on a range of possible gun-related policy issues including background checks, the people said. Mr. Manchin, a West Virginia Democrat, and Sen. Pat Toomey (R., Pa.) have long urged legislation expanding background checks for gun sales. Their bill failed to pass the Senate in 2013. (Restuccia and Andrews, 9/5)

Democratic presidential hopeful Beto O'Rourke says a mandatory government buyback program for AK-47 and AR-15 rifles is needed because other gun control measures don't do enough to remove weapons already on the streets. O'Rourke spoke Thursday at Tufts University in his first campaign stop in Massachusetts. He said that while universal background checks and red flag laws that allow guns to be removed from those deemed a danger to themselves or others will save lives, neither will address the millions of assault-style weapons already in private hands. (9/5)

The orders focus largely on strengthening law enforcement’s ability to respond to and prevent future shootings, mainly through improving reporting channels and closing "information gaps" when members of the public or law enforcement agencies worry that a person might be a threat to commit violence. But, Abbott's office added in a news release, "legislative solutions are still needed." (Pollock, 9/5)

The authorities in Houston said Thursday that they had brought charges in what they believed to be the country’s first prosecution under a new ban on bump stocks, the attachments that enable semiautomatic rifles to fire in sustained, rapid bursts. The ban, which went into effect in March, was ordered last year by the Trump administration following several mass shootings. The suspect in the Houston case, Ajay Dhingra, 43, drew the authorities’ attention in August after he sent an email to the George W. Bush Presidential Center asking the former president to “send one of your boys to come murder me,” according to court records. “I want to die by the hands of a white Christian.” (Zaveri, 9/5)

It haunts him. The face, its expression blank. No sign of anger, no flicker of excitement or worry. A numbness. The right arm is extended toward him, lining up a target for the gun in hand. “I see him every day,” Jim Meyers said, calmly but emphatically. “Every day. I saw him when I was in the shower this morning. It is burned into my mind.” (Sewell, 9/6)

After 26 people were gunned down in a Sutherland Springs church in 2017 and 10 people were shot and killed at a Santa Fe high school seven months later, Texas leaders sought answers. They talked exhaustively about mental health and campus safety. Lt. Gov. Dan Patrick talked about whether schools had too many doors. But the groups of stakeholders tasked with making recommendations about how to protect Texans did not seriously entertain measures to restrict gun access. (Allen, 9/5)

The St. Louis Board of Education took the brunt of the frustration about gun violence that has taken the lives of a dozen children in the city from residents, parents and school staff Thursday night. The school board held a special meeting at its Vashon High School to listen to ideas for how to keep its students alive. (Delaney, 9/6)

Civil rights groups sued President Donald Trump's administration Thursday over its decision to stop considering requests from immigrants seeking to remain in the country for medical treatment and other hardships. The American Civil Liberties Union of Massachusetts and Lawyers for Civil Rights filed a lawsuit in Boston federal court challenging the U.S. Citizenship and Immigration Services' decision to end its "deferred action" program as of Aug. 7. (9/5)

The suit “challenges the Trump administration’s abrupt termination of a longstanding government program [known as deferred action] that protects seriously ill people from deportation and death,” the complaint said. “The administration’s action is unconscionable. It is also illegal.”The plaintiffs want a judge to “declare the termination of USCIS’s deferred-action program unlawful and enjoin its enforcement,” according to the complaint. The filing names President Trump; Ken Cuccinelli, the acting director of US Citizenship and Immigration Services; Kevin K. McAleenan, the acting Homeland Security secretary, and other officials as defendants. (Andersen, 9/5)

The Irish International Immigrant Center, which represents at least 19 cases that were denied in August without notice, is the lead plaintiff in a lawsuit against U.S. Citizenship and Immigration Services and the Department of Homeland Security, arguing that the changes to medical deferred action were “motivated by animus based on race and national origin and disability." (Solis, 9/5)

“The Trump administration is hellbent on causing as much suffering as possible for immigrant families,” Carol Rose, executive director of the ACLU of Massachusetts, argued in a statement. “This attack on children and their families is inhumane and unlawful. We will not stand for it: The ACLU and our partners are in this fight until all immigrants are treated with compassion, humanity, and justice.” (Klar, 9/5)

Medicaid expansion has driven significantly more patients to hospital emergency departments for non-urgent conditions, according to a new Brookings Institution study by health economists. This finding, which follows a deep dive into states' widely varied Medicaid expansion programs under the Affordable Care Act, represents another rebuttal to the initial predictions that people with health coverage would stop relying on emergency departments for non-emergency care. By law, hospital emergency departments must take any patient regardless of ability to pay. (Luthi, 9/5)

Kaiser Health News: How Political Maneuvering Derailed A Red State’s Path To Medicaid Expansion

This was supposed to be the year Medicaid expansion finally happened in Kansas. Democratic Gov. Laura Kelly, elected in November, had run on the issue. She triumphed in a state that had gone for Trump in 2016 by more than 20 percentage points and replaced a Republican governor who had vetoed a previous expansion bill. (Weber, 9/6)

When it comes to infrastructure, health care and teacher pay raises, Lt. Gov. Tate Reeves and Secretary of State Delbert Hosemann — who would be the state’s next governor and lieutenant governor, respectively, if Republicans have their way in November — have pitched clashing solutions during their respective campaigns. The contrasting policy ideas call into question how the duo might work together atop state government and, by extension, how much they would get done. (Ganucheau, 9/5)

A bipartisan push for legislation to protect patients from massive "surprise" medical bills is facing a buzzsaw of opposition from doctors and hospitals and reservations from some Democrats worried about delivering President Trump a health care victory when he is still attacking ObamaCare. The surprise billing measure has support from bipartisan committee leaders in both the House and Senate, patient advocates and insurers — and was moving forward quickly before Congress left town for August. It was seen as one of the most promising avenues for lawmakers to target health costs this year. (Sullivan, 9/5)

A hospital trade group and healthcare economists squared off on the impact of hospital mergers, a debate that will continue to resonate amid an increasingly consolidated industry. The American Hospital Association commissioned a new study Wednesday that supports mergers and acquisitions, making the case that they reduced costs at acquired hospitals and boosted care quality. Economists hosted a discussion following the report's release, sharing their research on how consolidation typically raises prices, often doesn't produce the expected savings and can diminish quality. (Kacik, 9/4)

Medicare Advantage market share has little effect on how physicians care for or code their fee-for-service patients, according to new research from the Medicare Payment Advisory Commission on Thursday. Many health experts believe Medicare Advantage's growing rolls have "spillover" effects on traditional, fee-for-service Medicare because most physicians care for both types of patients. As Medicare Advantage grows in popularity, they hoped that would induce physicians to practice lower-cost medicine and code more. (Brady, 9/5)

The CMS will be able to revoke healthcare providers or suppliers' Medicare enrollment if they are affiliated with targeted "bad actors," a final rule issued Wednesday established. As part of the CMS' "Program Integrity Enhancements to the Provider Enrollment Process" going into effect Nov. 4, its new "affiliations" provision allows authorities to bar individuals and organizations that "pose an undue risk of fraud, waste or abuse based on their relationships with other sanctioned entities." (Kacik, 9/5)

Kaiser Health News: Groupons For Medical Treatment? Welcome To Today’s U.S. Health Care

Emory University medical fellow Dr. Nicole Herbst was shocked when she saw three patients who came in with abnormal results from chest CT scans they had bought on Groupon. Yes, Groupon — the online coupon mecca that also sells discounted fitness classes and foosball tables. (Weber, 9/6)

Insurers are scrambling to blunt the expense of new drugs that can carry prices of more than $2 million per treatment, offering new setups aimed at making the cost of gene therapies more manageable for employers. Cigna Corp. announced Thursday a new program that allows employers and insurers to pay per-month fees for a service that will cover the cost of gene therapies and manage their use. CVS Health Corp. says it plans to offer a new layer of coverage specifically for gene therapies, which would handle employers’ costs above a certain threshold. (Walker and Wilde Mathews, 9/5)

In the halls of MD Anderson Cancer Center, the drug Vitrakvi is known for having a "Lazarus effect" in some patients because it can reverse late-stage cancer that has defied all other treatment options. Developed by Eli Lilly and Co's Loxo Oncology and marketed by German drugmaker Bayer, it fights a rare genetic mutation that appears in less than 1% of solid tumors, regardless of where they appear in the body. (9/6)

Novartis has nabbed the U.S. Food and Drug Administration's breakthrough therapy designation for its experimental medicine capmatinib as it joins Pfizer in the race to treat a tough-to-treat mutated lung cancer type. Novartis aims to file for U.S. approval for oral capmatinib later this year as a first-line treatment for patients with metastatic MET exon14 skipping-mutated non-small cell lung cancer (NSCLC), the Basel-based company said on Friday. (9/6)

A federal judge in Philadelphia grilled the city's top federal prosecutor Thursday over his opposition to a plan to open the nation's first supervised injection site to address the opioid crisis. U.S. Attorney William McSwain called the goal of reducing overdose deaths "laudable," but accused organizers of "hubris" for thinking they can ignore the law. (Dale, 9/5)

Along with six other Massachusetts counties, the Essex County House of Correction launched a pilot program Sunday to provide buprenorphine (often known as Suboxone) and methadone to newly arriving inmates who are already taking the medications under a doctor’s supervision. The drugs ease cravings, prevent overdoses, and help keep people in treatment. (Freyer, 9/5)

Opioid addiction can happen to anyone, and that includes doctors and nurses. But unlike the general population, they are often barred from medications like methadone, the gold standard of treatment. (Simmons-Duffin, 9/5)

When Sarah Carter was pregnant with her first child, she started digging into the research on ultrasounds, scouring studies in mice and rats. She couldn’t find any evidence in humans they cause harm — professional groups agree that ultrasounds are helpful and safe to perform during pregnancy. But Carter didn’t see any studies that explicitly showed they were safe. Then, she heard something that compounded her concerns. After an ultrasound, a friend of a friend was told her fetus had a limb malformation. She spent her pregnancy riddled with anxiety, only to find out nothing was wrong after the baby’s birth. (Thielking, 9/6)

When Ben Wald, 75, was dying of cancer in 2012, he wanted to use Oregon’s Death with Dignity Act to receive a prescription for a lethal medication that would end his life. His hospice nurse, Linda, was part of the discussion and provided both information and support, said his wife, Pam Wald, of Kings Valley, Ore. His colon cancer had spread to his lungs, and his weight dropped from 180 to 118 pounds. He struggled to speak or eat. (Lucchesi, 9/6)

More than a million Americans have donated genetic information and medical data for research projects. But how that information gets used varies a lot, depending on the philosophy of the organizations that have gathered the data. Some hold the data close, while others are working to make the data as widely available to as many researchers as possible — figuring science will progress faster that way. But scientific openness can be constrained b y both practical and commercial considerations. (Harris, 9/6)

With measles making a comeback in many upper-income countries including the United States and still rampant in some poorer nations such as Democratic Republic of Congo and Madagascar, a leading measles expert is warning of a danger beyond the spread of the disease itself: There's mounting evidence that when a person is infected with measles, the virus also wipes out the immune system's memory of how to fight off all sorts of other life-threatening infections – ranging from gastro-intestinal bugs that cause diarrhea to respiratory viruses that trigger pneumonia. (Aizenman, 9/5)

A new study found using antibacterial mouthwash after working out negated the blood-pessure-lowering effects of exercise. But don't rush out and change your habits just yet, says cardiologist Dr. Martha Gulati. She runs the cardiology division at the University of Arizona College of Medicine and is a spokesperson for the American College of Cardiology. (LaMotte, 9/5)

Women who have experienced multiple symptoms of post-traumatic stress disorder have double the risk of developing ovarian cancer, according to a new study authored in part by a researcher from Tampa’s Moffitt Cancer Center. The research team, which also included members from the Harvard T.H. Chan School of Public Health, found that women who experience six or more symptoms of PTSD in their lifetimes double their risk for ovarian cancer compared to women who’ve never suffered that level of trauma. (Griffin, 9/5)

Ever wonder why there’s so much bad news out there? Maybe it’s because people find bad news more interesting than good news. A new study involving more than 1,000 people across 17 countries spanning every continent but Antarctica concludes that, on average, people pay more attention to negative news than to positive news. The findings, published this week in the Proceedings of the National Academy of Sciences, hint that this human bias toward negative news might be a large part of what drives negative news coverage. (Khan, 9/5)

For the first time, scientists have identified the genetic differences associated with left-handedness, a trait found in 10% of the human population. What's more, those genetic variants result in differences in brain structure, which might mean that left-handed people have better verbal skills than the right-handed majority. (Dixon, 9/5)

U.S. college students are using marijuana at the highest rates in 35 years, according to a report released Thursday. About 43% of full-time college students said they used some form of pot at least once in the past year, up from 38%, a University of Michigan survey found. About 25% said they did so in the previous month, up from 21%. The latest figures are the highest levels seen in the annual survey since 1983. (9/5)

Kaiser Health News: Watch: Five Things To Know About Hunger Among America’s Aging

One out of every 13 seniors in America struggles to get enough food to eat while the federal program intended to help hasn’t kept pace with the graying population. Kaiser Health News Midwest editor/correspondent Laura Ungar explains what you need to know about this largely hidden problem. (9/6)

The firefighters came on Monday. They went up and down the halls, knocking on every apartment in the six-story Ansonborough House building in downtown Charleston, S.C., and leaving notices on the doors of those who didn't answer: This area is under mandatory evacuation. The manager of the building heeded the warning and left a note on the window in the lobby explaining that the building would not be staffed all week. (Hersher, 9/5)

As of midday Thursday, health care facilities along the Georgia coast were preparing to receive their patients who were returning from evacuations triggered by Hurricane Dorian. The storm did not hit Georgia as hard as was feared last week, but it brushed the state’s coast, knocking out power to thousands, before heading north to pound the South Carolina coast. (Miller, 9/5)

It almost didn't matter where the storm hits; HCA Healthcare's hospitals were going to be affected. With dozens of hospitals on Florida’s east and west coasts, the for-profit hospital chain is exposed every time a hurricane threatens the Sunshine State. Late last week, the nation's largest hospital company granted WPLN rare access to observe storm preparations as Dorian bore down on the Florida coast. (Farmer, 9/5)

Texas attorneys asked a federal appeals court Thursday to revive the state’s requirement that fetal remains from abortions and miscarriages at health care facilities be buried or cremated. A three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans gave no indication when it would rule following the arguments. One panel member raised the possibility that a decision could be delayed until after the Supreme Court rules in a pending Louisiana abortion regulation case. No date for consideration has been set in that case. (McGill, 9/5)

Gov. Gavin Newsom’s effort to change legislation that would tighten immunization rules for California schoolchildren could prompt a rush for new vaccine exemptions, revisions that go far beyond what his advisors have insisted would be nothing more than a “technical” tweaking of the proposal. The governor’s 11th hour demands — which could reduce or eliminate the number of existing vaccine exemptions that would be scrutinized by state officials — were made just days before the Legislature adjourns for the year, creating confusion and new conflict at the state Capitol. (Gutierrez and Luna, 9/5)

California lawmakers dropped this year’s most controversial public health bill into Gov. Gavin Newsom’s lap on Wednesday, but it’s not clear whether he will sign the measure, which would tighten the rules for exempting children from routine vaccinations. The state Senate voted 28-11 to approve SB-276 by state Sen. Richard Pan (D-Sacramento), prompting protesters who were watching from the gallery to chant, “You are not representing California for all!” All Senate Republicans voted against the measure and all Democrats voted in favor, except for one who didn’t vote. (Ibarra, 9/5)

Legislation introduced in the New York state Senate Thursday would grant students mental health days to take during the school year. The bill, sponsored by state Sen. Brad Hoylman (D), would “establish mental or behavioral health issues as permitted reasons for a student’s absence from school,” according to a statement from Hoylman. (Pitofsky, 9/5)

Gov. Kim Reynolds on Thursday appointed a top health official from Texas to lead Iowa's human services department, a move the governor said came after a national search. Reynolds, a Republican, said she selected Kelly Kennedy Garcia to serve as director of the Iowa Department of Human Services after narrowing an applicant pool of between 30 and 40 people from multiple states. Garcia starts the job on Nov. 1. (Rodriguez, 9/5)

Republican Gov. Kim Reynolds announced Thursday she appointed Kelly Kennedy Garcia to be the new Iowa Department of Human Services director, two and a half months after Reynolds abruptly ousted the previous director. Garcia is currently a deputy executive commissioner of the Texas Health and Human Services Commission. She has also worked for the Texas Sunset Advisory Commission, which studies whether state agencies should be abolished, and for former Texas Republican Gov. Rick Perry. (Sostaric, 9/5)

A coalition of Philadelphia-area health systems led by Thomas Jefferson University Hospital Inc. won bankruptcy court approval Thursday to buy the residency program of Hahnemann University Hospital, effectively killing hopes of reviving the historic institution, which served the city’s poor. (Brickley, 9/5)

Key improvements have been made to Cuyahoga County jail operations this year to address crowding, security issues and abysmal conditions, says a consultant’s report released Friday, but county officials still have a long list of challenges to overcome. A dozen county officials, including County Executive Armond Budish and jail leadership, met with cleveland.com Thursday to discuss a long list of changes they have made or are making in the troubled jail. (Astolfi, 9/6)

Minnesota officials are delaying updating new contracts for public health programs worth as much as $5 billion a year after some local leaders complained about the selection process and a current provider sued the state. The decision came after a Ramsey County district judge issued a temporary restraining order Aug. 30 putting the brakes on the state’s efforts to finalize new provider contracts in 80 counties outside the Twin Cities metro. The state plans to renew the current contracts for another year. (Magan, 9/5)

Just using data better might save the state $600 million in what it spends on publicly funded medical care. That was one of the takeaways from a task force meeting Thursday at the state Capitol on the cost of health care and access to it. (Hart, 9/5)

The company had several warnings. In-house audits at PG&E Corp. as early as 2010 said workers were falsifying records of ground-marking at excavation sites intended to protect buried electricity cables and gas pipelines. The workers made it appear they were keeping up with their workload when they were not. Midlevel managers told higher-ups by 2014 that an ambitious program director was pressuring people to burnish on-time results, according to sworn testimony from utility employees to a California regulator. (Smith, 9/5)

The report, "KIDS COUNT, Exclusionary Discipline, Racial Disparities in the Equality State" draws on data gathered by the U.S. Department of Education. It found that in the 2015-2016 school year, Native American students were overrepresented by more than 5 percent when it came to in and out-of-school suspensions. Hispanic students were overrepresented by close to 4 percent. (Maher, 9/5)

An outbreak of hepatitis A has been identified in Minnesota, prompting state health officials to appeal for broader vaccination efforts in high-risk areas such as homeless shelters and jails. While Minnesota has been insulated somewhat from a national hepatitis A outbreak — which has sickened more than 23,000 individuals and caused 233 deaths since 2016 — state officials said Wednesday that a recent uptick in cases is cause for concern. None of the Minnesotans has died, but 23 infections have been identified and 13 patients required hospital care for a virus that can cause severe liver damage. (Olson, 9/6)

Leading Health Care of Louisiana, a Lafayette-based in-home care company that serves elderly and disabled patients, opened an office in Baton Rouge. It's the latest for the company, which opened on office in Opelousas in April and offices in Thibodaux and Lake Charles last year. It has begun expansion projects at its Hammond, Baton Rouge and Thibodaux offices this month that will add 65 new jobs. (Boudreaux, 9/5)

Medical sterilization plants in Covington and Madison suffered inadvertent leaks of ethylene oxide years before concerns about emissions of the toxic gas raised alarms by federal regulators, The Atlanta Journal-Constitution has learned. The leaks at plants now owned by Becton Dickinson in Covington in 2016 and a separate facility in Madison in 2006 were reported to state regulators at the time they occurred. (Trubey, 9/5)

Thirty people have been charged with a multimillion-dollar scheme that allegedly bribed doctors and others to steer Medicare patients to the largest home health care provider in the San Francisco Bay Area, federal prosecutors announced Thursday. The criminal complaints name Amity Home Health Care and its CEO along with a related company, hospice service provider Advent Care Inc., along with dozens of doctors, nurses, marketers and a social worker. (9/5)

While V. vulnificus is a concern following hurricanes, the bacteria are not directly related to pollution, but occur naturally in warm waters such as bays, estuaries and rivers close to the ocean during the summer months. About 80 percent of vibrio infections occur between May and October, according to the CDC. The CDC estimates vibriosis causes 80,000 illnesses each year in the U.S. About 52,000 contract it as the result of eating contaminated shellfish. Vibrio parahaemolyticus is the most commonly reported species and is estimated to cause 45,000 illnesses a year in the U.S. (Talton, 9/6)

A California beef processing and packaging company has announced a recall of approximately 25,000 pounds of beef after declaring it's just not safe to eat, the USDA announced. American Beef Packers, Inc., of Chino, California, deemed the beef "unfit for human consumption," according to the the U.S. Department of Agriculture's Food Safety and Inspection Service. The company told the regulator a carcass that was awaiting test results had been mistakenly put back into the production line, where it was processed into a variety of products. (Johnson, 9/5)

Newmarket doctor who was affiliated with Wentworth-Douglass Hospital pleaded guilty Thursday to sexually assaulting a patient with multiple mental health diagnoses and was sentenced to five to 10 years in prison. Dr. Hugh MacDonald, 58, of Newfields, pleaded guilty to four counts of aggravated felonious sexual assault for three incidents that occurred at his office in March and April 2018. The plea and sentence were part of a negotiated agreement between MacDonald and the Rockingham County Attorney’s office. (Schreiber, 9/5)

Daughters said they sacrificed careers when their relatives wouldn’t. Others said hiring help sapped finances. And more than a few found treasured final moments with loved ones despite the overwhelming work of caring for them. After The Times published a pair of articles on elder care — one about a Connecticut home health aide and another about women forgoing careers to care for older relatives — hundreds of our readers shared their own experiences with the hardships of trying to make the final years of a loved one’s life comfortable. (Gardiner, 9/5)

Jonathan Duce entered Dion's, his neighborhood liquor store in Waltham, Massachusetts, walked past the wine and six-packs and headed straight for the gummy worms. At $69 for a jar of 25, they were more expensive than the Chateauneuf du Pape, but he didn't mind. His wife likes them, he says, because they help her sleep. The gummies aren't just candy. Each one packs a 30-milligram wallop of cannabidiol, or CBD, a constituent of the cannabis plant, more commonly known as hemp, a cousin of marijuana. Dion's started selling CBD products four months ago and now one in every 15 people who walk in buys at least one of the store's 30 CBD products, which include tinctures, vaping cartridges, smokable "flower," capsules and lotions. "But gummies are our biggest mover," says Kristen Correia, who works behind the counter. (Freedman, 8/29)

Hate crime is rising, the Arctic is burning, and the Dow is bobbing like a cork on an angry sea. If the nation seems intolerant, reckless and more than a little cranky, perhaps that’s because the American republic is showing its age. Somewhere along the way, a once-new nation conceived in liberty and dedicated to the proposition that all men are created equal (not men and women; that came later) became a wheezy gerontocracy. Our leaders, our electorate and our hallowed system of government itself are extremely old. (Noah, 9/3)

Fifty years ago this summer, Melanie Dreher, a registered nurse and a young graduate student in anthropology, landed in rural Jamaica to study how people there were using cannabis. It was the same summer of the moon landing and Woodstock, where “400,000 of my best friends were having a good time,” she says. Dreher didn’t really want to be in Jamaica. But doing fieldwork in an unfamiliar place was required by her Columbia University doctorate program, and for Dreher, who had never been to Jamaica or used cannabis, this assignment met that criterion. (Callahan and Undark, 9/2)

Civil rights advocates have long sought increased accountability for law enforcement in California, particularly in recent years, as police shootings and the Black Lives Matter movement have roiled cities nationwide. But even in a Democrat-controlled Capitol, those efforts — to make police misconduct records public, to require the release of body camera footage, to create an independent body to investigate police shootings — have historically failed amid objections from law enforcement organizations and their influential unions. (Rosenhall, 7/18)

Gov. Gretchen Whitmer risked triggering a run on college convenience stores Wednesday when she announced that Michigan would become the first state to ban the sale of flavored e-cigarettes. Days after the Michigan Department of Health and Human Services reported a “vaping crisis among youth,” created by manufacturers luring young people into addiction to their potentially harmful products, Ms. Whitmer invoked her emergency powers. “We can’t wait on Washington, D.C.,” she said on MSNBC. “We have to take action right now.” (Spencer Bokat-Kindell, 9/5)

When e-cigarettes were introduced a decade ago, the battery-operated nicotine inhalers that don't burn tobacco were seen as a means of helping smokers quit. This premise remained unproven, even as vaping devices started to flood the American market. The effect of long-term use also remains unknown. Despite authority granted by Congress in 2009, the Obama administration didn't extend Food and Drug Administration oversight to electronic cigarettes until 2016, and the Trump administration gave vaping device manufacturers until 2022 to comply.  (9/6)

In June of 2019, Mayor London Breed signed an ordinance effective January 2020 to suspend the sales and distribution in San Francisco of electronic cigarettes that have not undergone premarket review by the U.S. Food and Drug Administration (FDA). This legislation by Supervisor Shamann Walton and unanimously approved by the San Francisco Board of Supervisors represents a logical and powerful public policy strategy to enforce the law. (John Maa and Jeffrey Wigand, 9/5)

Health officials have identified one potential cause of the mysterious vaping-related illness that has sickened more than 200 people and claimed at least two lives: vitamin E acetate, an oil found in some marijuana-based vaping products. But there’s still a lot they don’t know. Are other adulterants also involved? Does a combination of vaping ingredients, or the use of a certain vaping device, increase the likelihood of falling ill? Parents have been anxious, as many patients so far have been teenagers and young adults. (9/5)

As three of the nation’s leading public health officials, we are deeply concerned about the epidemic of youth e-cigarette use, and we are using every tool we have to protect the public, especially kids, from tobacco-related disease and death. Any opportunity for electronic cigarettes to serve as an off-ramp for individual addicted adult cigarette smokers must not come at the expense of children. We’ll take every step necessary to prevent these products from becoming an on-ramp to nicotine addiction for a generation of youth. (Secretary of Health and Human Services Alex M. Azar II, acting commissioner of the Food and Drug Administration Ned Sharpless and Director of the Centers for Disease Control and Prevention Robert Redfield, 9/5)

Michael Baden, an 85-year-old forensic pathologist, is best known for his role in investigations of such high-profile cases as the assassination of President John F. Kennedy and the murder of Nicole Brown Simpson. But for Baden, who worked in the New York City medical examiner’s office before the Roe v. Wade Supreme Court decision, the most haunting cases involve people whom society seems to have forgotten: women who died after illegal abortion attempts. Baden told me he saw about 20 deaths per year attributable to attempted pregnancy termination, usually self-induced. “Metal wire coat hangers, knitting needles, and slippery tree branches” were the most common approaches, he said. When abortion was legalized in 1973, Baden says, with very rare exceptions, deaths due to unsafe abortions stopped. Soon, however, we may once again see increases in morbidity and mortality due to self-induced abortion. (Lisa Rosenbaum, 9/5)

A key result of our cumulative efforts as U.S. health care providers over the past 46 years is that there are fewer abortions per 1000 reproductive-age women per year today than immediately after the Supreme Court’s decision in Roe v. Wade legalized abortion nationwide. Deaths due to unsafe abortions in the United States have been essentially eliminated, with 90% of procedures done today in the first trimester, when the risk of maternal mortality is less than one tenth of that associated with carrying a pregnancy to term.Although the Centers for Disease Control and Prevention has documented the reductions in deaths, there is no official national accounting of the numbers of women who became critically ill and lost their future reproductive potential because of injuries and infections after unsafe abortions. ...Some of us are old enough to have witnessed first-hand the consequences of illegal abortions performed by unskilled providers under nonsterile conditions; the rest of us have learned those lessons from history. Sadly, however, we will not need history as our teacher if Roe is overturned in the Supreme Court, because we will again witness deaths and permanent injuries of women desperate to terminate pregnancies. (The Editors, the American Board of Obstetrics and Gynecology, the American Gynecological and Obstetrical Society, the Council of University Chairs of Obstetrics and Gynecology, the Society for Academic Specialists in General Obstetrics and Gynecology, and the Society for Maternal–Fetal Medicine, 9/5)

There are alarming consequences for the survival of human beings and the success of the society they inhabit when the brain suffers without treatment. And it has become frighteningly common for Americans to find their way into despair and self-murder. About 7 percent of American adults had at least one major depressive episode in 2017. Nearly 13 percent of the U.S. population likely took antidepressant medication during the past month, yet suicide rates have risen to the highest since World War II. The odds of dying from suicide or an opioid overdose — the “diseases of despair” — are now higher than that of dying from a motor-vehicle accident. (Michael Gerson, 9/5)

Despite decades of efforts to increase the number of women working in science, technology, engineering, and medicine (STEM), these fields still aren’t tapping into all of the brainpower available to them. That’s the take-home message from more than 500 “report cards” from academic and scientific institutions. (Whitney H. Beeler, Reshma Jagsi and Susan L. Solomon, 9/5)

A primary driver of high spending in the US health care system, relative to other countries, is the higher prices paid for health care in the United States. Part of what sustains these high prices is that health care prices are largely opaque. The goal of price transparency is to empower patients with new information so they can consider prices, along with quality, when making choices about when and where to receive health care. Ideally, such informed decision making would increase competition in the health care system, which in turn, would create incentives to lower prices or demonstrate value. (Anna D. Sinaiko, 9/5)

You’ve heard of the Wars on Drugs, Terror, Poverty, even Women. Well, welcome to the War on Children. It’s being waged by the Trump administration and other right-wing public officials, regardless of any claimed “family values.” For evidence, look no further than the report released Wednesday by the Department of Health and Human Services’s own inspector general. (Catherine Rampbell, 9/5)

Thirty years ago, when I first started in public relations, corporate social responsibility programs were mainly company-funded foundations that donated money to various charities and organizations. There wasn’t necessarily a strategy behind these efforts — it was just understood that charity was part of doing business. While these programs have become incredibly sophisticated — MAC’s Viva Glam Fund, for example, engages the social consciousness of today’s customers and their willingness to reward companies that give back to society — it is time for them to evolve to drive social change and highlight often underfunded and overlooked issues. The misuse of opioids, leading to addiction and stigma, is an excellent candidate. (Kate Cronin, 9/6)

The nurses were hiding drugs above a ceiling tile in the hospital — not because they were secreting away narcotics, but because the hospital pharmacy was slow, and they didn’t want patients to have to wait. I first heard about it from Karen Feinstein, the president and chief executive of the Jewish Healthcare Foundation, who reported it at a board meeting several years ago. I wasn’t surprised: Hiding common medications is a workaround, an example of circumventing onerous rules to make sure patients get even basic care. (Brown, 9/5)

If the billions of dollars now spent on non-productive health care financing activities could be redistributed — and if employers and employees paid an amount similar to what they pay today for their portion of health care insurance premiums — there would be more than enough money to pay for Medicare for All, or what I call “M4A.” There are plenty of smart consultants who can be engaged to figure out the details and provide services to make it work smoothly. (Kirk Wilson, 9/5)