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Medical experts are cautioning that there are long-term health risks for migrant children who are separated from their parents, including "irreplaceable harm" to those children's lifelong development. “[It can] cause irreparable harm to lifelong development by disrupting a child’s brain architecture,” American Academy of Pediatrics (AAP) President Colleen Kraft told BuzzFeed News this week. “Immigration has become so politicized. We would really like people to sit back instead and think of the health of these children.” (Sanchez, 6/16)

The administration is facing increasing pressure on existing facilities, even without the possibility of new facilities to detain families together. The Department of Health and Human Services’ Office of Refugee Resettlement is adding bed space after eclipsing more than 11,000 children in its custody. A temporary, soft-sided structure has been erected in Tornillo, Texas, near El Paso, as part of that expansion. Eric Hargan, deputy secretary of HHS, said in a statement Sunday that the agency had welcomed lawmakers’ tours and that the semi-permanent structures—including at Tornillo—had ventilation and cooling “to ensure appropriate temperature” for the minors placed there, who, he said, were all teenagers. (Radnofsky, Hackman and Caldwell, 6/17)

The family separations that stem from the Trump policy add a new burden. On top of overseeing the welfare of people housed there, staff at the McAllen facility coordinate sending children to detention centers run by the Department of Health and Human Services’ Office of Refugee Resettlement while their parents head to court. There are only 10 permanently assigned agents at the facility, though officials would not say how many contract or other staff were on site. (Schor, 6/17)

The center costs about $12.1 million to operate annually, compared with the entire sector’s budget of $15 million. Built for 1,500 people, it has held more than 2,000 recently. It has a staff of 10 but due to the influx, Padilla added 300 more, about 10% of his workforce. There’s a medical unit with three paramedics, two medical staffers and space to quarantine those who have contracted chicken pox, scabies and other communicable diseases. There is no mental health staff, and agents have not received mental health training since the Trump administration “zero tolerance” policy was implemented May 6. (Hennessy-Fiske, 6/17)

This week, Health and Human Services opened what it called a “soft-sided” and “semi-permanent” shelter for 360 unaccompanied minors outside El Paso in Tornillo, Texas. The tents, however, are air conditioned. Immigrant advocates decried the desert shelter as a “tent city.” Similar facilities were erected after an influx of Central American families arrived in the U.S. in 2014, but were later dismantled. Health and Human Services is also considering whether to open temporary shelters at military bases near the border, as it did in 2012. (Hennessy-Fiske, 6/16)

Elizabeth Holmes, the disgraced founder of Theranos, the lab testing company that promised to revolutionize health care, and its former president, Ramesh Balwani, were indicted on Friday on charges of defrauding investors out of hundreds of millions of dollars as well as deceiving hundreds of patients and doctors. The criminal charges were the culmination of a rarity in Silicon Valley — federal prosecution of a technology start-up. This one boasted a board stacked with prominent political figures and investors, and a startling valuation of $9 billion just a few years ago. (Abelson, 6/15)

Holmes, who was once considered a wunderkind of Silicon Valley, and her former Chief Operating Officer Ramesh Balwani, are charged with two counts conspiracy to commit wire fraud and nine counts of wire fraud each, the U.S. Attorney's Office for the Northern District of California said late Friday. If convicted, they could face prison sentences that would keep them behind bars for the rest of their lives, and total fines of $2.75 million each. Prosecutors allege that Holmes and Balwani deliberately misled investors, policymakers and the public about the accuracy of Theranos' blood-testing technologies going back to at least 2013. Holmes, 34, founded Theranos in Palo Alto, California, in 2003, pitching its technology as a cheaper way to run dozens of blood tests. (6/15)

The indictments of Ms. Holmes and Ramesh “Sunny” Balwani, Theranos’s former president and chief operating officer who was also Ms. Holmes’s boyfriend, are the culmination of a 2½-year investigation by the U.S. attorney’s office in San Francisco, sparked by articles in The Wall Street Journal that raised questions about the company’s technology and practices. (Carreyrou, 6/15)

The Justice Department alleges that the two founders knew that their technology could not deliver on the promises they had been making to the media, investors and doctors. According to the indictment, the company gave doctors — and through them, their patients — “materially false and misleading information concerning the accuracy and reliability of Theranos’s blood testing services.” After signing up patients for blood tests with the promise that the technology could detect a range of diseases, Holmes and Balwani would transmit them results despite knowing that the tests were unreliable. (Neidig, 6/15)

The fall of Holmes represents a cautionary Silicon Valley tale, demonstrating how a charismatic tech industry leader making grandiose claims about a disruptive new product can attract massive investments while allegedly bamboozling investors, consumers and a high-profile corporate partner. Before Theranos’ claims unraveled — starting with a Wall Street Journal exposé — Holmes had been widely praised as a Silicon Valley wunderkind pushing forward technology’s cutting edge. (Baron, 6/15)

Meanwhile, Theranos may soon go out of business. The company has repeatedly laid off employees in an effort to cut costs and is staring down debts that could force it to liquidate as early as this summer, the Wall Street Journal has reported. Both Holmes and Balwani appeared in federal court in San Jose, Calif., on Friday, according to the indictment. Their case has been assigned to Judge Lucy Koh, who’s handled a number of high-profile cases involving Silicon Valley. (Robbins and Garde, 6/15)

Iowans who buy their own health insurance will have at least three choices of carriers next year — after nearly going without any options for 2018. Medica, which is the sole carrier selling individual health insurance policies in Iowa this year, will continue doing so for 2019, an executive said Friday. Wellmark Blue Cross & Blue Shield has previously said it would resume selling such policies for 2019. (Leys, 6/15)

Minnesota's largest health insurers for small businesses are proposing average rate increases next year of between 3 percent and 12 percent, according to numbers released Friday by state regulators. The report from the Minnesota Department of Commerce also shows that Minnetonka-based UnitedHealthcare, the nation's largest health insurer, is following through with plans announced last year to enter the state's small group market in 2019. (Snowbeck, 6/15)

Anthem Inc., one of the state’s largest insurers, has cut reimbursement for breast pumps, igniting fears about whether mothers will have access to adequate equipment that works for them at no extra cost. In April, Indianapolis-based Anthem started paying suppliers less for breast pumps that are sold to mothers throughout Anthem’s entire 14-state footprint. Anthem would not disclose how much they now pay for pumps, but a breast pump maker said it’s at least a 36 percent cut in reimbursement, to $95 from about $150. (Liss, 6/16)

The National Institutes of Health will shut down a controversial industry-funded study of moderate drinking and heart disease after a task force found severe ethical and scientific lapses in the study’s planning and execution, the agency’s director said Friday. The way NIH officials secured funding for the research “casts doubt” on whether “the scientific knowledge gained from the study would be actionable or believable,” according to the task force’s scathing presentation to NIH officials. (Begley and Joseph, 6/15)

The extensive government trial was intended to settle an age-old question about alcohol and diet: Does a daily cocktail or beer really protect against heart attacks and stroke? To find out, the National Institutes of Health gave scientists $100 million to fund a global study comparing people who drink with those who don’t. Its conclusions could have enshrined alcohol as part of a healthy diet. (Rabin, 6/15)

The National Institutes of Health used money from the alcohol industry to help pay for a study that ultimately was expected to cost $100 million. It's legal for NIH to use industry money in addition to taxpayer dollars for research as long as certain rules are followed. The problem: An NIH investigation concluded Friday that a small number of its employees had close contact with industry officials that crossed those lines. Some of those interactions "appear to intentionally bias" the study so that it would have a better chance of showing a benefit from moderate alcohol consumption, said NIH Deputy Director Lawrence Tabak. (Neergaard, 6/15)

NIH Director Francis S. Collins said the results of the 10-year, $100 million study would not be trusted because of the secretive way in which staff at an institute under NIH met with major liquor companies, talked to them about the trial’s design and convinced them to pick up most of the tab for it. “Many people who have seen this working-group report were frankly shocked to see so many lines crossed,” he said, calling the staff interaction with the alcohol industry “far out of bounds.” (Wan and Bernstein, 6/15)

In a meeting Friday of an advisory board to Dr. Collins, Lawrence A. Tabak, NIH principal deputy director, said an outside report on the study that was commissioned by the NIH concludes that NIAAA officials “appear to have intentionally biased the framing of the scientific premise” of the study in the direction of focusing on possible benefits of alcohol. The report said that email correspondence involving NIAAA staff, outside researchers and the alcohol industry “appear to be an attempt to persuade industry to provide funding” for the study. Also at the meeting, NIAAA director George Koob said, “I’m disappointed in what transpired. I think the trial is irrevocably damaged.” (Burton, 6/15)

The plan was to enroll 7,800 people ages 50 and up who did not have diabetes. Some of them would be randomly assigned to consume about 15 grams of alcohol per day. The others would be asked to abstain from drinking. Researchers from Beth Israel Deaconess Medical Center in Boston, along with colleagues in the United States, Nigeria, Denmark and the Netherlands, would then follow these volunteers for about six years to see whether the moderate drinkers developed fewer cases of cardiovascular disease and diabetes compared to their teetotaling counterparts. (Kaplan, 6/15)

The last two secretaries of the Department of Veterans Affairs were private-sector outsiders intent on bringing expertise from beyond Washington’s Capital Beltway into the VA. But Robert Wilkie, President Donald Trump’s presumptive nominee to head the department, is the opposite—a long-serving public official steeped in federal bureaucracy. Mr. Wilkie has decades of experience in government and familiarity with the companies and industries that rely on it, and now is expected to take over a sprawling department that has been on the verge of large-scale changes. (Kesling, 6/15)

Statistics the VA has not released paint a picture of government nursing homes that scored worse on average than their private sector counterparts on nine of 11 key indicators last year, including rates of antipsychotic drug prescription and residents’ deterioration. In some cases, the internal documents show, the VA ratings were only slightly worse. In others, such as the number of residents who are in pain, the VA nursing homes scored dramatically worse. (Estes and Slack, 6/17)

The U.S. Department of Veterans Affairs has agreed to continue to provide in-home health care for a Springfield veteran with Lou Gehrig's disease who needs around-the-clock help and sued the federal agency when it threatened to halt the care. The Veterans Affairs department agreed to contract with Michael Williamson's choice of  in-home care providers through a newly formed agency, "Better Horizons.'' If any problems arise, the federal agency will work to meet Williamson's wishes and medical needs, according to their settlement. (Bernstein, 6/16)

The Department of Veterans’ Affairs Community Living Center in Prescott is ranked near the bottom among VA nursing homes nationwide, according to federal data and evaluations obtained by the USA TODAY Network. ...The Department of Veterans Affairs owns and operates 133 nursing homes in 46 states and has tracked quality statistics at those facilities for years but kept them from the public. (Wagner, 6/17)

But STAT found that the auto-injectors donated to some police agencies through the Kaleo Cares program were just months away from expiration. One police department in Massachusetts threw away scores of expired injectors because it couldn’t use them fast enough. An agency in a medium-sized North Carolina city donated expired product to a local nonprofit willing to accept them. In interviews with officers at more than a dozen law enforcement agencies, nine said they had received naloxone anywhere from four to 11 months away from expiration. Fresh off the production line, naloxone typically has a shelf life of two years. Kaleo, for its part, says patients prescribed Evzio can expect to receive auto-injectors with a shelf life of over a year. (Blau, 6/18)

For at least six months, staffers in the Office of National Drug Control Policy — often political appointees in their 20s — have crossed 17th Street, entered the Eisenhower Executive Office Building, and sat through weekly meetings of an “opioids cabinet” chaired by Kellyanne Conway. Then they have returned to their desks and reported back to veteran career staff — who have listened, often with disappointment, to the ideas proposed by Conway and Katy Talento, a domestic policy adviser. (Facher, 6/18)

House Republicans are beefing up their efforts to tackle the nation's deadly opioid crisis, but some experts question how effective their piecemeal approach will be. Congress is touting its recent flurry of action — the House is on track to pass more than 50 bills addressing the issue by the end of this week — on an issue that is hitting many constituents hard, and one that lawmakers are sure to hear about on the campaign trail this year. (Zanona and Roubein, 6/17)

Lawmakers on Friday argued over a controversial drug bill before passing it, 239-142, as the House closed out the first of two weeks dedicated to opioid legislation. The legislation (HR 2851) by Rep. John Katko, R-N.Y., would create a new class on the controlled substances schedule for compounds related to the synthetic drug fentanyl. It would also speed up the process by which a drug can be temporarily or permanently added to this schedule. The legislation also includes penalties for distributing or trafficking these drugs. (Raman, 6/15)

The CDC says that skin contact with fentanyl can be a risk, but that fentanyl “is not likely to lead to overdose unless large volumes of highly concentrated powder are encountered over an extended period of time. Brief skin contact with fentanyl or its analogues is not expected to lead to toxic effects if any visible contamination is promptly removed.” (Daugherty, 6/16)

McKesson Corp. cut Chief Executive Officer John Hammergren’s pay by about 10 percent following a shareholder revolt spurred by claims about the health-care firm’s alleged role in the nation’s opioid crisis. The International Brotherhood of Teamsters led a vote-no campaign in 2017 against the firm’s executive pay plan after accusing the drug distributor of aggravating the opioid epidemic. Last year’s pay package received 26.6 percent support, the second-lowest to date and among the worst of S&P 500 companies. (Ritcey, 6/15)

A painkiller prescription could become a ticket for medical marijuana in Illinois. Lawmakers there passed a bill making anyone with a prescription for opioids eligible for its medical cannabis program. With this move, Illinois joins a growing number of states turning to legal cannabis in the fight against painkiller addiction. (Herman, 6/15)

A hard-hit Ohio county that expanded availability of naloxone during the opioid epidemic has been seeing a decline in its overdose death toll. Hamilton County's program of increasing overdose antidote availability and quick response to requests for addiction treatment started last fall, the Cincinnati Enquirer reported. Public health officials increased distribution of the overdose-reversing Narcan nasal spray by 375 percent over a seven-month period. (6/17)

Video games work hard to hook players. Designers use predictive algorithms and principles of behavioral economics to keep fans engaged. When new games are reviewed, the most flattering accolade might be “I can’t put it down.” Now, the World Health Organization is saying players can actually become addicted. (Hsu, 6/17)

The U.N. health agency said classifying “Gaming Disorder” as a separate condition will “serve a public health purpose for countries to be better prepared to identify this issue.” Dr. Shekhar Saxena, director of WHO’s department for mental health, said WHO accepted the proposal that Gaming Disorder should be listed as a new problem based on scientific evidence, in addition to “the need and the demand for treatment in many parts of the world.” (Keaten and Cheng, 6/18)

To understand why it’s so hard to pry yourself free from your phone, Facebook account and Twitter, you need to know about B.F. Skinner’s pigeons. In the 1950s, Skinner began putting the birds in a box and training them to peck on a piece of plastic whenever they wanted food. Then the Harvard psychology researcher rigged the system so that not every peck would yield a tasty treat. It became random — a reward every three pecks, then five pecks, then two pecks. (Wan, 6/17)

Following the birth of her third child, Kristin Rulon took a birth-control shot that triggered a wave of depression and anxiety. The 32-year-old suburban Kansas City, Missouri, mother and writer explored natural remedies before joining the millions of Americans who’ve turned to mobile-device apps that offer therapy via text messages. A therapist from the BetterHelp app in early 2016 typically exchanged three to four daily texts with Rulon from morning to bedtime. The access was great, Rulon said, but the $28 weekly charge for unlimited texting not covered by health insurance became too expensive. And Rulon worried that texts could not convey everything she wanted to share. (Alltucker, Connor and O'Donnell, 6/15)

What impressed medical experts most was Google’s ability to sift through data previously out of reach: notes buried in PDFs or scribbled on old charts. The neural net gobbled up all this unruly information then spat out predictions. And it did it far faster and more accurately than existing techniques. Google’s system even showed which records led it to conclusions. Hospitals, doctors and other health-care providers have been trying for years to better use stockpiles of electronic health records and other patient data. More information shared and highlighted at the right time could save lives -- and at the very least help medical workers spend less time on paperwork and more time on patient care. But current methods of mining health data are costly, cumbersome and time consuming. (Bergen, 6/18)

Top executives of IBM’s Watson Health division told employees at a meeting on Wednesday that they are scaling back the part of their business that sells tools to help hospitals manage their pay-for-performance contracts, citing softening demand in the market, according to a source who attended the meeting. This represents a major shift in business strategy for Watson Health, which has invested billions of dollars to win lucrative contracts from hospitals seeking to reform their payment systems to focus on patient outcomes, instead of the volume of care they provide. The effort was central to Watson Health’s efforts to help realize the promise of personalized medicine and improve the efficiency of care. (Ross and Swetlitz, 6/15)

Three years ago Dyan deNapoli, a 57-year-old author and TED speaker who specializes in penguins, was given a 23andMe genetic testing kit for her birthday. Intrigued, she spit in the tube and sent the results to a lab in Burlington, N.C. About two months later she received a pie chart breaking down where her ancestors lived (99.4 percent of them were from Europe). What she was most giddy about, however, was a 41-page list of all the people who had done the test and were genetically related to her: 1,200 in all. (Customers can choose whether their information is shared with others.) (6/16)

Rita Adele Steyn's mother had a double mastectomy in her 40s because she had so many lumps in her breasts. Her first cousin died of breast cancer. And Steyn's sister is going through chemotherapy for the disease now. So Steyn worries she might be next. "Sometimes you feel like you beat the odds. And sometimes you feel like the odds are against you," said Steyn, 42, who lives in Tampa, Fla. "And right now I feel like the odds are against me." (Stein, 6/18)

Paetyn, an impish 1-year-old, has two fathers. One of them gave birth to her. As traditional notions of gender shift and blur, parents and children like these are redefining the concept of family. Paetyn’s father Tanner, 25, is a trans man: He was born female but began transitioning to male in his teens, and takes the male hormone testosterone. "I was born a man in a female body,” he said. (Grady, 6/16)

A new field is beginning to pop up on patient registration forms: preferred pronouns. The healthcare industry, notoriously slow to change culturally and technologically, is beginning to speed up in both areas when it comes to gender identity. To do that, electronic health record vendors and health systems alike are pushing to include gender identity alongside other patient information. As with any piece of data in an EHR, the question is where to put it, which options to include, and what to do with the information once it's there. (Arndt, 6/16)

Father’s Day is different when there’s no father around."What do these days mean to children like me who had to grow up without one parent in their lives?" asks Louis Steptoe, 18, who just graduated from high school here. Instead, he celebrates what he calls "Father Figure Day" and honors his godfather, William Ford, who "was always present." Kaylynn Tobin, 12, of Rockville, Maryland, met her father only once, years ago, and barely remembers him. Her sister Aras, 10, has a different father and sometimes gets gifts from him. But she doesn’t have a good relationship with her father. (O'Donnell and Lewter, 6/15)

The number of men in the United States who are full-time, stay-at-home parents has risen steadily in recent decades, from maybe a million or so in 1984, according to a Pew Research Center estimate, to roughly double that in 2014. That's still much smaller than the number of stay-at-home moms, of course, and many of the challenges these dads face are universal to parenting. "It's a tough job," says Ben Sanders, who's raising two young boys in Haymarket, Va. His kids are 3 ½ and 6 ½ years old. "There are no breaks. It's 24/7. There's no vacation. You can't get sick." (Beaubien, 6/17)

Can what you don’t hear hurt you? Researchers are studying whether the largely inaudible interplay of ultrasound beams from sensors and other devices can trigger headaches and dizziness. Those were among symptoms reported by some U.S. diplomatic personnel stationed in China and Cuba who returned home in the past year after becoming incapacitated. Ultrasonic signals are almost everywhere but the side-effects from so many transmissions remain a mystery, several experts said. (Hotz, 6/16)

Abortions send women to hospital emergency rooms at lower rates than such routine procedures as colonoscopies and surgeries to have wisdom teeth removed, new research has found. In fact, for every 100,000 abortions provided, about 108 women sought out emergency care for what they thought was a complication of the procedure. (Healy, 6/15)

We’ve known that much since at least 2016 when researchers studied risk factors — depression, previous suicide attempts, stressful life events and substance abuse — and expert’s ability to predict suicidal thoughts and behaviors over long periods of time. Predicting if someone will attempt to take his or her own life is only slightly better than chance and has not significantly improved during the last five decades. (Bonds Staples, 6/15)

A new essay from two Harvard University scientists concluded that the Trump administration’s environmental policies could result in an additional 80,000 deaths per decade. The research, from public health economist David Cutler and biostatistician Francesca Dominici, pointed specifically to the health impacts of the Environmental Protection Agency’s (EPA) policies on air pollutants and toxic chemicals. (Anapol, 6/16)

As a salmonella outbreak that sickened dozens forced a recall of some cereal products this week, federal officials announced that a separate outbreak linked to cut fruit has expanded to almost two dozen states. The outbreak linked to Kellogg’s Honey Smacks cereal had sickened 73 people in 31 states as of Thursday, according to a statement from the Centers for Disease Control and Prevention; 24 of them had been hospitalized and no deaths had been reported. (Hauser, 6/15)

It’s easy to look down at your bundle of joy and imagine a glowing future. Surely your child will be the best and brightest — and if you care about their intellectual development, you might try to smooth their path with an educational toy that promises to develop baby’s skills. But are those toys a smart buy? Science writer Erik Vance takes on that question in the June edition of Scientific American. His article, “Sorry, Mom and Dad, Toys Cannot Supercharge Your Baby,” cuts down to size an industry that makes outsize promises and rakes in billions, and it may make you think twice before buying a toy that promises to make your baby a brainiac. (Blakemore, 6/17)

Her boyfriend became abusive about six months after they met. He would drink himself into a stupor and tear the house apart while screaming and insulting her, once even threatening to snap her neck. She worried for herself, but also for her beloved golden retriever, Cody, whom she had rescued from an abusive former owner. “The biggest argument I had with him in the beginning was saying, ‘Do not raise your voice in front of the dog. Don’t scream and yell in front of her. Don’t throw things around her,’ ” recalled K., a steely 44-year-old who spent two decades in the military. “ ‘These things traumatize her.’ ” (Strauss and Brulliard, 6/15)

A state appeals court has reinstated — at least for now — California's law allowing terminally ill people to end their lives. The Fourth District Court of Appeals in Riverside issued an immediate stay Friday putting the End of Life Option back into effect. The court also gave opponents of its decision until July 2 to file objections. (6/15)

“I am thrilled and relieved,” said Sen. Bill Monning, D-Carmel, who co-sponsored the legislation that led to the Act. “This decision will offer reassurance and certainty, for now, to any terminally ill patient who feared that their end of life options had been curtailed.” A flurry of rulings in May created confusion among patients, their families and doctors regarding the status of the Act, a law that allows a terminally ill adult with a six-month prognosis to obtain aid-in-dying drugs from a physician, subject to numerous safeguards. (Krieger, 6/15)

California officials, having concluded coffee drinking is not a risky pastime, are proposing a regulation that will essentially tell consumers of America's favorite beverage they can drink up without fear. The unprecedented action Friday by the Office of Environmental Health Hazard Assessment to propose a regulation to clear coffee of the stigma that it could pose a toxic risk followed a review of more than 1,000 studies published this week by the World Health Organization that found inadequate evidence that coffee causes cancer. (6/16)

A California agency has proposed a regulation that would get rid of a cancer warning placed on coffee. ...“The proposed regulation would state that drinking coffee does not pose a significant cancer risk, despite the presence of chemicals created during the roasting and brewing process that are listed under Proposition 65 as known carcinogens,” the agency said in a statement. In 1986, state voters passed a law requiring a warning be placed on chemicals known to cause cancer or birth defects. One of those chemicals was acrylamide, which is a byproduct of coffee roasting and brewing. (Sanchez, 6/16)

A Houston hospital announced Friday that it has reactivated its renowned heart transplant program after a two-week suspension of all medical procedures following the deaths this year of several patients. Baylor St. Luke's Medical Center's decision to temporarily halt its program came after a series of joint reports by the Houston Chronicle and ProPublica revealing the departure of several top physicians and an unusually high number of patient deaths in recent years. (6/15)

In a written statement, the hospital said its review "did not identify systemic issues related to the quality of the program" but that it had nonetheless reorganized its transplant surgery team, refined the criteria for which patients it would accept for heart transplants, and made other improvements to strengthen the program. Among the changes: The hospital's top lung transplant surgeon, Dr. Gabriel Loor, will now perform or participate in every heart transplant going forward, working alongside the heart program's surgical director, Dr. Jeffrey Morgan.(Hixenbaugh and Ornstein, 6/15)

Amid sharply rising rates of teen suicide and adolescent mental illness, two states have enacted laws that for the first time require public schools to include mental health education in their basic curriculum. Most states require health education in all public schools, and state laws have been enacted in many states to require health teachers to include lessons on tobacco, drugs and alcohol, cancer detection and safe sex. Two states are going further: New York’s new law adds mental health instruction to the list in kindergarten through 12th grade; Virginia requires it in ninth and 10th grades. (Vestal, 6/15)

Alan Andersen wishes he'd known beforehand that the surgeon who performed a complex heart operation on him had never done the procedure before. The Iowa Supreme Court decided Friday that Andersen has a fair point. The court ruled he may sue surgeon Sohit Khanna and Khanna's former employer, the Iowa Heart Center, over the lack of disclosure. Khanna had no experience or training in the specific surgery, the Iowa Supreme Court wrote. The 2004 operation at Des Moines’ Mercy Medical Center involved replacing a flawed section of artery right next to the heart. (Leys, 6/15)

Years of information about payments for health insurance claims in New Hampshire that is being used to help patients do comparison price shopping will soon help the state judge health networks and may even help those networks improve, especially for behavioral health. “It may be that there is a non-traditional provider or a lower cost provider that is performing a service,” said Jennifer Patterson, Director of Health Policy for the Insurance Department. An upcoming change in rules, she said, should help the state ensure that insurance providers know about or make use of alternatives such as nurse practitioners, social workers or even telemedicine. (Brooks, 6/15)

More than 10,000 Columbus-area women could lose their access to affordable reproductive health care under a Trump administration proposal to block federal family-planning funds from going to any clinic with a connection to abortion services or referrals. That’s according to a new analysis from Columbus City Auditor Megan Kilgore and Councilwoman Elizabeth Brown, who say health-care availability creates ripples — for good or for ill — that reach deeply into local and state economies. (Price, 6/15)

As mass shootings continue, more and more states have adopted “red flag” laws that allow law enforcement, and sometimes family members or other parties, to ask a court to order the seizure or surrender of guns from people who are deemed dangerous by a judge. After Texas’ second high-profile mass shooting in six months — a Santa Fe High School student has been charged with last month’s slaying of 10 students and teachers at the school — lawmakers are discussing whether this notably pro-gun state needs its own red flag measure. (McCullough, 6/18)

OneTaste is a sexuality-focused wellness education company based in the Bay Area. It’s best known for classes on “orgasmic meditation,” a trademarked procedure that typically involves a man using a gloved, lubricated fingertip to stroke a woman’s clitoris for 15 minutes. For Michal, like those at her wedding, OneTaste was much more than a series of workshops. It was a company that had, in less than a year, gained sway over every aspect of her life. ...But many who’ve become involved in the upper echelons describe an organization that they found ran on predatory sales and pushed members to ignore their financial, emotional, and physical boundaries in ways that left them feeling traumatized. (Huet, 6/18)

Shortly after he turned 2, Yadriel Hernandez started struggling to breathe. His doctor prescribed an inhaler and an allergy pill for asthma, and his symptoms were mostly under control. Then Hurricane Maria devastated Puerto Rico, strewing mold-producing wreckage across the island and forcing many to use fume-spewing generators for power. The boy, now 8, started having twice-monthly attacks and needing nearly four times the amount of medicine he used to take. (Coto, 6/18)

Undocumented immigrants such as Juan, who don’t have a Social Security number and can’t afford private insurance, are often turned away for dialysis unless they are near death, and even then they often have to go through emergency departments. (King, 6/16)

UnitedHealth Group maintained its status as Minnesota’s largest public company in 2017 as the Minnetonka-based health care giant for the first time surpassed the $200 billion mark in annual revenue. The company’s UnitedHealthcare business remained the largest private health insurer in the country, with particularly strong growth in its already large business providing coverage to Medicare beneficiaries. Meanwhile, the Optum division for health care services grew, too, including an acquisition announced in January 2017 that’s making UnitedHealth Group one of the nation’s largest operators of surgery centers. (Snowbeck, 6/16)

Saying its front-line workers have been overburdened and underpaid, a local agency that provides support services for people with disabilities is raising its starting pay rate by nearly 28 percent, to $13 an hour. ...In a special report in April, The Dispatch wrote about how that workforce crisis is affecting thousands of people with disabilities and their families as wages rarely exceed $11 to $12 an hour. Turnover rates approach 50 percent. (Price, 6/15)

For low-income seniors who can’t afford care at home and don’t want or need the full medical services of a nursing facility, the state’s few options aren’t enough to meet demand. A middle-ground choice — assisted living — requires special permission under government rules and is available to fewer than 4,000 Californians, although state health officials and lawmakers are both proposing increases. (Gorn, 6/15)

One out of every 20 people in Massachusetts has been diagnosed with a type of skin cancer, one of the highest rates in the country, a recent report found. The rates are even higher on Cape Cod, where the Barnstable-Yarmouth area placed in the top five metropolitan areas for skin cancer. (Capelouto, 6/16)

Most Floridians knew about the Zika virus and how it spread—but that wasn't enough to get them to protect themselves, according to a new study in the journal Risk Analysis.As the Zika virus emerged in the United States two summers ago, researchers from the Annenberg Public Policy Center of the University of Pennsylvania and the Centers for Disease Control and Prevention surveyed more than 12,000 Americans. (Mack, 6/15)

Dozens of fired workers and their supporters demonstrated outside the Whittier Street Health Center in Roxbury Friday morning to protest what they say is retaliation for trying to organize a union. ...Chief executive Frederica Williams said the cuts were due to two grants being denied, accounting for a loss of $680,000 in expected funds, and were unrelated to unionization. (Johnston, 6/15)

As many as 20 employees of Whittier Street Health Center in Roxbury were fired Thursday, according to a major state health care workers union that characterized the downsizing as retribution for their support of efforts to unionize professionals at the health center. 1199 SEIU United Health Care Workers East Executive Vice President Tim Foley said the dismissals come just days before a vote is scheduled to be held to determine whether professionals at the health center, including doctors, nurses and counselors, will unionize. (Murphy, 6/15)

A Northern California emergency room doctor has been suspended after cursing and mocking a man who said he had an anxiety attack. The San Jose Mercury News reports that Dr. Beth Keegstra, a contract doctor with El Camino Hospital in Los Gatos, was suspended after she was recorded on June 11 questioning whether 20-year-old Samuel Bardwell was sick or just looking for drugs. (6/17)

In an abrupt reversal, 20 workers laid off last week from the Whittier Street Health Center in Roxbury will get to keep their jobs, after the nonprofit found a “pathway forward” toward financial stability with the help of Mayor Martin J. Walsh, officials said Sunday. In a statement, Frederica Williams, the center’s chief executive, said the organization will still have to review its programs and staffing “to ensure we are properly sized to deliver the best care possible to our community today and into the future.” (Hilliard and Guerra, 6/18)

The city, after years of reluctance to post state-mandated warnings and vacate homes with lingering lead hazards that poisoned children, now has ordered occupants to leave dozens of homes it helped to remediate with federal money. (Dissell, 6/17)

A mother-daughter bond. An hours-long surgery. A robot performing a kidney transplant. Live on Facebook. Methodist Dallas Medical Center's Facebook page has drawn thousands of viewers to a series of live videos of a mother-daughter kidney transplant surgery. Maribel Gutierrez is donating a kidney to her 20-year-old daughter, Jessica, who was born with kidney-related complications, the hospital said. (Gross, 6/16)

Public health officials are warning people who recently dined at a restaurant in the Loop that they may have been exposed to measles after another customer contracted the highly contagious virus. Customers who dined at Honeygrow, 70 E. Lake St., between 6:30 p.m. and 9:30 p.m. Tuesday may have been exposed to the virus, according to the Chicago Department of Public Health. Honeygrow has cooperated with the CDPH’s investigation and there is no ongoing risk at the restaurant. (Schuba, 6/17)

The family of a black man who died in Sacramento police custody is questioning whether officers should have sought medical care before transporting him to jail. Police department video released on Wednesday show Brandon Smith breathing heavily and complaining of “having a heart attack” as officers heft him into the back of a patrol wagon. (Caiola, 6/14)

Synthetic forms of heroin have flooded Midwestern communities and taken lives at unprecedented and tragic rates. We now have an opportunity to make significant progress to help combat the influx of fentanyl — the deadliest killer in this crisis. This week, the House of Representatives passed the STOP Act, a bipartisan bill we authored that will help keep more synthetic drugs like fentanyl from being shipped into the U.S., and a Senate committee approved the bill, moving it to the Senate floor where we hope it will soon have a vote. We need the STOP Act because fentanyl has invaded our communities and is increasingly robbing people of their God-given potential and taking lives. (Sen. Rob Portman and Rep. Mike Bishop, 6/16)

As the opioid crisis spills across this country, one aspect that we believe gets far too little attention is this: When millions of Americans are addicted to drugs and tens of thousands are overdosing and dying each year, this isn't simply a drug problem. It's a social breakdown. Excuse us if this comes across as a little preachy, but sometimes the role of a newspaper's editorial board is to call out important issues that are too easy for most people to gloss over. (6/16)

The legalization of recreational marijuana use in California has set off an advertising boom on billboards across the state. The gigantic ads try to persuade us — and our offspring — that we can easily get “chill vibes,” say “goodbye stress” or “get rid of pesky hangovers.” The proposed cure-all, of course, is marijuana. ...The ordinance focuses on outdoor advertising, and it mirrors established tobacco-advertising guidelines. It will prohibit a billboard promoting marijuana within 700 feet — more than twice the length of a football field — of obvious places children might be. This includes daycare and youth centers, schools, public parks, libraries and playgrounds. It will also restrict smaller outdoor signage, limiting a cannabis retail business to one on-site sign — no portable signs or sandwich boards. Solid data about the effects of marijuana advertising back up these restrictions. A seven-year research project my colleagues and I recently completed for the nonprofit Rand Corp., confirmed what common sense suggests: The more exposure young people have to marijuana advertising, the more likely they are to use the drug and to have positive views about it. (Elizabeth J. D'Amico, 6/18)

Drug abuse by Kansas parents – particularly meth – continues to take an extreme toll on both our youth and the state agencies which oversee their care and well-being. The Department for Children and Families is overrun with reports of abuse, neglect and at-risk children to the extent that it cannot hire enough qualified workers to properly investigate, and new DCF Secretary Gina Meier-Hummel has floated filling these positions with lesser-qualified individuals out of pure necessity. In 2016, Child Protective Services received 34,537 reports of abuse or neglect and was able to substantiate only 7.2 percent of these reports. Nationally, 16.5 percent of reports were substantiated that same year. It is likely that this discrepancy can be attributed to case overload and botched investigations – not frivolous reports. (Blake Shuart, 6/18)

In April, the Congressional Budget Office reported the U.S. annual budget deficit will reach $1 trillion by 2020. That’s a troubling trajectory, but no one in Washington seems to care enough to stop spending money. I only see one answer. Washington needs to spend more money. Spending in one area now might actually help avert a fiscal apocalypse later. A single disease, Alzheimer’s, costs America $277 billion per year; a figure projected to quadruple — to over $1 trillion (that’s one thousand billion dollars annually)— by midcentury. That would cost Medicare and Medicaid $750 billion; the equivalent of one-fifth of the federal government’s entire current budget. (Andrew Tisch, 6/17)

The medical research grant system in the United States, run through the National Institutes of Health, is intended to fund work that spurs innovation and fosters research careers. In many ways, it may be failing. It has been getting harder for researchers to obtain grant support. A study published in 2015 in JAMA showed that from 2004 to 2012, research funding in the United States increased only 0.8 percent year to year. It hasn’t kept up with the rate of inflation; officials say the N.I.H. has lost about 23 percent of its purchasing power in a recent 12-year span. (Aaron E. Carroll, 6/18)

On Sunday, a day we as a nation set aside to honor fathers and the bonds of family, I was among the millions of Americans who watched images of children who have been torn from their parents. In the six weeks between April 19 and May 31, the Department of Homeland Security has sent nearly 2,000 children to mass detention centers or foster care. More than 100 of these children are younger than 4 years old. The reason for these separations is a zero-tolerance policy for their parents, who are accused of illegally crossing our borders. I live in a border state. I appreciate the need to enforce and protect our international boundaries, but this zero-tolerance policy is cruel. It is immoral. And it breaks my heart. (Former first lady Laura Bush, 6/17)

The small shelter along the Texas border to Mexico held 60 beds and a little playground for children. Rooms were equipped with toys, books and crayons. To Colleen Kraft, this shelter looked, in many ways, like a friendly environment for children, a place where they could be happy. But the first child who caught the prominent pediatrician’s attention during a recent visit was anything but happy. Inside a room dedicated to toddlers was a little girl no older than 2, screaming and pounding her fists on a mat. One woman tried to give her toys and books to calm her down, but even that shelter worker seemed frustrated, Kraft told The Washington Post, because as much as she wanted to console the little girl, she couldn’t touch, hold or pick her up to let her know everything would be all right. That was the rule, Kraft said she was told: They’re not allowed to touch the children. (Kristine Phillips, 6/16)

The Trump administration’s announcement that it will prohibit federal funding to any medical entity that provides or refers women for abortion care — the gag rule — is a straight-up attack on low-income women. And it is an attack on my obligation as a physician to give my patients unbiased advice on their health care options. (Sara Imershein, 6/15)

When it comes to public health in the developed world, the perfect can be the enemy of the good. The American Heart Association urges every American to reduce sodium intake to an “ideal” level of less than 1,500 milligrams of sodium per day – a goal that fewer than 1 percent of the world’s population achieves. No wonder: 1,500 milligrams represents the inescapable amount of sodium that’s embedded in the amount of food we need to avoid starving. Setting that as the “ideal” is really a zero-tolerance policy toward sodium: You can’t add salt when cooking, let alone eat anything from packages or restaurants. (Faye Flam, 6/15)

I’m glad I was lying down when the doctor told me the true cause of my stomach pains. “Well, you’ve got a tumor” were his first words to me. I had just awakened in a hospital bed on the morning after emergency surgery. It was Tuesday, Oct. 31, 2017. Halloween. The doctor’s scary outlook came after two agonizing trips to the emergency room that had begun the preceding Friday night. After looking at abdominal X-rays, an ER doctor said constipation was making me feel as though a drawer full of forks was trying to pierce through my belly. He recommended an over-the-counter laxative. (Susan Lisovicz, 6/17)

After each new episode in our nation’s worsening gun violence epidemic, the same two things happen: First, our screens and social media feeds are saturated with hauntingly familiar images — and then we’re told that it’s too soon to talk about gun laws. We need to break this cycle. For physicians, this is particularly poignant. While the rest of the country sees the television coverage from a distance, we see the trauma up close. Audiences see the vigils; we see the victims. And after audiences turn their attention to the next news story, we see patients through their long and painful roads to recovery. And for all these reasons, it is time for physicians and nurses to speak out. (Kenneth L. Davis, 6/16)

Moments after Neo eats the red pill in “The Matrix,” he touches a liquefied mirror that takes over his skin, penetrating the innards of his body with computer code. When I first learned about the controversial new digital drug Abilify MyCite, I thought of this famous scene and wondered what kinds of people were being remade through this new biotechnology. (Anthony Ryan Hatch, 6/15)

State lawmakers should be working on ways to bring transparency to prescription-drug pricing, and Sunday’s Dispatch report on secret practices of pharmacy benefit managers shows why. For months, pharmacy owners have been telling reporters that PBMs — hired to negotiate price rebates with drug manufacturers and save money for insurers and patients — instead rake off much of the savings for themselves, shorting taxpayers and starving the pharmacies in the process. (6/18)

We call them deaths of despair — and they’re increasing. Recent data show suicide deaths have risen 25 percent over the past 20 years. The root cause cannot be tied to one problem or one issue, but rather a myriad of factors ranging from social determinants to health-related issues. But, no matter how you break it down, the rise in deaths appear to be grounded in despair and hopelessness. This makes the new U.S. Centers for Disease Control and Prevention (CDC) data, released today, alarming: 1 in 3 teens reports persistent feelings of sadness or hopelessness, according to the most recent annual survey of high school students; and 1 in 5 teens has seriously considered suicide, according to that same report. Among these students, all races and genders seem at risk. But girls are almost twice as vulnerable as boys. And, perhaps most disturbing, one in four lesbian, gay and bisexual students report they have not just thought about suicide — they have actually attempted suicide. (John Auerbach and Benjamin F. Miller, 6/16)

While clicking through Snapchat the other day, an ad for Merck’s new Versed campaign for Gardasil, its vaccine against the human papillomavirus (HPV), stopped my thumb in its tracks. As a researcher interested in how gender and science interact in the realm of health policy, I knew what a controversial blunder its earlier marketing had been. I clicked with caution, was directed to the campaign’s website, and was surprised: a diverse, coolly confident group of 20-year-olds — female and male — dressed in beanies, snapbacks, neutrals, and raw denim were telling me “to get versed about HPV.” Although it was clearly trying very hard to be hip, perhaps overcompensating for Merck’s previously unpopular marketing, the website did highlight important facts about HPV and also mentioned that the virus could be transmitted by sex. (Ashley Andreou, 6/18)