Minority Leader Martin Nesbitt Dies at 67
By Rose Hoban
North Carolina Senate Minority Leader Martin Nesbitt, known for his slow drawl, folksy turns of phrase and occasional flashes of sharp humor during floor debates, died at home in Swannonoa on Thursday, March 6, after a brief illness, his family announced. He was 67.
On March 3, Nesbitt, a Democrat who represented Buncombe County, announced he was stepping down from his ranking position, saying that it had “become clear that I will need to take some time in the coming weeks and months to focus on my health.”
As reported in the Asheville Citizen-Times on March 4, a bipartisan group of well-wishers lined the roadways as Nesbitt returned home in an ambulance earlier Tuesday. His popularity on both sides of the aisle has been underscored by the tributes that came swiftly after the announcement of his death Thursday afternoon.
“We are terribly saddened to hear of Senator Nesbitt’s untimely passing. Although we may have disagreed on some issues over the years, Senator Nesbitt was an honorable and dedicated public servant who worked to improve the lives of North Carolinians,” wrote Republican Party Chairman Claude Pope in a statement late Thursday.
In a separate statement, Senate President Pro Tempore Phil Berger (R-Rockingham) wrote, “Sen. Martin Nesbitt cared deeply about people and spent a lifetime fighting for what he believed would make North Carolina a better place. His passing leaves a deep void in our Senate family.”
“The citizens of the State of North Carolina have lost a leader and champion of exemplary and distinguished public service,” read a statement from the North Carolina Democratic Party Thursday evening.
Nesbitt, an attorney who attended law school at UNC-Chapel Hill, gained his first appointment to the legislature after his mother, Mary Cordell Nesbitt, died, in 1979.
“I’m probably the only person down here who got into office through my mother. My mother served down here for five years. I was appointed to office to replace her,” Nesbitt told UNC-TV’s Kelly McKullen in 2011.
Except for an election loss in 1994, Nesbitt has served ever since. He moved from the House to the Senate in 2004.
in the early 1980s, he championed a room tax that helped funnel money to the Buncombe County Tourism Development Authority, allowing Asheville to position itself as a tourist destination. For his help in passing the levy, the Asheville Chamber of Commerce honored Nesbitt in 2009.
“You get it, you’ve always been a straight shooter, and I know we can always pick the phone up and get exactly what’s happening at any given time down in Raleigh,” Kelly Miller, executive director of the Asheville Convention and Visitors Bureau, said at the time.
Nesbitt also championed passage of a bill that became known as the “Clean Smokestacks Act,” in 2002, which compelled power companies to significantly cut nitrogen oxide and sulfur dioxide emissions from coal-powered plants. Environmental-health experts credit the law with reducing ozone levels throughout the state.
As co-chair of the Joint Legislative Oversight Committee on Health and Human Services, Nesbitt was involved in setting health policy for the state for years and had an encyclopedic memory of health care legislation over the past two decades.
After Republicans took over the General Assembly in 2010, Nesbitt continued on the health and human services committee, providing sharp critiques, which also frequently aroused laughter from both sides of the aisle.
Judge Rules Coal Pond Owners Take Action to Eliminate Sources of Groundwater Contamination
Today’s ruling from Wake County Superior Court on a petition by environmental groups intended to force Duke Energy to clean up coal ash ponds and surrounding groundwater contamination.
A Wake County judge ruled on March 6 that owners of older coal ash ponds “must take immediate action to eliminate sources of contamination” in groundwater, countering a legal argument by the N.C. Environmental Management Commission, which develops state regulations. The judge specified that pond owners cannot first propose a remediation plan; their cleanup must take place immediately.
The environmentalists who filed the suit said they are hopeful this ruling will force Duke to move all of its coal ash–from 14 N.C. ponds–into dry, lined landfills.
Dzau To Leave Duke Medicine for U.S. Institute of Medicine
A statement from Duke University Medicine News dated Feb. 19, 2014
DURHAM, N.C. – Victor J. Dzau, M.D., chancellor for health affairs at Duke University and president and chief executive officer for the Duke University Health System, has been named president of the Institute of Medicine (IOM). Dzau will be leaving Duke on June 30, 2014, and will succeed current IOM president Harvey V. Fineberg, M.D., Ph.D., effective July 1, 2014.
Dzau is recognized nationally and internationally for his visionary and transformational leadership across Duke Medicine’s renowned academic, research and clinical care enterprises. He is also an acclaimed voice in academic health systems, national health policy, health care innovation and global health. Dzau has served as an advisor to universities, corporations and foreign governments, and is a member of the Board of Health Governors and chair of the Global Agenda Council on Personalized and Precision Medicine for the World Economic Forum.
“I’m deeply honored to become the next president of the IOM and recognize the critically important role that the IOM will have in improving the health of the nation at a time of extraordinary evolution in biomedical research and health care delivery,” Dzau said. “The explosion of new data resources, novel technologies and breathtaking research advances make this the most promising time in history for driving innovations that will improve health care delivery, outcomes and quality.”
Under the congressional charter of the National Academy of Sciences, the Institute of Medicine is recognized widely as a primary source for independent, scientifically informed analysis and recommendations on health issues. IOM provides advice to government policymakers, health professionals, and the public on issues such as health care delivery and quality, the obesity epidemic, vaccine safety, nutrition, cancer prevention and management, and military and veterans’ health.
In his nearly 10 years at Duke, Dzau has been the driving force behind the creation of the Duke–National University of Singapore Graduate Medical School, as well as the Duke Global Health Institute, Duke Institute for Health Innovation, Duke Cancer Institute and the Duke Translational Medicine Institute. Most recently, under his leadership, Duke University Health System has undergone a historic system-wide transformation of its clinical information systems to a single, state-of-the-art electronic health record. Dzau also led a transformation of the Duke Medicine campus that has added the new Duke Cancer Center facility, the Duke Medicine Pavilion, the Trent Semans Center for Health Education, a new Duke University School of Nursing facility, and a Duke Eye Center building that is under construction.
New Rule Gives Patients Direct Access To Their Lab Reports
By Ankita Rao
Calling your doctor to get lab results might be a thing of the past: A new federal rule will allow patients to have direct access to their completed laboratory reports.
The regulation was announced in early February by the Department of Health and Human Services. It amends privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) and the Clinical Laboratory Improvement Amendments of 1988 (CLIA) that required patients to get their lab results from their physician, according to the announcement.
The final rule notes that some labs and physicians had raised concerns about the move when the administration issued a preliminary rule in June 2011:
“Commenters expressed concern that patients might receive and act upon results that appear to be abnormal (showing false positives or false negatives, or results that are out of the normal range for the general population) but may be normal for that particular patient due to his or her medical conditions.”
But HHS said the rule helps ensure patients have full access to their health information and can be proactive in their choices for care. The rule also notes that studies have found “physician practices failed to inform patients of abnormal test results about seven percent of the time, resulting in a substantial number of patients not being informed by their providers of clinically significant tests results.”
Jon Cohen, senior vice president and chief medical officer at Quest Diagnostics, welcomed the change. “I think more physicians are comfortable with having their patients access this information – the conversations between patients and doctors will be more substantive,” he said.
He said Quest, the largest diagnostic laboratory system in the country, believes the rule will help reduce medical errors and duplicate tests, since patients will have quicker access to this part of their medical history.
Jessie Gruman, president of nonprofit patient-advocacy organization Center for Advancing Health, said the rule eliminates only one small part of a larger barrier to patients receiving information they need to make better decisions about their health and treatment. She said there is a need for more transparency about drugs and medical-device costs.
“It’s certainly welcome,” Gruman said, “but this is not a big, heroic change in policy.”
This story originally appeared in Kaiser Health News an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
North Carolina Obamacare Enrollment Remains Robust
By Rose Hoban
North Carolina added more than 52,000 people to the federal insurance exchange created by the Affordable Care Act by the end of January, according to a federal report released this week.
The new enrollments bring the state’s total to more than 160,000 people who’ve signed up for insurance under the new law. Federal officials estimate that more than 1.6 million North Carolinians are uninsured.
This week’s report also revealed that North Carolina continues to be among the states that have signed up the highest percentage of people projected to enroll: about 83.9 percent of 191,000 people who were projected to sign up by the end of March have already done so.
Of the 36 states participating in the federal insurance exchanges, only Maine and New Hampshire have higher percentages.
A larger percentage of females (58 percent) than males (42 percent) signed up for plans; but of all the enrollees, 90 percent qualified for financial assistance to pay for their plans.
“More Americans are enrolling every day, and finding quality, affordable coverage in the marketplace,” said Health and Human Services Sec. Kathleen Sebelius.
According to federal statistics, 25 percent of North Carolina’s enrollees are in the key age group of 18 to 34. For the exchanges to work and be economically viable for insurers, a higher percentage of young people needs to sign up for coverage to balance the risk from older, sicker enrollees, health economists say.
Federal officials looked for at least 33 percent of enrollees to be in that demographic; but for the law to perform optimally, closer to 40 percent of enrollees need to be young people. Nationally, 31 percent of enrollees are under 34.
One inducement to enroll created by the law is catastrophic coverage, available only to people under 30. But only 1,799 (1 percent) of total enrollees in North Carolina signed up for the coverage, which tends to be much cheaper. An additional 95,000 young people under the age of 26 have enrolled for insurance under their parents’ plans.
DHHS Issues Health Advisories for Dan River Area
This advisory was issued at 4 p.m. Wednesday, Feb. 12. The coal ash spill into the Dan River was detected Sunday, Feb. 2.
Raleigh, N.C. - The N.C. Department of Health and Human Services’ Division of Public Health is issuing two health advisories related to the recent coal ash spill in the Dan River in Eden. The advisories address concerns associated with human exposure and consumption of fish and shellfish.
Recreational Water Advisory
Because the Duke Power-Eden coal ash spill is located in North Carolina’s portion of the Dan River, a potential hazard exists immediately downstream of the release. Therefore, the DHHS Division of Public Health recommends that people avoid recreational contact with water and sediment in the Dan River in North Carolina downstream of the Duke Power-Eden spill site.
DHHS also recommends that people do not contact submerged or floating coal ash, or ash washed up on the riverbank. Direct contact with the water or sediment may cause skin irritation. Wash skin that has been exposed to the water or sediment with soap and water. The Department will continue to monitor data as it becomes available to identify when health risks are no longer a concern.
Fish and Shellfish Consumption
Because the Duke Power-Eden coal ash spill is located in North Carolina’s portion of the Dan River , a potential hazard exists immediately downstream of the release. The DHHS Division of Public Health recommends that people not consume any fish or shellfish collected from the Dan River in North Carolina downstream of the Duke Power-Eden spill site.
DHHS is working with other agencies to collect fish downstream of the spill and will evaluate the data from fish samples as it becomes available to identify when health risks associated with eating the fish are no longer a concern.
Illegal Dumping in Charlotte Creek Prompts Emergency Action
Mecklenburg County officials have discovered two separate incidents of illegal dumping in the county’s waterways in the past few weeks. The most recent one was discovered over the past weekend.
Below is the press release from the City of Charlotte:
Sunday, February 9, 2014 5:30 p.m.
On Sunday afternoon, Charlotte-Mecklenburg Utility Department (CMUD) officially opened an Emergency Operations Center to respond to the illegal chemical dumping at Mallard Creek Wastewater Treatment Plant and Sugar Creek Wastewater Treatment Plant.
As a precaution, the public is advised to refrain from human and animal contact with Sugar Creek / Little Sugar Creek (Tyvola Road downstream or south to Hwy51 or South Carolina border) until further notice.
As a precaution we are advising people to avoid human or animal contact with Mallard Creek and the Rocky River in Cabarrus County until more testing is completed. N.C. water quality officials are aware of the situation and we also are notifying downstream authorities to share this advisory with folks along Rocky River in Cabarrus, Union and Anson counties.
Advanced testing has confirmed that the substance that entered the Sugar Creek Wastewater treatment plant does not contain PCB as originally suspected.
Tests indicate that the substance flowing into Sugar Creek Wastewater Treatment Plant was ethanol, which is typical of a fuel spill.
There appears to be no connection between the Sugar Creek and the Mallard Creek incidents.
Staff of CMUD are on alert due to the Mallard Creek incident. The substance that entered Sugar Creek had similar characteristics, which led to the public notification at 4:00 a.m. Sunday morning.
Testing continues at the Mallard Creek plant and shows continual fluctuations.
The city drinking water supply was not affected by the incidents at Sugar Creek or Mallard Creek treatment plants. Testing of the water processed for drinking has no PCBs detected.
As a precaution additional tests are being taken at all wastewater treatment plants and drinking water treatment plants. Test results take several hours. City officials continue to reiterate that drinking water is safe to drink, bathe and cook with. This incident did not affect drinking water in Mecklenburg County.
Charlotte-Mecklenburg Police Department Criminal Investigation
Given the seriousness of this offense, The Mayor and City Manager have authorized the creation of a joint task force to investigate this incident. The Charlotte-Mecklenburg Police Department has joined forces with Local, State and Federal agencies in an effort to identify and prosecute those involved in this egregious criminal act.
Members of the task force include:
• The Charlotte-Mecklenburg Police Department (CMPD)
• The Charlotte Fire Department (CFD)
• The Environmental Protection Agency’s Criminal Investigation Division (EPACID)
• Charlotte Mecklenburg Utilities Department (CMUD)
• North Carolina State Highway Patrol
The extent of the offense for unlawfully dumping toxic chemicals can include both State and Federal charges. The most serious of these charges would be a felony State charge of “Dumping of toxic substance” and a felony Federal charge of “Violation of the Clean Water Act”.
The public is asked to call CRIMESTOPPERS at 704-334-1600 if you have information that could lead to the apprehension of the person(s) responsible for the illegal dumping.
UNC Study: Young Women Know Tanning Beds Harm, Use Them Anyway
By Rose Hoban
As lawmakers worked their way through a bill to ban tanning beds for teens under 18 years old last summer, researchers at UNC-Chapel Hill were asking young women what they thought about tanning beds and how often they use them.
And they found a few surprises, including the big revelation that most of the young women who use tanning beds know it can be bad for their skin in the long run, but that it had no effect on how often they used them.
“The big motivator is appearance; they think it makes them look better,” said lead researcher Seth Noar, a faculty member at the School of Journalism and Mass Communications who is associated with the Lineberger Cancer Center at UNC Hospitals.
But he also found an association for some tanning bed users with mood enhancement, and some parallels to tobacco use.
Noar and his students in a health communications class surveyed more than 700 sorority members from UNC. He said that while other studies done on tanning bed use have surveyed only 100 to 200 people, he got assistance from the Pan-Hellenic Society at UNC, which promoted participation in the study in an effort to help its sisters stay healthier.
The survey found that close to half (45 percent) of the young women had used a tanning bed. Of that number, two-thirds had tanned in the past year; the rest were more occasional users.
“The prom ends up being the significant, number-one event that they tanned for the first time for,” said Noar, who found that 80 percent of the women used indoor tanning in high school.
“If you want to do true prevention, that’s the time to intervene,” he said.
But Noar said that other factors influencing tanning bed use were particularly intriguing.
For example: While a majority of women went tanning for the first time with their friends, a significant number started alongside their mothers.
“And we found that women who reported going with mothers the first time were more likely to become regular tanners than women who did not,” Noar said.
The other surprising phenomenon Noar found was that many of the women reported significant mood enhancement from tanning.
“It was the idea that going tanning was relaxing. It lifts one’s spirits, makes someone feel good, and is enjoyable,” he said. “That’s the most potent factor.”
Noar said these findings indicate that some tanners actually develop something like an addiction to indoor tanning.
“There’s some interesting research on the UV light and mood, which might make it more difficult in terms of trying to persuade regular tanners to reduce or stop tanning,” he said.
Noar found such behavior to be eerily similar to tobacco use.
“People know there are risks, [but] they still do it,” he said. “There’s a mood component and, for some, a dependence component.”
“Most tobacco users want to quit, but they’re addicted,” Noar said. “It’s not a perfect parallel, but there are some parallels between tanning and smoking.”
The indoor-tanning industry was launched in the 1970s and gained widespread use in the ’80s and ’90s. It’s only now, Noar said, that dermatologists are seeing the effects in the form of a sharp uptick in young white women being diagnosed with skin cancer and melanoma.
An effort to ban tanning bed use for teens passed the state House of Representatives last summer and will likely be before the Senate during the short legislative session this summer.
Burn Awareness Week Tips
This week is Burn Awareness Week, and this year’s theme is scalds. The N.C. Jaycee Burn Center offers the following tips and resources for avoiding and treating scalds.
10 tips to avoid scalds
- Install tempering valves on faucets to keep the water temperature constant and anti-scald valves in the showerhead to automatically turn off the flow if the cold water is turned off while the hot water is on.
- Supervise children and individuals with special needs in the bath or kitchen.
- Install grab bars on tubs and single faucet handles in tubs and bathroom sinks.
- Check your water heater, and if the temperature is higher than 120 degrees dial it back accordingly.
- Test the temperature of the water before getting in or placing a child or adult in a bath by running your hand, wrist or forearm quickly through the water.
- Establish a “kid-free” zone in the kitchen. An area at least three feet in front of the stove should be marked off with tape and the child instructed not to step inside that area. If that’s not possible, cook on back burners and keep pot handles turned so kids can’t pull them over.
- Never hold children while cooking, drinking a hot beverage or carrying hot foods.
- Open microwaved foods carefully, opening them away from you so steam releases safely. Always allow microwaved foods to cook before eating.
- Never heat a baby bottle in the microwave.
- Place hot liquids and foods in the center of the table where toddlers and young children can’t reach them.
How to treat a scald
Most scalds should be treated by a medical professional, with the exception of burns smaller than a quarter.
“Treat with cool water for three to five minutes and wrap in a clean dry-gauze dressing,” explains Ernest Grant, outreach coordinator at the N.C. Jaycee Burn Center in Chapel Hill. “Do not apply ice to the burn area, as this may also cause a frost-bite injury. Ointments, creams or solvents shouldn’t be applied, as they hold the heat in the tissue and make the injury deeper.”
And if a blister appears, don’t pop it. Instead, watch the area for signs of an infection over the next two or three days post-burn. Seek medical attention if there is any redness extending well beyond the border of the wound or if there is extreme pain.
CareFusion to Pay N.C. More Than $500,000 for Medicaid Fraud
Medical equipment manufacturer to pay for improper marketing, illegal kickbacks
Press release from N.C. Attorney General’s office, dated Feb. 3, 2014
Raleigh: Medical device manufacturer CareFusion will pay more than $500,000 to North Carolina to resolve allegations that it defrauded the state’s Medicaid program, Attorney General Roy Cooper announced Monday.
The recoveries for North Carolina are part of a $40.1 million multistate settlement that also includes the federal government. The settlement resolves allegations that CareFusion improperly promoted and marketed its surgical preparation solution Chloraprep and concealed kickbacks to a doctor who promoted the drug.
“Using trickery to sell medical products diverts tax dollars for treatments that aren’t approved as safe and effective,” Cooper said. “This kind of fraud cheats Medicaid and also drives up health care costs for everyone.”
North Carolina’s total share of the settlement is $581,363.13 and includes funds for Medicaid efforts in the state as well as civil penalties for the public schools. Medicaid is a joint federal-state program that provides health insurance for the poor.
North Carolina and the other states allege that the company promoted and marketed Chloraprep for uses that were not approved by the Food and Drug Administration (FDA). Once the FDA approves a drug as safe and effective, a manufacturer cannot market or promote that drug for an unapproved use, a practice called off-label marketing. Chloraprep was approved for very specific inpatient hospital procedures, including the preparation of a patient’s skin prior to surgery or injection.
The states contend that between September 1, 2009, and August 31, 2011, the company promoted Chloraprep for use with intravenous preparation and suture care, even though the FDA had explicitly rejected Chloraprep for those uses. The states also contend that CareFusion’s predecessor, Cardinal Health, entered into agreements to make payments to Health Care Concepts, Inc. (HCC). The payments, for which CareFusion assumed legal and financial responsibility, were made to conceal kickbacks paid to HCC’s physician-owner in exchange for promoting Chloraprep to other health care providers.
CareFusion’s unlawful conduct led to false and/or fraudulent claims being submitted government funded health care programs, including Medicaid. North Carolina’s share of the funds will go to resolve these claims.
The settlement is based on whistleblower actions filed in the United States District Court for the District of Kansas, under the provisions of the federal False Claims Act and equivalent state False Claims statutes.
The North Carolina settlement agreement was reached by the Attorney General’s Medicaid Investigations Division (MID) and the North Carolina Division of Medical Assistance. The MID investigates fraud and abuse by hospitals, doctors, pharmaceutical companies, mental health care providers, and others, as well as patient abuse and neglect in Medicaid-funded facilities. Over the past decade, Cooper’s MID has recouped more than $500 million and helped to convict hundreds of individuals on criminal charges.