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POLITICO New York Health Care: Board of health repeals circumcision consent forms; requires salt warnings

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at and we'll set you up for trial access.

written by Dan Goldberg

REPEALED — The city's Board of Health on Wednesday repealed a controversial rule requiring parents sign a consent form before a mohel could practice metzitzah b'peh, the circumcision ritual that involves directly sucking blood away from the wound. The majority of the board, led by health commissioner Dr. Mary Bassett, felt the consent forms were ineffective and doing more harm than good.

...The board's decision is an acknowledgement of its own limitations, and sets a different tone from Bloomberg-era boards that often sought to legislate through their actions. This board, which has four of its 11 members appointed in the last few months by Mayor Bill de Blasio, believes its role is to educate instead of legislate. And while the members appear to believe metzitzah b'peh puts infants at risk, the majority do not believe they have the authority to stop the practice. Read my full story here:

SALTY TALK — The city's board of health on Wednesday voted unanimously to require chain restaurants to publish a warning if a menu item contains more than the recommended daily limit for sodium, becoming the first jurisdiction in the United States to do so. Citing the link between sodium and heart disease, Bassett said cardiovascular disease is not only a leading cause of death in the city but also a leading driver of health disparities. The new rule requires chains with 15 or more locations in New York City to display a warning symbol — a salt shaker inside a triangle — if a menu item has more than 2,300 milligrams of salt. The health department estimates the regulation will apply to 10 percent of all menu items. The rule, which takes effect December 1, is the most overt attempt yet by Bassett and members of the current board of health to address New Yorkers' diet. Ready my story here: [PRO]

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EXCLUSIVE — The de Blasio administration will begin accepting applications for a new $30 million mental health program this morning, one of the first steps in an effort to refocus and reshape the city's mental health system. The Connections-to-Care program, first announced in July, is an important part of first lady Chirlane McCray's efforts to offer more services to New Yorkers who suffer from a mental illness but have never been diagnosed or would not describe themselves as mentally ill. The Connections-to-Care program will contract with 12 community-based organizations for five years and target three groups of people: expectant parents and parents of children under the age of four; young adults ages 16 to 24 who are out of school and out of work; and unemployed, low-income working-aged adults. Under the program, staff at the 12 organizations, who do not need to be medical doctors or formally trained in mental health, will be trained to screen for common mental health and substance disorders so they can spot those who need help and direct them to appropriate care. It's a pilot program, an experiment to see if this type of intervention improves outcomes. Will an unemployed person suffering from an anxiety disorder be more likely to find a job thanks to an intervention by staff trained by the Connections-to-Care program? That's what the city wants to find out. The program will also track how many participants continue with prescribed psychotropic medications and/or therapy, whether relationships between parents and children improve, and whether interventions reduce self-reported mental health-related symptoms, reduction in hospitalizations and emergency room use. The value, McCray said, is that low-income New Yorkers, who are more likely to have trouble finding mental health providers, would already be availing themselves of these city services. [PRO]

NOW WE KNOW — Researchers at the Johns Hopkins University School of Medicine say baseball catchers are more at risk from errant balls and bats than from home-plate collisions. The study, published in The American Journal of Sports Medicine, found fewer than 15 percent of injuries were because of home-plate collisions. This proves, the researchers say, that baseball’s new rule meant to protect catchers from collisions is misguided. “Our results indicate that while well-intended, the league’s current efforts to reduce contact injuries among catchers may be overlooking other types of trauma among this subgroup that tend to inflict more physical harm and lead to more loss of game time,” senior investigator Edward McFarland, professor of orthopaedic surgery at Johns Hopkins, said in a press release accompanying the article.

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CORRECTION — In Wednesday’s newsletter, I said New York had the lowest percentage of Obamacare enrollees receiving federal subsidies. New York is 10th lowest. (And that includes Washington D.C.) A POLITICO Health Care reader also pointed out to me that I didn’t put these percentages in their proper context. States that did not expand Medicaid have a higher percentage of enrollees receiving tax credits because those with incomes between 100 and 133 percent of the federal poverty level can’t sign up for Medicaid.

DONE DEAL — Montefiore Health System and Yeshiva University will announce Thursday that they have finalized an agreement for running Albert Einstein College of Medicine. Montefiore will assume operational authority and YU will be in charge of the curriculum. POLITICO New York first reported on this deal 15 months ago. Montefiore believes it can stabilize the finances of the medical school, and the merger fixes a historically odd quirk in the relationship between Yeshiva University and the Bronx's pre-eminent health system. Most medical schools derive a significant portion of their revenue from clinical services, which help offset the gap between what tuition brings in and what the school spends on education. But Yeshiva never owned the hospital. Montefiore did. That made it hard for Yeshiva to recoup losses. [PRO]

ATTACK! — The personal information of roughly 7 million people may have been compromised because of a "sophisticated cyber attack" on Rochester-based Excelllus BlueCross BlueShield. It’s unclear whether customers' personal information — such as their name, date of birth, Social Security number, mailing address, telephone number, member identification number, financial account information and claims information — has been removed from the IT system or used inappropriately.

VALUE-BASED CONTRACT — North Shore-LIJ and Humana on Wednesday announced a value-based contract that will cover 1,000 Medicare Advantage members. The contract will begin Jan.1. North Shore-LIJ will coordinate Humana members’ care through North Shore-LIJ Premium, a preferred provider network. LIJ now has 30 full-risk, pay-for-performance or shared service agreements covering about 300,000 lives, according to a press release from LIJ.

MAKING ROUNDS — Dr. Jeffrey Weber, whose research in melanoma treatment has led to a better understanding of how immunotherapy helps cancer patients, will join the senior faculty of NYU Langone Medical Center, and become the deputy director of the Laura and Isaac Perlmutter Cancer Center, and co-director of its melanoma program. His appointment takes effect Nov. 2. Weber previously served as a senior member of the H. Lee Moffitt Cancer Center in Tampa, Florida, and director of its Donald A. Adam Comprehensive Melanoma Research Center. He has also served as chair of the U.S. Veterans Administration’s Clinical Oncology Study section.

HAPPENING THIS WEEK — NYU Langone’s Perlmutter Cancer Center and the Natural Gourmet Institute will teach cancer patients and their families how to prepare meals that boost the immune system. Events take place Saturday and Sunday. Learn more here:

OPINION — Ezekiel Emanuel says drug prices are too high and suggests the federal government cap the price.


-ANOTHER OBAMACARE LAWSUIT — Nicholas Bagley has the best explanation I have read on a district court judge’s decision, which allows the House of Representatives to bring a lawsuit alleging the Obama administration is spending federal money to finance the Affordable Care Act, absent a congressional appropriation.

-STEM CELL TROUBLE — POLITICO reports: “Stem cell clinics in the United States are taking advantage of patients' misguided confidence in regenerative medicine and lax FDA policy to sell unapproved and untested products, according to a critical New England Journal of Medicine op-ed published Wednesday.” Read the op-ed here:

-A SECOND OPINION — A group of senators, led by Democrat Joe Manchin of West Virginia, wrote to HELP Committee leadership Wednesday requesting hearings on the FDA's decision to approve OxyContin for use in children, as well as a broader investigation into the growing abuse of prescription painkillers, according to POLITICO. The FDA approved OxyContin for use in children as young as 11 earlier this year after new studies by its manufacturer, Purdue Pharma, about the drug's use in children.

-RIGHT TO DIE — California’s state Assembly approved legislation that would allow physicians to prescribe life-ending drugs to terminally ill patients. The legislation is now being sent to the Senate, which passed a similar proposal previously, Patrick McGreevy of the Los Angeles Times reports. The proposal, which is modeled after a law in Oregon, gained steam after the death of California resident Brittany Maynard, who moved to Oregon to end her life after being diagnosed with a debilitating form of brain cancer. If made into law, patients would be required to submit two oral requests 15 days apart and a written request to their attending physician. The two written requests would have to be signed in front of two witnesses who must attest that the patient is of sound mind and under no duress.

-SANDERS ON DRUGS — Vermont Senator and Democratic presidential candidate Bernie Sanders will hold a press conference today to introduce legislation targeting high drug costs. Here is his plan:

-COMING UP — Modern Healthcare previews this week’s congressional hearings, which will examine the effect of insurance consolidation.

TODAY'S TIP Comes from the state health department, which offers us tips for making your workplace healthier.


-MRSA VACCINE — Researchers at NYU Langone Medical Center believe they now understand why HA-MRSA is so deadly, and that they might now be able to create a vaccine to fight the bacteria. They say, according to a press release from Langone, a toxin called LUK-PV secreted only by community-acquired MRSA, counteracts the effects of another more deadly toxin, LUK-ED, secreted by both forms of the bacterium. That means that in community-acquired MRSA, the toxins neutralize each other, while in the hospital superbug form, they do not.

-PRECISELY — William Travis, attending thoracic pathologist in the department of pathology, at Memorial Sloan Kettering Cancer Center, says physicians need to know the histologic classification of the tumor and know its genetic characteristics. The ability to do so is made much easier with the release of the 2015 WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart (Fourth edition). Read it here:

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